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This case study examines country-level primary health care (PHC) systems in Rwanda. The case study is part of a collection of case studies providing critical insights into key PHC strengths, challenges and lessons learned using the Astana PHC framework, which considers integrated health services, multisectoral policy and action, and people and communities. Led by in-country research teams, the case studies update and extend the Primary Health Care Systems (PRIMASYS) case studies commissioned by the Alliance in 2015.
The COVID-19 pandemic has caused unprecedented disruption worldwide highlighting once again the interdependency of health and socioeconomic development, and the global lack of health systems resilience. Two years into the pandemic, most countries report sustained disruptions across service delivery platforms and health areas with a profound impact on health outcomes. The impact of these disruptions is magnified within marginalized communities and in countries experiencing protracted conflict. There is an urgent need to focus on recovery through investment in the essential public health functions (EPHFs) and the foundations of health systems with a focus on primary health care, and whole-of-government and -society engagement. The aim of this Research Topic is to gather, transfer and promote operationalization of key experiences from COVID-19 to inform global and country level recovery that better promote health; guide policy direction towards building health systems resilience; and thereby ensure economic and social prosperity. Experience with COVID-19 has demonstrated that traditional approaches to health system strengthening have failed to achieve the complementary goals of Universal Health Coverage (UHC) and health security with the divide between the most vulnerable and well-off only widening. Much of what had been learned from previous experiences such as Ebola in West Africa has not been widely applied. This has left health and economic systems vulnerable to 21 st century public health challenges, ranging from conflict and natural disasters to aging demographics and rising rates of non-communicable and communicable diseases and antimicrobial resistance. These challenges require intentional focus and investment as well as whole-of-government and -society engagement with health to build health system resilience. Greater action is needed to prevent the devastating effects of war and conflict on the health of the most vulnerable. This Research Topic will convene the knowledge and practices of leaders in public health, health systems, and humanitarian and development sectors. This is to ensure lessons from COVID-19 inform the recovery agenda and promote sustainable health and socioeconomic recovery for all. Lest we forget and find ourselves again unprepared and vulnerable in the face of an even greater threat.
This collection draws upon a range of thematic and regional case studies and uses the right to health as a normative framework to explore the devastating impact of the COVID-19 pandemic in Africa. Drawing lessons from across the continent, the book discusses the challenges faced by African states seeking to ensure the availability, accessibility, and quality of health care in the context of the COVID-19 pandemic. In particular, the volume explores the impact of the pandemic on the right to health of vulnerable and marginalized groups, such as women, children, elderly persons with disabilities, refugees and asylum seekers, and people from disadvantaged communities. Due to the poor funding of the healthcare systems, access to health-related services was limited to these groups in many African countries, thereby leading to avoidable COVID-19-related deaths through shortages of vital supplies, including diagnostic tests, ventilators, and oxygen cylinders. Chapters in the volume also explore the contentious issues of vaccine mandates, equity, resource allocation, and the rights of healthcare providers during the pandemic. This collection will be of interest to students of public health, human rights, and the social sciences, as well as to academics and policymakers with an interest in the nexus between the COVID-19 pandemic and public health policy in Africa.
Executive Summary: In many ways COVID-19 Pandemic has seriously affected vulnerable and marginalized groups. The pandemic has made a bad situation worse this study contributes to the growing base of evidence regarding the ways in which COVID-19 Pandemic has exacerbated existing disparities of vulnerable and marginalized groups in accessing essential services such as Health care services, sexual reproductive health and access to justice. Given the ongoing disparities experienced by marginalized and vulnerable populations, within and outside of the context of the COVID-19 pandemic, it is critical to take actions to ensure that the needs of these groups are met. Our results in this research demonstrate a number of pressing unmet needs, especially for the Lesbian, Gay, Bisexual, Transgender, Intersex and Queer groups. However, with both immediate action and consistent, structural-level investment these inequities can be addressed, not only to ensure an appropriate COVID-19 response and recovery process but also to ensure long-term equity for vulnerable and marginalized populations in Rwanda.
Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.
"Experiences of Health Workers in the COVID-19 Pandemic shares the stories of frontline health workers - told in their own words - during the second wave of COVID-19 in Australia. The book records the complex emotions health workers experienced as the pandemic unfolded and the challenges they faced in caring for themselves, their families, and their patients. The book shares their insights on what we can learn from the pandemic to strengthen our health system and prepare for future crises. The book draws on over 9,000 responses to a survey examining the psychological, occupational, and social impact of COVID-19 on frontline health workers. Survey participants came from all areas of the health sector, from intensive care doctors to hospital cleaners to aged care nurses, and from large metropolitan hospitals to rural primary care practices. The authors organise these free text responses thematically, creating a shared narrative of health workers experiences. Each chapter is prefaced by a commentary providing additional context and exploring the significance of the themes that emerged from the survey. This book offers a unique historical record of the experiences of thousands of healthcare workers at the height of the second wave of the pandemic and will be of great interest to anyone interested in healthcare policy and the psychological, organisational, and social challenges of the COVID-19 pandemic"--
The Infectious Disease Vulnerability Index is intended to inform actions for preparedness and response to infectious disease outbreaks and foster greater resiliency of national health systems worldwide.
Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases in African Populations examines the profile of non-communicable diseases (NCDs) in the rural South African population. The burden of diseases in South Africa is characterized by a combination of poverty-related diseases with emerging NCDs associated with urbanization, industrialization, and a Westernised lifestyle. Chapters in this book examine the effects of poverty, COVID-19, and other social factors on the prevalence of cardiovascular disease, reproductive health, and diabetes in rural South Africa.
The COVID-19 pandemic not only ravaged human bodies but also had profound and possibly enduring effects on the health of political and legal systems, economies and societies. Almost overnight, governments imposed the severest restrictions in modern times on rights and freedoms, elections, parliaments and courts. Legal and political institutions struggled to adapt, creating a catalyst for democratic decline and catastrophic increases in poverty and inequality. This handbook analyses the global pandemic response through five themes: governance and democracy; human rights; the rule of law; science, public trust and decision making; and states of emergency and exception. Containing 12 thematic commentaries and 25 chapters on countries of diverse size, wealth and experience of COVID-19, it represents the combined effort of more than 50 contributors, including leading scholars and rising voices in the fields of constitutional, international, public health, human rights and comparative law, as well as political science, and science and technology studies. Taking stock after the onset of global emergency, this book provides essential analysis for politicians, policy-makers, jurists, civil society organisations, academics, students and practitioners at both national and international level on the best, and most concerning, practices adopted in response to COVID-19 – and key insights into how states and multilateral institutions should reform, adapt and prepare for future emergencies.
The COVID-19 pandemic has disproportionately affected those population sectors that experience inequality. Specifically, marginalized racial and ethnic populations with pre-existing health conditions, those living in poverty, those possessing a low education level, hourly wage employees, etc. have experienced an excess burden of COVID-19 morbidity and mortality compared to their White counterparts in developed countries. The interaction of the social determinants of health with a novel virus has made visible the inequities that have been hidden or accustomed to in many communities globally. As we work to end the current pandemic, we must consider the post-COVID-19 pandemic era and address the social determinants of health so that populations start from a place of health, as opposed to a place of disease for the next public health challenge. Syndemic research has demonstrated the interaction among socio-cultural factors, socio-economic factors, structural factors, and individual factors (collectively referred to as the social determinants of health) and infectious disease epidemics (e.g., COVID-19, AIDS) and social epidemics (e.g., structural racism). These interactions can exacerbate and sustain adverse health outcomes for marginalized populations. How can communities improve the social determinants of health for impoverished populations? The importance of doing so would have implications not only for the health status of communities but could also improve economic conditions for these geographic areas. Addressing the social determinants of health for marginalized populations has the potential to improve health for all.