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1
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14 January 2021
This practical guide can be used to help countries monitor and analyse the impact of COVID-19 on essential health services to inform planning and decision-making. It provides practical recommendations on how to use key performance i
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ndicators to analyse changes in access to and delivery of essential health services within the context of the COVID-19 pandemic; how to visualize and interpret these data; and how to use the findings to guide modifications for safe delivery of services and transitioning towards restoration and recovery. The guide focuses on existing indicators and data that are captured in routine reporting systems and how they can be used by national and subnational authorities to understand specific contexts, challenges and bottlenecks. This guide supports Maintaining essential health services: operational guidance for the COVID-19 context, which provides an integrated framework to guide countries in their efforts to reorganize, adapt and maintain safe delivery of high-priority essential health services within the context of the pandemic.
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The procurement of essential medicines and other health products is a critical function in support of the effective discharge of WHO’s mandate, and WHO values the importance of the quality of essential medicines and
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health products that are supplied to countries. The first World Health Assembly in 1948 recognized the need to establish a procurement service at WHO, and recommended setting up an office “to give advice on the procurement of essential drugs, biological products and other medical supplies”.
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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 syst
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ems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary 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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This document synthesizes key elements of the World Health Organization (WHO) normative guidance on health policy and system support for community health
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worker (CHW) programmes and their application for HIV programmes. Building on relevant elements of HIV guidelines, tools and evidence identified by experts, it provides recommendations on tasks and roles that can be performed by CHWs (including for HIV), identifies the policy and system supports to optimize CHW performance, and gives examples of best practice. Its purpose is to inform the optimal design and delivery of CHW programmes targeting – either specifically or as part of a broader approach – the scale-up and sustainability of HIV services.
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Update 68
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) sta
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rted implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportion
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ally on low- and middle-income countries. Injury Prevention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year.
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Findings, interpretations and conclusions
expressed in this document are based on infor-
mation gathered by GIZ and its consultants,
partners and contributors from reliable sources.
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.
In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro
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nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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The extensive use of natural resources threatens to exceed the carrying capacity of the Earth. The concept of a
circular economy offers an avenue to sustainable growth, good health and decent jobs, while saving the environment
and its natural reso
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urces. Further, the change from a linear economy (take, make, dispose) to a circular economy (renew, remake, share) is expected to support significantly the attainment of the Sustainable Development Goals
(SDGs), particularly SDG 12 on responsible consumption and production.
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Strengthening mental health responses to COVID-19 in the Americas: A health policy analysis and recommendations
A. Tausch; Oliveira e Souza, R.; Martinez Viciana, C.; et al.
Pan American Health Organization
(2021)
CC
The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies
show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young
people, those with pre-exist
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ing mental health conditions, health workers, and persons living in vulnerable condi-
tions. Mental health systems and services have also been severely disrupted. A lack of financial and human resource
investments in mental health services, limited implementation of the decentralized community-based care approach
and policies to address the mental health gap prior to the pandemic, have all contributed to the current crisis. Coun-
tries must urgently strengthen their mental health responses to COVID-19 by taking actions to scale up mental
health and psychosocial support services for all, reach marginalized and at-risk populations, and build back better
mental health systems and services for the future.
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The health sector In Ukraine is beginning to change in recent years. The sector, based on a system of health care (Semashko) originating from the Soviet Union, had been stagnant for many years. Rema
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rkably little had changed since Independence and the health care system is as of today still characterized by a very hierarchical and territorial system with large numbers of beds in institutional care settings. At the same time the Government of Ukraine has only limited resources available that are spread thin over the existing infrastructure
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Ensuring mental health and well-being has become a worldwide imperative and an important target
of the Sustainable Development Goals.
But in all countries around the world, our response has been woefully insufficient, and we have made
little prog
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ress to advance mental health as a fundamental human right.
One in ten people are affected by a mental health condition, up to 200 million people have an
intellectual disability and an estimated 50 million people have dementia. Many persons with mental
health conditions, or psychosocial, intellectual, or cognitive disabilities lack access to quality mental
health services that respond to their needs and respect their rights and dignity.
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This policy brief aims to provide a review of the current progress on implementing the Kenya national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audienc
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e includes all those concerned with implementing actions to combat antimicrobial resistance in Kenya.
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