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This report is the first of its kind to measure health service coverage and financial protection to assess countries' progress towards universal health coverage. It shows that at least 400 million people do not have access to one or more essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of health spending. Universal health coverage (UHC) means that all people receive the quality essential health services they need without being exposed to financial hardship. A significant number of countries at all levels of development are embracing the goal of UHC as the right thing to do for their citizens. It is a powerful social equalizer and contributes to social cohesion and stability. Every country has the potential to improve the performance of its health system in the main dimensions of UHC: coverage of quality services and financial protection for all. Priorities strategies and implementation plans for UHC will differ from one country to another. Enhanced and expanded monitoring of health under the Sustainable Development Goals (SDGs) should seek to build on that experience sharpening our focus on the key health service and financial protection interventions that underpin UHC. Effective UHC tracking is central to achieving the global goals for poverty alleviation and health improvement set by the World Bank Group and WHO. Without it policymakers and decision-takers cannot say exactly where they are or set a course for where they want to go. They cannot know whether they are focussing their efforts in the right areas or whether their efforts are making a difference. Monitoring is thus fundamental to the achievement of UHC objectives. It will also be vital to the realization of the SDGs. This report is a critical step to show how monitoring progress can be done telling us what the state of coverage of interventions and financial protection is and telling us where to focus most.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
How can countries chart their own course toward universal health coverage? Like many ambitious global goals, universal health coverage (UHC) remains an aspiration for many countries. The World Health Organization estimates that half the world's population lacks access to basic health services. Moreover, this already staggering number masks inequities that exist between and within countries: gaps between rich and poor, men and women, young and old, and among people of different ethnic backgrounds. UHC promises to give all people greater access to higher quality health services without the fear of financial hardship. But the task of turning this vision into reality poses a significant challenge for countries at all stages of economic development. In The Road to Universal Health Coverage, Jeffrey L. Sturchio, Ilona Kickbusch, Louis Galambos, and their contributors explore the ways in which the private sector is already helping countries achieve universal health coverage. Stressing the many positive aspects of UHC developments, the book focuses on the new health economy and the sometimes controversial dimensions of the private sector helping countries achieve UHC. Theoretical chapters are complemented by a series of case studies that explore the myriad ways in which private sector actors are already addressing UHC. What are the conditions required for countries to translate their successful experiences and policy promises into practical results for improved population health? In answering this question, the contributors examine the relationship between health employment and economic growth. They also analyze the critical success factors for private sector engagement in UHC, the role of healthy women in creating and sustaining healthy economies, and the role of the pharmaceutical sector. Looking to the political, economic, and social implications of moving from aspiration to implementation, The Road to Universal Health Coverage points the way to the many opportunities ahead as companies continue to work with governments and civil society partners to help achieve UHC. Jean-Louise Arcand, Héctor Arreola-Ornelas, Nathan J. Blanchet, Christine Bugos, Jim Campbell, John Campbell, Jr., Ibadat Dhillon, Donika Dimovska, Christian Franz, Michael Fürst, Louis Galambos, Belén Garijo, Adeel Ishtiaq, Sowmya Kadandale, Ilona Kickbusch, Felicia Marie Knaul, Jeremy Lauer, Robert Marten, Justin McCarthy, Harald Nusser, K. Srinath Reddy, Yasmine Rouai, Jeffrey L. Sturchio, Cicely Thomas, Tana Wuliji, Snow Yang, Pascal Zurn
Universal health coverage (UHC) has been recognized by the World Health Organization as a key element in reducing social inequality and a critical component of sustainable development and poverty reduction. In most of the world UHC is sought through a combination of public and private-sector health care systems. In most low- and middle-income countries health systems are evolving to increasingly rely on the private sector because the public sector lacks the infrastructure and staff to meet all health care needs. With growing individual assets available for private-sector expenditure, patients often seek better access to technology, staff, and medicines. However, in low-income countries nearly 50 percent of health care financing is out-of-pocket. With the expected increase in the overall fraction of care provided through the private sector, these expenditures can be financially catastrophic for individuals in the informal workforce. In the global workforce of approximately 3 billion people, only 10 to 15 percent are estimated to have some type of access to occupational health services. The informal workforce is growing worldwide, and the degree to which its occupational health needs are satisfied depends on the capabilities of the general health care system. In July 2014, the Institute of Medicine held a workshop on approaches to universal health coverage and occupational health and safety for informal sector workers in developing countries. This report summarizes the presentations and discussions from this workshop. Approaches to Universal Health Coverage and Occupational Health and Safety for the Informal Workforce in Developing Countries identifies best practices and lessons learned for the informal workforce in developing countries in the financing of health care with respect to health care delivery models that are especially suitable to meeting a population's needs for a variety of occupational health issues, including the prevention of or mitigation of hazardous risks and the costs of providing medical and rehabilitation services and other benefits to various types of workers within this population. These experiences and lessons learned may be useful for stakeholders in moving the discussions, policies, and mechanisms forward to increase equitable access to quality health services without financial hardship for the informal workforce.
