This guidebook for people in school settings is intended to offer strategies for use and adaptation with children and families to re-establish routines of hygiene with basic access to water and sanitation services through an approach that visibly shows that the school is WASHfriendly, inclusive - so... that all children, including those with disabilities have "ownership of the information and activities", and sustainable, repeating messages "over time to encourage lasting behaviour change"
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population wa...s very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
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Full eHandbook under: http://www.msh.org/resources/health-systems-in-action-an-ehandbook-for-leaders-and-managers
Effective supply management has the potential to make a powerful contribution to the reliable availability of essential medicines, which are a crucial part of the delivery of highqualit...y health care services. Because medicines are costly and poor management so often results in waste, good supply management is also crucial to the cost-effectiveness of providing medicines.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Based on research by a team of Nepalese and international experts, this report carries an analysis of the five key elements in the sector - land, basic services, housing finance, building materials and construction technologies, and labour. It gives an assessment
of how these components are governe...d by policy, institutional and legal frameworks, and how they are linked with one another and other urban policies.
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The Capacity Project used the Learning for Performance (LFP) approach to develop the family planning (FP), HIV/AIDS and gender components included in the competency-based A1 nursing and midwifery pre-service curricula. LFP was also used to adapt the Rwanda national FP curriculum to an on-the-job tra...ining approach. This study documents the implementation of the and the lessons learned from its application in preservice education and in-service training in Rwanda.
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A System of Health Accounts 2011: Revised Edition provides an updated and systematic description of the financial flows related to the consumption of health care goods and services. As demands for information increase and more countries implement and institutionalise health accounts according to the... system, the data produced are expected to be more comparable, more detailed and more policy relevant. It builds on the original OECD Manual, published in 2000, and the Guide to Producing National Health Accounts to create a single global framework for producing health expenditure accounts that can help track resource flows from sources to uses. It is the result of a collaborative effort between the OECD, WHO and the European Commission, and sets out in more detail the boundaries, the definitions and the concepts – responding to health care systems around the globe – from the simplest to the more complicated.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PH...C approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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The revision of the SRHR Policy is based on the results of the analysis of the implementation process of the past policy, which has provided evidence to
ensure that the revised policy is relevant and effective. The revision has also been done with the participation of all national stakeholders who ...have
also international experience on SRHR issues. The Ministry urges all public and private institutions to use this policy as a guide in the implementation of
SRHR services in the country.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou...gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situation in a country, including the state of the health s...ector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
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Evidence- and rights-based national policies, guidelines and legislation play a key role in improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH), framing the enabling environment for equitable provision and accessibility of quality services. The SRMNCAH policy sur...vey monitors the existence of national SRMNCAH laws, policies, strategies and guidelines and the extent to which they are aligned with WHO recommendations on SRMNCAH. This publication reports on the findings from the 2023 WHO SRMNCAH policy survey.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub...erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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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.
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom...ote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re...fugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
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Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential health services, including those that addres...s sexual and reproductive health and rights (SRHR), gender-based violence (GBV) and preventing harmful practices such as child marriage and female genital mutilation.
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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a...nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
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