The risk of increasing rates of acute malnutrition during the COVID-19 pandemic demonstrates the urgent need to adapt, and expand access to, acute malnutrition diagnosis and treatment services in humanitarian and fragile contexts.
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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There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as differences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new... Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
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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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During theC OVID-19 crisis, the hospital observed a reduction of about 50% in inpatient visits for palliative care. Some patients postponed appointments given the risk of potential infection. Instead of in-person visits, weekly phone calls and remote follow-up were given priority.Palliative care is ...also needed for COVID-19 patients. It is of utmost importance for humanizing care so that it is effective and aligned with the expectations of patients.
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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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One of the most obvious ways in which to ensure impartiality in a health care system is to require impartiality of all actors in the system, i.e. to give health care professionals a duty to treat everyone impartially and to deny them the ‘right’ to give their patients preferential treatment. And... one of the possible side-effects of allowing individual health care professionals to give preference to ‘their clients’ is to create inequality in health care. This paper explores the conflict and proposes that it can be right to give preference to ‘your’ patients in certain circumstances.
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June 2020In die Skriflig/In Luce Verbi 54(1)
DOI: 10.4102/ids.v54i1.2562
To provide recommendations on the initial care of persons with acute respiratory illness (ARI) in the context of coronavirus disease (COVID-19) in healthcare facilities based on a decision-making process flowchart. These recommendations are preliminary and subject to review as new evidence becomes a...vailable. The recommendations provided in this document apply for adults olden than 18 years old.
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This interim guidance has been updated with advice on safe and appropriate home care for patients with coronavirus disease 2019 (COVID-19) and on the public health measures related to the management of their contacts.
Interim guidance, 12 August 2020This interim guidance has been updated with advice on safe and appropriate home care for patients with coronavirus disease 2019 (COVID-19) and on the public health measures related to the management of their contacts.
Primary care can play a significant role in the COVID-19 response by differentiating patients with respiratory symptoms from those with COVID-19, making an early diagnosis, helping vulnerable people cope with their anxiety about the virus, and reducing the demand for hospital services. This document... provides national and subnational health managers, as well as staff at primary care facilities, with interim guidance on timely, effective and safe supportive management of patients with suspected and confirmed COVID-19 at the primary care level; and delivery of essential health services at the primary care level during the COVID-19 outbreak
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This content provides concise, pragmatic guidance to front-line healthcare workers. The guidance is written by PCI’s Clinical Associates, who are themselves primary healthcare workers. It draws on up-to-date guidance from key sources including the WHO, UNHCR and PCI’s own sister organisation R...ed Whale (a leading provider of medical education in the UK). The modules include: A guide to public health measures; The definition of a case of COVID-19 virus, Preparing the primary health care centre; Prevent the spread of COVID-19; Triage and management in primary care; Managing patients with NCDs; Mental health -patients and healthcare workers; and Case studies.
How to access the course:
Go to the ‘PCI Academy’ website homepage https://covid19.pci-academy.org/
Register for an account, Go to the ‘COVID-19’ course
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