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Delivering quality health services: A global imperative for universal health coverage
Kieny, Marie-Paule; Evans, Timothy Grant; Scarpetta, Stefano; Kelley, Edward T.; Klazinga, Niek; Forde, Ian; Veillard, Jeremy Henri Maurice; Leatherman, Sheila; Syed, Shamsuzzoha; Kim, Sun Mean; Nejad, Sepideh Bagheri; Donaldson, Liam
World Health Organization (WHO), Organisation for Economic Co-operation and Development (OECD), and The World Bank
(2018)
C_WHO
Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an ... d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an ... d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care and treatment in Ghana. The purpose of this analysis was to identify the gaps within the current delivery of paediatric HIV care and support system and develop a road map for effecti
...
ve implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept). more
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept). more
WHO TRS N°1012.
Key updates include: (i) surveillance strategies, including cross-sectoral linking of systems and suitable diagnostics; (ii) the latest recommendations on human and animal immunization; (iii) palliative care in lowresource settings; (iv) risk
...
assessment to guide management of bite victims; and (v) a proposed process for validation and verification of countries reaching zero human deaths from rabies.
more
Humanitarian emergencies and crises (Humanitarian emergencies and crises) are large-scale events that may result in the breakdown of health care systems and society, forced displacement, death, and physical, psychological, social and spiritual suffering on a massive scale. Current responses to Human
...
itarian emergencies and crises rightfully focus on saving lives, but for both ethical and medical reasons, the prevention and relief of pain, as well as other physical and psychological symptoms, social and spiritual distress, also are imperative. Therefore, palliative care, should be integrated into responses to Humanitarian emergencies and crises. The principles of humanitarianism and impartiality require that all patients receive care and should never be abandoned for any reason, even if they are dying. Thus, there is significant overlap in the principles and mission of palliative care and humanitarianism: relief of suffering; respect for the dignity of all people; support for basic needs; and accompaniment during the most difficult of times
more
Access to Services and Barriers faced by People with Disabilities: A Quantitative Survey
Nathan Grills, Lawrence Singh, Hira Pant, Jubin Varghese, GVS Murthy, Monsurul Hoq, Manjula Marella
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2017)
CC
In low- and middle-income middle-income countries, reliable and disaggregated disability data on prevalence, participation and barriers are often unavailable. This study aimed to estimate disability prevalence, determine associated socio-demographic factors and compare access in the community betwee
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n people with and without disability in Dehradun district of Uttarakhand, India, using the Rapid Assessment of Disability survey.
more
BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r
...
eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
more
This is an open-access training course for frontline healthcare providers who manage acute illness and injury with limited resources. Produced in response to requests from multiple countries and international partners, the BEC package includes a Participant Workbook and electronic slide decks for ea
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ch module. Integrating the guidance from WHO Emergency Triage, Assessment and Treatment (ETAT) for children and the Integrated Management of Adult/Adolescent Illness (IMAI), BEC teaches a systematic approach to the initial assessment and management of time-sensitive conditions where early intervention saves lives
more
Manual for use in primary care.
There is substantial evidence for the benefits of screening and brief intervention in primary health care for alcohol problems. However, there is a need for screening and brief interventions with cross-cultural relevance for substances other than alcohol or tobacco,
...
such as cannabis, amphetamines, cocaine and opiates.
The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect and manage substance use and related problems in primary and general medical care settings. Primary health care professionals are well-positioned to provide interventions targeted to all substances irrespective of their legal status.
The ASSIST screening test version 3.0 is available in English and in 10 other languages (Arabic, Chinese, Farsi, French, German, Hindi, Portugüse, Russian, Spanish and Ukrainian).
more
This report presents further analysis of the 2015 Nepal Health Facility Survey. Data analysis is based on the Donabedian framework for assessing quality of care in health services, which divides the indicators into three groups: structure, process, and outcome. The World Health Organization Service
...
Availability and Readiness Assessment (SARA) indicator guideline was used to assess facility service readiness, service quality and client satisfaction with maternal health services. The study performed both bivariate and multivariate regression analysis to examine the association of maternal health service readiness and quality indicators with client satisfaction.
more
Mental illness can affect not only the life of the person with the illness, but also their close family, partners
and friends. Significant people in a person’s life are often a source of support with the illness.
However, family, partners and friends may be faced with a loved one’s men
...
tal illness without much
information on ways to deal with it and its impact on their life.
NOTE: This guide is NOT a replacement for medical advice and we strongly recommend that you or the person you care
for discuss issues related to treatment with a clinician.
more
The Ministry of Health together with its partners realizes that efficient and effective
delivery of clinical care is highly dependent on the availability of appropriately
upgraded environment, which is in well facilitated space. Such facilities and utilities
should always be properly designed, bu
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ilt, and maintained, so as to ensure efficient
treatment in clean and safe from infection.
The main challenges in achieving this include the lack of, appropriate holistic and
futuristic management plans, human resource for facility/utility management and
maintenance, adequate budget funds for renovation/maintenance activities at all
levels which means daily and long-term of facility maintenance plans and executions.
