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4
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 thei
...
r health care. Salaries were not paid for more than
six months and life for the general population was 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
more
This guidance is targeted to primary health care policy-makers and only addresses issues relevant for primary health care providers. It has been prepared on the basis
...
of a systematic review of the best available evidence and emergent country practices in response to the COVID-19 outbreak in the WHO European Region. It will be updated on a regular basis as new information becomes available.
more
The primary audience of these recommendations includes healthcare providers who are responsible for developing national and local health protocols (particularly those related to hypertensive disorders of
...
pregnancy), and those directly providing care to pregnant women and their newborns, including midwives, nurses, general medical practitioners, obstetricians, obstetric physicians, managers of maternal and child health programmes, and relevant staff in ministries of health, in all settings.
more
The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was first published in 2016 with the objectiv
...
e of improving the quality of routine health care that all women and adolescent girls receive during pregnancy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutritional interventions in pregnancy.
more
These guidelines group all recommendations on TB care and support in one document and are complemented by an operational handbook. The guidelines are to be used primarily by national TB programmes, or their equivalents in Ministries
...
of Health, stakeholders and technical organizations working on TB care in the public and private sectors and in the community.
more
Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate and high priority needs
...
of an affected population and is often the first type of response activated and/or requested by authorities and affected communities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
more
The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by redu
...
cing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
more
Multi-month dispensing (MMD) is the prescribing and dispensing of three to six months of antiretrovirals
(ARV) and other medicines required for treatment
...
of people living with HIV (PLHIV). This approach is in
contrast to the current standard of care approach where drug dispensing requires monthly clinical visits.
While many programs have moved to providing MMD for adults, implementation in children has been
particularly challenging. MMD takes a client-centered approach and has the promise of improving and
sustaining continuity of treatment and rates of viral suppression (VS), as well as reducing the provider the
provider workload and other burdens on the health system.
more
Areas for action include: increasing prioritisation and awareness of dementia; reducing the risk of dementia; diagnosis, treatment and care; suppor
...
t for dementia carers; strengthening information systems for dementia; and research and innovation.
more
This module has been developed to provide training and guidance to improve the quality of care and human rights conditions in inpatient, outpatient and community based mental health and related serv
...
ices, following the conduct of a comprehensive assessment using the WHO QualityRights assessment toolkit.
more
About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk
...
for TB disease after infection depends on several factors, the most important being the person’s immunological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance.
more
About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk
...
for TB disease after infection depends on several factors, the most important being the person’s immunological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
more
he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian responses to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH servic
...
es. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
more
A manual intended for medical and other personnel responsible for humanitarian activities in armed conflicts. It covers the following topics: setting up a health-care system that meets the essential needs
...
of war victims, particularly of displaced persons; public health tools most frequently used for evaluation, establishment of priorities, analysis of possible activities and their follow-up; protecting war victims and aspects of humanitarian law related to health; and lastly, ethical problems
more
mhGAP is based on evidence-based technical guidelines (4) and provides a set of tools and
training packages to extend service provision. The mhGAP Intervention Guide (mhGAP-IG)
for MNS disorders i
...
n non-specialized health settings (8) is a clinical decision-making tool
for assessing and managing priority MNS conditions (depression, psychoses, epilepsy, child
and adolescent mental and behavioural disorders, dementia, disorders due to substance
use, self-harm and suicide).
more
Case management is an approach at the core of social work. Case management is the process required for improving the quality of life for vulnerable children in need
...
of care and protection. This manual is intended to support social workers in their case management role and reduce overall workload by ensuring case management processes are conducted efficiently with best outcomes for children.
more
The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers
...
of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women and preterm infants, such as obstetricians, paediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth.
more
Refugees1 with disabilities have specific needs and face particular forms of discrimination. As highlighted in the Executive Committee Conclusion No. 110 (LXI)–2010, it is important for UNHCR to ensure that the rights
...
of persons with disabilities who are of concern to the Office are met without discrimination. This places an onus on offices to develop a thorough
understanding of the circumstances of persons with disabilities under their care. This note provides staff with guidance on a range of issues to consider in meeting these responsibilities.
more
This resource presents "the minimum level of educational quality and access in emergencies through to recovery. The aim of the handbook is to enhance the quality
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of educational preparedness, response and recovery; to increase access to safe and relevant learning opportunities for all learners, regardless of their age, gender or abilities; and to ensure accountability and strong coordination in the provision of education in emergencies through to recovery...The INEE Minimum Standards are organised in five domains: Foundation standards; Access and learning environment; Teaching and learning; Teachers and other education; personnel; Education policy". Available in different languages: English, French, Arabic, Azerbajani, Bangla, Indonesia, Bosnian, Coratian, Serbian, Burmese, Chinese, Dari, Japanese, Nepali, Pashto, Portugese, Russian, Spanish, Turkish, Urdu, Vietnamese
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The present Community Empowerment Manual draws upon the lessons learned of the Community Protection Approach implementation in Lebanon, the occupied Palestinian territory and Central America during the period 2015-2020 by WeWorld – GVC and its par
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tners.
The Manual means to accompany Field Staff in devising the most appropriate strategy to engage with communities, given the conditions of access, security and time of the specific context in which a project is implemented. Even though the steps described proceed alongside the implementation of the Community Protection Approach, the manual has different sections providing guidance for the definition of engagement strategies in any context or project in question.
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