scholarly journals Análise situacional de saúde da primeira infância

2021 ◽  
Vol 11 (1) ◽  
pp. e5464
Author(s):  
Carolina Maia Menezes ◽  
Ravane Vasconcelos Santos ◽  
Mariana Carvalho Gavazza
Keyword(s):  
Health Care ◽  
Early Childhood ◽  
Primary Health Care ◽  
Health Services ◽  
Health Planning ◽  
Family Health ◽  
Population Monitoring ◽  
Situational Analysis ◽  
Heterogeneous Distribution ◽  
Primary Health

A atenção básica é a principal porta de entrada nos serviços de saúde, atuando na coordenação do cuidado e resolução dos problemas de saúde. A Estratégia de Saúde da Família trabalha com abordagem territorial e comunitária, com definição, adscrição da clientela, cadastramento e acompanhamento da população. Dessa forma, o planejamento e programação em saúde é fundamental para os processos de trabalho através da Análise Situacional de Saúde (ASIS). Este trabalho traz um relato de experiência da Residência Multiprofissional em Saúde Coletiva sobre o processo de construção e realização da ASIS da primeira infância em uma Unidade de Saúde da Família no município de Salvador, no ano 2019. Foi encontrada distribuição heterogênea de crianças na primeira infância de acordo com a microárea e subnotificação das condições de saúde, especialmente das deficiências. Nas oficinas com profissionais e usuários, foram elencados problemas semelhantes relacionados ao acesso e utilização dos serviços de saúde e questões sociais que afetam a primeira infância deste território. A assistência à saúde da criança na USF mostrou-se satisfatória, porém necessitando de melhorias quanto ao monitoramento das crianças. A realização da análise proporcionou maior conhecimento acerca da realidade local, com o recorte da primeira infância e pode ser utilizada como ferramenta o planejamento local em saúde e enfrentamento dos problemas priorizados, tanto para primeira infância quanto para outros ciclos de vida. ABSTRACTThe primary health care is the main gateway in health services system, operating on coordinate care and resolution of health problems. The Family Health Strategy (ESF) works with territorial and community approach, with definition, clientele adscription, registration, and population monitoring. Therefore, planning and programming in health care are fundamental to the work processes through the Health Situational Analysis (ASIS). This article reports an experience of Multi-Professional Residency in Public Health about the construction and conduction process of early childhood ASIS at a Family Health Unit (FHU) in the city of Salvador in 2019. It was found a heterogeneous distribution of children on early childhood according to the micro-area and health conditions underreporting, especially physical and mental deficiencies. In workshops with professionals and users, similar problems were related to access and use of health services and social matters that affect early childhood in this territory were listed. Child’s health care assistance in FHU proved to be satisfactory, however, needing improvement in the children monitoring. The conduction of ASIS provided greater knowledge about the local reality, with the cutout of early childhood. It can be used as a tool both to the local planning in health care and the coping of prioritized problems as early childhood and other life cycles.Keywords: Health Planning; Child Development; Primary Health Care. RESUMENLa atención primaria es la principal puerta de acceso a los servicios de salud, trabajando para coordinar la atención y resolver los problemas de salud. La Estrategia Salud de la Familia trabaja con un enfoque territorial y comunitario, con definición, asignación de clientes, registro y seguimiento de la población. Así, la planificación y programación de la salud es fundamental para los procesos de trabajo a través del Análisis Situacional de Salud (ASIS). Este artículo es un relato de experiencia de la Residencia Multiprofesional en Salud Pública sobre el proceso de construcción e implementación de ASIS de la primera infancia en una Unidad de Salud de la Familia (USF) en la ciudad de Salvador, en el año 2019. Se encontró una distribución heterogénea de niños en la primera infancia. niñez según el área micro y subregistro de condiciones de salud, especialmente discapacidad. En los talleres con profesionales y usuarios se enumeraron problemas similares relacionados con el acceso y uso de los servicios de salud y los problemas sociales que afectan a la primera infancia de este territorio. La atención de la salud infantil en la USF demostró ser satisfactoria, pero es necesario mejorar el seguimiento de los niños. La realización del análisis brindóun mayor conocimiento sobre la realidad local, con el corte de la primera infancia y se puede utilizar como herramienta la planificación local en salud y el afrontamiento de los problemas priorizados tanto para la primera infancia como para otros ciclos vitales.Palabras Clave: Planificación en Salud; Desarrollo Infantil; Atención Primaria de Salud. 

