Dear friends and colleagues with an interest in primary health care and community health:
As most of you know, I have been slowly adding people who have an interest in PHC/CH to a listserv, and you are one of these people. From time to time I send out a note with some information that I think might be of interest to you. If you want to be removed from this listserv, just reply and say delete. If you know of someone you think might be interested in subscribing to this, just send me an email.
Since my last missive on 21 April 2022, there have been some notable publications of relevance to all of us:
Financing primary health care
The Lancet has sponsored a Commission on Financing Primary Health Care that has just released its findings, available here<https://www.thelancet.com/commissions/financing-primary-health-care>. A copy of their 50-page report is also attached, and it can also be accessed online here<https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00005-5/fulltext>. The report calls for, among other things, tracking the amount of funding that PHC receives from governments in comparison to the amount of funding going to hospitals – an important and overlooked issue for many decades now.
Article in the New York Times about community health workers in India (ASHAs)
On 17 May 2022 the front page of the NYT featured the following article: “The Foot Soldiers in India’s Battle to Improve Public Health<https://www.nytimes.com/2022/05/17/world/asia/india-asha-health.html>.”
Article about Raj Panjabi in The Lancet
Over the past decade, Raj Panjabi has been one of the great spokespersons for and leaders of efforts to build stronger community health programs around the world, arising from his work in establishing the NGO Last Mile Health in Liberia. Now, we can take great pride in knowing that Raj is now in a highly influential position in the Biden White House, serving as Special Assistant to the President and Senior Director for Global Health Security and Biodefense at the White House National Security Council in Washington, DC, which advises the President on foreign policy and security issues. With the US government now committing substantial financial resources to global health security, it is great to know that Raj is in a position to argue forcefully for the need to provide adequate funding for community health worker programs around the world so that they can contribute to the early detection of disease outbreaks in addition to their many other important tasks. The Lancet recently published a profile of Raj, available here<https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00826-1/fulltext> and also attached.
Recent autobiographical reflections from a global health giant by Jon Rohde (“Ten Lessons from a Career in Global Health: Guidance to Those Considering a Life Working with Poor Countries of the World”)
Jon Rohde is one of the giants of community health and primary health care during our lifetimes who has played a seminal role in so many different ways that have advanced programs in South and Southeast Asia, Africa and beyond. His recently published reflection is a must read for those who considering or beginning careers in global health – recently appearing in the Oxford Research Encyclopedias, Global Public Health. This is attached.
Reflections on Progress and Missed Opportunities in Maternal and Child Health Care by Nick Cunningham
Nick Cunningham, now 94, wrote his doctoral dissertation on and published one of the pioneering evaluations of community-based primary health care programs – the Imesi Under Fives Clinic in Nigeria. This publication (attached) is almost unknown, unfortunately, and was mostly ignored by technical experts and policy makers. Now, five decades later, Professor Cunningham reflects on the evolution of MCH services in poor countries in the attached article, just published in the Oxford Research Encyclopedias, Global Public Health.
An emerging leader for community health and community health workers – Madeleine Ballard – and the Community Health Roundup
Some of you may not know of Madeleine Ballard<https://mssm.academia.edu/MadeleineBallard>. If not, you should. She is an emerging leader and spokesperson for strengthening CHW programs around the world and for providing them with the salaries and other support that they need and deserve. She attended Harvard and then spent several years working in Liberia as Founding Program Manager and Director of Scale-Up for Last Mile Health, and later went as a Rhodes Scholar to obtain a PhD in Evaluation Science at the University of Oxford in 2017. At the time, she co-founded and became CEO of the Community Health Impact Coalition<https://chwimpact.org/> (CHIC), now housed at the Icahn School of Medicine at Mount Sinai in New York City. The Coalition is made up of health organizations in 40+ countries and “works to ensure community health workers get the fair pay, field support, and official recognition they deserve so everyone can access high quality healthcare.” The Coalition also works to build, test, and scale community health delivery practices that improve quality of care. CHIC publishes a listserv (Community Health Research Round-Up<https://chwimpact.org/research-round-up>.) every two weeks that contains recent peer-reviewed publications about community health workers – this is a must resource for those of us interested in helping to strengthen the contribution of CHWs around the world You can sign up here<https://mailchi.mp/840ecf2e2d35/ch-roundup-signup> to receive this.
Pioneering research on the effectiveness of community health workers in controlling hypertension in China
The Lancet published on 29 April 2022 a pathbreaking piece of research demonstrating the effectiveness of community health workers in treating hypertension in rural China. This randomized trial demonstrated that hypertension control by CHW is “a feasible, effective, and sustainable implementation strategy [that] could be scaled up in rural China and other low-income and middle-income countries.” A copy of this is attached. Given that hypertension is the leading cause of preventable deaths worldwide, these findings will provide momentum for strengthening CHW programs throughout the world as they continue to play an increasingly important role in the control of non-communicable diseases.
Further reflections on the extraordinary career of Paul Farmer
The previous two missives from me have included remembrances of Paul Farmer. Bill Gates has recently provided a remembrance here<https://www.youtube.com/watch?v=p-JdCveXogQ> that is quite information and inspiration as well.
That’s it for now. Feel free to share any of this information with others who might be interested.
If you have any information that you think others might be interested in, feel free to forward it to me. I intend to be highly selective in what I share since all of us are overburdened with information of questionable value!
Onward and upward!
Henry B. Perry, MD, PhD, MPH
Senior Associate, Health Systems Program
Department of International Health
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD, USA 21205
HIFA profile: Henry Perry is a Senior Scientist at the Johns Hopkins Bloomberg School of Public Health, USA. Professional interests: Community health and primary health care. hperry2 AT jhu.edu
[Note from HIFA moderator, Neil PW. The original message had attachments which are not carried by HIFA.]