orientations provisoires, 25 juin 2021. Des tests de diagnostic rapides et précis sont un outil essentiel pour prévenir et contrôler la propagation du COVID-19. Ce document décrit les recommandations relatives aux stratégies nationales de dépistage et à l'utilisation de la PCR et des tests an...tigéniques rapides dans différents scénarios de transmission de l'épidémie de COVID-19, y compris la manière dont les tests pourraient être rationalisés dans les milieux à faibles ressources. Tous les tests doivent être suivis d'une réponse de santé publique forte, comprenant l'isolement des personnes dont le test est positif et la fourniture de soins, la recherche des contacts et la mise en quarantaine des contacts.
more
Обновленная версия. В этой версии приведены обновленные рекомендации относительно стратегии диагностического тестирования в контексте обновлённой классификаци...и способов передачи, мер общественного здравоохранения и социальных мер, эпиднадзора за общественным здравоохранением и установленных ВОЗ определений случая COVID-19. В данном руководстве учтено использование новых инструментов, таких, как диагностические экспресс-тесты для выявления антигенов (ДЭТ-АГ) и аспекты тестирования привитых лиц, а также тестирования на генетические мутации, связанные с вариантами. Кроме того, для этой версии разработаны приложения, включая подборку полезных ресурсов и десять компонентов расширения тестирования на субнациональном уровне.
more
This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public health care. The Standards identify major components and features of effective systems for the tre...atment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
more
National emergency medical teams are the best option for providing immediate and appropriate surge response for emergencies directly affecting populations, while international teams may help relieve overwhelmed health systems. The efficiency and effectiveness of countries and local authorities in mo...bilizing existing resources is only as good as the quality of care they are able to provide. This publication serves as a practical guide for teams and aims to compliment emergency response systems, fostering seamless collaboration with all emergency response actors and networks
more
No country can claim to be free from health-care associated infections, therefore, improvement of infection prevention and control (IPC) strategies is essential. WHO recommends the use of multimodal improvement strategies to implement IPC interventions. These include each item of standard and transm...ission-based precautions according to national guidelines or standard operating procedures and under the coordination of the national IPC focal point (or team, if existing). This publication consists of three focused improvement tools, called “aide-memoires”, which focus on 1) respiratory and hand hygiene, 2) personal protective equipment, and 3) environmental cleaning, waste and linen management, all elements of standard, droplet/contact and airborne precautions.
more
July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in... the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
more
No education system is effective unless it promotes the health and well-being of its students, staff and community. These strong links have never been more visible and compelling than in the context of the COVID-19 pandemic. Towards making every school a health-promoting school: Let’s start with a... shared vision based on the standards and indicators presented in this publication.
more
Guide to national implementation of the Shanghai Declaration describes policy orientations and approaches that can unlock the transformative potential of health promotion for sustainable development. This guide was developed to support country level implementation of the commitments and recommendati...ons in the Shanghai Declaration.
more
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
more
Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasison healthy lifestyle and prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of prima...ry care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing. Substitution of nurses for doctors is one strategy used to improve access, efficiency, and quality of care. This is the first update of the Cochrane review published in 2005.
more
Modern healthcare has given rise to extremely complex and multifaceted ethical dilemmas. All too often physicians are unprepared to manage these competently. This publication is specifically structured to reinforce and strengthen the ethical mindset and prac...tice of physicians and provide tools to find ethical solutions to these dilemmas. It is not a list of “rights and wrongs” but an attempt to sensitise the conscience of the physician, which is the basis for all sound and ethical decision-making. To this end, you will find several case studies in the book, which are intended to foster individual ethical reflection as well as discussion within team settings.
more
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.... 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.
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.
more
Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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.