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1
Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
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
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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
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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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second edition
Included more self-measured blood pressure (SMBP)-focused content with tools and resources.
Showcased more tools to find patients with potentially undiagnosed HTN.
Added new strategies that focus on chronic kidney disease testing and identification.
This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha
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llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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The Essential Nutrition Actions and Essential Hygiene Actions Training Guide: Community Workers strengthens the capacity of community workers to deliver and promote the essential nutrition and hygiene actions. It introduces technical content within hands-on sessions to practice counseling and negoti
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ation, using role plays and field practice. It guides community workers in understanding why and how to integrate messages on nutrition and hygiene into their different program platforms using a life cycle approach to deliver the right message to right person at the right time.
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Training Manual and Reference Guide
Abridge Course for Physicians. Facilitator guide for modules, Integrated Management of Neonatal and Childhood Illness (IMNCI)
English Analysis on World about Climate Change and Environment, Health and Epidemic; published on 03 Nov 2021 by World Bank
The purpose of this publication is to to provide a practical, stepwise approach to the implementation of the national action plans on AMR within the human health sector; and to provide a process and collation of existing WHO tools to prioritize, cost, implement, monitor and evaluate national action
...
plan activities. The target audience of the publication are national/subnational stakeholders working on AMR within the human health sector. This includes national health authorities, national multi-sectoral coordination groups, senior technical experts and policymakers involved in implementing AMR activities at all levels of the health system, and implementation partners to accelerate sustainable implementation and monitoring and evaluation of national action plans on AMR.
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This half-day training module introduces participants to basic skills in psychological first aid (PFA). It is suitable for all Red Cross and Red Crescent staff and volunteers working in any sector. It aims to enable participants to:
know what psychological first aid is and what it is not
...
understand the three action principles of ‘Look, Listen and Link’
practise providing PFA to someone in distress
be aware of the importance of self-care when helping others.
This training module is one of four on psychological first aid, which accompany a set of materials on PFA. This include an introductory booklet called A Guide to Psychological First Aid for Red Cross and Red Crescent Societies and a small booklet, A Short Introduction to Psychological First Aid for Red Cross and Red Crescent Societies.
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It aims to enable participants to:
know more about reactions to distress
know what psychological first aid is and what it is not
understand the three action principles of ‘Look, Listen and Link’
have practised providing PFA to someone in distress
have considered comple
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x reactions and situations
be aware of the importance of self-care when helping others.
This training module is one of four on psychological first aid, which accompany a set of materials on psychological first aid
more
t aims to enable participants to:
know more about children’s reactions to distress
know what psychological first aid for children is and what it is not
understand the three action principles of ‘Look, Listen and Link’ in relation to children
have practised providing PFA t
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o a child and caregiver in distress
have considered complex reactions and situations
be aware of the importance of self-care when helping others.
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The toolbox contains guidance and tools (sample templates) for data collection in M&E of PSS programmes. The tools can be adapted to PSS programme, depending upon target group, activities and scope. These are tools that may be useful for your programme and many are drawn from existing PSS programme
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M&E tools, but they are not an exhaustive list. They can act as an inspiration and supplement to other existing tools.
The Toolbox is also available in word format for easy use and adaptation here:
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The roadmap highlights and advocates for the existing and potential key role of national public health institutes (NPHIs) in climate adaptation and mitigation, and how they contribute to climate policies, research and action.
an operational guide to support all those responsible for planning and implementing the rollout of COVID-19 vaccine to refugees and migrants at national and local levels, 14 March 2022
The biosphere underlies the whole sustainable development concept, as the layer on
which society and the economy rely. Nature and biodiversity fuel the natural cycles
and life-support systems of the planet, on which humanity ultimately depends.
Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change.
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Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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