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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti
...
cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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Antibiotics and other antimicrobial agents are invaluable life savers, particularly in resource-limited countries where infectious diseases are abundant. Both uncomplicated and severe infections are potentially curable as long as the aetiological agents are susceptible to the
...
antimicrobial drugs. The rapid rate with which antimicrobial agents are becoming ineffective due to resistance acquired as a result of unchecked overuse and misuse threatens to undo the benefit of controlling infections. The evidence for resistant microorganisms, many times to more than a single antimicrobial agent, has been observed globally. In Tanzania, there is evidence in the form of few scattered studies conducted in different parts of the country in a multitude of settings including health care facilities, the community, domesticated animals and wild animals
more
The State of the world’s nursing 2020 report provides the latest, most up-to-date evidence on and policy options for the global nursing workforce. It also presents a compelling case for considerable – yet feasible – investment in nursing education, jobs, and leadership.
The primary chapters
...
of the report outline the role and contributions of nurses with respect to the WHO “triple billion” targets; the health labour market and workforce policy levers to address the challenges to nurses working to their full potential; the findings from analysis of National Health Workforce Account (NHWA) data from 191 Member States and progress in relation to the projected shortfall of nurses by 2030; and forward-looking policy options for an agenda to strengthen the nursing workforce to deliver the Sustainable Development Goals, improve health for all, and strengthen the primary health care workforce on our journey towards universal health coverage.
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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from
...
Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa
...
cerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
more
As part of our commitment to the fight against NCDs, Nigeria was signatory to the political declaration at the UN General Assembly High Level Meeting on NCDs in September 2011. Thus, the purpose of this document is to develop and ensure the implementation of policies and p
...
rogrammes that will engender and guarantee a healthy lifestyle and quality health for all Nigerians. The core sections include background, scope of the policy, policy goal, strategic thrusts for implementation, programme management and coordination, roles of stakeholders and partnership coordination. It is expected that with the adoption of this policy, the control and prevention of NCDs and their associated risk factors will be well integrated at all levels of government and health care delivery system in Nigeria. This policy document is therefore a stepping stone towards the development of guidelines for the prevention and management of NCDs.
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Updated version – September 2020
The COVID-19 pandemic is affecting everyone. Globally, millions of people have been infected with the virus, while hundreds of thousands have lost their lives. In Moldova, the pandemic is placing an ever-increasing pressure on the health
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care and social protection systems, causing major disruptions to economic processes and limitations to social life, deepening inequalities and proving how vulnerable we are.
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Thefirst report on Latin America and the Carribean presents key indicators on health and health systems in 33 Latin America and the Caribbean countries. . Analysis is based on the latest comparable data across almost 100 indicators including equity, health status, determinants of health, health
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care resources and utilisation, health expenditure and financing, and quality of care. The editorial discusses the main challenges for the region brought by the COVID-19 pandemic, such as managing the outbreak as well as mobilising adequate resources and using them efficiently to ensure an effective response to the epidemic.
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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis
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B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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Integrated Management of Newborn and Childhood Illness, Part 1 Blended Learning Module for the Health Extension Programme
HEAT, UNICEF, Open University, AMREF, WHO
Ministry of Health, Federal Democratic Republic of Ethiopia
(2011)
C1
These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium Development Goals to reduc
...
e maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery, postnatal care, the integrated management of newborn and childhood illness, communicable diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases), family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene and environmental health, non-communicable diseases, health education and community mobilisation, and health planning and professional ethics.
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COVID-19 Vaccines: 1 Safety Surveillance 2 Manual
While there is no indication that pregnant women have an increased susceptibility to infection with SARS-CoV-2, there is evidence that pregnancy may increase the risk of severe illness and mortality from COVID-19 disease in comparison with non-pregn
...
ant women of reproductive age. As seen with non-pregnant women, a high proportion of pregnant women have asymptomatic SARS-CoV-2 infection and severe disease is associated with recognized medical (e.g., high body-mass index (BMI), diabetes, pre-existing pulmonary or cardiac conditions) and social (e.g., social deprivation, ethnicity) risk factors. Pregnant women with symptomatic COVID-19 appear to have an increased risk of intensive care unit admission, mechanical ventilation and death in comparison with non-pregnant women of reproductive age, although the absolute risks remain low. COVID-19 may increase the risk of preterm birth, compared with pregnant women without COVID-19, although the evidence is inconclusive.
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This document describes the ethical values that are most important to the nursing profession in Ontario. It also provides scenarios of ethical situations in which there is a conflict of values. Nurses are encouraged to use these scenarios for reflection and discussion. No solutions are offered becau
...
se there is no one solution that is best in all situations. The behavioural directives are intended to help nurses work through ethical situations and provide information about the College of Nurses of Ontario’s (CNO’s) expectations for ethical conduct. These are taken into account when CNO Committees assess nurses’ practices. Nurses need to consider behavioural directives carefully when making decisions about ethical care as this process will strengthen their practice.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea
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rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
more
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
...
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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This standard Operating procedure (SOP) for JDWNRH is intended to describe and
address various important areas like admission procedure, on call process of the
doctors, interdepartmental consultation, patient discharge process and verity of
other areas which was so far solely based on verbal i
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nstruction in the workplace by
the seniors which very often led to mishaps and other associate problems. This SOP,
though not comprehensive, would serve as a guidebook for newly recruited health
staff as well as a reference book for existing health professionals in JDWNRH while
delivering health care services
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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
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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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Guidelines on Management of COVID-19 in Kenya
recommended
It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi-sectoral technical working groups on testing, case management, risk communication and community engag
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ement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama
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nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i
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s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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Overview
Epilepsy is one of the most common neurological disorders globally. The WHO epilepsy technical brief aims to strengthen action for epilepsy and complements the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031.
The technical bri
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ef presents the key information on epilepsy and recommends actions to policy makers and other stakeholders. Using the concept of levers for change introduced by the Operational Framework for Primary Health Care, it identifies actions on the policy and operational levels that stakeholders should take to strengthen services for people with epilepsy using a person-centered approach based on human rights and universal health coverage.
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