The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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This guide provides practical, step-by-step guidance on how to organize, implement, and monitor community-based care for DR TB. It is equally useful for program planning or supervision. The target audience for this guide is TB Program Managers, governments, policy makers, nongovernmental organizatio...ns (NGOs), donors and TB advocates.
This guide does not replace other guidelines and documents that contain important medical information, such as Guidelines for the Programmatic Management of Drug-resistant TB (WHO, 2008 and 2011 updates), and Management of MDR-TB: A Field Guide (WHO, 2009).
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The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South Africa.
The NCS define fundamentals for quality of care based on six ...dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
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The intended purpose of this compendium is to provide program managers, organizations, and policy makers with a menu of indicators to better “know their HIV epidemic/know their response” from a gender perspective. The indicators in the compendium are all either part of existing indicators used i...n studies or by countries or have been adapted from existing indicators to address the intersection of gender and HIV. The indicators can be measured through existing data collection and information systems (e.g. routine program monitoring, surveys) in most country contexts, though some may require special studies or research.
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Mounting an effective international humanitarian response to a chemical, biological, radiological or nuclear (CBRN) event, especially if the response is undertaken on an ad hoc basis, would be extremely difficult and would pose many risks to the responders. The International Committee of the Red Cro...ss (ICRC) has created a competency-based capacity to respond to at least small-scale CBRN events, including a deployable capability to undertake operational activities. This involves informed assessments of CBRN risks, timely and competent decisions on how to respond, and effectively mobilizing appropriate resources to implement these decisions, through the creation of an emergency roster. In addition to the acquisition of technical expertise and material resources, the creation of such capacity requires the application of central processes, ensuring systematic management of CBRN response (including risk-based decision-making), standing operational procedures, and availability of and access to the necessary resources. Implementation of the ICRC's CBRN response framework as described in this article should be considered by any agency or other stakeholder preparing for international humanitarian assistance in CBRN events – especially if such events are related to armed conflict.
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This publication is intended for professionals training or practicing in mental health and not for the general public. The opinions
expressed are those of the authors and do not necessarily represent the views of the Editor or IACAPAP. This publication seeks to
describe the best treatments and pra...ctices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws of their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all dosages and unwanted effects are mentioned. Organizations, publications and websites are cited or linked to illustrate issues or as a source of further information. This does not mean that authors, the Editor or IACAPAP endorse their content or recommendations, which should be critically assessed by the reader. Websites may also change or cease to exist.
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Dans cette perspective, nous espérons que notre expérience pratique dans ces domaines constituera un apport aux prochaines éditions de ce guide. Et si le renforcement des systèmes de santé peut ne pas être une science exacte et que l’approche universelle n’existe pas, cette publication dé...montre que la quantité de connaissances empiriques et les bonnes pratiques peuvent grandement contribuer à accélérer et à affiner les initiatives nationales du mieux possible afin d’adapter les besoins, les compétences et les circonstances.
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25 August 2021. The earthquake on August 14, 2021 was almost as strong as the severe quake in 2010, which killed about 300,000 people. The current number of victims is more than 2,200 people, and more than 12,000 people have been injured. More than 52,000 houses were destroyed and more than 77,000 ...damaged. Thousands of families were affected! The magnitude 7.2 earthquake struck southwest Haiti at 8:30 a.m. local time at a depth of about 10 km. The epicentre was measured about 12 km northeast of Saint-Louis-du-Sud, about 125 km west of the capital Port-auPrince. The situation on the ground remains chaotic and the extent of the disaster cannot yet be predicted. In addition, heavy rainfall and the unstable security situation are complicating relief efforts. What is needed most now is food and drinking water, tents and primary health care. MEDBOX has already created the Natural Hazard Toolbox after the severe earthquake in 2010 and has collected many essential materials on health care, shelter & reconstruction after an earthquake in English, French and Kreyol there. In this issue brief, we provide a quick
overview of the most important information.
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Brucellosis is widespread in both humans and livestock in many developing countries. The authors have performed a series of epidemiological studies on brucellosis in agro-pastoral areas in Tanzania since 2015, with the aim of the disease control. Previously, the potential of a community-based brucel...losis control initiative, which mainly consisted of the sale of cattle with experience of abortion and vaccinating calves, was assessed as being effective and acceptable based on a quantitative approach. This study was conducted to investigate the feasibility of community-based brucellosis control program using participatory rural appraisals (PRAs) and key-informant interviews. Four PRAs were performed together with livestock farmers and livestock and medical officers in 2017. In the PRAs, qualitative information related to risky behaviors for human infection, human brucellosis symptoms, willingness to sell cattle with experience of abortion, and willingness to pay for calf vaccination were collected, and a holistic approach for a community-based disease control project was planned. All of the communities were willing to implement disease control measures. To avoid human infection, education, especially for children, was proposed to change risky behaviors. The findings of this study showed that community-based disease control measures are promising.
