First Global Patient Safety Challenge Clean Care is Safer Care
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to impro...ve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants.
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This field study to measure access to and use of medicines was undertaken in GHANA in May-June 2008. The study assessed information on the socio-economic level of households, and access to and use of medicines for acute and chronic conditions as well as opinions and perceptio...ns about medicines. The survey was conducted in six regions. In each region, six reference public heath care facilities were selected among those participating in the Level II Facility Survey that was carried out in parallel. Within defined distances from each reference public health care facility, households were selected by purposive cluster sampling. A total of 1065 household respondents were interviewed by means of a structured paper questionnaire
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This updated implementation guidance is intended for all those who set policy for, or offer care to, pregnant women, families and infants: governments; national managers of maternal and child health programmes in general, and of breastfeeding- and BFHI-related programmes in particular; and health-f...acility managers at different levels (facility directors, medical directors, chiefs of maternity and neonatal wards). The document presents the first revision of the Ten Steps since 1989. The topic of each step is unchanged, but the wording of each one has been updated in line with the evidence-based guidelines and global public health policy.
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A treatment literacy guide for pregnant women and mothers living with HIV
Positive Health, Dignity and Prevention for Women and their Babies is intended for use by networks of women living with HIV, women’s groups, peer educators and others wishing to help guide women living with HIV t...hrough the decisions they will need to take before, during and after their pregnancy. It is not intended as a substitute for going to a health facility and seeking information from a healthcare worker.
The facilitator’s manual and flipchart are intended to be used by leaders of support groups, peer educators or lay counsellors to facilitate small groups or community sessions with women living with HIV. Together, they provide accurate and comprehensive information to enable pregnant women and mothers living with HIV to know their rights and make informed decisions about their health, and the health of their baby.
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In the context of the Support to National Malaria Control Programme (SuNMaP), demand creation is the strategic combination of advocacy, communication and mobilisation approaches that seek to achieve increased community awareness of, and demand for, effective malaria prevention and treatment services.... For malaria treatment, demand creation focuses on promoting improved testing, prompt and proper use of artemisinin combination therapy (ACT) treatment for individual cases of malaria, and effective home management of fever, together with referrals of severe cases to a higher-level health facility.
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All young people, including those with special needs and from the most vulnerable groups, have the right to quality health care services. Unfortunately, this right is not a reality, particularly in the case of sexual and reproductive health services. Many youth in need of sexual and reproductive hea...lth care may either decline or be denied access to health services for a variety of reasons: Providers are often biased and do not feel comfortable serving youth who are sexually active; youth do not feel comfortable accessing existing services because they are not "youth-friendly" and may not meet their needs; and, often, community members do not feel that youth should have access to sexual and reproductive health services.
To address provider and site bias toward serving youth, EngenderHealth created a training curriculum intended to sensitize all staff at a health care facility on the provision of youth-friendly services. The curriculum was created as a result of the participatory work that we have been doing with youth in Nepal to address the needs of all levels of providers at different service-delivery settings. The curriculum has been field-tested and used in Nepal, Russia, Mongolia, and the United States.
Youth-Friendly Services allows staff to reflect upon and assess their own beliefs about adolescent sexuality while ensuring that those values and attitudes do not compromise the basic sexual and reproductive health rights to which youth are entitled. The curriculum also helps providers understand cross-cultural principles of adolescent development and health needs specific to youth. Once participant knowledge, attitudes, and skills are improved, sites conduct a self-assessment on the youth-friendliness of their services and create an action plan for specific improvements.
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The main goal of the National Health Plan (NHP) 2017-2021 is to extend access to a basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. In order to extend service delivery to all communities, the NHP calls for all health workers (whether c...ommunity-based, outreach-based or facility-based) involved in the delivery of health promotion, prevention and treatment services to be fully recognised and institutionalized within the health system to ensure efficient use of resources, necessary oversight and quality service provision (regardless of whether the health workers are voluntary or salaried). The first year Annual Operational Plan (AOP) of the NHP 2017-2021 calls for a comprehensive literature review of the situation of all Village Based Health Workers (VBHWs) in the country to inform the development of a comprehensive, institutionalized approach to community health for the country.
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A two-week mission was conducted by WASH and quality UHC technical experts from WHO headquarters and supported by the WHO Ethiopia Country Office (WASH and health systems teams) in July 2016, to understand how change in WASH services and quality improvements have been implemented in Ethiopia at nati...onal, sub-national and facility levels; to document existing activities; and through the “joint lens” of quality UHC and WASH, to identify and seek to address key bottlenecks in specific areas including leadership, policy/financing, monitoring and evaluation, evidence application and facility improvements. Ethiopia has implemented a number of innovative and successful interventions.
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DHS Methodological Report No. 20
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method—principal component analysis (PCA).
We scored ...the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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It is the policy of the GoR to ensure that children’s rights are met through the provision of basic needs and services for all children in the country, and protect them from abuse and exploitation. Children are defined as persons below the age of 18 years and the ICRP covers children from the time... before their birth until they complete the age of 18 years. The Integrated Child Rights Policy of Rwanda is based on seven key themes: Identity and Nationality; Family and Alternative Care; Survival, Health and Standards of Living; Education; Protection; Justice; and Child Participation.
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Infectious diseases like COVID-19 can disrupt the environments in which children grow and develop. Disruptions to families, friendships, daily routines and the wider community can have negative consequences for children’s well-being, development and protection. In addition, measures used to preven...t and control the spread of COVID-19 can expose children to protection risks. Home-based, facility-based and zonal-based quarantine and isolation measures can all negatively impact children and their families.
The aim of this brief is to support child protection practitioners to better respond to the child protection risks during a COVID-19 pandemic. Part 1 presents the potential child protection risks COVID-19 can pose to children. Part 2 presents programmatic options in line with the 2019 Minimum Standards for Child Protection in Humanitarian Action (CPMS) and the Guidance Note: Protection of Children During Infectious Disease Outbreaks.
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The COVID-19 pandemic is challenging health systems across the world. Rapidly increasing demand for care of people with COVID-19 is compounded by fear, misinformation and limitations on the movement of people and supplies that disrupt the delivery of frontline health care for all people...
This g...uidance addresses the specific role of community-based health care in the pandemic context and outlines the adaptations needed to keep people safe, maintain continuity of essential services and ensure an effective response to COVID-19. It is intended for decision-makers and managers at the national and subnational levels and complements a range of other guidance, including that on priority public health interventions, facility-based care, and risk communication and community engagement in the setting of the COVID-19 pandemic.
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Bull World Health Organ 2020;98:773–780
Universal health coverage (UHC) depends on a strong primary health-care
system. To be successful, primary health care must be expanded at community and household levels as much of the world’s population still lacks access to health facilities for basic... services. Abundant evidence shows that community-based interventions are effective for improving health-care utilization and outcomes when integrated with facility-based services. Community involvement is the cornerstone of local, equitable and integrated primary health care.
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Health Care Facilities (HCFs) are primarily responsible for management of the healthcare waste generated within the facilities, including activities undertaken by them in the community. The health care facilities, while generating the waste are responsible for segregation, collection, in-house trans...portation, pre-treatment of waste and storage of waste, before such waste is collected by Common Bio-medical Waste Treatment Facility(CBWTF) Operator. Thus, for proper management of the waste in the healthcare facilities the technical requirements of waste handling are needed to be understood and practiced by each category of the staff in accordance with the BMWM.
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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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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro...nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in failure to provide adequate, accessible and quality m...aternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing ...and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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