Integration of community home based care programmes within national primary health care revitalisation strategies in Ethiopia, Malawi, South-Africa and Zambia: a comparative assessment

In 2008, the WHO facilitated the primary health care (PHC) revitalisation agenda. The purpose was to stregthen African health systems in order to address communicable and non-communicable diseases. The aim of this article was to assess the position of civil society-led community home based care programmes (CHBC), which serve the needs of patients with HIV, within this agenda. It examined how their roles and place in health systems evolved, and the prospects for these programmes in national policies and strategies to revitalise PHC, as new health care demand arise. 

The perceived impact of family physicians on the district health system in South Africa: a cross-sectional survey

The 2008 World Health Report "Primary Health Care-Now More Than Ever" defines strong Primary Health Care (PHC) systems as those systems which offer first contact care that is patient-centred with an orientation to the patient´s family and community context, embedded in a service that is comprehensive, integrated, continuos, and community-orientated, and in which patient-care is well co-ordinated. This report warned against oversimplified approaches to PHC in developing countries, which only focus on priority deseases or rely on unsupported health workers who are poorly equipped for the complexity of PHC. The World Health Assembly supports the report´s recommendation that ...

Utilization of community-based health planning and services compounds in the Kintampo North Municipality: a cross-sectional descriptive correlational study

The Community-based Health Planning and Services (CHPS) initiative was introduced to improve coverage and utilization of basic health services for people in remote rural communities whose use of orthodox health services was hitherto limited by distance. So the objectives of this study were to examine the extent of patronage of CHPS compounds in the Kintampo North Municipality , factors associated with their use and challenges faced by community members regarding the use of these facilities. 

How to Integrate HIV and Sexual and Reproductive Health Services in Namibia, the Epako Clinic Case Study

During the past two decades, HIV and Sexual and Reproductive Health services in Namibia have been provided in silos, with high fragmentation. As a consequence of this, quality and efficiency of services in Primary Health Care has been compromised. 

The authors conducted an operational research (observational pre-post study) in a public health facility in Namibia. A health facility assessment was conducted before and after the integration of health services. A person-centred integrated model was implemented to integrate all health services provided at the health facility in addition to HIV and Sexual and Reproductive Health services. Comprehensive services are provided by ...

Social accountability in primary health care in West and Central Africa: exploring the role of health facility committees

Social accountability has been emphasised as an important strategy to increase the quality, equity, and responsiveness of health services. In many countries, health facility committees (HFCs) provide the accountability interface between health providers and citizens or users of health services. This article explores the social accountability practices facilitated by HFCs in Benin, Guinea and the Democratic Republic of Congo. 

An Evaluation of the Role of an Intermediate Care Facility in the Continuum of Care in Western Cape, South Africa

A comprehensive primary healthcare (PHC) approach requires clear referral and continuity of care pathways. South Africa is a lower-middle income country (LMIC) that lacks data on the role of intermediate care (IC) services in the health system. This study described the model of service provision at one facility in Cape Town, including reason for admission, the mix of services and skills provided and needed, patient satisfaction, patient outcome and articulation with other services acrross the spectrum of care 

Perceived mHealth barriers and benefits for home-based HIV testing and counseling and other care: Qualitative findings from health officials, community health workers, and persons living with HIV in South Africa

mHealth has been proposed to address inefficiencies in the current South African healthcare system, including home-based HIV testing and counseling (HTC) programs. Yet wide-scale adoption of mHealth has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by skateholders remains. 

Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability

Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduce to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. 

This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level sclae-up implications. The paper focuses on costs to provider (healht system andd donors) to inform planning and budgeting, and does not cover cost-effectiveness. 

Integration of community home based care programmes within national primary health care revitalisation strategies in Ethiopia, Malawi, South-Africa and Zambia: a comparative assessment

In 2008, the WHO facilitated the primary health care (PHC) revitalisation agenda. The purpose was to strengthen African health systems in order to address communicable and non-communicable diseases. The aim of this study was to assess the position of civil society-led community unity home based care programmes (CHBC), which serve the needs of patients with HIV, within this agenda. It examined how their roles and place in health systems evolved, and the prospects for these programmes in national policies and strategies to revitalise PHC, as new health care demands arise. 

Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Patient–centered care (PCC) is increasingly recognized as a key dimension of quality healthcare, but unfortunately remains poorly implemented in practice. This paper explores the current state of PCC in sub-Saharan Africa and potential barriers to its implementation, with a focus on public first line health services. They develop an analytical framework based on expert knowledge, field experience, and a conceptual literature review. Factors contributing to the (lack of) implementation of PCC are structured in three distinct but interacting layers. The first layer encompasses factors that influence and shape the performance of providers.  The training of health workers is key ...