Epidemiology and Primary Health Care

2021 ◽  
pp. 1-19
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Systems Approach ◽  
Health Planning ◽  
District Health ◽  
The Sustainable Development ◽  
Primary Health ◽  
Local Decision Making

This chapter introduces the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) and the central role of epidemiological concepts, knowledge, and skills in planning, management, and evaluation of district health systems in support of primary health care. It focuses on interventions to improve the health status of whole populations and shows how epidemiology is essential to support local decision-making for improvements in the population’s health. Health planning is outlined using a systems approach for high-priority health services and public health programmes delivered by district health services and programmes. The differences between interventions for clinical medicine and public health are explained. The systems approach to district planning are also explained.

scholarly journals Equipe de enfermagem: percepção sobre a doença de Chagas

2020 ◽  
Vol 10 (32) ◽  
pp. 367-372
Author(s):  
Fernanda Cristina Santos Rodrigues ◽  
Izabella Cristina Alves de Souza ◽  
Alexandra Paiva Araújo Vieira ◽  
Janice Maria Borba ◽  
Liléia Gonçalves Diotaiuti ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Health Services ◽  
Chagas Disease ◽  
Family Health ◽  
Minas Gerais ◽  
Primary Health ◽  
Nursing Team ◽  
El Sistema

O Sistema Único de Saúde enfrenta desafios em relação à doença de Chagas devido ao elevado número de portadores crônicos no Brasil. Os enfermeiros e auxiliares/técnicos de enfermagem são os profissionais que prestam acolhimento e encaminhamento dos portadores nas Unidades Básicas de Saúde. Objetivou-se analisar a percepção da equipe de enfermagem sobre a doença de Chagas e serviços de saúde relacionados nos municípios da microrregional de saúde de Itaúna, Minas Gerais. Foram aplicados questionários semiestruturados aos profissionais de enfermagem. Os profissionais dominam aspectos relacionados aos vetores, sintomas, exames diagnósticos e fluxo de exames. Há ausência de ações de promoção à saúde voltadas a doença, problemas no rastreamento dos portadores na Atenção Primária à Saúde, e ausência de capacitações para os profissionais abordando o manejo clínico da doença. Sugere-se a realização de capacitações com foco técnico/clínico voltadas à equipe de enfermagem, e implantação de ações de promoção a saúde nos municípios.Descritores: Atenção Primária à Saúde, Estratégia de Saúde da Família, Serviços de Saúde. Nursing team: perception of Chagas diseaseAbstract: The primany health care in Brazil, faces challenges in relation to Chagas disease due to the high number of chronic carriers in Brazil. Nurses and nursing assistants / technicians are professionals who provide care and referrals to patients in Basic Health Units. The objective of this study was to analyze the perception of the nursing team about Chagas disease and related health services in the municipalities of the micro health region. Itaúna, Minas Gerais. Semi-structured questionnaires were applied to nursing professionals. Professionals master aspects related to vectors, symptoms, diagnostic tests and flow of tests. There is an absence of health promotion actions aimed at disease, problems in tracking patients in Primary Health Care, and an absence of training for professionals addressing the clinical management of the disease. It is suggested to carry out training with a technical/clinical focus on the nursing team, and to implement health promotion actions in the municipalities.Descriptors: Chagas Disease, Family Health Team, Primary Health Care, Health Services. Equipo de enfermería: percepción de la enfermedad de ChagasResumen: El Sistema Único de Salud enfrenta desafíos en relación con la enfermedad de Chagas debido a la gran cantidad de portadores crónicos en Brasil. Las enfermeras y los asistentes / técnicos de enfermería son profesionales que brindan atención y derivaciones a pacientes en Unidades Básicas de Salud. El objetivo de este estudio fue analizar la percepción del equipo de enfermería sobre la enfermedad de Chagas y los servicios de salud relacionados en los municipios de la región de micro salud. Itaúna, Minas Gerais. Se aplicaron cuestionarios semiestructurados a profesionales de enfermería. Los profesionales dominan aspectos relacionados con vectores, síntomas, pruebas de diagnóstico y flujo de pruebas. Hay una ausencia de acciones de promoción de la salud dirigidas a la enfermedad, problemas en el seguimiento de pacientes en Atención Primaria de Salud y una falta de capacitación para profesionales que aborden el manejo clínico de la enfermedad. Se sugiere llevar a cabo capacitación con un enfoque técnico / clínico en el equipo de enfermería e implementar acciones de promoción de la salud en los municipios.Descriptores: Atención Primaria de Salud, Estrategia de Salud Familiar, Servicios de Salud.

