Orientação provisória 25 de junho de 2021
Recommendations for national testing strategies for SARS-CoV-2 and diagnostic capabilities
Methodology for evaluating national national arboviral disease prevention and and control of arboviral diseases in the Americas
Guidelines for the Vaccination Scheme against
COVID 19: Booster Dose Health Personnel
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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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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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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Guidance for clinical case management of thrombosis syndrome with thrombocytopenia (TTS) following vaccination to prevent coronavirus disease (COVID-19)
Interim guidance 19 July 2021
Considerations on the implementation and adjustment of
public health and social measures in the context of
COVID-19
Interim guidance 14 June 2021
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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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Resumo: o que é esta orientação dinâmica?
Pergunta clínica: qual é o papel dos medicamentos na prevenção da COVID-19?
Público-alvo: o público-alvo são os médicos e os tomadores de decisão na área da saúde.
Prática atual: o uso atual de medicamentos para prevenção da COVID-19 é ...variável, refletindo uma incerteza em grande escala. Numerosos estudos clínicos randomizados de muitos medicamentos estão em andamento para orientar melhor a prática. Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS contém novas
informações e uma recomendação sobre a hidroxicloroquina. (1) Segue-se a publicação de seis estudos sintetizados em uma meta-análise dinâmica de rede (NMA).
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Technical guidelines for the comprehensive care of patients with COVID-19 ; second version
Available in English, French, Spanish, Chinese, Russian and Arabic
https://apps.who.int/iris/handle/10665/337832
The WHO SAGE values framework for the allocation and prioritization of COVID-19 vaccination is intended to offer guidance on the prioritization of groups for vaccination when vaccine supply is limited. It provides a values foundation for the objectives of COVID-19 vaccination programmes and links t...hose to target groups for vaccination. This information is valuable to countries and globally while specific policies will be developed once vaccines become available.
This document it available in Arabic, Chinese English, French, Portuguese and Russian
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The publication draws on pre-COVID data to highlight how children with disabilities face greater risks in the midst of this pandemic. It documents what has happened to services for children and adults with disabilities across the world and includes examples of what has been done to address disruptio...ns in services. It also discusses the challenges in generating disability-inclusive data during the pandemic.
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This document aims to help EU/EEA public health authorities in the tracing and management of persons, including healthcare workers, who had contact with COVID-19 cases. It outlines the key steps of contact tracing, including contact identification, listing and follow-up, in the context of the COVID-...19 response.
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El propósito de este documento es presentar orientaciones para mejorar la aplicación de medidas de salud pública no farmacológicas durante la respuesta a la COVID-19, así como la adherencia a dichas medidas por parte de los grupos de población en situación de vulnerabilidad. Para ello, es nec...esario identificar los principales obstáculos a la aplicación de las medidas, lo que nos permite determinar los grupos y territorios más afectados en las diferentes fases de la pandemia. Con este objetivo, y desde un marco de equidad, derechos humanos y diversidad, se recomiendan políticas, estrategias e intervenciones que acompañan la aplicación y flexibilización de las medidas, de modo que nadie quede atrás.
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Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries
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