Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy)
and more specific interventions, such as carotid revascularization or... anticoagulation for atrial fibrillation. The objective of this review is to discuss effective interventions for optimal primary and secondary stroke prevention.
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In 2018 the Astana Declaration reaffirmed a global commitment to PHC as a cornerstone of sustainable health systems for accelerated progress on universal health coverage (UHC) (1). The vision for PHC in the 21st century is for a wholeof-government and whole-of-society approach to health that combine...s: 1) multisectoral policy and action; 2) empowered people and communities; and 3) primary care and essential public health functions as the core of integrated health service. Signatories, including Nigeria, were urged to implement the vision and commitments of the Declaration according to their national contexts. This case study examines Nigeria’s response to COVID-19 from a PHC perspective between March 2020 and mid-2021.
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The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing common medical conditions at the primary healthcare level. This document includes treatment protocols ...for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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WHO Package of Essential NCD interventions will help to improve the coverage of appropriate services for people with NCDs services in primary care settings. The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries in primary care settings.
The course aims to cover the types of NCDs and risk factors, the challenges of delivering NCD services in primary health care, elements of WHO technical packages (PEN and HEARTS) for NCDs and how to adapt these packages in primary health care.
The document is an instructional guide in english on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prepara...tion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in arabic on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, preparat...ion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in Burmese on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prepara...tion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in Portuguese on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prep...aration of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in somali on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, preparat...ion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in Spanish on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prepara...tion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide by the American Lung Association on how to properly use a metered-dose inhaler (MDI) with a valved holding chamber (spacer) and mask, specifically in Swahili. It provides step-by-step directions for preparing and using the inhaler to ensure effective medication... delivery for conditions such as asthma. The guide includes practical tips, cleaning advice, and contact information for further support from respiratory professionals through the American Lung Association's helpline.
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The document provides step-by-step instructions for using a Flexhaler dry powder inhaler effectively. It emphasizes proper inhalation technique, including priming the device, loading a dose, and breathing correctly. It also advises users to rinse their mouth after use and highlights the importance o...f bringing medications to appointments for review by healthcare providers.
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The document discusses the complexities of managing patients with COPD and multiple comorbidities, highlighting the importance of personalized care and the appropriate use of inhaled corticosteroids (ICS). It outlines common comorbidities, such as asthma, osteoporosis, and diabetes, and offers guida...nce on optimizing treatment regimens while minimizing risks and polypharmacy in primary care settings.
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In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors...ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
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En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niveles de hace veinte años. Estas cifras no solo imp...lican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
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En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niveles de hace veinte años. Estas cifras no solo imp...lican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
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Mejorar el cuidado y la atención de niñas y niños pequeños