scholarly journals Quality of Primary Health Care in Brazil: patients'view

2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Clinical History ◽  
Coordination Of Care ◽  
Primary Health ◽  
Comprehensive Health ◽  
Access And Quality ◽  
Transversal Study

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.

scholarly journals The role of health care workers in collaborating with traditional healers in primary health care. Part 1

1997 ◽  
Vol 2 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Rosemare Troskie
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Plan ◽  
Health Care Workers ◽  
Full Text ◽  
Traditional Healers ◽  
Primary Health ◽  
Care Workers

The Reconstruction and Development Plan as well as the National Health Plan of the ANC supports the reorganisation of health services. OpsommingDie Heropbou en Ontwikkelingsprogram sowel as die Nasionale Gesondheidsplan van die ANC staan die herorganisasie van gesondheidsdienste voor. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Melhores práticas de enfermagem na saúde da pessoa idosa

2020 ◽  
Vol 14 ◽  
Author(s):  
Maria Alice De Freitas ◽  
Angela Maria Alvarez
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Best Practices ◽  
Methodological Approach ◽  
Family Health ◽  
The Elderly ◽  
Structured Interview ◽  
Primary Health ◽  
La Red ◽  
The Impact

Objetivo: compreender, dentro das melhores práticas, as experiências de busca por conhecimento e utilização da experiência profissional dos enfermeiros no cuidado da pessoa idosa na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo e exploratório, com 30 enfermeiros atuantes nas Estratégias Saúde da Família. Utilizou-se um instrumento de entrevista semiestruturado. Analisaram-se os dados pela técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: revelaram-se a busca por conhecimento com outros profissionais e o acesso à rede de internet como fontes de conhecimento. Evidenciou-se a necessidade do estabelecimento de uma rotina de estudos sistematizada e agenda de educação permanente sob a temática do envelhecimento. Conclusão: conclui-se que o estudo confirma que os enfermeiros realizam ações que carecem de notoriedade e que estão preocupados com o impacto de suas ações para o usuário idoso, mas, para que as melhores práticas sejam completamente estabelecidas,  se faz necessária a imersão científica e metodológica dos profissionais e da gestão, além da busca por conhecimento e valorização da experiência, que já coexistem. Descritores: Idoso; Enfermagem; Conhecimento, Atenção Primária à Saúde; Saúde da Pessoa Idosa; Dinâmica Populacional.AbstractObjective: to understand, within the best practices, the experiences of searching for knowledge and using nurses' professional experience in the care of the elderly in Primary Health Care. Method: this is a qualitative, descriptive and exploratory study, with 30 nurses working in the Family Health Strategies. A semi-structured interview instrument was used. Data was analyzed using the Content Analysis technique in the Thematic Analysis modality. Results: the search for knowledge with other professionals and access to the internet network as sources of knowledge were revealed. The need to establish a systematic study routine and a permanent education agenda under the theme of aging became evident. Conclusion: it is concluded that the study confirms that nurses perform actions that lack notoriety and that they are concerned with the impact of their actions for the elderly user, but, for the best practices to be completely established, scientific immersion is necessary and methodological approach of professionals and management, in addition to the search for knowledge and appreciation of experience, which already coexist. Descriptors: Elderly; Nursing; Knowledge; Primary Health Care; Elderly health; Population Dynamics.ResumenObjetivo: comprender, dentro de las mejores prácticas, las experiencias de búsqueda de conocimiento y el uso de la experiencia profesional de los enfermeros en el cuidado de ancianos en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo y exploratorio con 30 enfermeros activos en las Estrategias de Salud Familiar. Se utilizó un instrumento de entrevista semiestructurada. Los datos se analizaron utilizando la técnica de Análisis de Contenido en la modalidad de Análisis Temático. Resultados: se reveló la búsqueda de conocimiento con otros profesionales y el acceso a la red de Internet como fuentes de conocimiento. La necesidad de establecer una rutina de estudio sistemática y una agenda de educación permanente bajo el tema del envejecimiento se hizo evidente. Conclusión: se concluye que el estudio confirma que los enfermeros realizan acciones que carecen de notoriedad y que están preocupados por el impacto de sus acciones para el usuario mayor, pero, para que las mejores prácticas se establezcan por completo, es necesaria la inmersión científica y enfoque metodológico de profesionales y directivos, además de la búsqueda de conocimiento y valoración de la experiencia, que ya coexisten. Descriptores: Anciano; Enfermería; Conocimiento; Atencíon Primária de la Salud; Saúde do Idoso; Dinámica Poblacional.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Integrating Mental Health Services into the Primary Health Care System: The Need for Reform in Iran

2021 ◽  
Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Financial Resources ◽  
Primary Health Care System ◽  
Primary Health ◽  
Integrated Mental Health

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.

scholarly journals 40 Years after Alma Ata: How People Trust in Primary Health Care?

