Annual and medium-term budget preparation processes are the platforms through which specific plans are transformed into actual resource allocation decisions. The aim of this Process Guide is to support key stakeholders involved in these processes (such as the Cabinet, Ministries of Finance and Healt...h, the Parliament, citizens, media, and civil society organizations) to reorient budgetary arrangements in order to facilitate the ability of national governments to respond to the COVID-19 pandemic by delivering, therapeutics, diagnostics, and vaccine services to their populations. Reorienting budgetary arrangements positions governments to sustain the capacity to mitigate and respond to COVID-19 while concurrently delivering other essential health services and working towards Universal Health Coverage (UHC). The reorientation process is an opportunity to better align budgetary arrangements to sustain systemic capacity to prevent emerging health threats over the short, medium, and long terms.
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Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society a...pproach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
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The Guidelines for the Prevention, Surveillance and Management of COVID-19 Infection amongst Health Care Workers (HCW) in Zimbabwe were developed to prevent, detect and manage HCW COVID-19 infection, an emerging pandemic affecting the whole world. The HCW is at the fore front of this pandemic, thus ...the need for standardised operating procedures is of utmost importance. These guidelines therefore seek to reduce the significant morbidity and mortality among the HCW, ultimately ensuring the reduction of the cost to the health care worker and the Ministry of Health and Child Care (MoHCC) as a whole. The Ministry of Health and Child Care requires that all health care workers in various health care settings follow infection prevention and control procedures.
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This policy brief describes key HIV viral load thresholds and the available viral load testing approaches for monitoring how well antiretroviral therapy is working for people living with HIV. It provides clarification for and elaborates upon the current treatment monitoring algorithm from the Consol...idated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach.
This information can help people living with HIV to live healthy lives, ensure that HIV is not transmitted to other people and support policy-makers in determining the optimal allocation of resources for viral load testing and communicating the results.
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The report showed commitments made three decades ago to protect the rights of children remain unfulfilled for millions. Violence still affects countless children. Discrimination based on age, gender, disability, sexual orientation and religion harms children worldwide.
The UN Convention on the Ri...ghts of the Child is the most widely ratified international human rights treaty in history. It has prompted substantial investment in children’s health, education and safety and the adoption of laws and policies that recognise the rights of children, particularly in areas where they are vulnerable, including labour exploitation, corporal punishment, alternative care and forced and early marriage.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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Ensuring mental health and well-being has become a worldwide imperative and an important target of the Sustainable Development Goals. But in all countries around the world, our response has been woefully insufficient, and we have made
little progress to advance mental health as a fundamental human ...right.
One in ten people are affected by a mental health condition, up to 200 million people have an intellectual disability and an estimated 50 million people have dementia. Many persons with mental health conditions, or psychosocial, intellectual, or cognitive disabilities lack access to quality mental health services that respond to their needs and respect their rights and dignity.
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This report provides an overview of the Key findings of the Rwanda 2014-2015 Demographic and Health Survey (RDHS). The 2014-15 Rwanda Demographic and Health Survey (RDHS) was designed to provide data for monitoring the population and health situation in Rwanda. The 2014-15 RDHS is the fifth Demogra...phic and Health Survey
conducted in Rwanda since 1992. The objective of the survey was to provide reliable estimates of fertility levels, marriage, sexual activity, fertility preferences, family planning methods, breastfeeding practices, nutrition, childhood and maternal mortality, maternal and child health, early childhood development, malaria, domestic violence, and HIV/AIDS and other sexually transmitted infections (STIs) that can be used by program managers and policymakers to evaluate and improve existing programs.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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This publication presents a comprehensive methodology to support the Member States of the Pan American Health Organization (PAHO) in preparing for and responding to heat-health risks in the Region of the Americas. It builds on World Health Organization and the World Meteorological Organization globa...l documents, as well as on the disaster preparedness methodologies employed throughout the countries of the Region. This publication is part of an effort coordinated by PAHO to support Member States in multihazard preparedness, and includes: early warning system strengthening; threat characterization; activation and deactivation procedure definition; and institutional coordination. It engages different disciplines and recognizes the importance of intersectoral collaboration to respond to heat-health risks. It aims to bring awareness of the impacts of heat on the health of people of the Americas to public health decisionmakers, and thereby strengthen health service provision.
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The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has ...developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
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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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The National Strategic Plan is based on the following guiding principles:
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recognizes the cross cutting health and development needs o...f young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare.