It is hoped that the guidelines will help to standardise
design of medical facilities and utilities country wide and result in efficient and
effective establishment of these life-saving function
more
Ce document a été élaboré par Peter Ventevogel, consultant, sous la supervision de Marian Schilperoord. Les versions préliminaires de cette publication ont grandement bénéficié de la contribution de plusieurs personnes au sein de l’UNHCR et d’organisations partenaires. Nous voudrions tou
...
t particulièrement remercier les collègues suivants pour leur relecture du document : A l’UNHCR: Gregory Garras, Sarah Harrison, Alexandra Kaun, Stefanie Krause, Preeta Law, Allen Gidraf Kahindo Maina, MaryBeth Morand, Audrey Nirrengarten, Martina Nicole Pomeroy, Monika Sandvik-Nylund, Ita Sheehy, Paul Spiegel, Margriet Veenma and Constanze Quosh. Dans les autres organisations: Carolina Echeverri (consultante SMSPS) Sabine Rakotomalala (UNICEF), Emmanuel Streel (consultant SMSPS), Wietse Tol (Université Johns Hopkins) Mark van Ommeren (OMS) et Inka Weissbecker (International Medical Corps).
more
Antimicrobial resistance has become a serious public health threat for effective treatment of an ever increasing range of infections caused by bacteria, parasites, viruses and fungi. When infections can no longer be treated by first-line antibiotics, other antibiotics must be used, which are both mo
...
re expensive and more toxic. Treatment and hospitalization is prolonged, and patients undergoing operations and other medical procedures are more vulnerable to infections. All this imposes a huge burden on health care systems and on the economy of countries. This is a major challenge to the health system in Mauritius which provides health care free of user cost to the whole population.
more
China is one of the major countries for the production and use of antibacterial agents. Antibacterial agents are widely used in healthcare and animal husbandry. It plays a significant role in treating infections and saving patient lives, preventing and treating animal diseases, improving farming ef
...
ficiency, and guaranteeing public health security. However, antimicrobial resistance has become increasingly prominent due to insufficient research and development capacity of new antimicrobials, sales of antimicrobials without prescriptions in pharmacies, irrational use of antibacterial agents in medical and food animal sectors, non-compliant waste emissions of pharmaceutical enterprises, as well as lack of public awareness toward rational use of antimicrobials. Bacterial resistance ultimately affects human health, but the cause of bacterial resistance and consequences are beyond the health sector. Antimicrobial resistance brings increasing biosecurity threats, worsens environmental pollution, constrains economic development and other adverse effects to human society, thus, there is an urgent need to strengthen multi-sectoral and multi-domain collaborative planning to jointly cope with this issue.
more
Options for the decontamination and reuse of respirators in the context of the COVID-19 pandemic
recommended
Guiding principles for reuse are:
Respirators which have been visibly contaminated (e.g. during procedure at intubated patients, such as suction cleaning of airways, taking probes, extubation attempts, etc.) or are damaged or not fitting, should be discarded and cannot be taken for re-use or de
...
contamination procedures.
Respirators may be protected by a medical face mask in order to prevent soiling.
Use of new ‘expired respirators’ (manufacturers expiry date) is possible if they were properly stored until use.
more
The document at hand presents key findings from a project undertaken globally between July 2014 and May 2015 to assess progress made by UNHCR country and regional operations to effectively protect lesbian, gay, bisexual, and transgender, and intersex (LGBTI) asylum-seekers and refugees. Globally, 10
...
6 offices, or roughly 90% of eligible country and regional operations, participated in the assessment. The key findings are presented along the following axes: legal, cultural and social context; outreach activities; displacement conditions; asylum and durable solutions; training on issues related to sexual orientation and gender identity (SOGI); operational guidelines and advocacy efforts.
more
For COVID-19, as for many infectious diseases, the true level of transmission is frequently underestimated because a substantial proportion of people with the infection are undetected either because they are asymptomatic or have only mild symptoms and thus typically fail to present at healthcare fac
...
ilities. There may also be neglected or under-served segments of the population who are less likely to access healthcare or testing. Under-detection of cases may be exacerbated during an epidemic, when testing capacity may be limited and restricted to people with severe cases and priority risk groups (such as frontline healthcare workers, elderly people and people with comorbidities). Cases may also be misdiagnosed and attributed to other diseases with similar clinical presentation, such as influenza.
Differences in mortality between groups of people and countries are important proxy indicators of relative risk of death that guide policy decisions regarding scarce medical resource allocation during the ongoing COVID-19 pandemic. This document is intended to help countries estimate CFR and, if possible, IFR, as appropriately and accurately as possible, while accounting for possible biases in their estimation
more
With about 24 million of Yemen’s 30 million people in need of some form of assistance, the United Nations calls Yemen the world’s worst humanitarian crisis. Cholera and other disease outbreaks are common, malnutrition is widespread, water is scarce, and the healthcare system is crumbling, with o
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nly half of the country’s 5,000 or so health facilities fully operational and with massive medical supply and staff shortages. In August 2020, the UN warned the country was again on the brink of full-scale famine.
more
The study on health facility preparedness for cholera outbreak response in Cameroon evaluates the ability of healthcare facilities in four cholera-prone districts to manage cholera outbreaks. The findings highlight significant weaknesses, including limited surveillance systems, inadequate access to
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water, poor sanitation, and lack of essential medical supplies such as Oral Rehydration Solution (ORS) and cholera case management guidelines. Many health facilities also lacked trained personnel and proper waste disposal systems, increasing the risk of disease spread within healthcare centers. The study underscores the urgent need for improved hygiene infrastructure, better training, and resource allocation to enhance outbreak response and reduce cholera-related mortality.
more
Licensed pharmaceutical products (marketing authorization) should be manufactured only by licensed manufacturers (holders of a manufacturing authorization) whose activities are regularly inspected by competent national authorities. This guide to GMP shall be used as a standard to justify GMP status,
...
which constitutes one of the elements of the WHO Certification Scheme on the quality of pharmaceutical products moving in international commerce, through the assessment of applications for manufacturing authorizations and as a basis for the inspection of manufacturing facilities. It may also be used as training material for government medicines inspectors, as well as for production, QC and QA personnel in the industry
more
