Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
more
This brief summarises key considerations about the social, political and economic context of Goma in relation to the outbreak of Ebola in the DRC as of March 2019. Goma is the administrative capital of North Kivu province and a major urban centre in the Great Lakes Region. The city is home to an est...imated 1.5 million people and serves as an important economic and transportation hub that links eastern Congo to the broader East African sub-region. The arrival of Ebola in Goma would substantially increase the at-risk population and heighten the potential for cross-border transmission to neighbouring countries, particularly Rwanda. This brief therefore focuses on local social and political structures that can be leveraged to promote preparedness and readiness actions.
more
In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
more
this publication serves as a practical guide and useful resource for practitioners, farmers, scientists, and technicians to better understand the initiative undertaken by GGGI. In this compendium, GGGI provides the latest knowledge and capacity building materials on these topics and offers informati...on on the most relevant topics on technologies related to climate-smart agriculture and solar irrigation – both of which can be used as training materials.
more
Results and Lessons Learned from CapacityPlus 2009-2015
It provides insight into WHO’s work that aims to improve the health of the people of the United Republic of Tanzania in collaboration with key stakeholders.
Looking forward, the 2019-2020 Regional Refugee Response Plan (RRRP) for the DRC situation aims at addressing the needs of new arrivals of Congolese refugees in the region, and those in protracted situations. By supporting livelihoods opportunities and through a resilience-based approach, refugees w...ill be able to contribute to the development of their host countries, and of their country of origin upon their return. Given the limited capacity of host communities to support the impact of massive numbers of refugees, the response strategy will also address the needs of local populations, strengthening peaceful co-existence and building social cohesion.
more
The Minimum Standards for Age and Disability Inclusion in Humanitarian Action inform the design, implementation, monitoring and evaluation of humanitarian programmes across all sectors and phases of response, and in all emergency contexts, ensuring older people and people with disabilities are not e...xcluded.
more
According to the Report, cascading and interlinked crises are putting the 2030 Agenda for Sustainable Development in grave danger, along with humanity’s very own survival. The Report highlights the severity and magnitude of the challenges before us. The confluence of crises, dominated by COVID-19,... climate change, and conflicts, are creating spin-off impacts on food and nutrition, health, education, the environment, and peace and security, and affecting all the Sustainable Development Goals (SDGs). The Report details the reversal of years of progress in eradicating poverty and hunger, improving health and education, providing basic services, and much more. It also points out areas that need urgent action in order to rescue the SDGs and deliver meaningful progress for people and the planet by 2030.
more
The pandemic presents tough choices for governments, local communities, health and school systems, as well as families and businesses: How to re-open safely? How to safeguard people’s lives and protect their livelihoods? Where to allocate scarce resources? How to protect those unable to protect th...emselves? Answers to questions like these will affect our short-term success in battling the spread of the virus and could have impacts for generations to come.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
more
It highlights how proven digital innovation can be replicated to curb the spread of COVID-19 in Africa. It also estimates investment required to implement such high impact solutions.
This UNAIDS 2024 report brings together new data and case studies which demonstrate that the decisions and policy choices taken by world leaders this year will decide the fate of millions of lives and whether the world’s deadliest pandemic is overcome.