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The humanitarian crisis in Northeast Nigeria, driven by conflict, climate-related shocks, and food insecurity, has created immense challenges for the health sector in Borno, Adamawa, and Yobe (BAY) States. About 1.8 million people remain displaced(1), with inadequate access to healthcare services an...d persistent disease outbreaks, malnutrition, and mental health challenges. This strategy outlines a comprehensive localization approach to strengthen the health sector's capacity by empowering local and national actors (L/NAs) include state and local government structures to lead humanitarian responses at respective levels with minimal oversight functions.
The localization strategy aligns with the global commitments of the Grand Bargain 2.0, prioritizing equitable partnerships, capacity sharing, and resource mobilization to enhance sustainable, community-owned health systems(2). Key components include increasing the visibility and meaningful participation of L/NAs in health sector coordination, promoting direct funding to local actors, and addressing systemic barriers such as governance, leadership, capacity, and resource gaps.
The global humanitarian community made a commitment, as reflected in the Grand Bargain 2.0, to localization (3) to improve the efficiency and effectiveness of humanitarian aid. A key priority of this commitment is to empower local actors to take a leading role in delivering assistance, ultimately leading to better outcomes for affected communities. A localized health response, strengthened by partnerships, can achieve several key outcomes, including rapid response and access, community acceptance, cost-effectiveness, links to long-term development, and increased accountability to the community. Localization in health matters because it ensures sustainable and community-owned health responses.
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This report started with a simple question—“How can we tell how much funding is devoted to global health programs?”—and ended (more than two years later) with an answer that is far from simple. As those who have tried know well, tracking health-related funding is challenging in any setting, ...given the range of public and private sources and the many types of services and programs that fall within the definition of “health sector.” It is made all the more complicated when significant external support from donors and private charities plus in-kind donations of drugs and other inputs are taken into account. The task is made yet harder by inadequate public expenditure management systems in countries where public agencies’ capacity is stretched very thin and by donor accounting structures that are not designed to respond in a timely way
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Ethiopia has seen high economic growth over the last decade, but remains a poor country with a high burden of disease. It has made considerable health gains in recent years, mainly by having health policies that focus on extending primary healthcare, using health extension workers. It... has made good use of existing resources,but has a low health expenditure (of around US$21 per capita, and totalling 4per centof GDP). It has a federal system with devolved healthcare financing, whereby block grants are allocated to sectors at regional and woreda(district) level. The challenge now,with the epidemiological transition (and a sense that the ‘low-hanging fruits’have already been gathered in relation to public health), is how Ethiopia, still poor, continuesto invest in health improvements?Human resources for health (HRH) are a critical pillar within any health system –the health staff combine inputs to provide the services, thus affecting how all other resources are used, and they make frontline (and back-office) decisions thatare importantdeterminants of servicequality,effectiveness and equity. HRH is usually the most resource-intensive element within the health system –commonly absorbing 50–70per centof public expenditure onhealth, although the proportions are very varied by individual countries and across regions. As they are commonly part of the public administration, reforms to HRH are also part of a complex political economy in most countries.Assessing value for money (VfM) in relation to HRH is correspondingly complex;across the value chain, manyfactors influence the conversion of inputs into outputs and outcomes (see Figure 1).A more detailed description of the HRH value chain can be found in Annex1.
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For many years, Community Health Care Workers (CHWs) in Tanzania and Africa in general have played significant role in community health promotion. Their specific roles have been changing from time to time. However, their key roles have over time included giving health education and dissemination of ...health information to communities, invariably moving on to include other services such as offering curative services and conducting community surveys. Deployment of CHWs has mainly been a response to the severe shortage of the human resource for health in most African countries due to brain drain for various reasons that include unattractive terms and conditions of employment. On the other hand the human resources for health (HRH) is a result of positive growing demand for health services, a situation confronted by inadequate supply of trained health personnel from training institutions to meet the demand.
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The objectives of the research presented in this report were to identify case studies of community-led HIV-related health and social inclusion service delivery organizations in eastern and southern Africa; describe the typologies of the services provided; and identify evidence of their service deliv...ery and contribution beyond HIV, including advancing universal health coverage.
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UNHCR’s Public Health Strategy 2021-2025 is based on the lessons learnt, and builds on the achievements, of the Global Strategy for Public Health 2014-2018.
Progress was made on policies favouring inclusion and integration into national systems3 with 92% of 48 operations surveyed reporting refuge...es having access to national primary health care facilities under the same conditions as nationals and 96% reporting refugees having access to all relevant vaccines under the same conditions as nationals. While many refugee hosting countries have policies that allow refugees to access national health services, many face partial access, prohibitive out-of-pocket expenditures and other barriers including distance to facilities, language and provider acceptance. Furthermore, more work is needed on strengthening these systems to be able to meet the needs of both host communities and refugees.
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This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th...e health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
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