The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based service delivery in different countries.
Countries were selected for their geographic diversity, type o...f service delivery model, and programmatic scale-up.
This brief reviews Malawi’s community health model to inform future policy, program design, and implementation in other countries.
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The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa...l health planning and the first point of reference for all actors working in the health sector. The overall aim of this policy is to ensure universal accessibility (in geographical and financial terms) of equitable and affordable quality health services (preventative, curative, rehabilitative and promotional services) for all Rwandans. It sets the health sector’s objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. A companion Health Sector Strategic Plan (HSSP) elaborates the strategic directions defined in the Health Sector Policy in order to support and achieve the implementation of the policy, and more detailed annual operational plans describe the activities under each strategy.
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These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium Development Goals to reduc...e maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery, postnatal care, the integrated management of newborn and childhood illness, communicable diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases), family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene and environmental health, non-communicable diseases, health education and community mobilisation, and health planning and professional ethics.
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The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has ...developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
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This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, used on its own, is not enough to understand the complexities of sanitation, hygiene, water, and health. It explores pastoralists’ views and perspectives ...on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.
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This primer aims to guide health professionals on engaging with WASH-related issues. It gives an overview of WASH interventions and the status of WASH services globally and outlines key linkages with health. It provides examples of key actions that health actors can take to ensure WASH efforts effec...tively protect public health and highlights World Health Organization (WHO) activities to support those actions.
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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Current evidence that the climate is changing is overwhelming. Impacts of climate change and variability are being observed: more intense heat-waves, fires and floods; and increased prevalence of food- water- and vector-borne diseases. Climate change will put pressure on environmental and health det...erminants, such as food safety, air pollution and water quantity and quality. A climate-resilient future depends fundamentally on reducing greenhouse gas emissions. Limiting warming to below 2 °C requires transformational technological, institutional, political and behavioural changes: the foundations for this are laid out in the Paris Agreement of December 2015. The health sector can lead by example, shifting to environmentally friendly practices and minimizing its carbon emissions. A climate-resilient future will increasingly depend on managing and reducing climate change risks to protect health. In the near term, this can be enhanced by including climate change in national health programming and creating climate-resilient health systems.
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Safe water, sanitation and hygiene (collectively known as WASH) are crucial for human health and well-being. Yet, millions of people globally lack adequate WASH services and consequently suffer from or are exposed to a multitude of preventable illnesses.
Prescriptions and Actionables for a Healthy and Green Recovery.
The practical steps outlined in this report aim at creating a healthier, fairer and greener world while investing to maintain and resuscitate the economy hit by the effects of COVID-19.
Policy makers, national and local decision-make...rs and a wide array of other actors wishing to contribute to a healthy recovery can now take decisive steps by shaping the way we live, work and consume. Effects on environmental degradation and pollution and climate change will be wide ranging. WHO and partner organizations have since long been developing substantive guidance and provide support for building healthier environments for healthier populations.
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The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in health care facilities. It also finds that 1 in 5 health care facilities has no sanitation service*, impacting 1.5 billion people. The report further rev...eals that many health centres lack basic facilities for hand hygiene and safe segregation and disposal of health care waste.
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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Health, safety and wellbeing of the Healthcare workers is a prerequisite for good quality of care and patient satisfaction in health services. Healthcare facilities that are not safe for workers and patients are not resilient to any shock arising from hostile events, outbreaks or any other emergenci...es. Occupational Safety and Health Act (2005) and the National Occupational Safety and Health Policy of Zanzibar require the development of stringent systems for managing occupational safety and health in all workplaces and the health system in general.
These Policy Guidelines have been developed by the Ministry of Health in consultation with the Ministry responsible for Labour and other stakeholders, such as organizations of workers, employers and professional associations in the health sector. The purpose of these guidelines is to foster the implementation of the international commitments and the national legislation regarding decent work in the health system as well as to improve the quality of care and the resilience of health facilities.
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Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene. I...n 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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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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The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems and communities.
Successful delivery of services through CHWs requires evidence-based models for edu...cation, deployment and management of these health workers. The guideline is intended as a tool for national policy makers and planners and their international partners to use in the design, implementation, performance and evaluation of effective community health worker programmes. It contains pragmatic recommendations on selection, training and certification; management and supervision: and integration into health systems and community engagement.
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For the 24th consecutive year, PAHO has published the report Health Situation in the Americas: Core Indicators featuring the latest information on key indicators for the Region of the Americas. This 2018 edition includes data on the 82 core indicators for the countries, territories, and sub regions ...of the Americas, grouped into the following categories: demographic-socioeconomic, health status, risk factors, service coverage, and health systems. Information is also presented on 22 indicators of the Sustainable Development Goals (SDGs).
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This is the sixth of our 11-paper supplement entitled “Community Health Workers at the Dawn of New Era”. Expectations of community health workers (CHWs) have expanded in recent years to encompass a wider array
of services to numerous subpopulations, engage communities to collaborate with and to... assist health systems in responding to complex and sometimes intensive threats. In this paper, we explore a set of key considerations for training of CHWs in response to their enhanced and changing roles and provide actionable recommendations based on
current evidence and case examples for health systems leaders and other stakeholders to utilize.
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Accessed: 07.03.2020
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe and neighbouring countries (D5.1)
Contract 2015 71 01 A behavioural survey for HIV/AIDS and assoc...iated infections and a survey and tailored training for community based health workers to facilitate access and improve the quality of prevention, diagnosis of HIV/AIDS, STI and viral hepatitis and health care services for men who have sex with men (MSM).
Pubic Health
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