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The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides
...
a framework to inform the exercise of the new essential functions. The third section proposes a new integrated approach for implementing the EPHFs. The fourth section presents a new list of 11 EPHFs related to each stage of this integrated approach. Finally, in the last section, considerations are put forth to guide EPHF implementation as a means of strengthening the health sector.
more
12 May 2021. This third survey in the series shows that the COVID-19 pandemic continues to impact societies, not only in terms of health, but also social and economic conditions and day-to-day life
The paper provides the rationale for these recommendations, which are based on analyses of data from the TRACT trial.
Guide for clinical case management and infection prevention and control during ameasles outbreak. This guide has been developed to reduce the high morbidity and mortality seen in some of the current outbreaks of measles. This short guide outlines practical clinical care interventions and is derived
...
from previously published WHO documents.
more
Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. D
...
espite LIMCs spending an average of 6% of their GDP on health, there have been minimal impacts compared to high-income countries. Health sector reform is a gradual process with complex systems; hence, the need for a vision and long-term strategies to realize the desired goals. In this chapter, we present our proposal to advance universal health coverage (UHC) in LMICs. Overall, our main aim is to provide strategies for achieving actual UHC and not aspirational UHC in LMICs by strengthening health systems, improving health insurance coverage and financial protection, and reducing disparities in healthcare coverage especially on prioritized health problems, and enhancing a primary care-oriented healthcare system.
more
Aide Memoire. O foco desta nota são as implicações da orientação atual da OMS sobre o uso máscaras cirúrgicas e não cirúrgicas/ de tecido durante a pandemia de COVID-19 para trabalhadores da saúde e trabalhadores que não são da área da
...
saúde, mas que estão envolvidos em atividades assistenciais comunitárias, especialmente as de combate à malária, doenças tropicais negligenciadas (DTN), tuberculose (TB), infecção pelo vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida (HIV/ AIDS) e doenças imunopreveníveis (VPDs). O uso de máscaras deve ser sempre acompanhado de outras medidas de prevenção e controle de infecção (PCI), como o distanciamento físico de pelo menos 1 metro, a higiene das mãos, evitar tocar o rosto e a etiqueta respiratória usando o cotovelo dobrado sempre que tossir ou espirrar. A limitação da permanência em locais com aglomeração ou espaços fechados, a garantia da ventilação adequada dos ambientes internos e fechados (6), e a limpeza regular das superfícies de alto contato também são medidas de precaução importantes a serem seguidas.
more
This article looks at the Baseline Standards developed by the International Society for Paediatric
Oncology (SIOP) for paediatric oncology nursing care in low- and middle-income countries. The
Baseline Standards lay the foundation for effective care and address barriers such as inadequate
staffin
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g levels, lack of support, limited access to nurse education and unsafe nursing environments.
more
Background Unrest in Chile over inequalities has underscored the need to improve public hospitals. Nursing has been overlooked as a solution to quality and access concerns, and nurse staffing is poor by international standards. Using Chile’s new d
...
iagnosis-related groups system and surveys of nurses and patients, we provide information to policy makers on feasibility, net costs, and estimated improved outcomes associated with increasing nursing resources in public hospitals.
more
Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effec
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tive as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
more
June 2021. Shock-responsive social protection (SRSP) operates in contexts where rapid on-set disasters mean needs for assistance are acute and urgent. Monitoring and identifying problems in programme design and delivery are therefore critical. However, there is limited existing guidance on how to mo
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nitor shockresponsive social protection in these contexts.
This Brief aims to help fill this gap. It does not provide a blueprint for developing monitoring indicators, but it presents a guiding framework with key questions and key issues to consider when monitoring SRSP to understand how the intervention contributes to broader crisis response.
more
Since the launch of the 2012–2020 World Health Organization (WHO) road map for the control, elim-ination and eradication of neglected tropical diseases (NTDs) (1), considerable progress against NTDs has been made. Between 2010 and 2020, the number of people requiring interventions against NTDs glo
...
bally fell by 600 million, and 42 countries, areas and territories eliminated at least one NTD (2). In January 2021, a new NTD road map for 2021–2030 (2) was launched, setting future targets and mile-stones for 20 diseases and disease groups. The road map also sets cross-cutting targets, including for strengthened capacity of national health systems to deliver interventions through existing infrastructure.
more
Journal of Clinical TB and other Mycobacterial Diseases
uberculosis (TB) in the gastrointestinal tract or peritoneum is an uncommon condition in clinical practice. Its rarity, combined with its nonspecific presentations, makes this kind of extrapulmonary tuberculosis difficult to diagnose as it can
...
mimic other inflammatory or malignant conditions. Delays in treatment and frequent misdiagnosis can lead to hazardous complications. In countries like Ecuador where the disease is endemic, TB should always be considered in the differential diagnosis of a patients who present with nonspecific abdominal symptoms. In these scenarios, laparoscopy can be an invaluable tool when used with sufficiently high clinical awareness and adequate training.
Case presentation
We present the case of a 37-year-old female patient from Ecuador with a 1-year history of abdominal pain, nausea, intermittent vomits, night sweats, and weight loss. After clinical evaluation and a laparoscopic intervention, abdominal TB was detected and promptly treated. Antituberculosis chemotherapy was initiated, and the patient successfully reco
High clinical awareness is imperative when approaching abdominal TB due to its wide spectrum of clinical symptoms and its rarity. Early detection and prompt treatment are critical to minimize the possibility of hazardous complications.
more
La détection directe des protéines virales du SRAS-CoV-2 (antigènes) dans les écouvillons nasaux et autres sécrétions respiratoires à l'aide de tests immunologiques à flux latéral (égaleme
...
nt appelés tests de diagnostic rapide, TDR) offre une méthode plus rapide et moins coûteuse pour tester le SRAS-CoV-2 que la méthode de référence, les tests d'amplification des acides nucléiques (TAAN). Ces lignes directrices provisoires offrent des recommandations sur les utilisations prioritaires des tests de diagnostic rapide à détection d'antigène (TDR-Ag) dans des populations et des contextes spécifiques, notamment (i) pour la détection primaire des cas chez les personnes symptomatiques suspectées d'être infectées et les personnes asymptomatiques à haut risque de COVID-19, (ii) pour la recherche des contacts, (iii) pendant les enquêtes sur les épidémies et (iv) pour surveiller les tendances de l'incidence de la maladie dans les communautés. Les TDR-AG répondant aux exigences minimales de performance peuvent être utilisés en dehors des milieux cliniques et des laboratoires, y compris dans les communautés, par des opérateurs formés conformément aux instructions. Le guide fournit en outre des recommandations sur la mise en œuvre, la sélection des produits et le stockage
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Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s
...
tudy aimed to test both interventions in low-income and middle-income countries.
more
Coronavirus Clinical Management Protocol (COVID-19) in Primary Health Care (Version 7)
This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20
...
20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
more
The global migration context is rapidly changing with new conflicts and coups, new public health threats, new levels of environmental stress and changing perceptions around human mobility. Against that backdrop, migration policies, actions and attitudes are becoming more and more extreme, according
...
to the 2021 edition of the Mixed Migration Review, the annual publication by the Mixed Migration Centre (MMC) of the Danish Refugee Council (DRC).
Download the full report here: https://reliefweb.int/sites/reliefweb.int/files/resources/Mixed-Migration-Review-2021.pdf
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