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Background: A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH) in two significant w...ays; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Studies. Methods: In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars) and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs) produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas—development assistance for health (in US Dollars) per DALY.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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The compendium provides guidance on low-cost handwashing facilities that can be widely used in low and middle-income countries. We hope that this can be shared extensively as governments and agencies tackle the crisis in low and middle-income countries where handwashing facilities are urgently neede...d in households, communities, schools and healthcare facilities.
The compendium includes information and further reading on: handwashing facilities – including facilities that are accessible for all, environmental cues to reinforce handwashing behaviours, physical distancing hygiene promotion.
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This Technical Brief focuses on current principles and approaches to Moderate Acute Malnutrition (MAM) management, highlighting key constraints, gaps in knowledge and areas still lacking consensus. It is intended to inform ongoing debates among practitioners, national partners, donors and analysts o...n what information and evidence on best practices are currently available, where the gaps are, and priorities for going forward.
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This Module, Count me in! Inclusive WASH in Ethiopia, was prepared by Ethiopian authors with support from The Open University UK. It was first published in June 2018. The contributors of original material are:Girma Aboma, Manager, GAA Economic Development ConsultBethel Shiferaw, SPCC Disability Incl...usion Advisor, Ethiopian Center for Disability and Development
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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La violencia contra las mujeres y las niñas es generalizada en la Región de las Américas, y tiene enormes consecuencias para su salud y bienestar, así como el de sus familias y sus comunidades. Se trata de un costo inaceptable que puede ser prevenido mediante acciones basadas en la evidencia, pr...omovidas por las políticas y los protocolos del sector de la salud, y la colaboración con otros sectores. El presente informe es el primero de su tipo y representa un hito importante para la Región. Se basa específicamente en los compromisos asumidos por los Estados Miembros en la Estrategia y plan de acción sobre el fortalecimiento del sistema de salud para abordar la violencia contra la mujer. El informe ofrece un análisis de los esfuerzos para avanzar en la prevención de la violencia contra las mujeres en la Región por medio de políticas de salud, protocolos clínicos, planes multisectoriales y otros enfoques relevantes. La atención a este tema es oportuna, ya que la pandemia de COVID-19 ha dado más visibilidad a esta esfera de trabajo. En este informe se ofrece información crucial sobre los esfuerzos llevados a cabo en la Región, de los cuales se puede aprender y utilizar el conocimiento extraído en el futuro para prevenir y responder a la violencia contra las mujeres y las niñas en todo el mundo.
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Guide à l’usage des établissements de santé.
Novembre 2015 Genève, Suisse.
Le présent guide présente plusieurs modèles de prise en charge différenciée, mis en oeuvre avec succès dans divers contextes et dans différents pays en Afrique subsaharienne. Il sera actualisé au fil des expé...riences rapportées concernant les démarches exposées ici ou d’autres démarches similaires.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A...Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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This is a detailed manual giving a step by step approach to undertaking the pharmacovigilance of antiretrovirals. It is intended to be a source of practical advice for Pharmacovigilance Centres and health professionals involved in HIV/AIDS prevention and treatment programmes. A number of WHO publica...tions are available that provide a background to pharmacovigilance and, as far as possible, that material will not be repeated here. Health officials, planners, the staff of Pharmacovigilance Centres, public health teams and all health workers should become familiar with these publications, which are: • Safety of Medicines: A guide to detecting and reporting adverse drug reactions
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La deuxième Enquête sur la prestation des services de soins de santé du Rwanda (EPSR-II), réalisée en 2007, est une enquête représentative au niveau national au cours de laquelle un échantillon de 538 établissements de santé ont été enquêtés. L’enquête a couvert les ôpitaux, les ce...ntres de santé, les dispensaires et les postes de santé et a inclus tous les établissements publics, qu’ils appartiennent au secteur gouvernemental ou Agréé, et la plupart des établissements privées. L’EPSR-II a collecté des informations sur les capacités des
établissements à fournir des services de qualité ainsi que sur l’existence de systèmes effectifs garantissant des services de qualité, par le biais d’interviews effectuées auprès des prestataires de santé et des patients ainsi que par le biais d’observations de consultations de patients ; ces informations concernent essentiellement l’infrastructure d’ensemble de l’établissement ainsi que les services de santé maternelle, infantile, de santé de la reproduction, de tuberculose, du paludisme, des infections sexuellement transmissibles (IST) et du VIH/sida. L’objectif de cette étude est, d’une part, d’évaluer les forces et faiblesses de l’infrastructure et des systèmes de support de ces services et, d’autre part, d’évaluer le niveau d’adhésion des prestataires aux standards de prestation des services.
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