DHS Working Papers No. 103
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Vanquishing violence and vulnerability in humanitarian settings
Background paper for the joint African Union–UNAIDS (in capacity of serving
Chair of H6) high-level side event at the 73rd United Nations General Assembly,
24 September 2018, at UNHQ, Conference Room 3
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh...ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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This monograph presents 12 reports of successful programs serving children with special needs in various nations. The program locations and the program report titles and authors are as follows: (1) Austria: "Integration Models for Elementary and Secondary Schools in Austria" (Volker Rutte)...; (2) China: "Integrated Education Project, Anhui Province" (Janet C. Holdsworth); (3) Ghana: "The Community-Based Rehabilitation Programme in Ghana" (Lawrence Ofori-Addo); (4) Guyana: "Involvement of Volunteers, Parents and Community Members with Children with Special Needs" (Brian O'Toole); (5) India: "Teacher Development Initiative To Meet Special Needs in the Classroom" (N. K. Jangira and Anupam Ahuja); (6) Jamaica: "Early Intervention and Education Initiatives in Rural Areas" (M. J. Thorburn); (7) Jordan: "The Role of Institutions in Community-based Rehabilitation and in Community-based Special Education" (Andrew L. de Carpentier); (8) Jordan: "The Resource Room at the Amman National School" (Hala T. Ibrahim); (9) Netherlands: "Individual Integration of Children with Down's Syndrome in Ordinary Schools" (Trijntje de Wit-Gosker); (10) Norway: "In Harmony We Learn" (Marna Moe); (11) International: "INITIATIVES for Deaf Education in the Third World" (Andrew L. de Carpentier); and (12) Sri Lanka: "The Integrated Education of Visually Impaired Children in Sri Lanka" (B. L. Rajapakse).
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This research aims to identify a core set of clinical skills for working in
a Community Based Rehabilitation (CBR) setting, and to discuss whether they are appropriate for task shifting to a new or an alternative cadre of rehabilitation workers.
This study examines the ability of political, legal, health, and communities to respond to gender-based violence in Kigali, Rwanda.
This paper aimed to demonstrate how participatory action research (PAR) within a Community-based Rehabilitation (CBR) project facilitated community participation to advocate for the rights of people with visual impairment. An advocacy campaign, led by the local people with and without disabilities, ...was launched for the construction of an accessible foot over- bridge (FOB) at Vangani railway station in Maharashtra, India.
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Review
www.co-hivandaids.com
Volume 12 Number 4 July 2017
Masangane Case Study
The Vesper Society commissioned ARHAP to do research on the integrated Masangane HIV/AIDS programme affiliated with the Moravian Church in Eastern Cape, South Africa. Completed in 2006, this study aimed to understand the role of the religious health assets of the Masangane ART ...programme for public health, as a model for a replicable response to HIV/AIDS. A crucial aspect of this research involved teasing out what value is added to this programme by its faith-based nature. Field work for this case study consisted of more than 20 key informant interviews of various stakeholders: Masangane staff and management; church leaders; health seekers; donors and health providers. Health seekers also answered 77 questionnaires and were involved in two focus groups.
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En una crisis de salud pública como la actual pandemia de COVID-19, cuando se implementan medidas de “distanciamiento social” para frenar la propagación de la infección, las personas que enfrentan cualquier tipo de violencia basada en género, como violencia de pareja íntima, violencia psico...lógica, física o sexual, pueden correr riesgos adicionales. Muchas de las personas sobrevivientes de violencia basada en género (VBG) se encuentran encerradas en los mismos espacios con los agresores durante períodos prolongados de tiempo, lo cual limita su privacidad y su capacidad de huir de la violencia y exacerba las amenazas a su vida, salud e integridad.
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La vigilancia de la resistencia a los antimicrobianos (RAM) desempeña un papel importante en la detección temprana de cepas resistentes que revisten gran importancia para la salud pública, así como en la respuesta rápida a los brotes en los hospitales y en la comunidad. Los resultados de la vig...ilancia son necesarios para fundamentar la práctica médica, la administración de antibióticos, y las políticas e intervenciones para combatir la RAM. El uso apropiado de antimicrobianos, fundamentado en la vigilancia, mejora los resultados del tratamiento de los pacientes y reduce la aparición y propagación de la RAM.
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In order to streamline and effectively control compounding of medicinal products in hospitals and pharmacies, these Guidelines for Production of Extemporaneous and Hospital Based Sterile Preparations has been crafted. The purpose of these guidelines therefore is to assist pharmacists in ...discharging their legal and professional obligations to patients in the area of extemporaneous dispensing. This guidance will help to assure the safe and appropriate preparation and supply of extemporaneously prepared medicinal products to patients, where
the supply of such products is necessary.
Extemporaneous and hospital based sterile preparations are critical for patients whose clinical needs cannot be met by registered medicinal products. The guidelines outline the principles and application of the concepts of Good Manufacturing Practice (GMP) requirements for premises, equipment, personnel, storage, quality management system, quality control, compounding processes as well as documentation.
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Health and Human Rights Series. 6 Tobacco: a rights-based approach.
PLoS Neglected Tropical Diseases https://doi.org/10.1371/journal.pntd.0004762
This study shows the importance of an integrated entomological and medical surveillance for the evaluation of arboviral disease risk, which is a precondition for designing cost-effective vector control programs.
Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-...incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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