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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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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This guidance document has been produced by WHO to assist blood services in the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply, whether from an existing infectious agent that is changing in incidence and spread, or from a ...newly identified infectious agent. It is intended that this document be followed to guide the national blood service through the process of planning how to respond in a timely, controlled and appropriate way to any specific infectious threat that may subsequently emerge. It is acknowledged that it is not only the blood supply that may be affected by such emerging infectious threats; in those countries undertaking transplantation, the supply of cell, tissues and organs may also be threatened. Increasingly, blood services are taking overall national responsibility for transplantation in their capacity as the organization responsible for the collection, processing, storage and supply of cells, tissues and organs. This approach is both sensible and appropriate, as the overall donor selection and screening processes are the same or very similar. This guidance document can therefore also be used to assist those bodies responsible for the provision of cells, tissues and organs to prepare for an emerging infectious threat.
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This manual will aid in building the capacity of nurses with clinical knowledge of the unique needs, complex health problems, common geriatric syndromes, and principles of care of older people. It will also enable them to acquire the skills necessary to perform an in-depth multidimensional geriatric... assessment. This manual will go a long way in establishing effective geriatric care services and improving the awareness of nurses regarding the various aspects of geriatric care in the WHO South-East Asia Region.
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The manual has been designed in a comprehensive manner, the aim being to provide a holistic approach to the short-term development of human resources, with a focus on primary care physicians. This is a reference manual meant for primary care physicians who will provide care to older people in primar...y health care facilities. The information on old age care is meant to be incorporated into the everyday clinical practice of primary care physicians. This manual will help to enhance the knowledge and skills of physicians. It is expected that the use of the manual will improve the approach to issues of old age and promote holistic care of older people, which will ultimately improve their quality of life.
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As this report shows,
reports of child abuse and of children
witnessing violence between their
parents and caregivers have increased.
Ending violence against children is
increasingly within our reach. D
Millions of children in Yemen could be pushed to ‘the brink of starvation’ due to huge shortfalls in humanitarian aid funding amid the COVID-19 pandemic – according to a new UNICEF report marking more than five years since conflict escalated in the country.
Enabling young children to achieve their full developmental potential is a human right and an essential requisite for sustainable development. Given the critical importance of enabling children to make the best start in life, the health sector, among other sectors, has an important role and responsi...bility to support nurturing care for early childhood development. This guideline provides direction for strengthening policies and programmes to better address early childhood development.
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Guide for clinical case management and infection prevention and control during ameasles outbreak. This guide has been developed to reduce the high morbidity and mortality seen in some of the current outbreaks of measles. This short guide outlines practical clinical care interventions and is derived ...from previously published WHO documents.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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1 June 2020
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidan...ce for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges. This document expands on the content of pillar 9 of the COVID-19 strategic preparedness and response plan, supersedes the earlier Operational guidance for maintaining essential health services during an outbreak, and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. It is intended for decision-makers and managers at the national and subnational levels.
This is an update to COVID-19: Operational guidance for maintaining essential health services during an outbreak: Interim guidance, 25 March 2020
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Primary care health centers and providers who care for individuals with hypertension and cardiovascular disease have an important role to play in ensuring continued access to care, reducing the risk of coronavirus infection, and appropriately managing people with these co-morbidities who acquire COV...ID-19. This guidance includes these considerations
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The Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level provide a platform for transparency to enable equitable access to safe, effective, and affordable treatment options at hospital level taking into consideration the changing clinical needs of our population and th...e pragmatic implications of the introducing a new health technology.
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ObjetivoEl objetivodel documento es servir de guía de actuación para el manejo casos de COVID-19 en atención primaria.3.Recomendaciones generalesSe recomienda la colocación de información visual (carteles, folletos, etc.) en lugares estratégicosde los centros de atenció...n primaria (de ahora en adelante CAP)para proporcionar a la poblaciónlas instrucciones sobre higiene de manosehigiene respiratoria.Se ofrecerá una mascarilla quirúrgica a aquellos pacientes que acudan al centro sanitario con síntomas de infección respiratoria aguda.Se debedisponer de dispensadores con solución hidroalcohólica al alcance de la poblacióny el personal. Se deberá disponer de contenedores de residuos, con tapa de apertura con pedal, para la eliminación de los residuos generados.
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and challenges, maps existing international commitments and... frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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The arrival of COVID-19 in Afghanistan has brought heartache to millions of people who are now battling a deadly pandemic while simultaneously fighting for their survival amid poverty, disaster and war. Over my three years as Humanitarian Coordinator, I have marvelled at the resilience of the people... of this country to cope with the hardships of life in the world’s deadliest conflict – but even this remarkable strength is now being tested by the health, social and economic consequences of COVID-19. The virus is spreading across the country with frightening speed. Every province is now impacted, and people are understandably frightened.
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COVID‑19 strategic preparedness and response