Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309867
D. Peiris, Manushi Sharma, D. Praveen, A. Bitton, Graham Bresick, Megan Coffman, R. Dodd, F. El-Jardali, Racha Fadlallah, M. Flinkenflögel, F. Goodyear-Smith, L. Hirschhorn, Wolfgang Munar, A. Palagyi, K. Saif‐Ur‐Rahman, R. Mash
Amid massive health system disruption induced by the coronavirus disease 2019 (COVID-19) pandemic, the need to maintain and improve essential health services is greater than ever. This situation underscores the importance of the primary health care (PHC) revitalization agenda articulated in the 2018 Astana Declaration. The objective was to synthesize what was already known about strengthening PHC in low- and middle- income countries prior to COVID-19. We conducted a secondary analysis of eleven reviews and seven evidence gap maps published by the Primary Health Care Research Consortium in 2019. The 2020 World Health Organization Operational framework for primary health care was used to synthesize key learnings and determine areas of best practice. A total of 238 articles that described beneficial outcomes were analysed (17 descriptive studies, 71 programme evaluations, 90 experimental intervention studies and 60 literature reviews). Successful PHC strengthening initiatives required substantial reform across all four of the framework’s strategic levers – political commitment and leadership, governance and policy, funding and allocation of resources, and engagement of communities and other stakeholders. Importantly, strategic reforms must be accompanied by operational reforms; the strongest evidence of improvements in access, coverage and quality related to service delivery models that promote integrated services, workforce strengthening and use of digital technologies. Strengthening PHC is a “hard grind” challenge involving multiple and disparate actors often taking years or even decades to implement successful reforms. Despite major health system adaptation during the pandemic, change is unlikely to be lasting if underlying factors that foster health system robustness are not addressed.
{"title":"Strengthening primary health care in the COVID-19 era: a review of best practices to inform health system responses in low- and middle-income countries","authors":"D. Peiris, Manushi Sharma, D. Praveen, A. Bitton, Graham Bresick, Megan Coffman, R. Dodd, F. El-Jardali, Racha Fadlallah, M. Flinkenflögel, F. Goodyear-Smith, L. Hirschhorn, Wolfgang Munar, A. Palagyi, K. Saif‐Ur‐Rahman, R. Mash","doi":"10.4103/2224-3151.309867","DOIUrl":"https://doi.org/10.4103/2224-3151.309867","url":null,"abstract":"Amid massive health system disruption induced by the coronavirus disease 2019 (COVID-19) pandemic, the need to maintain and improve essential health services is greater than ever. This situation underscores the importance of the primary health care (PHC) revitalization agenda articulated in the 2018 Astana Declaration. The objective was to synthesize what was already known about strengthening PHC in low- and middle- income countries prior to COVID-19. We conducted a secondary analysis of eleven reviews and seven evidence gap maps published by the Primary Health Care Research Consortium in 2019. The 2020 World Health Organization Operational framework for primary health care was used to synthesize key learnings and determine areas of best practice. A total of 238 articles that described beneficial outcomes were analysed (17 descriptive studies, 71 programme evaluations, 90 experimental intervention studies and 60 literature reviews). Successful PHC strengthening initiatives required substantial reform across all four of the framework’s strategic levers – political commitment and leadership, governance and policy, funding and allocation of resources, and engagement of communities and other stakeholders. Importantly, strategic reforms must be accompanied by operational reforms; the strongest evidence of improvements in access, coverage and quality related to service delivery models that promote integrated services, workforce strengthening and use of digital technologies. Strengthening PHC is a “hard grind” challenge involving multiple and disparate actors often taking years or even decades to implement successful reforms. Despite major health system adaptation during the pandemic, change is unlikely to be lasting if underlying factors that foster health system robustness are not addressed.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"17 1","pages":"6 - 25"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81326824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309864
P. Singh
{"title":"Message from Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, on International Universal Health Coverage Day (12 December 2020)","authors":"P. Singh","doi":"10.4103/2224-3151.309864","DOIUrl":"https://doi.org/10.4103/2224-3151.309864","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"13 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89984342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309871
A. Kumari, R. Zangmo, D. Garg, KAparna Sharma
Obstetric care, because of the unique and varying needs specific to different patients, requires special consideration in times of a pandemic such as the coronavirus disease 2019 (COVID-19) pandemic. Health care facilities providing obstetric care need to develop contingency plans for minimizing antenatal visits to limit the exposure of both healthy pregnant women and care providers to the virus. However, to mitigate any potential adverse effects of reduced antenatal visits, intelligent use of evolving telemedicine capabilities can protect the continuum of care despite the overwhelming burden caused by the pandemic. A collaborative work model involving health workers in the community and regional-level health centres also has the potential to prevent the catastrophic collapse of obstetric care services during a pandemic such as the COVID-19 pandemic.