This report is structured in five parts: national framework for traditional and complementary medicine (T&CM); product regulation; practices and practitioners; the challenges faced by countries; and finally the country profiles. Apart from the section on practices and practitioners the report is consistent with the format of the report of the first global survey in order to provide a useful comparison. The section on practices and practitioners which covers providers education and health insurance is a new section incorporated to reflect the emerging trends in T&CM and to gather new information regarding these topics at a national level. All new information received has been incorporated into individual country profiles and data graphs. The report captures the three phases of progress made by Member States; that is before and after the first WHO Traditional Medicine Strategy (1999?2005) from the first global survey to the second global survey (2005?2012) and from the second survey to the most recent timeline (2012?2018).
How did seven low- and middle-income countries, inspired by the landmark Alma-Ata Declaration, dramatically improve citizen health by focusing on primary health care? The Alma-Ata Declaration of 1978 marked a potential turning point in global health, signaling a commitment to primary health care that could have improved the safety of air, food, water, roads, homes, and workplaces in all 180 countries that signed it. Unfortunately, progress in many countries stalled in the 1980s. The declaration was, however, embraced by a number of countries, where its implementation led to substantial improvement in citizen health. Achieving Health for All reveals how, inspired by Alma-Ata, the governments of seven countries executed comprehensive primary health care systems, deploying new cadres of community-based health workers to bring relevant services to ordinary households. Drawing on a set of narrative case studies from Bangladesh, Indonesia, Ethiopia, Nepal, Ghana, Sri Lanka, and Vietnam,the book explains how a primary health care focus succeeded in improving population health. The book also conclusively demonstrates that comprehensive, multisector, community-controlled, and population-level primary health care is a viable strategy that, against the odds, has led to sustainable, scalable good health at lower cost. Bringing together a group of experts to analyze the forty-year legacy of the Alma-Ata Declaration, Achieving Health for All is a fascinating look at the work needed to transform nations from places that make people sick to places where they stay healthy. An inspiring array of lessons learned along the way shows how readers can make policies that support the health of all people. Contributors: Onaopemipo Abiodun, Vinya Ariyaratne, John Koku Awoonor-Williams, Kedar Prasad Baral, Ayaga A. Bawah, Pedro Más Bermejo, Fred N. Binka, David Bishai, Carolina Cardona, Dennis Carlson, Chala Tesfaye Chekagn, Hoang Khanh Chi, Svea Closser, Luc Barrière Constantin, Zufan Abera Damtew, Marlou de Rouw, Nadia Diamond-Smith, Philip Forth, Mignote Solomon Haile, Nguyen Thanh Huong, Taufique Joarder, Alice Kuan, Seblewengel Lemma, Sasmira Matta, Ahmed Moen, Rituu B. Nanda, Frank K. Nyonator, Ferdous Arfina Osman, Claudia Pereira, Henry B. Perry, James F. Phillips, Meike Schleiff, Melissa Sherry, Rita Thapa, Kebede Worku
This accessibly written book explains universal healthcare; the many forms it can take; and the issues, debates, and historical context underpinning the continued struggle for its implementation in the United States. Universal healthcare may be defined as any healthcare system that ensures at least basic coverage to most, if not all, citizens of a country. Although it may be implemented in many ways, universal healthcare has been widely accepted by international humanitarian organizations such as the World Health Organization (WHO) as the best way to ensure the universal human right to health. So why is the United States the only industrialized country without universal healthcare? What are the political, social, and economic factors that have prevented its successful introduction? Universal Healthcare explores what universal healthcare is, the many forms it can take—using examples from countries around the world—and the tumultuous history of attempts to implement a system of universal healthcare in the United States. Part II delves into the contentious issues and debates surrounding adoption of universal healthcare in the United States. Lastly, Part III provides a variety of useful materials, including case studies, a timeline of critical events, a glossary, and a directory of resources.