For medical students and doctors
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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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t...echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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Making the Case for Alcohol as a Public Health Threat in the Region. The purpose of this document is to explain the need for making alcohol a top public health priority in the region and the need for national and regional action. Current evidence-based research shows that alcohol consumption and dri...nking patterns in the Americas are at damaging levels, with the region surpassing global averages for many alcohol related problems.
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Misceláneo
Capítulo J.6
Edición: Matías Irarrázaval & Andres Martin
Traducción: Fernanda Prieto-Tagle & Marina Romero
This guide provides a practical overview of the process of developing a Theory of Change, focusing on using a stakeholder-driven, workshop approach to achieve this.
Evaluando y mejorando la calidad y los derechos humanos en los establecimientos de salud
mental y de apoyo social
Trop peu de médecins ont les compétences nécessaires pour traiter la fistule génitale et pour suivre les patientes après l’opération chirurgicale. La plupart des actes ont lieu en Afrique et en Asie par des chirurgiens locaux, avec un support technique fourni par les chirurgiens de pays dév...eloppés, où les cas de fistules sont rares. Il faudrait de nombreuses années aux médecins actuellement capables de traiter les fistules obstétricales pour opérer toutes les femmes qui ont besoin de leurs expertises, ces femmes qui sont chaque jour de plus en plus nombreuses. Bien que le besoin de chirurgiens formés au traitement de la fistule soit reconnu, il n’existait pasjusque là de manuel de formation standard. Ce présent manuel a été conçu pour pallier à ce manque.
Ce manuel a été conçu en collaboration avec des chirurgiens de la fistule, des organisations professionnelles et des organisations spécialistes de la santé, basées en Afrique, en Asie, en Europe et aux États-Unis.
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A systematic approach to holistic wound care is essential for the delivery of high quality wound care. Holistic wound assessment considers the whole person and should comprise the components of the generic wound assessment minimal data set. Therefore holistic assessment is key to gathering informati...on on the
patient and their wound. This information should be documented at each review so that it can act as a baseline against which wound progress can be tracked and used to guide management decisions.
Inaccurate or lack of assessment can result in appropriate care and delays in healing, unnecessary patient suffering, poor outcomes and the inappropriate use of resources
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STANDARD OPERATING PROCEDURES
PARTICIPANT GUIDE
This Participant Guide has been designed to assist health facilities and community based non-clinicians to develop skills to provide linkage to care, adherence and retention in care services for chronic conditions
The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on... aid targeting reproductive, maternal, newborn, and child health (RMNCH). We take a multi-sectoral approach and extend the estimation to the four sectors that determine child survival: health (RMNCH and non-RMNCH), education, water and sanitation, and food and humanitarian assistance (Food/HA). Methods and findings: Using donor reported data, obtained mainly from the OECD Creditor Reporting System and Development Assistance Committee, we tracked the level and trends of aid (in grants or loans) disbursed to each of the four sectors at the global, regional, and country levels. We performed detailed analyses on missing data and conducted imputation with various methods. To identify aid projects for RMNCH, we developed an identification strategy that combined keyword searches and manual coding. To quantify aid for RMNCH in projects with multiple purposes, we adopted an integrated approach and produced the lower and upper bounds of estimates for RMNCH, so as to avoid making assumptions or using weak evidence for allocation. We checked the sensitivity of trends to the estimation methods and compared our estimates to that produced by other studies. Our study yielded time-series and recipient-specific annual estimates of aid disbursed to each sector, as well as their lower- and upper-bounds in 134 countries between 2000 and 2014, with a specific focus on Countdown countries. We found that the upper-bound estimates of total aid disbursed to the four sectors in 134 countries rose from US$ 22.62 billion in 2000 to US$ 59.29 billion in
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En la reunión de alto nivel de las Naciones Unidas del 2018 se fijó el objetivo de tratar al menos a 40 millones de personas con tuberculosis (TB) entre el 2018 y el 2022; sin embargo, en el 2021 ese objetivo solo se había cumplido en un 66%. Las pruebas diagnósticas son fundamentales para logra...r el objetivo, pero constituyen un eslabón débil en la continuidad de la atención. Las pruebas de diagnóstico rápido recomendadas por la Organización Mundial de la Salud (PDRO) son sumamente precisas, acortan el tiempo hasta el inicio del tratamiento, influyen en resultados importantes para el paciente y son costo-eficaces. Aunque el objetivo para el año 2025 es que todos los pacientes notificados se hagan inicialmente una PDRO, en el 2021 tan solo el 38% se hizo una PDRO como prueba inicial, y se determinó que el acceso a las pruebas diagnósticas era un problema crítico. Una de las principales consecuencias del uso insuficiente de las PDRO es la gran brecha en la detección de la farmacorresistencia. La presente Norma de la OMS: Acceso universal a las pruebas de diagnóstico rápido de la tuberculosis se basa en las directrices de la OMS y en el manual operativo conexo
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Needs assessment and analysis
Collect and analyze sex, age and disability disaggregated data (SADDD) and conduct a participatory gender analysis to understand different health needs, capacities, barriers and aspirations and identify populations with special health requirements
Population demogra...phics. E.g. pregnant and lactating women, infants, elderly, unaccompanied children, persons with disabilities, chronically ill persons 9 Gender roles and power dynamics. E.g. ability of women, girls, men and boys to make health decisions and access services; roles and responsibility of household members in health.
Gender and cultural norms and practices. E.g. preference for mixed/segregated facilities and staff; socio-cultural and religious taboos and beliefs around health, practices and beliefs on menstruation, practices and expectations on pregnancy, childbirth and breastfeeding; traditional health care providers
Intersectional issues. E.g. access to health care for LGBTIQ persons, for GBV survivors, for adolescent girls and boys
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