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This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ
...
e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
more
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations 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.
more
Handbook on Monitoring and Evaluation of Human Resources for Health with special applications for low- and middle-income countries
Mario R Dal Poz, Neeru Gupta, Estelle Quain and Agnes LB Soucat
World Health Organization (WHO); USAID; The World Bank
(2009)
The seven essential features of practice for scaling up are described with great clarity. They are practical and universal, and encourage local innovation. They include policy, funding and local management structure, as well as working with all possible partners and developing local context adaptati
...
ons. The case studies give ideas and inspiration to develop new programmes and find ways around obstacles in existing programmes, especially through involving those with most at stake including users and their families and local community leaders
more
The report shows that older people are not getting the healthcare treatments they desperately need. The COVID-19 response has disrupted services for non-communicable diseases such as cancer and diabetes, communicable diseases such as malaria, and much-needed services for mental health. Combined with
...
a loss of income, many older people are unable to get the medicines they need.
A Summary is available in Russian and Arabic
more
The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of
...
the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
more
For the global community to be able to achieve ambitious targets relating to the prevention and treatment of HIV, viral hepatitis and sexually transmitted infections (STIs), multiple types of medicines must be widely accessible to all affected populations in all countries.
The purpose of this rep
...
ort is to provide forecasts of future demand for medicines used in the fields of HIV, viral hepatitis and STIs. This report jointly presents medicines forecasts across three disease areas in recognition of the benefits of addressing HIV, viral hepatitis and STIs in a coordinated manner.
more
Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries
Tol, Wietse A. , Song, Suzan, Jordans, Mark J. D.
The Journal of Child Psychology and Psychiatry
(2018)
C1
Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions
...
.
more
Towards a Core Set of Clinical Skills for Health-Related Community Based Rehabilitation in Low and Middle Income Countries
Jessica O'Dowd, Malcolm MacLachlan, Chapel Khasnabis, Priscille Geiser
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2015)
CC
This research aims to identify a core set of clinical skills for working in
a Community Based Rehabilitation (CBR) setting, and to discuss whether they are appropriate for task shifting to a new or an alternative cadre of rehabilitation workers.
Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin
...
g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
more
This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 to 2016. It examines the national dimension of reforms but focuses above all on implementation and results in the economically fragile district of Caraba
...
yllo, in northern Lima.
more
The Lancet Global Health Published:May 12, 2020DOI:https://doi.org/10.1016/S2214-109X(20)30229-1
Int J Hyg Environ Health. 2019 Jun; 222(5): 765–777. doi: 10.1016/j.ijheh.2019.05.004;
To develop updated estimates in response to new exposure and exposure-response data of the
burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth
infec
...
tions and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours
(WASH) with a focus on low- and middle-income countries.
more
Front. Public Health, 30 April 2021 | https://doi.org/10.3389/fpubh.2021.628744
Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to clim
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ate shifts and least able to adapt given weak health systems and poor infrastructure. Low-carbon approach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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Results from studies evaluating the effectiveness of focused psychosocial support interventions in children exposed to traumatic events in humanitarian settings in low-income and middle-
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income countries have been inconsistent, showing varying results by setting and subgroup (eg, age or gender). We aimed to assess the effectiveness of these interventions, and to explore which children are likely to benefit most.
Lancet Glob Health 2018; 6: e390–400
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these c
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ountries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Census Report Volume 4-A
This thematic report presents findings on fertility and nuptiality in Myanmar. The analysis hows that the total fertility rate is 2.5 children per woman at the Union level, 1.9 children per woman for urban areas, and 2.8 children per woman for rural areas. Total fertili ... ty for States and Regions varies from a high of 5.0 children per woman for Chin State to a low of 1.8 children per woman for Yangon Region. Total fertility appears to have declined at a rate of at least one child per woman per decade between 1970 and 2000. This relatively rapid decline apparently ceased sometime during the 1990s or 2000s. Estimates from the 2001 and 2007 surveys suggest that the level of fertility may have fluctuated between 2000 and 2014, but with no overall trend up or down. The marital status data shows an exceptionally high proportion of women remaining never married at age 50. more
This thematic report presents findings on fertility and nuptiality in Myanmar. The analysis hows that the total fertility rate is 2.5 children per woman at the Union level, 1.9 children per woman for urban areas, and 2.8 children per woman for rural areas. Total fertili ... ty for States and Regions varies from a high of 5.0 children per woman for Chin State to a low of 1.8 children per woman for Yangon Region. Total fertility appears to have declined at a rate of at least one child per woman per decade between 1970 and 2000. This relatively rapid decline apparently ceased sometime during the 1990s or 2000s. Estimates from the 2001 and 2007 surveys suggest that the level of fertility may have fluctuated between 2000 and 2014, but with no overall trend up or down. The marital status data shows an exceptionally high proportion of women remaining never married at age 50. more
Census Report Volume 4-K
The results of the 2014 Census collected only relates to four of the six types of disability domains recommended by the Washington Group on Disability Statistics, namely: seeing, hearing, walking, and remembering or concentrating.
Out of a total of 50.3 million pe ... rsons enumerated in the 2014 Census, there were 2.3 million persons (4.6 per cent of the total population) who reported some degree of difficulty with either one or more of the four functional domains. Of this number, over half a million (representing over 1 per cent of the population as a whole) reported having a lot of difficulty or could not do one or more of the four activities at all (referred to as severe disability). Among those with the severest degree of disability, 55 thousand were blind, 43 thousand were deaf, 99 thousand could not walk at all and 90 thousand did not have the capability to remember or concentrate.
The Census shows that disability is predominantly an old age phenomenon with its prevalence remaining low up to a certain age, after which rates increase substantially. more
The results of the 2014 Census collected only relates to four of the six types of disability domains recommended by the Washington Group on Disability Statistics, namely: seeing, hearing, walking, and remembering or concentrating.
Out of a total of 50.3 million pe ... rsons enumerated in the 2014 Census, there were 2.3 million persons (4.6 per cent of the total population) who reported some degree of difficulty with either one or more of the four functional domains. Of this number, over half a million (representing over 1 per cent of the population as a whole) reported having a lot of difficulty or could not do one or more of the four activities at all (referred to as severe disability). Among those with the severest degree of disability, 55 thousand were blind, 43 thousand were deaf, 99 thousand could not walk at all and 90 thousand did not have the capability to remember or concentrate.
The Census shows that disability is predominantly an old age phenomenon with its prevalence remaining low up to a certain age, after which rates increase substantially. more
