This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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The case for evidence- based communication of science
Die WHO hat mit Hilfe der Delphi-Methode eine klinische Falldefinition für das Post-COVID-19-Syndrom entwickelt, die 12 Domänen umfasst und in allen Bereichen verwendet werden kann. Diese erste Version wurde von Patienten, Forschern und anderen Personen aus allen WHO-Regionen entwickelt, wobei dav...on ausgegangen wird, dass sich die Definition ändern kann, wenn sich neue Erkenntnisse ergeben und sich unser Verständnis der Folgen von COVID-19 weiterentwickelt.
Die Post-COVID-19-Erkrankung tritt bei Personen mit einer wahrscheinlichen oder bestätigten SARS-CoV-2-Infektion in der Anamnese auf, in der Regel drei Monate nach dem Auftreten von COVID-19 mit Symptomen, die mindestens zwei Monate anhalten und nicht durch eine andere Diagnose erklärt werden können. Zu den häufigen Symptomen gehören Müdigkeit, Kurzatmigkeit, kognitive Störungen, aber auch andere Symptome, die sich im Allgemeinen auf das tägliche Leben auswirken. Die Symptome können nach der anfänglichen Genesung von einer akuten COVID-19-Episode neu auftreten oder nach der ersten Erkrankung fortbestehen. Die Symptome können auch schwanken oder im Laufe der Zeit wieder auftreten.
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L'OMS a développé une définition de cas clinique de l'état post COVID-19 par la méthodologie Delphi qui comprend 12 domaines, disponible pour une utilisation dans tous les contextes. Cette première version a été élaborée par des patients, des chercheurs et d'autres personnes, représentant... toutes les Régions de l'OMS, étant entendu que la définition peut changer à mesure que de nouvelles preuves apparaissent et que notre compréhension des conséquences de la COVID-19 continue d'évoluer.
L'état post COVID-19 survient chez les personnes ayant des antécédents d'infection probable ou confirmée par le CoV-2 du SRAS, généralement 3 mois après l'apparition de symptômes qui durent au moins 2 mois et ne peuvent être expliqués par un autre diagnostic. Les symptômes courants comprennent la fatigue, l'essoufflement, le dysfonctionnement cognitif mais aussi d'autres et ont généralement un impact sur le fonctionnement quotidien. Les symptômes peuvent être d'apparition récente après le rétablissement initial d'un épisode aigu de COVID-19 ou persister depuis la maladie initiale. Les symptômes peuvent également fluctuer ou rechuter au fil du temps.
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La OMS ha elaborado una definición de caso clínico de la afección posterior a la COVID-19 mediante la metodología Delphi que incluye 12 dominios, disponible para su uso en todos los entornos. Esta primera versión fue elaborada por pacientes, investigadores y otras personas, en representación d...e todas las regiones de la OMS, en el entendimiento de que la definición puede cambiar a medida que surjan nuevas pruebas y siga evolucionando nuestra comprensión de las consecuencias de la COVID-19.
La afección posterior a la COVID-19 se produce en personas con antecedentes de infección probable o confirmada por el CoV-2 del SRAS, normalmente a los 3 meses de la aparición de la COVID-19 con síntomas y que duran al menos 2 meses y no pueden explicarse por un diagnóstico alternativo. Los síntomas más comunes son la fatiga, la dificultad respiratoria y la disfunción cognitiva, pero también otros, y generalmente tienen un impacto en el funcionamiento diario. Los síntomas pueden ser de nueva aparición tras la recuperación inicial de un episodio agudo de COVID-19 o persistir desde la enfermedad inicial. Los síntomas también pueden fluctuar o recaer con el tiempo.
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me...thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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(Synthesis Report 2021) [EN] - World Analysis on World about Agriculture, Climate Change and Environment, Drought, Flood and more; published on 09 Dec 2021 by FAO
The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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Climate Change 2021: The Physical Science Basis. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change
Ce glossaire actualisé sur le paludisme vise à améliorer la communication et la compréhension mutuelle au sein de la communauté scientifique, ainsi qu'avec les organismes de financement, les responsables de la santé publique chargés des programmes de lutte contre le paludisme et les décideur...s des pays où le paludisme est endémique.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance...), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at home immediately after discharge from health care c...enters. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
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South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South A...frica’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
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Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health coverage? As the proactive arm of the health services, community health workers teams provide ho...usehold and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with... authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
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WHO's Health in the Green Economy sector briefings examine the health impacts of climate change mitigation strategies considered by the Intergovernmental Panel on Climate Change in their Fourth Assessment Report.
BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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The 20th century was a period of unprecedented ecological change, with dramatic reductions in natural ecosystems and biodiversity and equally dramatic increases in people and domestic animals. Never before have so many animals been kept by so many people—and never before have so many opportunities... existed for pathogens to pass from wild and domestic animals through the biophysical environment to affect people causing zoonotic diseases or zoonoses. The result has been a worldwide increase in emerging zoonotic
diseases, outbreaks of epidemic zoonoses as well as a rise in foodborne zoonoses globally, and a troubling persistence of neglected zoonotic diseases in poor countries.
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