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2
Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health
...
care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
more
Continuum of HIV services refers to a comprehensive package of HIV prevention, diagnostic, treatment, care and support services provided for people at risk of infection or living with HIV and their
...
families. This revised edition of the guidelines for use of ARV and opportunistic infection
(OI) drugs in adults, adolescents and children is based on recent national and
global evidences and experiences. The Federal Ministry of Health believes that
these guidelines, along with other national guidelines and training manuals, will be
instrumental in maintaining the standard of care and ensuring quality of HIV service
delivery.
more
Vision Statement
From birth to 8 years of age, all children of the Republic of the Union of Myanmar will receive holistic, high-quality and developmentally-appropriate care from their parents, ... caregivers and service providers to ensure they will be happy, healthy, well nourished, socially adept, emotionally balanced and well protected in conditions of freedom, equity and dignity in order to contribute positively to their families, communities and the nation. more
From birth to 8 years of age, all children of the Republic of the Union of Myanmar will receive holistic, high-quality and developmentally-appropriate care from their parents, ... caregivers and service providers to ensure they will be happy, healthy, well nourished, socially adept, emotionally balanced and well protected in conditions of freedom, equity and dignity in order to contribute positively to their families, communities and the nation. more
Primary care visits may be a time that refugee families express concerns about their child’s functioning at home or school and/or providers may identify concerns about emotional or behavioral health. Most refugee
...
children have experienced trauma which may affect their emotional, behavioral, and physical development. However, many refugee children are resilient
and may not exhibit symptoms related to trauma.
more
PEN-Plus is an integrated care delivery strategy focused on alleviating the noncommunicable disease (NCD) burden among the poorest children and young adults by increasing the accessibility and quali
...
ty of chronic care services for severe NCDs – such as type 1 diabetes (T1D), rheumatic heart disease (RHD) and sickle cell disease – in the rural areas of low- and lower-middle-income countries (LLMICs) where more than 90 percent of the world’s poorest people live.
more
PowerPoint slides for Integrating Violence Against Children Prevention and Response into HIV Service
Slides for use with the facilitator manual.
This three-day training package includes ten modules to be delivered to groups of 25-30 health workers. The training is aimed at different cadres of health workers, including: nurses and midwives; clinic
...
ians; HIV counselors; medical social workers; pharmacists; community health workers, and others who are involved in children’s health care in health settings
more
Pharmacological and nonpharmacological interventions for children with attention-deficit hyperactivity disorder (ADHD)
World Health Organization
(2012)
C_WHO
Q7: What is the effectiveness, safety and role of pharmacological and non-pharmacological interventions, within non- specialist health care for children
...
with a diagnosis of Attention-deficit hyperactivity disorder (ADHD)?
more
Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201
...
6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
more
Cryptococcal disease, particularly cryptococcal meningitis is a significant cause of morbidity and mortality among people living with HIV with advanced HIV disease. It is estimated that it is responsible for nearly 19% of AIDS-related mortality, sec
...
ond only to tuberculosis. Rapid screening, diagnosis and linking to appropriate treatment are critical actions national programs must take to reduce the burden of disease.
WHO in 2022 introduced updated guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. This policy brief provides a summary of the key recommendations, clinical considerations, and also stresses the importance of ensuring access to life-saving antifungals. There is an urgent need for countries to scale-up management for not just cryptococcal meningitis, but address cryptococcal disease in the context of a package of care for advanced HIV disease as recommended by WHO.
more
This booklet is aimed at HCP’s, and serves to raise awareness, and emphasize the need for
the inclusion and integration of psychosocial support in the Comprehensive HIV and AIDS
Care, Management
...
and Treatment (CCMT) of children and adolescents.
more
This Course for Service Providers on how to give Vitamin A Supplementation and Deworming (VAS+D) uses both a Learner’sGuide and a Facilitator’s Guide. The Learner’s Guide is designed for parti
...
cipants in the course who are healthcare workers or trainers learning to deliver vitamin A and Albendazole(for deworming) as part of regular activities associated with community or facility-based health care services, while the Facilitator’s Guide is designed for course facilitators who are planning and conducting courses .
more
As slight hints of recovery begin to surface in West Africa, UNICEF is looking at the impact of Ebola on children and the response and work of the affected communities in the report, Ebola: Getting to zero –
...
for communities, for children for the future. The document traces some of the outbreak’s history along with the stories of survivors, health care workers and those working to make things better on the ground. The report also helps map out the actions that urgently must continue to help build resiliency and resuscitate basic services and systems decimated by Ebola.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
...
sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disp
...
roportionately high asthma-related mortality relative to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
more
Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.”
...
Children worldwide repeatedly suffer symptoms which severely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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Part of the CBM Prevention Toolkit on Cerebral Palsy. | This manual is meant to be used in combination with the Flipcharts on Cerebral Palsy developed by CBM and CCBRT (Tanzania). The full Prevention Toolkit on Cerebral Palsy (composed of the A4 Flipcharts, this Manual and a Fact sheet) aims to miti
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gate the disabling effects of cerebral palsy through improved new born care and greater community awareness.
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People younger than 20 years comprise 35% of the global population and 40% of the global population of least-developed nations. The number of children - neonates, infants, children, and adolescents
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up to 19 years of age - who need pediatric palliative care (PPC) each year may be as high as 21 million. Another study found that almost 2.5 million children die each year with serious health related suffering and that more than 98% of these children are in low- and middle-income countries (LMICs) (3). While estimates differ, there is no doubt that there is an enormous need for prevention and relief of suffering among children - for PPC.
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Disclosure of HIV Status Toolkit for Pediatric and Adolescent Populations
N. Rakhmanina; J. Kose; K. Wallner; et al.
Elizabeth Glaser Pediatric New Horizons (Advancing Pediatric HIV Care) ; Johnson & Johnson; AIDS Foundation (Until no child has AIDS); Children & Aids
(2019)
C2
Accessed: 26.10.2019
Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor
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for other noncommunicable diseases and comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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Standard operating procedures (SOP) for the management of tuberculosis in children
National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program), Kenya
Ministry of Health, Kenya
(2017)
C1
2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms
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of TB in children mimic those of other childhood diseases. Children do not readily expectorate and they have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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