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2021 UNAIDS Global AIDS Update. UNAIDS report shows that people living with HIV face a double jeopardy, HIV and COVID-19, while key populations and children continue to be left behind in access to HIV services
July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in
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the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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1 in 3 countries are not taking action to help students catch up on their learning post-COVID-19 school closures
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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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit
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h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the
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y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in
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community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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The menu was developed using the WHO-CHOICE methodology to prepare and update, as appropriate, WHO estimates of the cost-effectiveness of a range of mental health interventions, in line with the development of Appendix 3 to the global action plan for the prevention and control of noncommunicable dis
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eases 2013–2020.
WHO-CHOICE is a programme that helps countries to identify priorities based on health impact and cost-effectiveness. It can be applied to a wide range of strategies relevant to policies affecting health outcomes. All options are compared to a common comparator, a null scenario in which the impacts of currently implemented interventions are removed, thereby enabling comparison of interventions across geographical areas and aspects of health.
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is
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intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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The Community Health Systems (CHS) Catalog is a resource that provides information on community health program workers, and interventions for the 25 countries deemed priority by USAID’s Of of Population and Reproductive Health. It comprises a compilation of 25 country profiles developed from a de
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sk review of community health policies, strategies, a related documentation.
This document summarizes country trends drawn from the CHS Catalog and highlights interesting and relevant findings
about the global community health policy landscape.
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To help trainers to create awareness,attitude and skills in waste handlers in day to day management of medical waste in health care settings.
The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnan
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cy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutrition in pregnancy.
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The toolkit provides practical guidance and tools that can support efforts, including planning and implementation activities, to create dementia-inclusive societies.
The toolkit is divided into two parts. Part I contains background information and a conceptual framework for creating dementia-incl
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usive societies. Part II includes four practical modules, each featuring a series of practical steps and exercises. The four modules focus on: starting a new dementia-friendly initiative (DFI), integrating dementia into an existing initiative, monitoring and evaluation a DFI, and scaling a DFI. The modules can be used together or separately and offer guidance that can be adapted to suit local needs and settings.
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin
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g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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In the last quarter of 2019 Southern African Regional Interagency Standing Committee Africa (RIASCO) reported that more than 11 million people were experiencing crisis or emergency levels of food insecurity in nine Southern African countries1 due to deepening drought and climate related crisis. The
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Southern African Development Community (SADC) urged for urgent humanitarian action, and at the beginning of November 2019 Angola, Botswana, Lesotho and Namibia had declared states of drought emergencies, requiring international assistance to address the worsening food insecurity situation.
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Following flood levels of the hydrological stations monitored in Niamey (Niger Republic) and Malan Ville (Benin Republic) reaching the red alert zone, torrential rainfall and ensuing floods affected 91,254 people or 15,209 households in Jigawa, Kebbi, Kwara, Sokoto, and Zamfara state (amongst other
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states) of Nigeria on 6 October 2020. The flood incident was caused by the intensity of the rainfalls at the peak of the flood season and the release of dams located in neighbouring Niger, Cameroon, and Benin, which resulted in the Benue and Niger rivers overflowing and affecting communities living along their banks and in surrounding areas.
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Alors que de nombreux pays touchés par le COVID-19 au cours des premiers mois de l'année commencent maintenant à assouplir les mesures de confinement à mesure que les taux d'infection et de mortalité diminuent, dans les régions les plus touchées par le VIH, la tuberculose et le paludisme, com
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me l'Afrique, l'Asie du Sud et l'Amérique latine, la pandémie continue de s'accélérer. Dans les environnements à faibles ressources, les mesures de confinement sont moins efficaces et difficiles à maintenir, et les installations de soins cliniques sont extrêmement limitées. Dans de tels environnements, la réponse à COVID-19 doit se concentrer sur l'endiguement de la propagation de la pandémie par le dépistage, la recherche des contacts et l'isolement, la protection du personnel de santé par la formation et la fourniture d'équipements de protection individuelle (EPI) et la réduction de l'impact sur d'autres maladies par le renforcement des systèmes de santé fragiles et l'adaptation des programmes existants.
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