2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Health Services ◽  
Public Trust ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Trust Level ◽  
Primary Health ◽  
Individual Variables

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. PHC as a first level of health services delivery needs to be more trustfulness to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in 2016 in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression.Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.

scholarly journals Gestão do cuidado e matriciamento na atenção primária à saúde: um relato de experiência

2021 ◽  
Vol 3 (2) ◽  
pp. 95-101
Author(s):  
Minéia da Costa Figueiredo ◽  
Fabiana Lopes de Paula
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Management ◽  
Family Health ◽  
Patient Care Team ◽  
Unified Health System ◽  
Primary Health ◽  
Health Strategy ◽  
The Matrix ◽  
Family Health Strategy

Este artigo irá abordar a vivência em uma unidade de Estratégia Saúde da Família (ESF) no município de Canto do Buriti-PI sobre os aspectos relacionados ao processo de matriciamento e a gestão do cuidado. A descrição será feita a partir da análise da gestão do cuidado e articulações com o Núcleo de Apoio à Saúde da Família (NASF) e suas ações de apoio matricial desenvolvidas na unidade. O NASF tem fundamental importância na resolução de casos mais complexos e na efetivação de cuidado integral, bem como para a assistência humanizada aos usuários na Atenção Primária à Saúde. O relato traz como contribuição a análise do processo de trabalho entre eSF e NASF, com uma visão que traz subsídios para a reflexão; tendo a intenção de cooperar para o aperfeiçoamento, progresso das ações na APS e a concretização das políticas públicas. Palavras-chave: Atenção Primária à Saúde; Estratégia Saúde da Família; Equipe de Assistência ao Paciente; Integralidade em Saúde; Sistema Único de Saúde.   Abstract This article will address the experience in a Family Health Strategy (ESF) unit in the city of Canto do Buriti-PI on aspects related to the matrix support process and care management. The description will be made from the analysis of care management and articulations with the Family Health Support Center (NASF) and its matrix support actions developed in the unit. The NASF is of fundamental importance in solving more complex cases and in providing comprehensive care, as well as in providing humanized assistance to users in Primary Health Care. The report contributes to the analysis of the work process between eSF and NASF, with a a vision that supports reflection; with the intention of cooperating for the improvement, progress of actions in the PHC and the implementation of public policies. Keywords: Primary Health Care; Family Health Strategy; Patient Care Team; Integrality in Health; Unified Health System.

scholarly journals The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox’s Bazar, Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253013
Author(s):  
Rosanna Jeffries ◽  
Hassan Abdi ◽  
Mohammad Ali ◽  
Abu Toha Md Rezuanul Haque Bhuiyan ◽  
Mohamed El Shazly ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Sector ◽  
Advisory Group ◽  
Primary Health ◽  
Working Groups

On August 25 2017, an unprecedented influx of Rohingya refugees began from Rakhine State in Myanmar into Bangladesh’s district of Cox’s Bazar. The scale and acuteness of this humanitarian crisis was unprecedented and unique globally, requiring strong coordination of a multitude of actors. This paper reflects on the health sector coordination from August 2017 to October 2019, focusing on selected achievements and persisting challenges of the health sector strategic advisory group (HSSAG), and the health sector working groups including epidemiology and case management, sexual and reproductive health, community health, mental health and psychosocial support, and emergency preparedness. In the early days of the response, minimum service standards for primary health care were established, a fundamental initial step which enabled the standardization of services based on critical needs. Similarly, establishing standards for community health outreach was the backbone for capitalizing on this important health workforce. Novel approaches were adopted for infectious disease responses for acute watery diarrhoea and varicella, drawing on inter-sectoral collaborations. Sexual and reproductive health services were prioritized from the initial onset of the crisis and improvements in skilled delivery attendance, gender-based violence services, abortion care and family planning were recorded. Mental health service provision was strengthened through community-based approaches although integration of mental health programmes into primary health care has been limited by availability of specialist psychiatrists. Strong, collaborative and legitimate leadership by the health sector strategic advisory group, drawing on inter-sectoral collaborations and the technical expertise of the different technical working groups, were critical in the response and proved effective, despite the remaining challenges to be addressed. Anticipated reductions in funding as the crisis moves into protracted status threatens the achievements of the health sector in provision of health services to the Rohingya refugees.

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