People-centred health systems, a bottom-up approach: where theory meets empery

BACKGROUND AND METHODS:

Health systems are complex and constantly adapt to changing demands. These complex-adaptive characteristics are rarely considered in the current bureaucratic top-down approaches to health system reforms aimed to constrain demand and expenditure growth. The economic focus fails to address the needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program approaches in the poor neighbourhoods of Nairobi, Kenya.

FINDINGS AND CONCLUSIONS:

A small group of nurses and community health workers focused on the care of terminally ill HIV/AIDS patients. This work identified additional problems: tuberculosis (TB) was underdiagnosed and undertreated, a local TB-technician was trained to run a local ...

Health care expenditure and health outcome nexus: new evidence from the SAARC-ASEAN region

The total health expenditure (as a percentage of GDP) and health outcomes in the region of South Asian Association for Regional Cooperation (SAARC) and Association for South East Asian Nations (ASEAN) are lower than that of the OECD region and the world. This study investigated the relationship between different types of healthcare expenditures (public, private and total) and three main health status outcomes - life expectancy at birth, crude death rate and infant mortality rate - in the region.

Adaptation and piloting of an integrated intervention model for alcohol use disorders in primary healthcare in rural Tanzania: a study protocol

According to Africa WHO, the African Region is faced with a growing burden of harmful alcohol consumption and its disastrous effects. There is no other consumer product as widely available as alcohol that accounts for as much premature death and disability. There are two main characteristics that describe alcohol consumption patterns in the Region: a high level of alcohol abstention in some countries and high volume consumption with severe health and social consequences in others. Alcohol use has immediate and long-term effects that increase the risks associated with numerous health conditions. Alcohol is a leading cause of risky sexual behaviours such as unprotected sex, sex with multiple partners, and produces an increased risk of sexual assault. These behaviours can result in unintended pregnancies and sexually transmitted infections (STIs) such as human papillomavirus (HPV) and HIV.

Integration of evidence-based interventions for alcohol use disorders (AUDs) into primary healthcare has potential to ...

Universal access to healthcare: lessons learned from Public-Private Partnerships

In response to the global pandemic, International Financing Institutions and governments mobilized significant amounts of financial resources. COVID-19 hit weak and under-funded public health systems around the world harder, and showed market failure in private healthcare: we need to draw lessons and look forward. This interactive session will look at the impacts of public-private partnerships (PPPs) in the health sector, including World Bank Group-supported projects, especially for women and the poorest communities. This session will share evidence-based views on the World Bank Group’s role in health systems strengthening to understand the extent to which it is addressing the most urgent needs.