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• W2897926874 abstract "Weakness of primary health-care (PHC) systems has represented a challenge to the achievement of the targets of disease control programmes (DCPs) despite the availability of substantial development assistance for health, in resource-poor settings. Since 2005, Ethiopia has embraced a diagonal investment approach to strengthen its PHC systems and concurrently scale up DCPs. This approach has led to a substantial improvement in PHC-system capacity that has contributed to increased coverage of DCPs and improved health status, although gaps in equity and quality in health services remain to be addressed. Since 2013, Ethiopia has had a decline in development assistance for health. Nevertheless, the Ethiopian Government has been able to compensate for this decline by increasing domestic resources. We argue that the diagonal investment approach can effectively strengthen PHC systems, achieve DCP targets, and sustain the gains. These goals can be achieved if a visionary and committed leadership coordinates its development partners and mobilises the local community, to ensure financial support to health services and improve population health. The lessons learnt from Ethiopia's efforts to improve its health services indicate that global-health initiatives should have a proactive and balanced investment approach to concurrently strengthen PHC systems, achieve programme targets, and sustain the gains, in resource-poor settings. Weakness of primary health-care (PHC) systems has represented a challenge to the achievement of the targets of disease control programmes (DCPs) despite the availability of substantial development assistance for health, in resource-poor settings. Since 2005, Ethiopia has embraced a diagonal investment approach to strengthen its PHC systems and concurrently scale up DCPs. This approach has led to a substantial improvement in PHC-system capacity that has contributed to increased coverage of DCPs and improved health status, although gaps in equity and quality in health services remain to be addressed. Since 2013, Ethiopia has had a decline in development assistance for health. Nevertheless, the Ethiopian Government has been able to compensate for this decline by increasing domestic resources. We argue that the diagonal investment approach can effectively strengthen PHC systems, achieve DCP targets, and sustain the gains. These goals can be achieved if a visionary and committed leadership coordinates its development partners and mobilises the local community, to ensure financial support to health services and improve population health. The lessons learnt from Ethiopia's efforts to improve its health services indicate that global-health initiatives should have a proactive and balanced investment approach to concurrently strengthen PHC systems, achieve programme targets, and sustain the gains, in resource-poor settings. Putting nursing and midwifery at the heart of the Alma-Ata visionThe Alma-Ata vision of a health system rooted in primary health care, which is person-centred and multisectoral, is as relevant now as it ever was. Nursing and midwifery can play a more central part in making this vision a reality. The health workforce has always been central to the 1978 Declaration of Alma-Ata that recognised the important role of health workers in achieving this vision.1 More recently, the World Health Assembly adopted resolutions on the Global Strategy on Human Resources for Health in 20162 and the Working for Health 5-year action plan in 20173 that committed countries to develop a primary health care workforce responsive to population needs as part of universal health coverage. Full-Text PDF Reform of primary health care in PakistanWith a neonatal mortality rate exceeding 45 per 1000 livebirths, a UNICEF report ranked Pakistan as the riskiest place to be born on earth.1 Although the recent Demographic and Health Survey indicates that the situation has improved, the neonatal mortality rate in Pakistan is among the highest in the world.2 Other health indicators, particularly those pertaining to maternal and child health and nutrition, are worse than other countries in the region with comparable or lower socioeconomic indicators. Full-Text PDF Primary health care and universal health coverage: competing discourses?In October, 2018, WHO celebrates 40 years since the International Conference on Primary Health Care (PHC) and offers a renewed vision of PHC—building on, but not replacing, the Declaration of Alma-Ata.1 In those four decades, PHC has faced challenges. Undermined early by the divisive selective-comprehensive debate, PHC was marginalised by structural adjustment and sectoral reforms in the 1990s.2 PHC was, however, acknowledged in the World Health Report 2000 Health Systems: Improving Performance as a precursor of the new universalism: “high quality delivery of essential health care, defined mostly by the criterion of cost-effectiveness, for everyone, rather than all possible care for the whole population or only the simplest and most basic care for the poor”. Full-Text PDF How primary health care can make universal health coverage a reality, ensure healthy lives, and promote wellbeing for all40 years on from the Declaration of Alma-Ata in 1978,1 primary health care (PHC) is at a defining moment. Progress in the uptake of PHC across the world has contributed to raising global standards of health care and improving health, including a revolution in child survival and dramatic improvements in life expectancy. However, we are still far from addressing the determinants of health and the growing health needs of the 21st century and from realising a vision for health supported by health systems oriented around PHC. Full-Text PDF Primary health care for the 21st century, universal health coverage, and the Sustainable Development GoalsGood health and wellbeing are fundamental to the prosperity of societies. By many measures, modern humanity enjoys better health than earlier generations.1 But the benefits of modern health care are not accessible to all. Even as the incidence of infectious diseases such as HIV, tuberculosis, and malaria are reduced, many countries struggle to cope with the growing burden of non-communicable diseases, and the complex and growing health needs of ageing populations.2,3 Full-Text PDF The Astana Declaration: the future of primary health care?Primary health care is in crisis. It is underdeveloped in many countries, underfunded in others, and facing a severe workforce recruitment and retention challenge. Half the world's population has no access to the most essential health services. Yet 80–90% of people's health needs across their lifetime can be provided within a primary health-care framework—from maternity care and disease prevention through vaccination, to management of chronic conditions and palliative care. As populations age, and multimorbidity becomes the norm, the role of primary health-care workers becomes ever more important. Full-Text PDF" @default.
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• W2897926874 date "2018-10-01" @default.
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• W2897926874 title "Effectiveness and sustainability of a diagonal investment approach to strengthen the primary health-care system in Ethiopia" @default.
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• W2897926874 doi "https://doi.org/10.1016/s0140-6736(18)32215-3" @default.
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