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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 systems 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
Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o
...
r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
more
This global progress report attempts to lay the groundwork for the kind of accelerated action needed. Section 1 presents key data, trends and developments in women’s, children’s and adolescents
...
health and well-being. That is followed in Section 2 by a deeper dive into the impact of the COVID-19 pandemic, which has created and contributed to many threats and challenges to progress for women, children and adolescents. In Section 3, the report concludes with recommendations for accelerating progress towards the achievement of the 2030 Agenda even in such challenging times, with an emphasis on partnership
and clear-eyed recognition of the consequences of failing to do better.
more
This report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of power dynamics and power reorientation towards individuals with lived experience; informed decisio
...
n-making and health literacy; community engagement across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights.
It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives,inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
more
Toward Resilience
recommended
Marilise Turnbull, Charlotte L. Sterrett, and Amy Hilleboe
Practical Action Publishing Ltd, Catholic Relief Services
(2013)
C1
A Guide to Disaster Risk Reduction and Climate Change Adaptation
One Health Joint Plan of Action (2022-2026)
World Organisation for Animal Health
Food and Agriculture Organization of the United Nations; United Nations Enviroment Programme; Wolrd Health Organization; World Organisation for Animal Health
(2022)
C_WHO
The desired impact of the OH JPA is a world better able to prevent, predict, detect and
respond to health threats and improve the health of humans
...
, animals, plants and the
environment while contributing to sustainable development. The OH JPA aims to work
towards this vision in the following way:
• Provide a framework for action and propose a set of activities the four organizations
can offer together to advance and sustainably scale up One Health.
• Provide upstream policy and legislative advice and technical assistance, to help
set national targets and priorities across the sectors for the development and
implementation of One Health legislation, initiatives and programmes.
• Take stock of existing cross-sectoral global and regional initiatives around One
Health, identify and advise on synergies and overlaps, and support coordination.
• Mobilize and make better use of resources across sectors, disciplines and
stakeholders.
• The OH JPA is guided by a theory of change and makes use of One Health principles
to strengthen collaboration, communication, capacity building and coordination
more
The Camp Managment Toolkit
recommended
Applicable to both IDP and refugee scenarios, the Toolkit incorporates a wide range of relevant information on managing displaced populations living in communal settings (collective centres, spontaneous sites, established camps, etc.). Large scale d
...
isplacements caused by recent conflict and natural disaster events have created a high demand for the Toolkit, which has proven an invaluable resource for field practitioners, government actors and displaced populations since its original release in 2004.
Available in other languages
more
Asia-Pacific Disaster Report 2017
The report looks at the extent and impact of natural disasters across the region and how these intersect with ... poverty, inequality and the effects of violent conflict. But it also shows how scientific and other advances have increased the potential for building disaster resilience and ensuring that even in the most extreme circumstances people can survive disaster impacts and rebuild their communities and livelihoods.
Disaster resilience is a key element of the 2030 Agenda for Sustainable Development. The Sustainable Development Goals are based on the premise of reaching absolutely everyone. When the drought is assessed, when the flood warnings are broadcast, when the tsunami siren sounds, the aim is to ‘leave no one behind’. more
The report looks at the extent and impact of natural disasters across the region and how these intersect with ... poverty, inequality and the effects of violent conflict. But it also shows how scientific and other advances have increased the potential for building disaster resilience and ensuring that even in the most extreme circumstances people can survive disaster impacts and rebuild their communities and livelihoods.
Disaster resilience is a key element of the 2030 Agenda for Sustainable Development. The Sustainable Development Goals are based on the premise of reaching absolutely everyone. When the drought is assessed, when the flood warnings are broadcast, when the tsunami siren sounds, the aim is to ‘leave no one behind’. more
he statistics in this report are from the Emergency Events Database (EM-DAT) maintained by the Centre for Research on the Epidemiology of Disasters (CRED) which records disasters which have killed ten or more people; affected 100 or more people; resulted in a declared state of emergency; or a call f
...
or international assistance.
In the period 2000 to 2019, there were 7,348 major recorded disaster events claiming 1.23 million lives, affecting 4.2 billion people (many on more than one occasion) resulting in approximately US$2.97 trillion in global economic losses.
This is a sharp increase over the previous twenty years. Between 1980 and 1999, 4,212 disasters were linked to natural hazards worldwide claiming approximately 1.19 million lives and affecting 3.25 billion people resulting in approximately US$1.63 trillion in economic losses.
Much of the difference is explained by a rise in climate-related disasters including extreme weather events: from 3,656 climate-related events (1980-1999) to 6,681 climate-related disasters in the period 2000-2019.
more
Together we can Prevent and Control the World's Most Common Diseases
Objectives of the training manual
(1) To improve knowledge of NCD trends, burdens, as well as systems for management ... and monitoring of NCD services for Township Medical Officers (TMOs), Township Public Health Officers (TPHOs), Medical Officers (MOs). The manual can also be used for training of Basic Health staff (BHS), TMOs, TPHOs and MOs,
(2) To equip trainers to train BHS to conduct PEN protocols at the primary care level health centers,
(3) To equip trainers to train in processes to conduct PEN scaling up monitoring , supervision and evaluation activities. more
Objectives of the training manual
(1) To improve knowledge of NCD trends, burdens, as well as systems for management ... and monitoring of NCD services for Township Medical Officers (TMOs), Township Public Health Officers (TPHOs), Medical Officers (MOs). The manual can also be used for training of Basic Health staff (BHS), TMOs, TPHOs and MOs,
(2) To equip trainers to train BHS to conduct PEN protocols at the primary care level health centers,
(3) To equip trainers to train in processes to conduct PEN scaling up monitoring , supervision and evaluation activities. more
Prevention, Assessment and Management
The aim of this guidance manual is to introduce the user to project/programme plan- ning in a Red Cross Red Crescent environment. It describes the different stages of the planning phase of the “project/programme cycle” within the context of Results-Based
...
