In the year 2008, for the first time in history, more than half of the world’s population was living in urban areas. Cities have become more numerous, more populous, and denser. The complexity and density of urban environments significantly alter the viability of certain humanitarian protection st...rategies that might work well in rural, more sparsely populated areas. In addition, it has become difficult to draw the line between acute and chronic vulnerability and therefore, the identification of beneficiaries. This blur in distinction between chronic and acute vulnerability has raised a number of important questions for humanitarian organizations regarding if and how they should intervene. While many such organizations are equipped with the appropriate skills to mitigate overwhelming public health challenges is such contexts, the absence of a crisis point - such as armed conflict or natural disaster - brings the mandate of humanitarian agencies into question.
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Imported and local rice prices increased modestly in March. A recovery in economic activity is leading to an improvement in unskilled wage rates (up 7 percent compared to February).
The households who are depending the most on negative coping strategies are in the districts of Kailahun, Kon...o, Bombali, Tonkolili and Koinadugu.
March data continues to show that negative coping strategies are most frequently used by the poorest households, by those living in Ebola-affected rural areas and by households headed by women.
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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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DHS Working Papers No. 69
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant economic change in India. The main predictor is a new... measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level.
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This operational guidance on MHPSS provides a practical orientation and tools for UNHCR country operations. It covers specific points of good practice to consider when developing MHPSS programming and offers advice on priority issues and practical difficulties, while also providing some background i...nformation and definitions. Since MHPSS is a cross cutting concept this operational guidance is relevant for programming in various sectors, including health, community based protection, education, shelter, nutrition, food security and livelihoods.
The focus of this operational guidance is on refugees and asylum seekers, but it may apply to other persons of concern within UNHCR operations such as stateless persons, internally displaced persons and returnees. The guidance is meant for operations in both camp and non-camp settings, and in both rural and urban settings in low and middle-income countries with a UNHCR presence.
The guidance should be adapted according to different contexts. A standardized format for programme implementation cannot be offered because this depends to a large extent on existing national capacities and local opportunities.
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The World Health Organization (WHO) and United NationsHuman Settlements Programme (UN-HABITAT) joint globalreport, Hidden cities: unmasking and overcoming healthinequities in urban settings, exposes the extent to whichcertain city dwellers suffer disproportionately from a wide range of diseases and ...health problems. This report provides information and tools to helpgovernments and local leaders reduce health inequities in their cities. The objective of the report is not tocompare rural and urban health inequities. Urban healthinequities need to be addressed specifically for they aredifferent in their magnitude and in their distribution.
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General fact sheet in booklet form about the 2014-2015 Demographic and Health Survey conducted in Rwanda. The 2014-15 Rwanda Demographic and Health Survey (RDHS) provides data for monitoring the health situation of the population in Rwanda. The 2014-15 RDHS is the 5th Demographic and Health Survey c...onducted in the country. The survey is based on a nationally representative sample. It provides estimates at the national and provincial levels, as well as for urban and rural areas, and for some, at the district level.
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Provision of integrated RH/FP/STI/HIV services
In Togo, the limited access of populations, especially women, young girls and children to Reproductive Health (RH), Family Planning, treatment of sexually transmissible infections (STI) and struggle against HIV quality services is responsible for t...he continuously low indicators in these areas. To remedy the problem, UNFPA Togo, in partnership with the Department of Family Health, the Health districts and the NGOs 3ASC and ATBEF, support the initiative of the Mobile Clinic to bring RH/FP/STI/HIV quality services closer to the women, the young girls and children living in rural areas in its intervention areas, with the aim of reaching MDG 4 and 5.
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In March, households in Lofa used fewer negative coping strategies than in February. The counties with highest levels of negative coping include Bomi, Grand Cape Mount, Gbarpolu and Lofa.
Negative coping strategies are most frequently used by the poorest households, by those living in Ebola...-affected rural areas and by households headed by women.
Imported and local rice prices remained stable. As the land preparation season advances, wage rates are improving (+3% compared to February).
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[Preface]. For more than forty years Primary Health Care (PHC) has been recognized as the cornerstone of an effective and responsive health system. The Alma-Ata Declaration of 1978 reaffirmed the right to the highest attainable level of health, with equity, solidarity and the right to health as its ...core values. It stressed the need for comprehensive health services, not only curative but services that addressed needs in terms of health promotion, prevention, rehabilitation and treatment of common conditions. A strong resolutive first level of care is the basis for health system development [...] The Pan American Health Organization/World Health Organization (PAHO/WHO) has supported the countries in the establishment of interprofessional PHC teams, in the transformation of health education and in building capacity in the strategic planning, and management of human resources for health. Nursing can play a critical role in advancing PHC. New profiles such as the advanced practice nurses, as discussed in this document, can be fundamental in this effort, and in particular, in health promotion, disease prevention and care, especially in rural and underserved areas.
