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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Humanitarian emergencies, regardless of type and cause, have a number of common risk factors for communicable diseases inextricably linked to excess risk of morbidity and mortality which can come from vaccine–preventable diseases (VPDs). The reduction of VPDs is a significant aim of public-health ...interventions during crises.
The WHO Strategic Advisory Group of Experts (SAGE) on Immunization carried out a comprehensive review of evidence on vaccination decision-making processes and considerations in humanitarian emergencies.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im...munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
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In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financialization in the
health domain could be described as the uncontrolled expansion of finance along vari...ous lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
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The world faces grave consequences from the lack of available mental health services and treatment. Mental illness impacts every country, culture and community, with the World Health Organization (WHO) stating that 10% of the global burden of disease is related to mental, neurological and substance ...use disorders. In low-and middle-income countries, more than 75% of people with mental disorders receive no treatment at all for their disorder. During 2020, as a result of the global pandemic, 93% of countries reported their mental health services were either halted or interrupted (WHO, 2020e). WHO reported a 25% increase in depression and anxiety alone during the pandemic. The Organisation for Economic Co-operation and Development estimates depression and anxiety cost the global economy US $1 trillion dollars a year. All nurses have a health care role in mental health and substance use. ICN strongly advocates for the investment of further education and professional development in this area in order to support individuals and communities achieve the highest attainable standard of health which includes
physical, mental and social wellbeing.
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8 January 2021
Sequencing enabled the world to rapidly identify SARS-CoV-2 and develop diagnostic tests and other tools for outbreak management. Continued genome sequencing supports the monitoring of the disease’s spread and evolution of the virus. Accelerated integration of genome sequencing int...o the practices of the global health community is required if we want to be better prepared for the future threats. This document provides guidance for laboratories on maximizing the impact of SARS-CoV-2 sequencing now and other emerging pathogens in the future.
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The Government of Malawi, in fulfilling its primary role of protecting the lives of its vulnerable citizens during disasters and reducing their exposure to risk through preparedness, led the development of a National Coronavirus Disease (COVID-19) Preparedness and Response Plan.
Sudan recorded the first COVID-19 case on 13 March 2020 and, at the beginning of July, the Federal Ministry of Health had confirmed that nearly 10,000 people had contracted the virus, including over 600 who died from the disease across the country. Although more than 70 per cent of the confirmed cas...es are in the Khartoum area, COVID-19 has spread throughout the country, with the highest numbers recorded in the central and eastern states. With extremely low testing capacity — around 800 samples per day, the lowest in the region — the official figures of confirmed cases likely underestimate the extent of the pandemic and the actual situation is unknown.
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A new survey on the impact of the floods in Pakistan on older people reveals that hundreds of lives are needlessly being put at risk due to the decimation of health services and the rise of diseases like malaria and diarrhoea, which can be killers to older people with weaker immune systems.
A companion to the Child Friendly Schools Manual
WASH in Schools aims to improve the health and learning performance of school-aged children – and, by extension, that of their families – by reducing the incidence of water and sanitation-related diseases. Every child friendly school r...equires appropriate WASH initiatives that keep the school environment clean and free of smells and inhibit the transmission of harmful bacteria, viruses and parasites.
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of transmission, co...ntext and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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Palliative care for children with life-limiting illness is the active total care of the child’s body, mind, and spirit. It begins at diagnosis and continues regardless of whether the child receives treatment directed at the disease. It seeks to control all forms of suffering related to the illness..., including pain. It involves social, psychological, spiritual, and legal support to siblings, parents, and other close family members. Effective palliative care for children requires health professionals trained to assess symptoms, care for children of different ages and developmental stages, and to provide medicines in pediatric formulations. Care may be provided in tertiary care facilities, community health centers, and at home. The child’s best interest must inform all aspects of the treatment andcare, and the child’s rights must be protected at all times.
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WHO‘s Global Strategy to Accelerate the Elimination of Cervical Cancer, launched today, outlines three key steps: vaccination, screening and treatment. Successful implementation of all three could reduce more than 40% of new cases of the disease and 5 million related deaths by 2050.
Climate-induced water insecurity poses one of the biggest threats to humanity and will lead to more hunger, disease and displacement
Oxfam water engineers are having to drill deeper, more expensive and harder-to-maintain water boreholes used by some of the poorest communities around the world, mo...re often now only to find dry, depleted or polluted reservoirs.
Today, during World Water Week, Oxfam publishes the first of its series of reports, “Water Dilemmas”, about the growing water crisis, in large part driven by global heating from greenhouse gas emissions. The report describes how climate change will impact water security in different regions, leading to more hunger, disease and displacement.
Carlos Calderon, Humanitarian Advocacy and Partnerships Lead for Oxfam Aotearoa said, “This new Oxfam research is focused on the global Water, Sanitation and Hygiene (WaSH) situation, but it paints a picture that illustrates the complexity of elements that, combined, will continue to increasingly affect women, girls, boys and men in the decades to come. Changing weather, poverty, inequality, gender-based violence, political instability and conflicts are impacting the availability and quality of adequate water systems. All governments, particularly those from rich countries, should responsively take action at a global scale. The clock is ticking. Our children will judge us for our actions today, or for the lack of them.”
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The Facilitator Training Manual on Workplace Pandemic Preparedness is a guide developed by GIZ and the Ministry of Health to help organizations prepare for and respond to pandemics while ensuring business continuity. It provides structured guidance on training, risk assessment, prevention, and respo...nse strategies for both medical and non-medical personnel.
Key topics include pandemic preparedness and response, covering diseases like Influenza, Cholera, Yellow Fever, and Meningitis, as well as personal hygiene, risk communication, and business continuity planning. The manual emphasizes participatory learning, practical training, and leadership in crisis management, aiming to enhance institutional resilience and ensure workplaces remain safe and operational during health crises.
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Over the 20 years that followed, this unique partnership has invested more than US$53 billion, saving 44 million lives and reducing the combined death rate from the three diseases by more than half in the countries in which the Global Fund invests.
The COVID-19 pandemic is causing untold fear and suffering for older people across the world. As of 26 April, the virus itself has already taken the lives of some 193,710 people, and fatality rates for those over 80 years of age is five times the global average. As the virus spreads rapidly to devel...oping countries, likely overwhelming health and social protection systems, the mortality rate for older persons could climb even higher.
Less visible but no less worrisome are the broader effects: health care denied for conditions unrelated to COVID-19; neglect and abuse in institutions and care facilities; an increase in poverty and unemployment; the dramatic impact on well-being and mental health; and the trauma of stigma and discrimination.
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For over a decade, Senegalese and international journalists, human rights advocates, and child protection experts have documented and denounced the ongoing exploitation, abuse and neglect of children living in many of Senegal’s traditional Quranic schools, or daaras. Thousands of these children, k...nown as talibés, continue to live in conditions of extreme squalor, deprived of adequate food and medical care.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy ...2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly cost-effective and improves effectiveness of core pu...blic health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
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