The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for developing EHBs; how they are being defined, costed, di...sseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced.
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A wide range of potential enablers and barriers were identified for influencing progress for the scale-up of severe wasting services within national health systems. Findings were categorised according to the six pillars of WHO’s health system strengthening framework.
This document presents an integrated strategy for mental health system development that will lead to enhanced service delivery, improved outcomes, and improved human rights for people with mental disorders.
By using the practical guidance provided in this document, countries can ensure that thei...r mental health systems are not haphazard, but rather, the products of careful consideration and planning.
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The scale of international migration in the WHO European Region has increased substantially in the last decade. The dynamics of large-scale migration pose specific challenges and opportunities to health systems, and responses will differ from country to country. Strengthening health system responses... is one of the priority areas in the 2016 Strategy and action plan for refugee and migrant health in the WHO European Region. Its agreed actions include the identification and mapping of practices for developing and delivering health services that respond to the needs of refugees, asylum seekers and migrants. This compendium aims to collect and present some of these practices in the form of case studies. Selected in 2016, the case studies reflect experience from different levels of administration in a variety of European countries, and during the different phases of the migration journey.
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Barriers to the prompt and effective diagnosis and treatment of malaria exist at both the community and health facility level. Household surveys measure malaria case management at the population level with standard indicators that assess treatment-seeking behavior, access to diagnostic testing, and ...access to appropriate treatment. Performance on these indicators varies widely from country to country. Among countries with Demographic and Health Surveys (DHS) or Malaria Indicator Surveys (MIS) completed between 2014 and 2016, advice and treatment was sought for a median of 47% of children under age 5 with fever.
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Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
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To understand the patterns of Rwanda’s achievements in health development, it is important to explore how Rwanda addresses the Social Determinants of Health (SDH) particularly those related to routine conditions in which people are born, live and work. It is in this particular context that a case ...study on Rwanda’s Performance in Addressing Social Determinants of Health was conducted by the Rwanda Ministry of Health, with technical and financial support from the World Health Organization (WHO). The overall goal of the exercise was to document Rwanda's recent initiatives that contribute to the advancements of the Rio Political Declaration on Social Determinants of Health.
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These standards for the quality of paediatric care in health facilities form part of normative
guidance for improving the quality of maternal, newborn, child and adolescent health care.
In view of the importance of the continuum of both the life-course and service delivery (1),
these standards bu...ild on the Standards for improving the quality of maternal and newborn
care in health facilities (2), during labour, childbirth and the early postnatal period.
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A focus on Cambodia and Ethiopia
o date, little evidence is available on how such integration occurs at country level. To address this knowledge gap, WHO has conducted several in-depth situational analysis in countries that are undertaking actions to improve WASH in Health Care Facilities as part o...f their quality of care improvement efforts. The purpose of the situation analyses was to capture mechanisms that “jointly support” WASH in HCF and quality of care improvements and also identify barriers and challenges to implementing and sustaining these improvements.
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This summary highlights the experiences, results and actions from the implementation of the Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages in Botswana. The tool – developed by IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW and Young Positives in 2009 – supports national assessmen...ts of the bi-directional linkages between sexual and reproductive health (SRH) and HIV at the policy, systems and services levels. Each country that has rolled out the tool has gathered and generated information that will help to determine priorities and shape national plans and frameworks for scaling up and intensifying linkages. Country experiences and best practices will also inform regional and global agendas.
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This study highlights the challenges and areas in need of improvement as perceived by CHWs and beneficiaries, in regards to a nationwide scale-up of CHW interventions in a resource-challenged country. Identifying and understanding these barriers, and addressing them accordingly, particularly within ...the context of performance-based financing, will serve to strengthen the current CHW system and provide key guidance for the continuing evolution of the CHW system in Rwanda.
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The Millennium Development Goals (MDGs) showed
that global commitment and collective action
could significantly reduce the disease burdens of
three deadly communicable diseases: HIV/AIDS,
tuberculosis (TB) and malaria. The MDGs helped
focus efforts on these three deadly diseases
and leveraged ...disease-specific programmes and
financing, thus achieving significant progress.
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CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at home immediately after discharge from health care c...enters. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
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What recommendations did the assessment produce?
• Developing guidelines and plans to further the process of SRH and Hiv integration.
• Training stakeholders at different levels of the health system on how to integrate activities.
• Establishing mechanisms for collaboration/coordinati...on on SRH and Hiv at different levels.
• Developing plans for SRH and Hiv integration that include: situation analysis; feasibility studies; assessment of needs for reorganizing and reorienting services towards better integration; necessary tools (e.g. job descriptions, work plans); and tools to evaluate service quality and user satisfaction in relation to integration.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness,... equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only violates the rights of people with disabilities under international law, but UHC and SDG 3 cannot be a...ttained without better health services for the one billion people with disabilities.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ...e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South A...frica’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
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