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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care syst
...
ems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary 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
Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focu
...
s on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
more
Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they
...
can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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This training module is designed to equip HWs with knowledge and communication skills to build their confidence and support them in their ability to promote acceptance of COVID-19 vaccination among other HWs.
According to the latest available estimates, more than 1 in 7 adolescents aged 10–19 is estimated to live with a diagnosed mental disorder globally. Almost 46,000 adolescents die from suicide each year, among the top five causes of death for their age group. Meanwhile, wide gaps persist between me
...
ntal health needs and mental health funding. The report finds that about 2 per cent of government health budgets are allocated to mental health spending globally.
The full report , excecutive summary, brief reports are available in English, French, Spanish and Arabic athttps://www.unicef.org/reports/state-worlds-children-2021?utm_source=referral&utm_medium=media&utm_campaign=sowc-web
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality
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health services: effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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Mycetoma is a chronic, progressively destructive infectious disease of the subcutaneous tissues, affecting skin, muscle and bone. Mycetoma occurs in tropical and subtropical environments characterized by short rainy seasons and prolonged dry seasons that favour the growth of thorny bushes. Global bu
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rden is not known, but the disease is endemic; it has been reported from countries in Africa, Asia, Europe and Latin America. This course addresses the epidemiology of mycetoma, clinical features, diagnosis, treatment, and public health interventions.
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Regional guide for determining health workforce staffing norms and standards for health facilities
WHO Universal Health CoverageLife Course Cluster, WHO Regional Office
WHO Regional Office for Africa
(2021)
C_WHO
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) sta
...
rted implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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The COVID-19 pandemic has led to large increases in healthcare waste, straining under resourced healthcare facilities and exacerbating environmental impacts from solid waste. This report quantifies the additional COVID-19 healthcare waste generated, describes current healthcare waste management syst
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ems and their deficiencies, and summarizes emerging best practices and solutions to reduce the impact of waste on human and environmental health. The recommendations included in the report build on actions in the WHO manifesto for a healthy recovery from COVID-19: prescriptions and actionables for a healthy and green recovery. They target the global, national and facility levels to promote a “win–win” scenario for COVID-19 PPE use, testing and vaccinations that are safe and support environmental sustainability.
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English Analysis on World about Climate Change and Environment, Health and Epidemic; published on 03 Nov 2021 by World Bank
South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within
...
health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
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A framework to guide planetary health education - The lancet, Planetary health
On the global scale, the impacts of the current food system on the environment are severe. The agro-industrial revolution has made it possible to increase food production at a price.
There is little doubt that 2019 was a defining year on many fronts for the environment. The repercussions of the climate emergency were experienced across the globe, with floods, devastating wildfires, and unprecedented melting of polar ice sheets and glaciers. While the new decade began with the Au
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stralian bushfires still raging after the hottest and driest year on record, the world was soon (and still is) in the grip of the COVID-19 pandemic.
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We live in a world in which global warming, pollution, social
injustice, inequity and population health fundamentally influence each other. As a result, health and
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health care can no longer be thought of and practiced in an isolated manner.
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This open access book not only describes the challenges of climate disruption, but also presents solutions. The challenges described include air pollution, climate change, extreme weather, and related health impacts that range from heat stress, vect
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or-borne diseases, food and water insecurity and chronic diseases to malnutrition and mental well-being.
more
BMJ Global Health 2022;7:e008007. doi:10.1136/ bmjgh-2021-00800
Front. Vet. Sci., 01 December 2021
