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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 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 world is off track to make significant progress towards universal health coverage (UHC) (SDG target 3.8) by 2030 as improvements to health services coverage have stagnated since 2015, and the pr
...
oportion of the population that faced catastrophic levels of out-of-pocket (OOP) health spending has increased.
more
The Health Equity Assessment Toolkit (HEAT) is a software application for use on desktop or laptop computers and mobile devices (minimum screen size of 7.9 inches recommended). It was developed to facilitate the assessment of within-country
...
health inequalities. The Built-in Database Edition, Version 1.0 is available as an online application and as a standalone version for download
more
“towards quality health and social welfare services”
The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportion
...
ally on low- and middle-income countries. Injury Prevention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year
more
Report on the nutrition and health situation of Nigeria
Data collection – 13th July to 13th September 2015
Data collection – 13th July to 13th September 2015
This document sets out Rwanda's Maternal, Neonatal Child Health (MNCH) national strategy (July 2013- June 2018). The MNCH strategy provides a framework for addressing maternal, neonatal and child health
...
challenges currently facing Rwanda. It is an overarching strategy for scale up of the national response to reduce the current levels of maternal, neonatal and child mortality and morbidity in line with the
MDG health related targets and HSSP III targets. The life cycle approach and continuum of care concept, starting with care from the home environment to health facility, guided the development of this roadmap. It aims also to maintain and expand the coverage of cost effective and high impact interventions for maternal, neonatal and child survival in order to achieve national and international targets.
more
The overall aim of the study was to understand the acceptability and usefulness of PHC clinical placements for nursing and midwifery students.
WHO recommendations on child health: Guidelines approved by the WHO Guidelines Review Committee
recommended
Updated May 2017
This document is meant to respond to the questions:
■ What health interventions should the child receive and when should s/he receive it?
■ What health beh ... aviours should a mother/caregiver practise (or not practise)? more
This document is meant to respond to the questions:
■ What health interventions should the child receive and when should s/he receive it?
■ What health beh ... aviours should a mother/caregiver practise (or not practise)? more
The main goal of the National Health Plan (NHP) 2017-2021 is to extend access to a basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. I
...
n order to extend service delivery to all communities, the NHP calls for all health workers (whether community-based, outreach-based or facility-based) involved in the delivery of health promotion, prevention and treatment services to be fully recognised and institutionalized within the health system to ensure efficient use of resources, necessary oversight and quality service provision (regardless of whether the health workers are voluntary or salaried). The first year Annual Operational Plan (AOP) of the NHP 2017-2021 calls for a comprehensive literature review of the situation of all Village Based Health Workers (VBHWs) in the country to inform the development of a comprehensive, institutionalized approach to community health for the country.
more