Management (RBM). It also gives an overview of the various components of RBM and explains how to integrate and apply this approach in practice. In addition, the manual summarizes briefly the other key phases of the cycle (assessment, imple- mentation and monitoring, evaluation) and provides references to the key Federation manuals on these phases.
The manual has been developed primarily for use by people managing projects and programmes either in a National Society or the secretariat of the International Federation of Red Cross and Red Crescent Societies (International Federation). Although it is mainly designed for use at the country level, the basic principles can be applied to project and programme planning at any level. The manual draws on two International Red Cross and Red Crescent Movement publications – the International Federation’s Project Planning Process (2002) and the ICRC Economic Security Unit’s Programme/ Project Management: The Results-Based Approach (2008) – reflecting the significant similarity of approach. The International Federation has developed the manual internally to suit the particular needs and uses of project/programme management within the organization.
more
The changes occurring in Myanmar highlight the need to have a robust DRR network that can support the Government as well as the communities in their efforts to build a resilient Myanmar. To this end, the DRR WG devised and facilitated a multi-stakeh
...
older process aiming to develop its Strategic Framework 2013-2018. This document is the outcome of a series of internal workshops and external consultations, in particular with the relevant departments of the Government of Myanmar. This Strategic Framework will guide the collective efforts of the DRR WG over the next five years.
more
Building Capacity for Disability Inclusion in Gender-based Violence (GBV) Programming in Humanitarian Settings
recommended
Leora Ward, Emma Pearce, Dale Buscher et al.
Women’s Refugee Commission (WRC) and The International Rescue Committee (IRC)
(2015)
C1
Women and girls with mental and intellectual disabilities were perceived to be most at risk of sexual violence,
...
and family and service providers may only become aware of sexual violence against them when they become pregnant.
Discrimination by GBV service providers, family and community members was the most common barrier to access. Inadequate transportation and inappropriate communication approaches were also common impediments.
On this website you can download the report in different languages,
more
Recent forecasts by the Food and Agriculture Organization of the United Nations (FAO) have indicated a risk of locust invasion in West Africa from June 2020. From East Africa, some swarms could reac
...
h the eastern part of the Sahel and continue westwards from Chad to Mauritania.
Surveillance and control teams will be mobilized across the region with a focus on Burkina Faso, Chad, Mali, Mauritania, and the Niger, and extended to Senegal. Countries such as Cameroon, the Gambia and Nigeria are also on watch in the event that desert locust spreads to these highly acute food-insecure countries. Since the region could be threatened in the coming months, FAO is strongly encouraging no regret investments in preparedness and anticipatory action to control swarms and safeguard livelihoods, given already high levels of acute food insecurity. Therefore, cost estimates for preparedness, anticipatory action and rapid response have been assessed.
more
Torrential rains and the onset of Cyclone Komen triggered severe and widespread floods and landslides in July
...
and August 2015 across 12 out of 14 states and regions in Myanmar. An estimated 1.6 million individuals were recorded as having been temporarily displaced from their homes by the disaster, and 132 lost their lives. Up to 5.2 million people were exposed to the floods and landslides in the 40 most heavily affected townships. Within the 40 most-affected townships, 775,810 individuals have been displaced, accounting for approximately half of the total displaced population.
The Project recognizes that although the major target disaster is cyclones, the methodology of the Project activities to enhance the capacity of EWS, HRD and CBDRM is also applicable to mitigate the damage of floods. By analyzing the results of a survey based on the experience of the Project activities, the Project can contribute to describe tangible lessons learned and future recommendations for the counterpart agencies and disaster management related agencies of the Government of Myanmar. more
The Project recognizes that although the major target disaster is cyclones, the methodology of the Project activities to enhance the capacity of EWS, HRD and CBDRM is also applicable to mitigate the damage of floods. By analyzing the results of a survey based on the experience of the Project activities, the Project can contribute to describe tangible lessons learned and future recommendations for the counterpart agencies and disaster management related agencies of the Government of Myanmar. more
Supporting the food and agriculture sectors in implementing the Global Action Plan on Antimicrobial Resistance to minimize the impact of antimicrobial resistance
The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume series entitled Managing Hazardous Material Incidents. The series is designed to help emergency response and
...
health care professionals plan for and respond to hazardous material emergencies.
- Volume I Emergency Medical Services: A Planning Guide for the Management of Contaminated Patients
- Volume II Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients
- Volume III Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to hazardous materials.
more
In aquaculture, antibiotics have been used mainly for therapeutic purposes and as prophylactic agents. The contribution to antimicrobial resistance of antibiotics used in aquaculture is reviewed here, using a
...
risk analysis framework. Some recommendations on responsible conduct in this context are proposed, aimed at diminishing the threat of build up of antimicrobial resistance.
more
Previous crises, such as the Ebola virus disease (EVD) in West Africa in 2014, indicate the direct impact movement restrictions and disease containment efforts have on food availability, access, uti
...
lization and violence – particularly gender-based violence (GBV). The importance of maintaining and upscaling food security interventions for the most vulnerable populations, alongside the health sector’s efforts to avert disease spread, is therefore undeniable. The COVID-19 outbreak in South Sudan threatens to paralyze an already fragile food system and negatively impact more than 6.5 million people in South Sudan who remain vulnerable. At the same time, the core national capacities for prevention, preparedness and response for public health events is limited, and the healthcare system has been weakened by years of conflict, poor governance and low investments.
more
