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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 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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Este protocolo tem como objetivo fornecer informações aos profissionais de saúde para que a pessoa com tuberculose receba o devido acolhimento e tratamento, apresentando os fluxos indicados para as transferências dentro e fora do país.
When situations occur in which unwanted events are rightly or wrongly connected with vaccination, they may erode confidence in vaccines and the authorities delivering them. This document presents the scientific evidence behind WHO’s recommendations on building and restoring confidence in vaccines
...
and vaccination, both in ongoing work and during crises. The evidence draws on a vast reserve of laboratory research and fieldwork within psychology and communication. It examines how people make decisions about vaccination; why some people are hesitant about vaccination; and the factors that drive a crisis, covering how building trust, listening to and understanding people, building relations, communicating risk and shaping messages to the audiences may mitigate crises. This document provides a knowledge base for stakeholders who develop communication strategies or facilitate workshops on communication and trust-building activities in relation to vaccines and immunization, such as immunization programme units, ministries of health, public relations and health promotion units, vaccine safety communication trainers and immunization advisory bodies.
more
Background Unrest in Chile over inequalities has underscored the need to improve public hospitals. Nursing has been overlooked as a solution to quality and access concerns, and nurse staffing is poor by international standards. Using Chile’s new diagnosis-related groups system and surveys of nurse
...
s and patients, we provide information to policy makers on feasibility, net costs, and estimated improved outcomes associated with increasing nursing resources in public hospitals.
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Health care and social service systems are facing exceptional demands at this time. Evidence is emerging that the COVID-19 pandemic is disproportionately impacting low-income neighborhoods, communities of color, immigrant and other economically and medically vulnerable patients. These are the patien
...
ts and communities Community Health Workers (CHWs) are best prepared
to serve. This workforce is defined by their connection to these populations and by their ability to communicate in linguistically and culturally appropriate ways.
more
The standards for the care of small and sick newborns in health facilities define, standardize and mainstream inpatient care of small and sick newborns, building on essential newborn care and ensuring consistency with the WHO quality of care framework. The standards will guide countries in caring fo
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r this vulnerable population and support the quality of care of newborns in the context of universal health coverage. They will provide a resource for policy-makers, health care professionals, health service planners, programme managers, regulators, professional bodies and technical partners involved in care
more
Haiti is one of the worst food crises in the world with 46 percent of the population projected to be in high acute food security, mainly due to reduced agricultural production caused by a long period of drought, storms and increased prices of basic foodstuffs, which are compounded by the effects of
...
the coronavirus disease 2019 (COVID-19).
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Pwoteje Manje ak Dlo Apre yon Dezas oswa Sitiyasyon Ijans
Menstruation is a natural fact of life and a monthly occurrence for 1.8 billion girls and women of reproductive age. Yet millions of menstruators across the world are denied the right to manage their monthly menstrual cycle in a dignified, healthy way. Girls and women with disabilities face even gre
...
ater challenges in managing their menstruation hygienically and with dignity, often facing a double stigma due to both social norms around gender and menstruation and having a disability. This tip sheet offers a framework for supporting menstrual health and hygiene (MHH) and practical entry points for meeting the needs of menstruators with disabilities.
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Кризис, связанный с COVID-19, вновь сделал очевидной настоятельную необходимость в наличии прочных,адекватно финансируемых и устойчивых систем здравоохранения, спос
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бных быстро и на справедливойоснове реагировать на чрезвычайные ситуации, обеспечивая при этом всеобщую финансовую защиту.В Кыргызстане были приняты важные решения по увеличению государственного финансирования ответныхмер системы здравоохранения в связи с COVID-19, включая усиление донорской поддержки. Достаточноегосударственное финансирование мер в ответ на вспышку COVID-19 требуется для поддержки расширениямасштабов и предоставления услуг населению в целом и отдельным гражданам. Данный краткий обзорпреследует своей целью предоставление основы для дискуссий между должностными лицами, отвечающими за национальную политику, международными донорскими организациями и другими партнерами по развитию, касающихся повышения эффективности финансирования здравоохранения с целью улучшения ответных мер в связи с COVID-19 в Кыргызстане
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Despite some improvements, current levels of air pollution still pose a considerable risk to the environment and to human health in the WHO European Region. One issue of concern is that monitoring of particulate matter is very limited in the countries of eastern Europe, the Caucasus and central Asia
...
. This paper summarizes the evidence about the health effects of air pollution from particulate matter and presents the policy implications, the aim being to stimulate policy-makers to develop more effective strategies to reduce air pollution and its health effects in those countries.
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El Ministerio de Salud a través de la Dirección de Salud Mental, con el apoyo técnico de UNICEF, llevó a cabo el presente estudio que mide la presencia de problemas de salud mental en niñez y adolescencia y los principales factores asociados, en el contexto de la COVID-19. El estudio fue real
...
izado por un grupo de profesionales expertos en investigación, epidemiologia, salud mental y psiquiatría infanto-juvenil, los datos se recogieron durante los meses de octubre y noviembre del 2020.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp
...
onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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World Health Organization, Food and Agriculture Organization of the United Nations & World Organisation for Animal Health. (2021). Antimicrobial resistance and the United Nations sustainable development cooperation framework: guidance for United Nations country teams. World Health Organization
...
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Ein Positionspapier des bundesweiten Netzwerks Flucht, Migration und Behinderung
Der Schutzbrief gegen weibliche Genitalverstümmelung informiert über die Strafbarkeit von weiblicher Genitalverstümmelung - auch bei einer Durchführung im Ausland - und über den möglichen Verlust des Aufenthaltstitels.
Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s
...
tudy aimed to test both interventions in low-income and middle-income countries.
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This publication is a companion document to the NDVP National Deployment and Vaccination Plans guidance, which provides a framework for countries to develop their national strategies. As countries face challenges with erratic vaccine supplies, use of multiple vaccine products with different charact
...
eristics, and the size of populations and their diversity, this document provides operational guidance and information to support planners and immunization programme managers at the national and sub-national levels on microplanning for COVID-19 vaccination implementation.
This Guide is available in English, French, Arabic, chinese, Portuguese, Spanish, Russian
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