Practical Guide on Trauma-Informed Approaches
Ebola Virus Disease Outbreak Response Plan in West Africa Annex 3
Assessment in action series
Key Findings from Azerbaijan, Georgia, Kyrgyzstan, Russia, and Ukraine
Writing by Katya Burns
Editing by Paul Silva and Roxanne Saucier
A Practical Guide for Mental Health Service Providers
www.jogh.org • doi: 10.7189/jogh.02.020405 ~ December 2012 • Vol. 2 No. 2 • 020405
In many humanitarian emergencies, there is a serious lack of access to even the most basic materials needed for managing the blood in addition to a lack of appropriate sanitation facilities (including water), which are critical for addressing menstrual hygiene. Privacy in emergencies is often scarc...e, and even if toilets are available they often lack locks, functioning doors, lighting and separation between genders. These barriers are often intensified by cultural beliefs and taboos surrounding menstruation which can restrict the movements and behaviors of girls and women
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Although Kenyans enjoy comparatively good health, the prevalence of
chronic disease is increasing and our ageing population is placing evergrowing pressures on the finite resources of our health system.
The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals.
Pharmaceutical and Therapeutics Committees (PTCs) are responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as... well as at higher levels of care.
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Disease epidemiology has a deeper relationship with the dynamic nature of culture. Health behaviors in general are largely shaped by the cultural norms and customs in a society. A mere identification of a behavior could be only a layer on the outer sphere of a particular disease epidemiology and the... interventional efforts to counteract such behaviors through for example public health measures could be futile and volatile, unless the deeper cultural factors are addressed.
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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.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa...l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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