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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Recognizing the extent to which the COVID-19 outbreaks affects women and men differently is hugely important. Some preliminary data suggested that more men than women are dying, potentially due to sex-based immunological differences, higher rates of cardiovascular disease for men and lifestyle choic...es, such as smoking. However, the experiences and lessons learned from the Zika and Ebola outbreaks and the HIV pandemic demonstrate that robust gender analysis and informed, gender-integrated response are vital to strengthen the access and acceptability of the humanitarian services needed to meet the distinct needs of women and girls, as well as men and boy and LGBTI people.
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Guinea’s 450 megawatt Souapiti dam, scheduled to begin operating in September 2020, is the most advanced of several new hydropower projects planned by the government of President Alpha Condé. Guinea’s government believes that hydropower can significantly increase access to electricity in a cou...ntry where only a fraction of people have reliable access to power.Souapiti’s output, however, has a human cost. The dam’s reservoir will ultimately displace an estimated 16,000 people from 101 villages and hamlets. The Guinean government had moved 51 villages by the end of 2019 and said it planned to conduct the remaining resettlements within a year. Forced off their ancestral homes and farmlands, and with much of their land already, or soon to be flooded, displaced communities are struggling to feed their families, restore their livelihoods, and live with dignity.
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South Africa reported it fist case of COVID-19 on 5 March 2020. While the first cases were imported, local transmission has led to a rapid increase in the number of cases. As of 21 April 2020, more than 3,400 cases and 58 deaths had been confirmed. On 15 March, President Cyril Ramaphosa declared a n...ational state of disaster, and the government has since taken several measures to curb the spread of the virus, including closing borders, implementing strict social distancing measures and a 35-day nation-wide lockdown. These measures, along with the global economic shock caused by the pandemic, are expected to generate rising needs requiring an immediate and urgent response. Although South Africa is considered an upper-middle-income country, the amount of disparities—social, economic, and gender—make the country particularly vulnerable during this emergency.
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The purpose of this document is to provide relevant information and guidelines on
coronavirus outbreaks – and in particular the novel coronavirus SARS-CoV-2 and the
diseases it produces, COVID-19 – for pharmacists and the pharmacy workforce, both in a
primary care context (i.e. community phar...macies and primary healthcare facilities) and in
hospital settings, as well as for pharmacists working as clinical biologists in medical
analysis laboratories, for example, as clinical biologists, and offer a set of references that
may be consulted for more informationstor
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The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to ...enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
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9 September 2020
In a snapshot, fair allocation of vaccines will occur in the following way:
An initial proportional allocation of doses to countries until all countries reach enough quantities to cover 20% of their population
This document is also available in Arabic | Chinese | French | R...ussian | Spanish | Portuguese
A follow-up phase to expand coverage to other populations. If severe supply constraints persist, a weighted allocation approach would be adopted, taking account of a country’s COVID threat and vulnerability.
The document is a final working document and may be adjusted in the future as new information about the vaccines and the epidemiology of COVID-19 becomes available.
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Technical Note on Antimicrobial Resistance
This document reflects UNICEF’s response to the growing global threat of AMR to child survival, growth and development. It identifies UNICEF’s AMR-specific and AMR-sensitive actions in reducing infections, promoting access to and optimal use of antimic...robials, and increasing AMR awareness and understanding. Of particular relevance to this group, UNICEF country offices are directed to provide technical support for development and implementation of national AMR action plans, linking them as appropriate to maternal, newborn and child health programmes and ensuring these are prioritized in both surveillance and policy changes. The guidance note on AMR is intended to inform UNICEF’s AMR-related internal initiatives, programming and activities, as well as external engagements with governments and other stakeholders.
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The aim of the people-centred framework is to help countries to develop fully prioritized and budgeted NSPs based on a culture of making full use of the available data, which are aligned with national planning cycles and which provide the basis for a robust national response that can accelerate prog...ress towards the goal of ending TB. In addition, applying the framework for other possible applications according to the country’s planning and policy cycle encourages the culture of data utilization and evidence translation into decision making and planning.
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MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic ...of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Accessed: 04.10.2019
The data collection process was organized by UCDC Director, Natalia Nizova, and M&E Department Head, Igor Kuzin, and implemented by M&E specialists from oblast AIDS Centers: Zhanna Antonenko, Oksana Gorbachuk, Volodymyr Zahorovskyi (Kiev City); Anna Lopatenko, Irina Kozina, I...ryna Chukhalova, (Dnipropetrovsk); Galina Vysotskaja, Iryna Petrovska, Oleksandr Guzieiev (Mykolayiv). Qualitative data collection as well as a desk review was done by the WB’s local consultants Anna Shapoval, Olesia Trofymenko, Anna Pisotska and Elena Dzyuba.
