In this editorial, the author comments on the feasibility of the Integrated Management of Childhood Illness (IMCI) strategy of the World Health Organization aimed at serving the poor. He analyses the reasons behind the failure of IMCI strategy to reach the poor. According to the author, IMCI failed due to several faults in its implementation including its initiation in well-off areas, a horizontal approach, and bad financial infrastructure of the poor regions
Bulletin of the World Health Organization, 84(10)
This case study outlines and assesses the Khayelitha programme, which focused on ART provision and aimed to document the feasibility of low-cost treatment and primary health care provision in developing countries. The document details the clinical outcomes of the programmes, the strategy used to ensure adherence and the contribution made by Treatment Action Campaign (TAC) to raise awareness and pressurise the government to develop an adequate response to the epidemic. The provision of ART in Khayelitsha had also a positive impact on prevention, making more HIV-positive people aware of their status, reducing stigma, being the catalyst of educational initiatives, improving the morale of health workers and keeping families intact and less at risk. The case study concludes with a comprehensive list of lessons learned and with key recommendations for the future, which include consolidation of nurse-based care, more training activities, integration of HIV/AIDS and TB services, educational programmes aimed at improving adherence to ART and a greater focus on paediatric AIDS and ART provision in rural remote areas
This report argues that real progress in health depends on strengthening health systems, centred on the principles of primary health care. This requires effective use of existing knowledge and technologies and innovation to create new health tools, along with appropriate structures and strategies to apply them. Success will need new forms of cooperation between international health agencies, national health leaders, health workers and communities, and other relevant sectors. Chapter 1 of the report looks at the current state of global health, highlighting the gap between the poor and better-off everywhere. Chapter 2 reflects on the slow progress towards achieving the Millenium Development Goals. Chapter 3 looks at the HIV/AIDS pandemic, and demonstrates why HIV/AIDS control needs to drive the agenda for the global health community. Chapter 4 looks at the steps needed to achieve polio eradication within the next few years, and chapter 5 concentrates on the lessons learned from the SARS outbreak. The theme of chapter 6 is the the overlap between communicable and non-communicable diseases and injuries occurring throughout the developing world, leading to a crisis of priorities for health systems. The concluding chapter returns to the statement that stronger health systems are necessary, and that strengthening health systems should be based on the principles and practices of primary health care
This report raises awareness of the global burden of mental and neurological disorders, and its cost in human, social and economic terms. It also aims to dismantle the barriers which prevent millions of sufferers of mental and neurological disorders from receiving the treatment they need and deserve. The report describes how mental health problems can be solved (eg. by drug therapy, psycho-social rehabilitation and psychotherapy, vocational rehabilitation, housing), and gives examples of the effectiveness of these treatments for a wide range of mental disorders
This document discusses the lessons learned from 25 years of the World Health Organization's experience in information, education and communication (IEC). It provides information on the lessons learned from general health programmes and reproductive health programmes. The lessons reflect a retrospective view of what is now known about planning, implementing , monitoring and evaluating IEC interventions. The focus is on practical steps, what has worked, and special considerations to be taken when applying IEC to reproductive health initiatives
[Publisher's abstract:] Summarizes lessons learned in five countries which are attempting to implement a sector-wide approach to health development. The sector-wide approach is a comparatively recent mechanism for coordinating the roles of governments and donors. A significant characteristic of this approach is the use of all significant funding to support a single sector policy and expenditure programme, under government leadership, with eventual reliance on the government to disburse and account for all funds. The approach also involves a transition of donor contributions away from project-funded vertical programmes and towards a single budget administered by the government. Case studies of the successes and failures of this approach were conducted in Cambodia, Mozambique, Tanzania, Uganda, and Viet Nam. Although these countries represent a range of different stages of implementing the approach, the review reached a number of conclusions about shared problems and impediments to progress. These include weaknesses in government monitoring procedures and a corresponding reluctance of donors to relinquish control, increased demands on staff within ministries of health, and a management complexity that can overwhelm government capacity. On the positive side, the review found evidence of greater agreement on a more restricted range of priorities, better integration of individual programmes within the budget planning process, better links between policy and implementation, and improved understanding of barriers to service utilization, including the role of corruption and incentive problems. On the basis of this assessment, the review issues six key recommendations for improved sector-wide management of projects and resources
This review looks at the status of female genital mutilation programming, the types of behaviour change strategies being implemented, their successes and failures, what lessons have been learned, and what support and strategies are required if the goal of eliminating female genital mutilation is to be achieved. The review focuses on the African and Eastern Mediterranean regions
There is a well-evidenced need for public education in the appropriate use of drugs, with potential benefits to the individual, community and policy-makers. This study looks at public education interventions in rational drug use in order to identify the type and rationale of such public education activities; how the activities are planned, implemented and evaluated; success rates; facilitating and constraining factors; organisations and bodies; areas which require further investigation / support; and how to best take public education forward. The report makes recommendations regarding funding for such activities, advocacy, training and tools, coalitions and partnerships, reporting / evaluation, and infrastructure
Participatory Hygiene and Sanitation Transformation (PHAST) is designed to promote hygiene behaviours, sanitation improvements and community management of water and sanitation facilities using specifically developed participatory techniques. This document describes the underlying principles of the approach, the development of the specific participatory tools, and the results of field tests in four African countries. It documents: the principles which underlie the approach; how the methodology was developed at workshops in the African region; the impact that PHAST made on communities and extension workers that were part of the field test; the lessons learned during the field test; and how the approach can be adopted more widely
The International Conference on Health Promotion, held in Sweden in 1991, focused on the interdependence of health and the environment in all its aspects. This handbook puts forward the theory and principles on which action aimed at creating supportive environments should be based. Stories provided by delegates to the conference are used to illustrate practical issues, approaches and methods, and offer a broad range of examples of efforts to bring about a healthier environment
The WHO Mental Health Gap Action Programme (mhGAP) aims at scaling up services for mental, neurological and substance use disorders for countries especially with low- and middle-income. The programme asserts that with proper care, psychosocial assistance and medication, tens of millions could be treated for depression, schizophrenia, and epilepsy, prevented from suicide and begin to lead normal lives– even where resources are scarce.