Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ...diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ...diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes im...plementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
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In 2018, approximately 60,000 Ugandans were estimated to be suffering from cancer. It was also reported that only 5% of cancer patients access cancer care and 77% present with late-stage cancer coupled with low level of cancer health literacy in the population despite a wide coverage of primary heal...thcare facilities in Uganda. We aimed to contribute to reducing the unmet needs of cancer prevention and early detection services in Uganda through capacity building.
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To help parents keep their children healthy and fit, WHO has developed the Child Nutrition and Physical Activity Guide. In addition to parents, the guide may prove to be a useful tool for other adults (such as grandparents or caregivers) working with primary school-aged children.
The Child Nutrit...ion and Physical Activity Guide is published only in the Russian language with support from the Ministry of Health of the Russian Federation for use in Russian-speaking countries. It addresses the urgent need in some countries to improve child nutrition, particularly in areas that face a double health burden characterized by coexistence of undernutrition and overweight, obesity or noncommunicable diseases. Many children in those countries never eat breakfast, and their diet consists of large quantities of sweets and sugar-sweetened beverages with almost no vegetables and fruit.
The WHO guide also offers ideas on how to stimulate children’s interest in physical activity, such as active play, exercise or sports. This is especially relevant for countries of the Commonwealth of Independent States (CIS), where, according to the latest findings, schoolchildren have a low participation in organized sports and exercise. On the other hand, a high proportion of schoolchildren walk to school every day. This could be a good starting point for CIS countries to make physical activity a daily habit that not only improves children’s physical health, but also promotes better mental health and well-being.
The guide aims to ensure that children obtain the knowledge and skills to make healthy food choices, critically evaluate their diet and integrate physical activity into daily life.
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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th...e implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur...ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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This is a case-ascertained prospective investigation of all identified health care contacts working in a health care facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Study population) receives care. Note that this study can be done in health care facilities at all 3 level...s of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers.
There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for:
To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level.
To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers.
To evaluate effectiveness of infection prevention and control measures among health care workers
To evaluate effectiveness of infection prevention and control programmes at health facility and national level
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom...ote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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Des efforts considérables ont été menés pour apporter aux
populations rurales du continent africain des soins de base. Mais
la qualité de ces soins reste aujourd’hui peu satisfaisante car le
médecin généraliste est le plus souvent absent en première
ligne. Cette situation est paradoxa...le en regard du nombre de
médecins formés dans les facultés en Afrique francophone et à
Madagascar. Le déficit en médecin généraliste, exerçant dans les
zones rurales, reste particulièrement préoccupant alors que
les jeunes médecins sans emploi se multiplient dans les villes.
L’ONG Santé Sud, depuis plus de vingt ans, propose un concept
– la médecine générale communautaire – qui, associé à un dispositif
d’accompagnement, a permis l’installation de plus de deux
cents médecins généralistes communautaires au Mali et à
Madagascar. Ce concept a pour intérêt d’associer, dans une même
pratique, la médecine de famille et les Soins de Santé Primaires.
S.F.S.P. | « Santé Publique »
2014/HS S1 | pages 59 à 65
Considerable effort has been made to provide rural African
populations with basic health care, but the quality of this care
remains unsatisfactory due to the absence of first-line GPs. This is
a paradoxical situation in view of the large number of physicians
trained in medical schools in French-speaking Africa and
Madagascar. of the lack of GPs working in rural areas is a real
concern, as many young doctors remain unemployed in cities.
For more than 20 years, the NGO Santé Sud has proposed a
Community General Medicine concept, which, combined with
a support system, has allowed the installation of more than
200 community GPs in Mali and Madagascar. The advantage of
this concept is that it provides family medicine and primary health
care in the same practice.
S.F.S.P. | « Santé Publique »
2014/HS S1 | pages 59 à 65
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The International Primary Care Respiratory Group (IPCRG) is a clinically-led charitable organisation. The scope is research and education to improve prevention, diagnosis and care of respiratory diseases in global community and primary care settings.
The document "Appropriate use and withdrawal of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD)" from the IPCRG provides guidance on when to start, adjust, or discontinue ICS in COPD treatment. It highlights the benefits and risks, emphasizing personalized... treatment based on patient history, exacerbation frequency, and eosinophil count, while detailing how to optimize bronchodilator use to manage symptoms effectively.
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The International Primary Care Respiratory Group (IPCRG) is a clinically-led charitable company that works locally in primary care and collaborates globally to improve respiratory health. Our vision is that, through universal access to the right care, everyone can breathe and feel well.
Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu...s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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Adults and adolescents 12+ years. Asthma medication options: Adjust treatment up and down for individual patient needs
The results of in-country database and reports analysis
Research globally has shown that metered dose inhaler (MDI) technique is poor, with patient education and regular demonstration critical in maintaining correct use of inhalers. Patient information containing pictorial aids improves understanding of medicine usage; however, manufacturer leaflets illu...strating MDI use may not be easily understood by low-literacy asthma patients.
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Original Research
African Journal of Primary Health Care & Family Medicine
ISSN: (Online) 2071-2936, (Print) 2071-2928
Open Access