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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs
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in the Region as of 2018. These populations are often vulnerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanit
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arian settings. The recommendations outlined here need to be adjusted to the scale of transmission, context and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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The contribution of religious entities to health in sub-Sahara Africa
Schmid B, Thomas E, Olivier J and Cochrane JR.
African Religious Health Assets Programme (ARHAP)
(2008)
CC
The purpose of this guide is to offer recommendations for improving the implementation of non‑pharmacological public health measures during the COVID-19 response and compliance with these measures by population groups
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in situations of vulnerability. This requires determining the main barriers to implementing these measures so that we can identify the groups and territories most affected during the different phases of the pandemic. With this objective in mind––and within the framework of an equity, human rights, and diversity approach––, policies, strategies, and interventions to accompany the implementation and flexibilization of the measures are recommended to ensure that no one is left behind.
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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
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experience, the report shows how community health workers save lives and improve quality of life and 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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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements
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in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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This Toolkit for ensuring rights-based and ethical use of digital technologies in HIV and health programmes is derived from the comprehensive UNDP Guidance on the rights-based and ethical use of dig
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ital technologies in HIV and health programmes document. The foundational UNDP Guidance document outlines key ethical, human rights and technical considerations for countries adopting digital technologies for health, detailing human rights risks, norms and standards, and provides a practical checklist for assessment.
The Toolkit serves as a quick reference guide for UNDP staff, governments, partners, technology developers, and civil society organizations, designed to provide practical guidance for implementing ethical digital health solutions by distilling and structuring the in-depth information from the broader UNDP Guidance into six easy-access modules. Each module addresses a specific key issue by outlining definitions, ethical principles, key considerations, and recommendations that align with the comprehensive framework established by the UNDP Guidance.
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The Minimum Standards for Age and Disability Inclusion in Humanitarian Action inform the design, implementation, monitoring and evaluation of humanitarian programmes across all sectors and phases of
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response, and in all emergency contexts, ensuring older people and people with disabilities are not excluded.
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This Toolkit aims to support the understanding and implementation of integrated mental health programs in humanitarian settings. It provides a framework for essential steps and components, with asso
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ciated key guidance and resources, that strengthen the integration process, and is primarily intended for (1) implementing agencies, but may also be useful for (2) donors, and (3) government actors. Users can access the three steps & three cross cutting components relevant to current program needs, or stages of programming.
Accessed August 7, 2019
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Needs and barriers for mental health and psychosocial support among syrian refugees in lebanon: perspectives for future interventions
European Union Civil protection and Humanitarian Aid
European Union Civil protection and Humanitarian Aid
(2018)
CC
Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ
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ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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Bolkan HA, Bash-Taqi DA, Samai M, Gerdin M, von Schreeb J. Ebola and Indirect Effects on Health Service Function in Sierra Leone. PLOS Currents Outbreaks. 2014 Dec 19. Edition 1. doi: 10.1371/curren
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ts.outbreaks.0307d588df619f9c9447f8ead5b72b2d.
Inpatient health services have been severely affected by the Ebola outbreak. The dramatic documented decline in facility inpatient admissions and major surgery is likely to be an underestimation. Reestablishing such care is urgent and must be a priority.
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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece
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, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
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Research Article
PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002374 August 8, 2017
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations
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in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Introduction
Chapter A.10
This brief guidance note seeks to provide advice on protecting and supporting the mental health and psychosocial wellbeing of refugees, asylum-seekers and migrants in Europe. It describes key princi
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ples and appropriate interventions to guide all those who are designing and organizing emergency services and/or providing direct assistance to the affected people
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