{"title":"Redesigning routine antenatal care in low-resource settings during the COVID-19 pandemic","authors":"A. Kumari, R. Zangmo, D. Garg, KAparna Sharma","doi":"10.4103/2224-3151.309871","DOIUrl":"https://doi.org/10.4103/2224-3151.309871","url":null,"abstract":"Obstetric care, because of the unique and varying needs specific to different patients, requires special consideration in times of a pandemic such as the coronavirus disease 2019 (COVID-19) pandemic. Health care facilities providing obstetric care need to develop contingency plans for minimizing antenatal visits to limit the exposure of both healthy pregnant women and care providers to the virus. However, to mitigate any potential adverse effects of reduced antenatal visits, intelligent use of evolving telemedicine capabilities can protect the continuum of care despite the overwhelming burden caused by the pandemic. A collaborative work model involving health workers in the community and regional-level health centres also has the potential to prevent the catastrophic collapse of obstetric care services during a pandemic such as the COVID-19 pandemic.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"62 1","pages":"36 - 40"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75883647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309879
A. Tandon, V. Oliveira Cruz, A. Bhatnagar, Hui Wang, Trina Haque, M. Jhalani
The coronavirus disease 2019 (COVID-19) pandemic is having a devastating impact and continues to take its toll in the World Health Organization South-East Asia Region. In addition to its direct impact on morbidity and mortality, the pandemic is adversely affecting economic activity as a result of lockdowns and voluntary social distancing. The average per capita economic contraction among South-East Asia Region countries is currently projected to be 5.3% in 2020, suggesting severe consequences for financing for health and sustaining progress towards universal health coverage. Health financing systems in many countries of the region – characterized by extremely low levels of public financing and a predominance of out-of-pocket spending – have contributed to weaknesses in primary health care (PHC), including in relation to pandemic preparedness and containing COVID-19. Without sustained countercyclical public spending and an increased priority for health in government budgets, countries will be likely to see a slowdown or even reversal in growth in public financing for health, which is already at a low level in several countries of the region. In the face of this economic adversity and fiscal tightening, efforts to improve the efficiency and equity of public spending on health will be key, especially for strengthening PHC and enhancing cost-effectiveness in terms of the choice and delivery of interventions. To this end, countries must emphasize the public health focus, improve targeting of public financing towards the poor and vulnerable, reduce fragmentation and duplication of financing flows, leverage strategic purchasing and cut wasteful spending. The COVID-19 pandemic also presents an opportunity to reset how health systems and PHC are prioritized and adequately financed in the countries of the South-East Asia Region, as areas of core public investment that not only contribute to better health outcomes but also are critical for ensuring a sustained economic recovery.
{"title":"Financing health care in the WHO South-East Asia Region: time for a reset","authors":"A. Tandon, V. Oliveira Cruz, A. Bhatnagar, Hui Wang, Trina Haque, M. Jhalani","doi":"10.4103/2224-3151.309879","DOIUrl":"https://doi.org/10.4103/2224-3151.309879","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic is having a devastating impact and continues to take its toll in the World Health Organization South-East Asia Region. In addition to its direct impact on morbidity and mortality, the pandemic is adversely affecting economic activity as a result of lockdowns and voluntary social distancing. The average per capita economic contraction among South-East Asia Region countries is currently projected to be 5.3% in 2020, suggesting severe consequences for financing for health and sustaining progress towards universal health coverage. Health financing systems in many countries of the region – characterized by extremely low levels of public financing and a predominance of out-of-pocket spending – have contributed to weaknesses in primary health care (PHC), including in relation to pandemic preparedness and containing COVID-19. Without sustained countercyclical public spending and an increased priority for health in government budgets, countries will be likely to see a slowdown or even reversal in growth in public financing for health, which is already at a low level in several countries of the region. In the face of this economic adversity and fiscal tightening, efforts to improve the efficiency and equity of public spending on health will be key, especially for strengthening PHC and enhancing cost-effectiveness in terms of the choice and delivery of interventions. To this end, countries must emphasize the public health focus, improve targeting of public financing towards the poor and vulnerable, reduce fragmentation and duplication of financing flows, leverage strategic purchasing and cut wasteful spending. The COVID-19 pandemic also presents an opportunity to reset how health systems and PHC are prioritized and adequately financed in the countries of the South-East Asia Region, as areas of core public investment that not only contribute to better health outcomes but also are critical for ensuring a sustained economic recovery.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"17 1","pages":"63 - 72"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88226736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309882
Ruchita A Rajbhandary, P. Negandhi, Anjali Sharma, S. Zodpey
{"title":"Using the SCORE for Health Data Technical Package to strengthen primary health care","authors":"Ruchita A Rajbhandary, P. Negandhi, Anjali Sharma, S. Zodpey","doi":"10.4103/2224-3151.309882","DOIUrl":"https://doi.org/10.4103/2224-3151.309882","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"41 1","pages":"87 - 90"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75865944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309883
