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There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as diff
...
erences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
more
Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and
...
comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
more
Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by pro
...
viding incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
more
Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoida
...
ble suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
more
Die Gesundheitskonferenz in Alma-Ata definierte 1978 Gesundheit als Menschenrecht. Man setzte auf Teilhabe und Basisgesundheitsdienste. Nun wird das Konzept wiederbelebt.
This document sets out the preparedness and response plan of the Nigerian Primary Health Care System for COVID-19 Acute Respiratory Disease. It out
...
lines the planning scenarios, key areas of work and priority activities required for the Primary Health Care Sector to quickly scale up its core capacity to prevent, quickly detect, characterize and efficiently respond, in a coordinated manner to the COVID-19 pandemic. These include guidelines for the setup and operationalization of COVID-19 response platforms at the national and state levels, guidelines for the provision of PHC services during the pandemic to minimize transmission in PHCs as well as guidelines for preparedness and response of PHC Centres and communities for COVID-19 case detection and response.
more
Ethiopian primary health care clinical guidelines (Sample)
Federal Democratic Republic of Ethiopia -Ministry of Health
Federal Democratic Republic of Ethiopia -Ministry of Health
(2017)
C1
Background: Primary health care (PHC) is a driving force for advancing towards universal health
...
coverage (UHC). PHC-oriented health systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments and project the associated resource needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs.
more
This case study in Chile focused on the following two strategic levers of the WHO/UNICEF PHC Operational Framework during the implementation period 2022–2023: “Political Commitment and Leadership” and “Governance and Policy Frameworks”. This included examining how support from the three le
...
vels of the Organization (WHO headquarters, Pan American Health Organization (PAHO)/WHO Regional Office for the Americas and PAHO/WHO Chile Country Office) has been coordinated and operationalized. The case study also explored how, through these two strategic levers, catalytic actions have been planned and implemented in relation to other operational levers, in particular “Models of care”.
more
A Global Perspective
Policy and systems. Global Mental Health(2017),4, e7, page 1 of 6. doi:10.1017/gmh.2017.3
The toolkit's purpose is to:
improve the primary health care response for older persons.
sensitize and educate
...
primary health care workers about the specific needs of their older clients.
provide primary care health workers with a set of tools/instruments to assess older people's health.
raise awareness among primary care health workers of the accumulation of minor/major disabilities experienced by older people.
provide guidance on how to make primary health care management procedures more responsive to the needs of older people's needs.
offer direction on how to do environmental audits to test primary health care centres for their age-friendliness.
The toolkit comprises a number of instruments (evaluation forms, slides, figures, graphs, diagrams, scale tables, country guidelines, exam sheets, screening tools, cards, checklists, etc.) that can be used by primary health care workers to assess and address older persons' health. These resources are meant to supplement and not to replace local and national materials and guidelines
more
Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as
...
a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse and misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
more
The region of Latin America and the Caribbean (LAC) has high levels of income inequality and urbanization. This leaves a large percentage of the population exposed and vulnerable to infectious disease outbreaks (1). The COVID-19 outbreak occurred suddenly, within a complex economic, social and polit
...
ical context and at a time of low economic growth and high levels of informal labour. Structural challenges of poverty, deep inequality across different dimensions, and weak health and social protection systems exacerbated the region’s vulnerability to the pandemic
more
In 2018 the Astana Declaration reaffirmed a global commitment to PHC as a cornerstone of sustainable health systems for accelerated progress on universal health coverage (UHC) (1). The vision for PH
...
C in the 21st century is for a wholeof-government and whole-of-society approach to health that combines: 1) multisectoral policy and action; 2) empowered people and communities; and 3) primary care and essential public health functions as the core of integrated health service. Signatories, including Nigeria, were urged to implement the vision and commitments of the Declaration according to their national contexts. This case study examines Nigeria’s response to COVID-19 from a PHC perspective between March 2020 and mid-2021.
more
Best Practices Report.PART 1 Primary Protection: Enhancing Health Care Resilience for a Changing Climatei
...
Primary Protection: EnhancingU.S. Department of Health and Human Services
more
This treatment guideline is intended to assist clinicians in the Behavioral Health department in treatment planning and service delivery for patients with Post Traumatic Stress Disorder (PTSD). It may also assist clinicians treating patients who hav
...
e some of the signs and symptoms of PTSD but who do not meet the full criteria of PTSD. The treatment guideline is not intended to cover every aspect of clinical practice, but to focus specifically on the treatment models and modalities that clinicians in our outpatient treatment setting could provide. These guidelines were developed through a process of literature review and discussion amongst clinicians in the Behavioral Health department and represent a consensus recommendation for service provision for this disorder. The guideline is intended to inform both clinical and administrative practices with the explicit goals of outlining treatment that is: effective, efficient, culturally relevant and acceptable to clinicians, program managers, and patients.
more
