This publication aims to provide examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately and effectively. Examples have been identifi ed from literature searches and from an international call... for examples through various organizations, including the European Association of Palliative Care and the European Union Geriatric Medicine Society. Some examples consider how to improve aspects within the whole health system; specifi c smaller examples consider how to improve palliative care education, support in the community, in hospitals or for specifi c groups of people, such as people in nursing homes and people with dementia and their families. Some examples await rigorous evaluation of effectiveness, and more research is needed in this fi eld, especially the cost–effectiveness and generalizability of these initiatives.
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In the area of nutrition and HIV, children deserve special attention because of their additional needs to ensure growth and development and their dependency on adults for adequate care. It was therefore proposed to first develop guidelines for children and thereafter consider a similar approach for... other specific groups.
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a biological process related to virus and host interactions. In trying to protect the nutritional well-being or reverse the undernutrition experienced by infected children, issues of food insecurity, food quantity and quality as well as absorption and digestion of nutrients are considered. Interventions are proposed that are practical and feasible in resource-poor settings and offer a prospect for clinical improvement.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
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4th edition. A manual for clinics, community health centers and district hospitals
Maternal and child malnutrition is a significant public health problem in South Sudan. Among children aged 6-59 months, 31% are stunted, 28% are underweight, and nearly 23% are acutely malnourished of which 13% are estimated to suffer from moderate acute malnutrition and 10% from severe acute malnut...rition.
Overall, South Sudan’s nutrition situation is worrisome, with GAM persistently above the emergency threshold in the Greater Upper Nile, Northern Bahr el Ghazal and Warrap states. Though data on micronutrient deficiencies is scanty, Vitamin A Supplementation (VAS) among children 6-59 months stood at only 2.6% in 2010, showing low uptake (SHHS, 2010). This is against a backdrop of high morbidity levels and a negligible proportion of children 6 to 23 months receiving at least the recommended minimum acceptable diet. In order to ensure optimal child growth, it is essential to ensure good nutrition and basic health care from pregnancy through two years of age (the first 1000 days).
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Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de...veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
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The International Council of Nurses (ICN) Code of Ethics ([1], p. 5) specifies the nurse’s role of promoting “an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected”. The Malta Code of Ethics supports this for nurse...s and midwives [2], stating that the nurse is to “recognize and respect the uniqueness of every patient/client’s biological, psychological, social and spiritual status and needs”. Since patients are attended by different members of the multi-disciplinary team, these codes of ethics also address the holistic care of health care professionals that contribute towards patients’ safety. Examples of some heroes in nursing are given, whereby, their being in care generated signs of spirituality in their attempts to address patients’ needs, while their caring attitude instilled hope and healing.
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Catholic hospitals and other health services provide invaluable care to many in the community. This article accentuates the pastoral nature of Catholic health care, which is definitive to its Catholic identity. Discussing contemporary Catholic health care in conjunction with the works of Henri Nouwe...n we explore the challenges faced by today’s Catholics in Catholic health care and respond to these issues. In support of the discussion are the results of qualitative research into the perceptions Perth parishioners have of Catholic health care’s pastoral nature and Catholic identity. This research aims towards understanding the challenges facing Catholic health care providing pastoral care within its Catholic identity.
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Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as h...igh as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
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Palliative care for children with life-limiting illness is the active total care of the child’s body, mind, and spirit. It begins at diagnosis and continues regardless of whether the child receives treatment directed at the disease. It seeks to control all forms of suffering related to the illness..., including pain. It involves social, psychological, spiritual, and legal support to siblings, parents, and other close family members. Effective palliative care for children requires health professionals trained to assess symptoms, care for children of different ages and developmental stages, and to provide medicines in pediatric formulations. Care may be provided in tertiary care facilities, community health centers, and at home. The child’s best interest must inform all aspects of the treatment andcare, and the child’s rights must be protected at all times.
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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.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea...rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
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The CHW Toolkit assists the assessment, improvement, and planning of CHW programs by deepening understanding of the elements of successful programs and the use of best practices as an evidence-based approach to improvement. The toolkit is framed around ten key themes that describe the definition, en...try level, age, gender, recruitment, training, scope of work, supervision, career progression, entry level and remuneration of CHWs.
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This film explains what antenatal care is and why it is important for the mother and baby. It explains the importance of attending 4 antenatal sessions before the baby is born and what should happen at each session.
This film is for use in community health education.
Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their n...ewborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community engagement, disease control regulations, and multisector approaches to improve resilience, EHS quality..., and equity.
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This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) infants as the foundation for small and/or sick newborn care within maternal, newborn, and child health p...rogrammes, and spur collaborative global action. The document summarizes the background information, evidence, and rationale for making KMC available to every preterm or LBW newborn and seeks to galvanize the international maternal, newborn, and child health community and families to come together to support the implementation of KMC for all preterm or LBW infants to improve their and their mothers and families health and well-being.
This position paper is intended to be used by policy-makers (i.e. those responsible for national policy, guideline development and budget allocation), development partners, programme managers, health workforce leadership, practising clinicians, civil society leadership (e.g. parent and professional organizations) and researchers/research organizations involved in KMC implementation research.
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This handbook offers a simple framework of action for actors in local government, and in particular, health leaders such as Civil Surgeons (CSs) and Upazila Health and Family Planning Officers (UHFPQOs), to take ownership and leadership to combat COVID-19 at each district and upazila respectively, w...ith support and guidance from elected representatives and local administration, and through effective engagement of various segments of society including informal health care providers, religious leaders, journalists, police and law enforcement agencies, etc. The toolkit draws extensively from the experiences in Chapainawabganj, Savar and other areas and contains relevant best practises that have already proven effective in these places, which should be readily adaptable to various contexts.
It is important to note that while this framework has been developed in the context of COVID-19 and with related best practises, it is by no means limited to COVID-19 response. Indeed, the experience from Savar shows that the same approach has proven extremely effective in combating the dengue outbreak and the severe floods in 2020, and hence can be used to combat future public health emergencies in Bangladesh and other countries having similar contexts.
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Mental health problems are common and cause great suffering to individuals and communities around the world. They have a significant impact not only on the physical and mental health of those affected but also on their families and the communities they live in. At the same time, all communities have... their own traditional mechanisms for support and contain a range wide of resources that can be helpful in preventing mental health conditions from developing, promoting positive mental health and supporting the recovery of people that are struggling with a mental health condition.
In the wider context, people living with a mental health condition are often excluded from their communities and experience various violations to their basic human rights (discrimination, violence, exclusion from employment opportunities). The World Health Organization (WHO) estimates that the mean prevalence of global mental health disorders is 10.8% while the prevalence in emergency settings is 22.1% in any conflict-affected population.
During emergencies and crisis, the stigma, exclusion and discrimination towards people living with mental health conditions is often higher, which can cause isolation and protection issues. Communities can play a crucial role in promoting mental health as well as enhancing primary care and access. Their role is to help reduce mental health inequalities by providing community resources that connect people to community-based resources and by providing mental health education. This also helps to reduce the massive mental health treatment gap.
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The article "Capacity-Building in Community-Based Drug Treatment Services" by Michael J. Cole focuses on the global challenges in providing adequate community-based drug treatment services. It highlights the gaps in availability, quality, and accessibility of evidence-based care. The article discuss...es the principles and strategies for capacity-building at three levels: individual, organizational, and service sector. It emphasizes using an empowerment model, engaging community stakeholders, and creating sustainable practices. The paper also addresses the need for systematic planning, assessment, and collaboration to strengthen drug treatment systems globally.
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