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1
Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
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These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and
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how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
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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
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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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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the
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y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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Mosby’s Pocket Guide to Nursing Skills and Procedures, eighth edition, is
a practical, portable reference for students and practitioners in the
clinical setting. Grouped alphabetically, 85 commonly performed skills
are presented in a clear, step-by-step format that includes:
■ Purpose for pe
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rforming each skill
■ Guidelines to help students in delegating tasks to assistive
personnel
■ List of equipment required
■ Rationales to explain why specific techniques are used
■ Full-color photographs and drawings to provide visual
reinforcement
In addition, Safety Alerts are included in the skills to highlight important
information about patient safety and effective performance.
Current Standard Precautions guidelines from the Centers for Disease
Control and Prevention are incorporated throughout. Preprocedure
and postprocedure protocols are conveniently located on the inside
back cover.
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Community health nurses have the potential to make significant contributions to meet the health care needs of various population groups in a variety of community settings. In order to assess the extent to which CHNs are achieving this potential, WHO conducted a study between 2010 and 2014 that exami
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ned the status of community health nursing in 22 countries, 13 of which were experiencing a critical shortage of health care workers. The study revealed that the countries surveyed had the basic and operational framework for optimizing CHN in their health systems as evidenced by the availability of PHC structures to guide interventions. However, challenges were identified related to the education, practice and management of CHNs in these countries. The major challenges identified were: Limited availability of career opportunities; poor worker retention; low recognition for CHNs; inadequate and unsupportive working conditions and environments; absence of educational standards; varying educational entry-level requirements for CHN programmes; and a lack of consensus on the scope of practice for CHNs.
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Midwifery Capacity Building Strategy for Northern Syria
2017-2021
Available in Arabic
March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives.
The menu was developed using the WHO-CHOICE methodology to prepare and update, as appropriate, WHO estimates of the cost-effectiveness of a range of mental health interventions, in line with the development of Appendix 3 to the global action plan for the prevention and control of noncommunicable dis
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eases 2013–2020.
WHO-CHOICE is a programme that helps countries to identify priorities based on health impact and cost-effectiveness. It can be applied to a wide range of strategies relevant to policies affecting health outcomes. All options are compared to a common comparator, a null scenario in which the impacts of currently implemented interventions are removed, thereby enabling comparison of interventions across geographical areas and aspects of health.
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Examining nursing practice guidelines to improve quality of care for patients with sepsis in low income countries is required. • A large amount of information about best practice standards in sepsis management is available for healthcare professionals; however, implementation and adherence to prac
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tice guidelines recommended by the Surviving Sepsis Campaign remains low in low income countries.
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This section provides general information on HCW and key elements of management procedures that are essential to know before developing a HCWM plan.
Wound care is a regular component of the package of care we offer in the majority of our health care facilities and represents a high volume of activities. The current practices in MSF projects are often based on the habits of each individual supervisor, the wound care material we off
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er is partly outdated and does not allow optimal wound care. There is a need for standardization of wound care and it needs to be evidence based as much as possible, taking into account the realities of the field.
The scope of this document is to guide the caregiver in the wound care process. It does not intend to provide in depth information on wound healing or physiology. There is a wide range of literature and background information available for this purpose in the references and in the list of extra reading
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Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environme
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ntal factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
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Best practice guidelines are systematically developed statements designed to assist nurses working in partnership with persons and their families to make decisions about health care and services (Field & Lohr, 1990). This nursing Best Practice Guideline (BPG) is intended to replace the RNAO BPGs Scr
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eening for Delirium, Dementia and Depression in Older Adults (2010b) and Caregiving Strategies for Older Adults with Delirium, Dementia and Depression (2010a).
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This manual summarizes key issues related to the safety of NTD medicines and their administration, with a focus on essential medicines used in mass drug administration (MDA), also called preventive chemotherapy. It can be used as a standalone reference manual, but is intended to be used in conjuncti
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on with the accompanying training modules, which provide practical instruction, and the aide-mémoires. Versions of the aide-mémoires and training modules are available respectively for both (i) programme managers and district-level health officials and (ii) community drug distributors and community health workers
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The toolkit provides practical guidance and tools that can support efforts, including planning and implementation activities, to create dementia-inclusive societies.
The toolkit is divided into two parts. Part I contains background information and a conceptual framework for creating dementia-incl
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usive societies. Part II includes four practical modules, each featuring a series of practical steps and exercises. The four modules focus on: starting a new dementia-friendly initiative (DFI), integrating dementia into an existing initiative, monitoring and evaluation a DFI, and scaling a DFI. The modules can be used together or separately and offer guidance that can be adapted to suit local needs and settings.
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The plan aims to practice the preparedness measures and response functions which need to be coordinated among relevant departments and organizations to reduce the risk of earthquakes. The plan has two main parts: preparedness and response. The first part includes the preparedness measures which can
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be practically implemented in collaboration with relevant government departments and communities. The latter part includes the response functions by the National Disaster Management Committee and it’s Work Committees if a damaging earthquake were to occur.
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