INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a...nd has provided an updated perspective on the status of cardiovascular health globally, regionally, and nationally.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions... (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only violates the rights of people with disabilities under international law, but UHC and SDG 3 cannot be a...ttained without better health services for the one billion people with disabilities.
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Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s...tudy aimed to test both interventions in low-income and middle-income countries.
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A review of current literature and up date data from the field, April 2015.
This report has been published in part in J Hosp Inf. 2015;90:1-9.
http://www.ncbi.nlm.nih.gov/pubmed/?term=ebola+nosocomial+shears
This paper aims to contribute to the reflection on effective practices to address protracted displacement, in support of the GP20 Plan of Action roll-out. It expands on the research conducted by Walter Kälin and Hannah Entwisle Chapuisat for the 2017 OCHA-commissioned study Breaking the Impasse: Re...ducing Protracted Internal Displacement as a Collective Outcome.1 That study provided a comprehensive picture of the impact of protracted internal displacement, as well as five country case studies in contexts of conflict and disasters.It also offered a road map for addressing such displacement through seven steps, including conducting joint analysis and defining collective outcomes.
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Giving Myanmar's displaced their land back
The Norwegian Refugee Council and Displacement Solutions have produced the report "Addressing Myanmar's Unsettled Restitution Gap" to advocate and help find ways for displaced people in Myanmar to be able to return home and recover their property and pos...sessions.
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Reporting system for the general public - This document aims to provide practical guidelines on how to set up national systems for consumers to report adverse reactions to medicines. The purpose is to help countries set up a well-organized and effective consumer reporting system within their pharmac...ovigilance centre. Throughout this document, the phrase “consumer reporting” is used to refer to reporting of adverse drug reactions (ADRs) by the general public.
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Every five minutes a child dies as the result of violence, according to a ground-breaking report from Unicef UK. The report reveals that the vast majority of children are killed outside warzones and that physical, sexual and emotional abuse is widespread with millions of children unsafe in their hom...es, schools and communities. Some 345 children could die from violence each day in the next year, unless governments act.
The report also finds that:
(1) Children who are victims of violence have brain activity similar to soldiers exposed to combat;
(2) A third of children who are victims of violence are likely to develop long-lasting symptoms of post-traumatic stress disorder;
(3) Those living in poverty are more likely to be victims of violence, wherever they live in the world;
(4) Over 7% of child deaths due to violence each day are the result of interpersonal violence, rather than conflict.
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In Paraguay, 1.8% of the population are indigenous people. The Maká community
29 mainly live in urbanized areas in the Central Region. This study focuses on the epidemiology
30 of tuberculosis (TB) among indigenous Maká and the non-indigenous people living in the
31 Central Region, the biggest ...metropolitan area of the Paraguay.
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Health Systems for Outcomes Publication | The government of Rwanda has identified human resources for health as one of its policy priorities. This study aims to contribute to building a better understanding of health worker choice and behaviour, and to improve evidence based polcies.
Contains: Application formal for ICMR Junior Research Fellowship Programme (for ICMR- Junior Research Fellow); 1st /2nd /3rd /4th Annual Report of the work done during the fellowship; Indian Council of Medical Research Fellowship Rules.
n Autumn 2013, HHI Executive Director, Vincenzo Bollettino, traveled to the Philippines to participate in an assessment of civil-military engagement in the humanitarian response to Typhoon Haiyan. The report was sponsored by the Center for Excellence in Disaster Management and Humanitarian Assistanc...e.
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39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response. The report shows that deliberate and proactive action is required to ensure that persons with disabilities from all constituencies are systematically included and meaningfully participate in DRR... and humanitarian preparedness, response and recovery. It draws lessons from field practices, but does not provide technical guidance. The newly published IASC Guidelines are the reference document to seek in-depth theoretical and technical information.
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n light of the potential risk posed by SARS-CoV-2 variants, in January 2021 WHO organized an ad hoc consultation to discuss the development of an R&D agenda in response to existing and emerging SARS-CoV-2 variants.
The key objectives were to identify the critical research questions related to var...iants and agree on a research approach to address them. Six breakout groups covered a range of specific issues related to COVID-19 variants: Epidemiology and mathematical modelling; evolutionary biology; animal models; assays and diagnostics; clinical management and therapeutics; and vaccines.
This report is a summary of presentations and panel discussions.
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DHS Further Analysis Reports No. 89 - The 2010 Rwanda Demographic and Health Survey shows that 3 percent of Rwandan adults age 15-49 have been infected with HIV. The prevalence was much higher in urban areas, among women, and among adults who had multiple lifetime sexual partners and used a condom a...t last sexual intercourse. The
level of and differences in HIV prevalence in Rwanda in 2010 are very similar to those observed in 2005. Using data from the two recent Rwanda Demographic and Health Surveys, implemented in 2005 and
2010, this study examined changes in key HIV-related knowledge, attitudes, and sexual behavior indicators. Significant changes in selected indicators during 2005 and 2010 were determined by Student ttest with p-values less than 0.05.
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Climate Change 2021: The Physical Science Basis. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change
PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find t...hat patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
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