The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa...l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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Table of contents
1: Introdução; 2: Considerações para atendimento em situação de pico de demanda em serviços de saúde e alocação de equipes médicas de emergência; 3: Equipes médicas de emergência; 4: Níveis de resposta em situação de pico de demanda por cuidados médicos; 5: Expan...são da capacidade em sistemas de emergência médica pré-hospitalares; 6: Identificação de locais alternativos de assistência; 7: Referências.
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MedPPE emphasizes the role and timing of health workers jobs and offers specific information to prevent the spread of COVID-19. The guidelines are aimed at all personnel working in health facilities, including security guards, administrative and cleaning personnel, transfer assistants, nurses, biome...dical and imaging technicians, surgeons, and physicians, among others.
MedPPE provides guidance for the use of PPE according to workers’ function, the level of care they provide, and the multiple environments of primary health care and hospitals. The tool also clarifies the type of PPE needed when performing aerosol-generating procedures and other activities related to the care of patients infected or suspected of being infected with COVID-19.
However, use of PPE alone is not enough to protect against COVID-19. Hand hygiene and proper PPE dressing and undressing procedures must also be followed, along with the proper disposal and management of waste.
MedPPE is available in Spanish, English, Portuguese and French for iOS and Android devices.
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Objetivos: • Fornecer recomendações para as práticas de prevenção e controle de infecções (PCI) a serem usadas durante atendimento em estabelecimentos não tradicionais, no contexto da doença do novo coronavírus (COVID-19). Estas recomendações são provisórias e estão sujeitas à revi...são conforme novas evidências forem disponibilizadas. Principais considerações: • Com uma demanda crescente por leitos hospitalares, existe a necessidade de transformar estabelecimentos não tradicionais em centros de tratamento para pacientes de COVID 19 que não necessitem de hospitalização. • Para os fins deste documento, estabelecimentos não tradicionais são definidos como hotéis, motéis, abrigos, dormitórios e assistência domiciliar. Estas recomendações não se aplicam a centros de quarentena ou instituições de longa permanência para idosos. • É necessário um planejamento abrangente antes do uso de estabelecimentos não tradicionais como locais de assistência à saúde (1). Para garantir os melhores resultados possíveis, medidas de logística, segurança, gerenciamento de resíduos e controle de infecções devem ser implementadas como parte da resposta à pandemia de COVID-19.
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The meeting was held from 26 to 27 March 2018 to review and discuss the following topics:
Advances and challenges in the use of fTLC, and new approaches to detecting mycolactone using monoclonal antibodies (mAbs).
The status of development of rapid diagnostic tests (RDTs) targeting the MUL..._3720 protein.
The role of PCR as a reference test, and hurdles in providing a confirmatory diagnosis and in establishing a quality assurance programme.
New molecular tools with potential for implementation at a level lower than in the national or regional reference laboratory, such as loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA).
The need to harmonize and standardize methods for collection and preparation of specimens, so samples can be referred for diagnosis and stored for evaluation of new diagnostic tests in optimal conditions.
Barriers to accessing early diagnosis and treatment, including coordination at the programme level, and lack of adequate diagnostic tools.
Defining target product profiles (TPPs) to guide the development of new diagnostic tools that can be applied at different levels of the health system. Participants agreed that two TPPs would be developed to address the current gaps: (i) a rapid test for BU diagnosis at the primary health-care level; and (ii) a test for diagnosis of BU that can also assist in treatment monitoring and differential diagnosis at the district hospital or reference centre.
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Este documento apresenta orientações provisórias para uma comunicação eficaz dos riscos relacionados com atransmissão do vírus Zikae das suas potenciais complicações. Ainda não foi, contudo, estabelecida uma relação causal entre ainfecçãopelo vírus Zika e essas potenciais complicaçõ...es. Nesta incerteza, deverão implementar-se estratégias de comunicação eficazes, para permitir às pessoas tomarem decisões informadas sobre a sua protecção, das suas famílias e das suas comunidades. Estas orientações provisórias destinam-se a ser usadas por: gestores de comunicação dos riscos e da saúde e pelo pessoal e voluntários a nível mundial, regional ou nacional; profissionais da comunicação; antropólogos; sociólogos; prestadores de cuidados de saúde; administradores hospitalares; líderes comunitários; directores de programas; e decisores políticos.
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Ancillary and Occupational Services. Volume 3: Improving Quality & Safety of Health Services. National Health Quality Standards. Standards and Guidelines for Hospital Standards. Volume 3
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 diagnosis-related groups system and surveys of nurse...s and patients, we provide information to policy makers on feasibility, net costs, and estimated improved outcomes associated with increasing nursing resources in public hospitals.
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In resource restriced countries
In resource restriced countries
MOH Policy and Guidelines for Health Institutions
This report is intended to provide information regarding reporting status of the public and private hospitals, availability and utilization of hospital services, performance of the hospitals under administration of Ministry of Health, hospital deliveries and leading causes of hospitalization and mor...tality. The varieties of presentation were used to illustrate different utilization patterns according to geographical distribution and hospital types. Changes of hospital statistics over time were elicited with graphical and tabular presentation.
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This report contains the results of an in-depth Training Needs Assessment (TNA) of Health Workers in the 4 project counties of the republic of Kenya – Nakuru, Kisumu, Nairobi and Bungoma. The assessment, facilitated by the UPOPs Project in close collaboration with the Ministry of Health and Minist...ry of Environment and Natural Resources, took place in the month of September 2017. This assessment focused on health workers at County and County referral health facilities.
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