Towards Universal Access to Prevention, Diagnosis and Treatment
Accès au site Octobre 2019
Guide de l'Apprenant
The Access to Controlled Medications Programme identified the development of treatment guidelines that cover the treatment of all types of pain as one of the core areas of focus for improving access to opioid analgesics. Such guidelines are interesting both for health-care professionals and policy-...makers. They are also important in improving access to controlled medicines for determining when those opioid medicines and when non-opioid medicines are preferred.
Based on a Delphi study, WHO planned the development of three treatment guidelines, covering chronic pain in children, chronic pain in adults and acute pain.
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From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic p...alliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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Accessed on 28.01.2020
Dans le cadre de la mise en œuvre d’approches spécifiques à la nutrition telles que les pratiques ANJE pour lutter contre la sous-nutrition, le renforcement de la santé communautaire et du rôle des relais communautaire est essentiel. Si de nombreux projets ont été ...développés en intégrant les relais communautaires comme partenaires d’exécution, un manque d’harmonisation est constaté entre les organisations, notamment lié à une absence de statut des relais.
L’étude a pour objectif d’évaluer le fonctionnement des relais communautaires à travers la revue des politiques de santé communautaire et à partir d’études de cas dans le cadre des activités de prévention de la malnutrition aigüe, au Burkina Faso, Mali et Sénégal. 12 projets portés par 9 ONG ont été retenus, et 8 ont fait l’objet d’une analyse qualitative. Au total, 13 villages ou quartiers urbains ont été visités, couvrant plus de 130 relais communautaires, une quinzaine d’agents de santé et une centaine de représentants de la communauté.
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Accessed on 02.02.2020
Selon la Conférence Internationale sur la Population et le Développement (CIPD, Caire, 94, paragraphe 7.2), « la santé de la reproduction ou santé génésique est un état de complet bien-être physique, mental et social et pas seulement l’absence de maladie ou d’inf...irmité, dans tous les domaines liés au système de reproduction, à ses fonctions et ses processus ». Lors de cette conférence, la communauté internationale a confirmé la relation étroite entre le développement, la santé de la reproduction et l’égalité des genres.
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Accessed on 13.02.2020
Il est habituel de penser le handicap comme une perte d'autonomie et le handicapé dans une situation de dépendance sociale(1). Au cours d'une enquête menée en 1985 et 1986 au Sénégal sur les solidarités en milieu urbain, j'ai été amené à m'interroger sur ce qu'on... appelle volontiers "la prise en charge sociale du handicap"(2) et. à la lumière des données empiriques recueillies, à proposer une autre lecture des rapports sociaux en jeu autour de l'infirmité physique(3). Ainsi, parti sur le terrain avec l'idée d'étudier comment la famille et la société africaines venaient en aide à leurs handicapés, j'ai découvert que le handicapé pouvait aussi bien à son tour aider ses parents et son groupe. Plus encore, m'intéressant initialement aux conséquences socio-professionnelles du handicap, j'ai dû introduire secondairement d'autres dimensions de l'échange social, en particulier les relations matrimoniales, de façon à rendre compte plus complètement de la signification sociale du handicap.
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Accessed on 03.03.2020
Situatiuon sanitaire du Sénégal
Dr Boubacar SARR - Coordonnateur du Programme National de Lutte contre la Cécité
Accessed on 11.03.2020
Au cours de l’EIPBF 2017-2018, plus de 6 300 ménages ont été enquêtés sur la prévention du paludisme et on a testé plus de 5 500 enfants de 6-59 mois pour le paludisme et l’anémie. Les résultats sont représentatifs pour l’ensemble du pays, pour le milieu urb...ains et rural, pour Ouagadougou, et pour les 13 régions.
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