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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The cost of newborn and child health interventions were estimated considering several different angles. At the first attempt, the cost of implementing all newborn and child health interventions packaged as antenatal, Intra natal, Essential newborn care, Care of sic...k newborn, Care of premature & LBW, Nutrition, Immunization, Care of sick infants and newborns, ECCD and WASH was estimated. This estimate reflects the cost of entire newborn and child care program thrust in the country. Costs of different intervention sub packages were also determined.
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The purpose of adding the books to the website of MCAI for download, is to make this life-saving, up-to-date information available to all who need it. Fill in a short registration field and you can download the pdf-files.
If you work in a hospital in a low income country - providing free care - y...ou are probably intitled to FREE copies of these books. MCAI will send them to you, all you have to do is to read our Flyer and fill in the request form.
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Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the...y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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This report presents key findings from a study carried out on the ‘Mainstreaming quality of care in empanelled hospitals under PMJAY’. It provides a detailed analysis of current coverage and perceptions of quality accreditation and certification across PMJAY empanelled hospitals from three diffe...rent states
(Haryana, Uttar Pradesh and Gujarat).
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Integrated Management of Childhood Illness (IMCI) is an integrated approach to child health that focuses on the holistic well-being of the child. IMCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMCI includes bo...th preventive and curative elements that are implemented by families and communities as well as by health facilities.
This booklet contains useful information on childhood sickness and offers practical guidance on diagnosis and treatment of said illnesses. it is divided into 2 parts, one for infants (new born until 2 months) and from 2 months to 5 years. It also includes:
Antiretroviral Therapy ART) treatment for children
Skin problems
Counselling the mother or caregiver on infant and you child feeding
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Nigeria is committed to end preventable newborn deaths, making life-saving interventions available to all mothers and babies who need them.
Integrated community case management (ICCM) – an approach where community-based health workers are trained to identify, treat and refer children under-five with pneumonia, diarrhoea and malaria – is increasingly being used across sub-Saharan Africa to supplement the gaps in basic healthcare prov...ision. ICCM programmes have been endorsed by major international organisations and donors, and many African Ministries of Health as a key strategy for reducing child mortality.
This learning paper describes Malaria Consortium’s approach to and experience of engaging local communities in integrated community case management (ICCM) in Uganda, Zambia and Mozambique.
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In 2015, WHO proposed the use of the Robson classification (also known as the 10-group classification) as a global standard for assessing, monitoring and comparing caesarean section rates both within healthcare facilities and between them. The system classifies all women into one of 10 categories t...hat are mutually exclusive and, as a set, totally comprehensive. The categories are based on 5 basic obstetric characteristics that are routinely collected in all maternities (parity, number of foetuses, previous caesarean section, onset of labour, gestational age, and fetal presentation).
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For the Fiscal Year 2014-2015, the Health Sector continued to implement interventions and strategies meant to improve the availability, accessibility and utilization of quality healthcare services across public and private health facilities; and to ensure the reduction of the burden of communicable ...and non-communicable diseases in Rwanda. This annual report highlights key achievements registered by the health sector during the Fiscal Year 2014-2015. Achievements are highlighted under three big components: Health Programs, Health Systems Support and Budget Execution.
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The GFF needs an additional US$2.5 billion from 2021 to 2025 to enable countries to protect health gains and accelerate progress toward the 2030 Goals. Of this amount, the GFF urgently needs to secure new pledges of US$1.2 billion by the end of 2021 to help its current 36 partner countries protect ...and maintain essential health services and implement time-sensitive service delivery and health system improvements to enable a sharp bend of the curve back to a positive trajectory to close the gap to the SDGs.
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within n...ational quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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This recommendation is an update of one of the 49 recommendations that were published in the WHO recommendations on antenatal care for a positive pregnancy experience. The recommendation was developed initially using the standardized operating procedures described in the WHO handbook for guideline d...evelopment.
In summary, the process included: (i) identification of priority question and outcomes; (ii) retrieval of evidence; (iii) assessment and synthesis of the evidence; (iv) formulation of recommendation; and (v) planning for the implementation, dissemination, impact evaluation and updating of the recommendation. This recommendation was identified by the Executive Guideline Steering Group (GSG) as a high priority for updating in response to new evidence on this question.
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