The report was prepared by a World Bank Task Team led by Iris Semini (seconded to the World Bank until July 2013, and now back with UNAIDS), and concluded by Emiko Masaki and Marelize Görgens (World Bank), with support and guidance provided by Daniel Dulitzky, Paolo Belli, Alejandro Cedeno, Alona Goroshko and Lombe Kasonde. Administrative support was provided by Anna Goodman, Mario Mendez and Uma Balasubramanian. When draft results were ready, an in-country workshop was held where stakeholders provided their inputs. Once a draft report was produced, written comments were received from World Bank colleagues, Son Nam Nguyen, Rosemary Sunkutu and Alona Goroshko.
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This FY 2019 Malaria Operational Plan presents a detailed implementation plan for Burkina Faso, based on the strategies of PMI and the National Malaria Control Program (NMCP). It was developed in consultation with the NMCP and with the participation of national and international partners involved in... malaria prevention and control in the country. The activities that PMI is proposing to support fit in well with the national malaria control strategy and plan and build on investments made by PMI and other partners to improve and expand malaria-related services, including malaria grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria. This document briefly reviews the current status of malaria control policies and interventions in Burkina Faso, describes progress to date, identifies challenges and unmet needs to achieving the targets of the NMCP and PMI, and provides a description of activities that are planned with FY 2019 funding.
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Looking forward, the 2019-2020 Regional Refugee Response Plan (RRRP) for the DRC situation aims at addressing the needs of new arrivals of Congolese refugees in the region, and those in protracted situations. By supporting livelihoods opportunities and through a resilience-based approach, refugees w...ill be able to contribute to the development of their host countries, and of their country of origin upon their return. Given the limited capacity of host communities to support the impact of massive numbers of refugees, the response strategy will also address the needs of local populations, strengthening peaceful co-existence and building social cohesion.
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Humanitarian Charter and Minimum Standards in Humanitarian Response.
The 2018 Sphere Handbook builds on the latest developments and learning in the humanitarian sector. Among the improvements of the new edition, readers will find a stronger focus on the role of local authorities and communities as ...actors of their own recovery. Guidance on context analysis to apply the standards has also been strengthened. New standards have also been developed, informed by recent practice and learning, such as WASH and healthcare settings in disease outbreaks, security of tenure in shelter and settlement, and palliative care in health. Different ways to deliver or enable assistance, including cash-based assistance, are also integrated into the Handbook.
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This brief focuses specifically on the Grand Nord (Great North): the Beni and Lubero territories of northern North Kivu that are the epicentre of the outbreak. Further participatory enquiry should be undertaken with the affected populations, but given ongoing transmission, conveying key consideratio...ns and immediate recommendations have been prioritised.
This brief is based on a rapid review of existing published and grey literature, professional ethnographic research in DRC, personal communication with administrative and health officials and practitioners in the country, and experience of previous Ebola outbreaks.
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In April 2018, Refugees International (RI) conducted a mission to Bangladesh, to research the GBV (gender-based violence) response for Rohingya women and girls. RI found that the entire humanitarian system is struggling under tremendous constraints in Bangladesh, and protection and health actors do ...deliver lifesaving services to survivors in an incredibly challenging environment. This report, however, focuses on key gaps and challenges in GBV programming, as communicated by practitioners deployed to Bangladesh at various stages of the emergency, by local organizations, and by the affected women and girls themselves.
In the analyses and recommendations provided in this report, RI draws in part from the framework of the international initiative to safeguard women and girls in emergencies — the Call to Action on Protection from Gender-Based Violence in Emergencies — and urges the donors and humanitarian organizations that are Call to Action partners to implement it more effectively and with urgency during this emergency.
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These guidelines form part of efforts to institutionalize the prevention and containment of antimicrobial resistance (AMR) in healthcare facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interr...elated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level. They aim to serve as a practical, step-by-step or ‘how-to’ guide, addressing the infection prevention and AMS components of a robust response in a hospital. They draw on
evidence from various international guidance documents and standards for interventions that have been shown to be successful in infection
prevention and AMS programmes. These interventions have been customised to the South African hospital setting based on local
experiences in the public and private health sectors. This was done through a series of workshops and requests for comment involving
country-level experts.
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This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment,... design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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March - December 2018
The Government of Bangladesh has kept its borders open to Rohingya refugees and leads the humanitarian response. The people of Bangladesh continue to show tremendous generosity and hospitality in the face of a massive influx. In keeping with its policies, the Government of Ban...gladesh refers to the Rohingya as “Forcibly Displaced Myanmar Nationals”, in the present context. The UN system refers to this population as refugees, in line with the applicable international framework for protection and solutions, and the resulting accountabilities for the country of origin and asylum as well as the international community as a whole. In support of these efforts, the humanitarian community has rapidly scaled up its operations as well. Over a two-month period, the refugee population in Cox’s Bazar more than quadrupled.
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