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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The European Commission against Racism and Intolerance (ECRI) was established by the Council of Europe. It is an independent body which ensures respect for human rights in the fight against racism, discrimination (based on "race", ethnic/national origin, colour, nationality, religion, language, sexu...al orientation and gender identity), xenophobia, anti-Semitism and intolerance. The members of the Commission shall be independent and impartial. They shall be appointed on the basis of their moral authority and recognised expertise in matters of racism, xenophobia, anti-Semitism and intolerance. As part of its statutory mandate, ECRI produces country reports for each country which analyse the situation regarding racism and intolerance in each member State of the Council of Europe and make proposals to resolve the problems identified.
Translated with www.DeepL.com/Translator (free version)
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This global guidance provided the framework for over 100 countries to develop their NDVPs. This updated (second) version supersedes the previous version published in 16 November 2020. New information has been added on the following areas:
the COVID-19 Partners Platform;
the use of COVID...-19 simulation exercises to test deployment strategies;
the indemnity agreement and no-fault compensation programme for vaccines secured through the COVAX Facility in the Advance Market Commitment (AMC) eligible economies;
the availability and use of the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool;
the COVAX Facility’s humanitarian buffer that enables allocation of vaccine to cover high-risk populations in humanitarian settings;
recommendations for vaccination of pregnant and lactating women;
supplementary information on infection prevention and control (IPC) measures to be used to deliver COVID-19 vaccines safely;
the WHO licensed COVID-19 vaccines product-specific information;
use of geospatial data and digital micro plans for equitable access and delivery of COVID-19 vaccines;
lessons learned from the development of NDVPs and early experiences in COVID-19 vaccine deployment in countries; and
updated additional resources at the end of each chapter.
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This threat assessment addresses the implications of the ongoing Marburg virus disease (MVD) outbreak in
Rwanda for the European Union/European Economic Area (EU/EEA). MVD is a severe disease in humans and,
although uncommon, it has the potential to cause epidemics with significant case fatality. ...All recorded MVD
outbreaks to date have originated in Africa. MVD is not an airborne disease and is considered not to be
contagious before symptoms appear. Direct contact with the blood and other body fluids of infected people
and animals or indirect contact with contaminated surfaces and materials like clothing, bedding and medical
equipment is required for transmission. The risk of infection is minimised when proper infection prevention and
control precautions are strictly followed. There is no approved treatment or vaccine for MVD; however, several
pharmaceuticals and candidate MVD vaccines are under investigation.
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This document presents an integrated strategy for mental health system development that will lead to enhanced service delivery, improved outcomes, and improved human rights for people with mental disorders.
By using the practical guidance provided in this document, countries can ensure that thei...r mental health systems are not haphazard, but rather, the products of careful consideration and planning.
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The context of the Ebola epidemic presented extreme challenges for Oxfam, as it did for many organisations. At the onset of the epidemic, there was a general lack of understanding of the disease and how to respond to it effectively and safely. A pervasive and persistent climate of fear, coupled with... changing predictions about the likely evolution of the epidemic, influenced analysis and response at all levels. There was strong pressure to treat the epidemic as a medical emergency requiring a medical response – organised through topdown processes – rather than standard humanitarian coordination
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WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), has published global standards for prosthetics and orthotics. Its aim is to ensure that prosthetics and orthotics services are people-centred an...d responsive to every individual’s personal and environmental needs. The standards advocate for the integration of prosthetics and orthotics services into health services, under universal health coverage. Implementation of these standards will support countries to fulfil their obligations under the Convention on the Rights of Persons with Disabilities and towards the Sustainable Development Goals, in particular Goal 3: Ensure healthy lives and promote well-being for all at all ages.
The standards provide guidance on the development of national policies, plans and programmes for prosthetics and orthotics services of the highest standard. The standards are divided into two documents: the standards and an implementation manual. Both documents cover four areas of the health system:
policy (governance, financing and information);
products (prostheses and orthoses);
personnel (workforce);
and provision of services.
The Standards have been developed through consultation with experts from around the globe via a steering group, development group and external review group.
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Some observers have described the coronavirus pandemic as an 'Anthropocene disease,' thereby highlighting its connection with this new ecological era that is characterised by the considerable pressure human activities are exerting on ecosystems and the consequences on public health, society and the ...environment. This article focuses on the recent emergence of the 'Planetary Health' paradigm. Launched by the Rockefeller Foundation and the medical journal The Lancet, Planetary Health is one of the most ambitious attempts in recent years to systematize global health in the Anthropocene. While recognising the interest and necessity of reflecting on human health and the health of the planet, this article aims to show, however, that the Planetary Health paradigm is problematic and aporetic for two reasons. First, because it is based on a scientistic and depoliticised conception of the Anthropocene, which obscures capitalism's responsibility for the contemporary global and, especially, ecological crisis. Second, because this conception leads to a promotion of solutions that are essentially based on the financialization and technoscientific management of the living world - precisely the underlying cause of the degradation of ecosystems and living conditions that created the Anthropocene in the first place. A different kind of 'planetary health' remains possible and desirable.
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The strategy focuses on mobilizing and coordinating partners, experts and resources to help countries enhance surveillance of the Zika virus and disorders that could be linked to it, improve vector control, effectively communicate risks, guidance and protection measures, provide medical care to thos...e affected and fast-track research and development of vaccines, diagnostics and therapeutics
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USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (PHC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system throu...gh achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
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Ghana's attempt to regulate health care waste management started in 2002 with the development of guidelines on health care waste manage-ment by the Environmental Protection Agency (EPA). In 2006, the Ministry of Health developed the health care waste policy and guidelines. This guidance document im...proved health care waste management in the country.
