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Essential Drug list on page 36!!
Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health
...
coverage? As the proactive arm of the health services, community health workers teams provide household and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
more
Lymphatic filariasis (LF) infection if untreated results in fluid accumulation in the limbs or breasts (lymphedema) or genitalia (hydrocele) that is painful and causes great discomfort. Morbidity management and disability prevention (MMDP) strategies such as surgery for hydrocele, treatment of acute
...
attacks and management of lymphedema are necessary for the management of the advanced stages of LF. However, very few countries including Zambia, have adequate information on the health beliefs and health seeking behavior of communities living in endemic areas towards MMDP services for LF. This study sought to explore community and health provider perspectives towards MMDP services for LF in a highly endemic region, Luangwa District, Zambia, between February and April 2019.
more
The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of
...
health services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
more
In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health
...
centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising regional and national referral hospitals [Figure 3].
more
Community Discussion Guide for Maternal and Newborn Health Care
Mobilising Access to Maternal Health Services in Zambia Programme, District Health Management Teams
UK Aid; Health Partner International, MOH Zambia
(2012)
C1
A training manual for safe motherhood action groups (MAMaZ)
A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia
Luwabelwa, M.; Banda, P; Palale M.; Chama-Chiliba, C.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia ... is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole. more
The health services delivery system in Zambia ... is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole. more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompan
...
iment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
A guide for district health and rehabilitation managers.
This guide contains recommendations for strengthening disability prevention and rehabilitation within primary
...
health care services. It is addressed to rehabilitation and general health care personnel within district health services, in particular to the managers of those services
more
Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to und
...
erserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
Availability and Accessibility of Treatment for Persons with Mental Illness Through a Community Mental Health Programme
Dr. Janardhan N Navaneetham, Shravya Raghunandan, D M Naidu, H Hampanna
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2011)
CC
This article describes experiences in implementing a community mental health and development project in a rural district in southern India, including the position of persons with mental illness when
...
the project was initiated, the challenges faced and the strategies that were developed to overcome these challenges. The authors conclude that when services are locally available, persons with mental illness can be treated and rehabilitated within their own community. They can live with dignity and their rights are respected. There is a great need for inclusion of persons with mental illness in the existing developmental activities and in disabled persons’ organisations.
more
This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 to 2016. It examines the national dimension of refo
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rms but focuses above all on implementation and results in the economically fragile district of Carabayllo, in northern Lima.
more
This guideline includes 48 updated and new evidence-based recommendations related to MNS conditions. The guideline is targeted towards non-specialized health workers at primary- or secondary-level healthcare facilities, or those working at the
...
district level including basic inpatient and outpatient services.
more
BMC Public Health. 2025 Jan 8;25(1):87. doi: 10.1186/s12889-024-21208-y. PMID: 39780111; PMCID: PMC11708247.
These findings provide an insight into the types of psychosocial support interventions provided by Community-based organisations to orphans
...
and vulnerable children. Conversely, the study also revealed that community-based organisations are experiencing challenges when delivering those services to orphans and vulnerable children.
more
People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to
...
health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.
more
Ethiopia has seen high economic growth over the last decade, but remains a poor country with a high burden of disease. It has made considerable health gains in recent years, mainly by having
...
health policies that focus on extending primary healthcare, using health extension workers. It has made good use of existing resources,but has a low health expenditure (of around US$21 per capita, and totalling 4per centof GDP). It has a federal system with devolved healthcare financing, whereby block grants are allocated to sectors at regional and woreda(district) level. The challenge now,with the epidemiological transition (and a sense that the ‘low-hanging fruits’have already been gathered in relation to public health), is how Ethiopia, still poor, continuesto invest in health improvements?Human resources for health (HRH) are a critical pillar within any health system –the health staff combine inputs to provide the services, thus affecting how all other resources are used, and they make frontline (and back-office) decisions thatare importantdeterminants of servicequality,effectiveness and equity. HRH is usually the most resource-intensive element within the health system –commonly absorbing 50–70per centof public expenditure onhealth, although the proportions are very varied by individual countries and across regions. As they are commonly part of the public administration, reforms to HRH are also part of a complex political economy in most countries.Assessing value for money (VfM) in relation to HRH is correspondingly complex;across the value chain, manyfactors influence the conversion of inputs into outputs and outcomes (see Figure 1).A more detailed description of the HRH value chain can be found in Annex1.
more
Руководство по осуществлению mhGAP
recommended
The WHO Mental Health Gap Action Programme (mhGAP) aims at scaling up mental health services in non-specialized
...
health settings to achieve universal health coverage. The mhGAP operations manual is an integral component of the mhGAP package and supports district health managers and others responsible for integrating mental and physical health services. The manual offers practical guidance and necessary tools for planning, preparing, implementing, monitoring and evaluating mhGAP
more
Guidelines for Maternity Care in South Africa - fourth edition 2016
Maternal Health Committee of the National Department of Health (NDoH) South Africa
NDoH South Africa
(2016)
CC
These guidelines have been prepared by the Sub directorate: Maternal Health for the guidance of health workers (doctors and midwives) providing obstetric, surgical and anaesthetic
...
services for pregnant women in district clinics, health centres and district hospitals. These guidelines are intended for use in clinics, community health centres and district hospitals where specialist services are not normally available. The guidelines deal mainly with the diagnosis and especially the management of common and serious pregnancy problems. The assumption is made that the reader has a basic knowledge and understanding about the care of pregnant women. With a few exceptions (e.g. pre-eclampsia), there is no mention of aetiology and pathogenesis of the conditions described.https://www.knowledgehub.org.za/elibrary/guidelines-maternity-care-south-africa-2016
more
The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South Africa.
The NCS de
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fine fundamentals for quality of care based on six dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
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