David Walcott, Sofiat M Akinola
The coronavirus disease 2019 (COVID-19) pandemic, which started as an outbreak in one country and very quickly travelled around the world
2019年冠状病毒病(COVID-19)大流行始于一个国家，并迅速蔓延到世界各地
{"title":"Shift to digital during the pandemic could enable universal health coverage","authors":"David Walcott, Sofiat M Akinola","doi":"10.4103/2224-3151.309883","DOIUrl":"https://doi.org/10.4103/2224-3151.309883","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic, which started as an outbreak in one country and very quickly travelled around the world","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"43 1","pages":"91 - 92"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79320963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309866
Alaka Singh, S. Topp
{"title":"The significance of primary health care for building back better: lessons from COVID-19","authors":"Alaka Singh, S. Topp","doi":"10.4103/2224-3151.309866","DOIUrl":"https://doi.org/10.4103/2224-3151.309866","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"128 1","pages":"3 - 5"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76395395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_278_20
Milan Maharjan, Samjhana Phuyal, Mana Shrestha, Rosy Bajracharya
The presence of wax is a common finding during ear examination of children and it is one of the main causes of avoidable hearing impairment in children. The objective of this study was to find out the prevalence of wax in ear and evaluate the hearing loss in school-aged children. This is a cross sectional school-based study conducted over a four-year period. Children aged 5-16 were examined by otoscope and pure tone hearing thresholds were obtained at 0.5, 1, 2, and 4 kHz frequencies. A total of 53,970 children from 312 schools of Kathmandu valley were screened. The prevalence of ear wax was 34.64% (n=18697) and hearing impairment associated with wax was 0.88% (n=475). Ear wax and associated hearing loss is a common problem in Nepalese children. Lack of trained personnel and the costs involved in its treatment makes ear wax a big challenge for Nepal's rudimentary health care system.
{"title":"Ear wax and hearing impairment in children in Nepal.","authors":"Milan Maharjan, Samjhana Phuyal, Mana Shrestha, Rosy Bajracharya","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_278_20","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_278_20","url":null,"abstract":"<p><p>The presence of wax is a common finding during ear examination of children and it is one of the main causes of avoidable hearing impairment in children. The objective of this study was to find out the prevalence of wax in ear and evaluate the hearing loss in school-aged children. This is a cross sectional school-based study conducted over a four-year period. Children aged 5-16 were examined by otoscope and pure tone hearing thresholds were obtained at 0.5, 1, 2, and 4 kHz frequencies. A total of 53,970 children from 312 schools of Kathmandu valley were screened. The prevalence of ear wax was 34.64% (n=18697) and hearing impairment associated with wax was 0.88% (n=475). Ear wax and associated hearing loss is a common problem in Nepalese children. Lack of trained personnel and the costs involved in its treatment makes ear wax a big challenge for Nepal's rudimentary health care system.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"10 1","pages":"29-31"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_50_21
Reem Mohyeldin Elfarra
Evidence shows that noncommunicable diseases (NCDs) are highly preventable by addressing the common risk factors embedded within and outside the health sector. Bangladesh's Ministry of Health and Family Welfare has adopted a multisectoral action plan for NCD control and prevention. This research aims at examining to what extent was the multisectoral engagement achieved. The stakeholder analysis method comprises two steps: (1) identifying the actors and (2) determining their roles, power, and positions to the policy. The study revealed seven main NCD stakeholder categories: policymakers, development partners (DPs), service providers, industry, research and academia, the media, and civil societies. The government, DPs, and civil societies hold the highest power and supportive position. However, the tobacco and food industries have an opposing position. Furthermore, there was a clear gap in the participation of nonhealth ministries.
{"title":"A stakeholder analysis of noncommunicable diseases' multisectoral action plan in Bangladesh.","authors":"Reem Mohyeldin Elfarra","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_50_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_50_21","url":null,"abstract":"<p><p>Evidence shows that noncommunicable diseases (NCDs) are highly preventable by addressing the common risk factors embedded within and outside the health sector. Bangladesh's Ministry of Health and Family Welfare has adopted a multisectoral action plan for NCD control and prevention. This research aims at examining to what extent was the multisectoral engagement achieved. The stakeholder analysis method comprises two steps: (1) identifying the actors and (2) determining their roles, power, and positions to the policy. The study revealed seven main NCD stakeholder categories: policymakers, development partners (DPs), service providers, industry, research and academia, the media, and civil societies. The government, DPs, and civil societies hold the highest power and supportive position. However, the tobacco and food industries have an opposing position. Furthermore, there was a clear gap in the participation of nonhealth ministries.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"10 1","pages":"37-46"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_21_21
Rajesh Sagar, Shivangi Talwar
{"title":"Modified psychological first aid during COVID-19.","authors":"Rajesh Sagar, Shivangi Talwar","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_21_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_21_21","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":"10 1","pages":"53-54"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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