Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y 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.
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Ces projets de programme prototype (curriculum) de niveau régional destinés à l’enseignement et à la formation des
infi rmiers et des sages-femmes sont en partie une étape vers la création d’un moyen de mise en œuvre des résolutions
prises par l’Assemblée mondiale de la Santé (AMS)... (la plus récente étant WHA 64.7, 2011) à intérêt régional et des
orientations stratégiques mondiales et régionales visant à renforcer la contribution des infi rmiers et des sages-femmes
dans le développement des systèmes de santé. Ces cursus sont également compatibles avec la « Feuille de route pour la
mise à l’échelle des ressources humaines pour la santé (RHS) en vue d’améliorer la dispense des services de santé dans
la région Afrique 2012-2025 » adoptée lors de la 62e session du Comité régional des ministres africains de la santé en
2012. L’un des six domaines stratégiques fi gurant sur la feuille de route est la mise à l’échelle de l’enseignement et de la
formation des travailleurs de la santé.
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Towards a Healthier Botswana
La résistance aux antimicrobiens (ou RAM, cette abréviation étant est ici également employée en mode adjectif pour désigner les organismes « résistants aux antimicrobiens ») est une préoccupation majeure pour la santé publique mondiale et une question de sécurité san...itaire des aliments. Lorsque des pathogènes deviennent résistants aux agents antimicrobiens, ils peuvent présenter un risque plus important pour la santé découlant d’un éventuel échec thérapeutique, de la diminution de choix thérapeutiques et de la probabilité accrue d’apparition et de gravité de la maladie. Les problèmes en rapport avec la RAM sont liés de façon inhérente à l’usage des antimicrobiens dans tous les types d’environnements, y compris les utilisations humaines et non humaines. L'utilisation d’agents antimicrobiens dans la production alimentaire animale et végétale représente un facteur de risque important pour la sélection et la transmission de micro-organismes résistants aux antimicrobiens (micro-organismes RAM) et de déterminants de la résistance aux antimicrobiens (déterminants de la RAM) des animaux et des plantes alimentaires à l’humain par sa consommation d’aliments.
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While the world was gripped by the unfolding COVID-19 pandemic in 2020, children continued to face the same crisis they have for decades: intolerably high mortality rates and vastly inequitable chances at life. In total, more than 5.0 million children under age 5, including 2.4 million newborns, alo...ng with 2.2 million children and youth aged 5 to 24 years – 43 per cent of whom are adolescents – died in 2020. This tragic and massive loss of life, most of which was due to preventable or treatable causes, is a stark reminder of the urgent need to end preventable deaths of children and young people.
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Primatur
Declaration de S.E.M. amadou gon Coulibaly, premier ministre, chef de gouvernement, ministre du budget et du portefeuille de l'état.
Abidjan, Le 31 mars 2020
Scabies is a global health concern disproportionately affecting vulnerable populations such as refugees and asylum seekers. Greece is a main point of entry in Europe for refugees, but epidemiological data on scabies in this population are scarce. We aimed to describe the epidemiology of scabies, inc...luding trends over the study period.
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Thefirst report on Latin America and the Carribean presents key indicators on health and health systems in 33 Latin America and the Caribbean countries. . Analysis is based on the latest comparable data across almost 100 indicators including equity, health status, determinants of health, health car...e resources and utilisation, health expenditure and financing, and quality of care. The editorial discusses the main challenges for the region brought by the COVID-19 pandemic, such as managing the outbreak as well as mobilising adequate resources and using them efficiently to ensure an effective response to the epidemic.
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AMR is a serious and growing global problem. A WHO report released in 2014 stated that this serious threat is no longer a prediction for the future it is happening now in every region of the world and has potential to affect anyone, of any age in any community – a real threat to the public health.... The coming together of the various important stakeholders to develop this document is the testimony of their agreement of how serious is the issue at hand and their intentions to combat AMR is translated into an Action Plan. WHO also reported that there are about 2 million people in the US are infected with the AMR organism while 23,000 die annually from AMR infections. Fiji is just 10 hours journey away from the United States of America therefore Fiji must act now to keep our population safe from AMR organisms.
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Third edition. The International Health Regulations (2005) (IHR) provide an overarching legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders.
Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultur...al backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in
a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups.The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition.
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This guide is designed to accompany the training module, Communicating with health workers about COVID-19 vaccination. It provides detailed explanations, resources and guidance to accompany the slides in the training module and support those implementing the training. It is intended for training fac...ilitators or trainers of trainers (ToTs) who will be conducting the training at the country level either face-to-face or online with a group of participants. Facilitators can use this guidance document to help them adapt the training content to their local context and facilitate discussion with training participants. Facilitators are encouraged to have this guide available to them as a tool during the training session.
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