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2
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
...
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.
more
The menu was developed using the WHO-CHOICE methodology to prepare and update, as appropriate, WHO estimates of the cost-effectiveness of a range of mental health interventions, in line with the development of Appendix 3 to the global action plan fo
...
r the prevention and control of noncommunicable diseases 2013–2020.
WHO-CHOICE is a programme that helps countries to identify priorities based on health impact and cost-effectiveness. It can be applied to a wide range of strategies relevant to policies affecting health outcomes. All options are compared to a common comparator, a null scenario in which the impacts of currently implemented interventions are removed, thereby enabling comparison of interventions across geographical areas and aspects of health.
more
This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards universal health coverage (UHC),
...
health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guidance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
more
This Eye health strategic plan presents the Ministry of Health’s five
year proposed strategies for eye care in Kenya. It sets the strategic
direction for the National Eye
...
Health Care System and presents
information on the priorities, objectives and indicators that the
Ministry has adopted especially with regard to the main eye diseases
and conditions in the country and health system strengthening.
more
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal
...
health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
more
The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take
...
urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 2030, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
more
The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respon
...
d to the health and well-being challenges, opportunities and needs of adolescents.
The guidance provides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
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Public health emergencies, including pandemics, highlight the need for health systems and services that are prepared, resilient and ready to respond to he
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alth security threats. Endorsed by Member States in 2023, the Asia Pacific Health Security Action Framework (APHSAF) is designed to engage multisectoral actors in health security, and to reflect the complex nature of current and future public health emergencies. The Framework presents six interconnected, multisectoral domains of work that together form a comprehensive, multi-hazard health security system — emphasizing the One Health approach. The Framework also supports progress towards the Sustainable Development Goals and universal health coverage while meeting the responsibilities and obligations of the International Health Regulations (2005).
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In 2008 the Ministry of Health and Social Services (MOHSS) commissioned a national health and social service system review which found that although some progress has been made in primary
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health care, provision of health services did not go beyond the health facilities, irrespective of the fast distances between the Health facilities and community. The review then recommended that health services should be extended in a structured manner to communities through the establishment of paid health workers.
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Reprod Health 19, 143 (2022). https://doi.org/10.1186/s12978-022-01452-4.
Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers w
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ho are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of training with onsite clinical mentorship towards self-reported performance in RMNH among healthcare workers in Mwanza Region, Tanzania.
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The World report on promoting the health of refugees and migrants: Monitoring progress on the WHO global action plan provides the first global baseline for assessing implementation of the 2019-2030 WHO Global Action Plan on Promoting the
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Health of Refugees and Migrants (GAP). Building on the 2022 World report on the health of refugees and migrants, it examines how countries are integrating refugee and migrant health into broader public health, migration governance, development, and universal health coverage (UHC) agendas.
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This multi-hazard Health Emergency Alert and Response Framework provides guidance for coordinating emergency response in countries, under the global Health Emergency Preparedness, Resilience and Res
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ponse (HEPR) framework. It outlines the public health functions, coordination systems and actions needed for effective local, sub-national and national response to a broad range of health emergencies, including disasters. The audience for this framework is the primary national and sub-national authorities with the designated responsibility for health emergency coordination.
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TArtificial intelligence (AI) is transforming health systems, reshaping how care is planned, delivered and governed. This report presents the first assessment of AI integration into health systems a
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cross the whole of the WHO European Region, based on findings from the 2024–2025 survey on AI for health care. It examines national strategies, governance models, legal and ethical frameworks, workforce readiness, data governance, stakeholder engagement, private sector roles and the uptake of AI applications. Drawing on insights from 50 Member States, the report explores how countries are navigating opportunities and challenges, highlighting emerging trends, gaps and practices to guide policy-makers towards coherent, ethical and people-centred approaches to AI in health care.
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These guidelines – an update to the World Health Organization’s 2015 publication Consolidated strategic information guidelines – present a set of essential aggregate indicators and guidance on choosing, collecting and systematically analysing
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strategic information to manage and monitor the national health sector response to HIV.
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A book of methods, aids, and ideas for instructors at the village level
An indispensable resource for health educators, this book provides hundreds of methods, aids, and learning strategies to make healt
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h education engaging and effective, encouraging community involvement through participatory education.
You can download chapter by chapter free of charge
The previous version (2005) is freely available here
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Core Competencies in Adolescent Health and Development for Primary Care Providers
Pierre André Michaud, Valentina Baltag, Venkatraman Chandra-Mouli et al.
World Health Organization (WHO)
(2015)
Including a Tool to Assess the Adolescent Health and Development Component in Pre-Service Education of Health-Care Providers
Equity and Quality in Health: a People's Right