With support from the UNDP-GEF medical waste management project, the Ministry of He lth has revised the existing National Health Care Waste Management (HCWM), policy and guideline, 2006 and has produced two separate documents- A National Health Care Waste Management Policy and a National Guideline for Health Care Waste Management
countrywide. This policy is replacing the 2006 policy and introduces new technical and administrative policy issues to enhance waste management in health care facilities.
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Forests, trees and green spaces, hereinafter ‘forests and trees’ for short, provide multiple goods and services that contribute to human health. These include medicines, nutritious foods and other non-wood forest products (NWFPs). Globally, at least 3.5 billion people use NWFPs, including medici...nal plants, which are particularly important for vulnerable groups and Indigenous Peoples and local communities (IPLCs).
During periods of crises, such as the COVID-19 pandemic, demand for forest products typically increases amongst these groups. Forests and trees also contribute to better health by playing a role in climate change
mitigation and adaptation, contributing to regulating the carbon cycle, but also moderating the micro-climate, filtering pollutants from the air and protecting settlements against the effects of extreme events such as droughts and flash floods.
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One of the many gender inequities in the health and care workforce that COVID-19 has exposed is around the fit and design of Personal Protective Equipment (PPE). The rapid onset and scale of COVID-19 led to shortages of PPE in most countries, causing preventable infection and mortality among healthc...are workers and others on the front lines. Even though most health workers are women, manufacturing specifications for medical PPE are usually drawn up based on the male body and there have been many reports of PPE not designed for women's bodies.
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This guide provides practical, step-by-step guidance on how to organize, implement, and monitor community-based care for DR TB. It is equally useful for program planning or supervision. The target audience for this guide is TB Program Managers, governments, policy makers, nongovernmental organizatio...ns (NGOs), donors and TB advocates.
This guide does not replace other guidelines and documents that contain important medical information, such as Guidelines for the Programmatic Management of Drug-resistant TB (WHO, 2008 and 2011 updates), and Management of MDR-TB: A Field Guide (WHO, 2009).
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2nd. edition
The new edition has been developed to make widely available to programme managers, health care workers in endemic settings, academic researchers, and other key partners, a concise source of information on strategies for MMDP for LF. It is a product of efforts to elaborate and concepts ...and approaches introduced in the previous edition, with a focus on ensuring that countries have the tools necessary to provide the essential package of care for LF.
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Since the last situation report on the multi-country outbreak of cholera was published on 1 June 2023 (covering data reported until 15 of May), no new country reported a cholera outbreak. In total, 24 countries have reported cases since the beginning of 2023. The WHO African Region remains the most ...affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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This is the fifteenth edition of the lecture notes. They were first published in 1987 as a summary of the material used in the biannual epilepsy teaching weekend organised under the auspices of the UK Chapter of the International League against Epilepsy.
(Lecture series consist of a total of 59 cha...pters. Section one - introduction (chapter 1-2). Section two - basic science (chapters 3-5). Section (chapters 6-16). Section four - differential diagnosis (chapter 17-19). Section five - investigations (chapter 20-24). Section six - medical treatment of epilepsy (chapters 25-35). Section seven - outcome (chapters 36-40). Section eight - special groups (chapters 41-44). Section nine - surgical treatment of epilepsy (chapters 45-49). Section ten - social aspects (chapters 50-56). Section eleven - provision of care (chapters 57-59). All chapters available at: https://www.epilepsysociety.org.uk/lecture-notes-0#.Wq-cn8NubIU)
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The meeting was held from 26 to 27 March 2018 to review and discuss the following topics:
Advances and challenges in the use of fTLC, and new approaches to detecting mycolactone using monoclonal antibodies (mAbs).
The status of development of rapid diagnostic tests (RDTs) targeting the MUL..._3720 protein.
The role of PCR as a reference test, and hurdles in providing a confirmatory diagnosis and in establishing a quality assurance programme.
New molecular tools with potential for implementation at a level lower than in the national or regional reference laboratory, such as loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA).
The need to harmonize and standardize methods for collection and preparation of specimens, so samples can be referred for diagnosis and stored for evaluation of new diagnostic tests in optimal conditions.
Barriers to accessing early diagnosis and treatment, including coordination at the programme level, and lack of adequate diagnostic tools.
Defining target product profiles (TPPs) to guide the development of new diagnostic tools that can be applied at different levels of the health system. Participants agreed that two TPPs would be developed to address the current gaps: (i) a rapid test for BU diagnosis at the primary health-care level; and (ii) a test for diagnosis of BU that can also assist in treatment monitoring and differential diagnosis at the district hospital or reference centre.
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The Haiti & Dominican Republic Cholera Operation Plan of Action outlines the Red Cross's strategy to combat cholera on the island of Hispaniola following the 2010 outbreak in Haiti. As part of a 10-year national strategy, the plan includes an initial two-year emergency response (2014-2016) with a bu...dget of 9.9 million Swiss francs. The approach focuses on three key areas: improving water and sanitation by repairing and expanding water systems and constructing sanitation facilities, prevention and hygiene promotion through community education and hygiene training, and preparedness and response by strengthening disease monitoring, training Red Cross volunteers, and prepositioning medical supplies. This initiative, led by the Haitian and Dominican Red Cross in collaboration with international partners and local governments, aims to reduce cholera infections and improve public health on the island.
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