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Cette formation a pour but de renforcer les capacités des acteurs communautaires sur la surveillance intégrée des maladies a potentiel épidémique.
Il s'avère nécessaire de former de manière adéquate les acteur communautaires et de mettre en place un système performant de surveillance int...égrée des maladies aux niveau communautaires soutenu par une communication appropriée avec les population aussi bien au milieu urbain que rural.
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La Surveillance épidémiologique est un processus continu de collecte, d'analyse et de diffusion d'informations pour la prise d'actions de riposte. Les activités de surveillance épidémiologique sont mises en oeuvre au Sénégal selon la stratégie SIMR (Surveillance Intégrée de la Maladie et R...iposte) et suivant le RSI (Version 2005). Cependant, très souvent les données de surveillance des maladies, surtout aux niveau communautaire, ne sont pas toujours bien enregistrées, notifiées et analysées.
Aujourd'hui, les maladies transmissibles emergentes et ré-émergentes comme la maldie à Virus Ebola (MVE), constituent une menace importante pour la santé et le bien-êtres de nos communautés. Fort heureusement, les interventions de lutte et de prévention sont bien connues pour certaines.
Il en résulte que des opportunités pour prendre et mettre en place des mesures de riposte appropriées de santé publique pour sauver des vies existens et doivent être clairement indentifiées. Pour cela, il s'avère nécessaire de former de manière adéquate les acteurs communautaires et de mettre en place un système perfomant de surveillance intégrée des maladies aux niveau communautaire soutenu par une communication appropriée avec les populations aussi bien en milieu urbain que rural.
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La Surveillance épidémiologique est un processus continu de collecte, d'analyse et de diffusion d'informations pour la prise d'actions de riposte. Les activités de surveillance épidémiologique sont mises en oeuvre au Sénégal selon la stratégie SIMR (Surveillance Intégrée de la Maladie et R...iposte) et suivant le RSI (Version 2005). Cependant, très souvent les données de surveillance des maladies, surtout aux niveau communautaire, ne sont pas toujours bien enregistrées, notifiées et analysées.
Aujourd'hui, les maladies transmissibles emergentes et ré-émergentes comme la maldie à Virus Ebola (MVE), constituent une menace importante pour la santé et le bien-êtres de nos communautés. Fort heureusement, les interventions de lutte et de prévention sont bien connues pour certaines.
Il en résulte que des opportunités pour prendre et mettre en place des mesures de riposte appropriées de santé publique pour sauver des vies existens et doivent être clairement indentifiées. Pour cela, il s'avère nécessaire de former de manière adéquate les acteurs communautaires et de mettre en place un système perfomant de surveillance intégrée des maladies aux niveau communautaire soutenu par une communication appropriée avec les populations aussi bien en milieu urbain que rural.
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Over the reporting period, THP-Burkina Faso (THP-Burkina) maintained a continuous focus on ensuring the selfreliance of the health program in each of its epicenters. Building upon its exclusive use of government-run health clinics at its epicenters, THP-Burkina developed a firstever partnership agre...ement with the national Ministry of Health. This allowed greater partnership with medical professionals at the epicenter level, as was practiced at Boulkon Epicenter in June 2012 (see photo). THPBurkina continued advancing four of its 10 Phase III epicenter rural banks toward government recognition.
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With an FGM prevalence of 75.8% among women aged 15-491, Burkina Faso is classified by UNICEF2 as a ‘moderately high prevalence’ country.
FGM is practised across all regions, ethnic groups and religions in Burkina Faso. There are distinct regional variations; FGM prevalence ranges from 54.8%... in the Centre-West to 89.5% in the Centre-East. Two-thirds of the population of Burkina Faso live in rural areas, and nearly 10% more women aged 15-49 have had FGM in rural areas (78.4%) than in urban areas (68.7%). Prevalence in the capital, Ouagadougou, is 64.8%.3
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According to the National Institute of Statistics and Demography (NSID) 168,094 persons out of Burkina Faso’s 14,017,262 inhabitants are living with a physical, sensory or mental disability. The numbers are questioned as the effort to collect in-depth statistics has not been great. Furthermore, mu...ch of the statistics is only collected in more densely populated provinces and towns and not in smaller rural communities. Handicap International (HI) estimates that the number is as high as 7 per cent.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o...f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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