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Background document to the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA: definition of skilled health personnel providing care during childbirth
A case study of the Essential Health Benefit in Tanzania mainland
Todd G.; Nswilla A.; Kisanga O.; Mamdani M.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and ... cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting. more
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and ... cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting. more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to
...
prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
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
...
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.
more
The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering quality
...
care services to patients over a long time. The new National Guidelines for Prevention and Management of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
more
This guide can be used to train medical officers to ensure BP is measured for all adults visiting the OPD, treat all patients with high BP, initiate treatment as per protocol, counsel patients for f
...
ollow-up, refer patients to local care, and report data.
more
The State of the World’s Children 2013: Children with Disabilities examines the barriers – from inaccessible buildings to dismissive attitudes, from invisibility in official statistics
...
to vicious discrimination – that deprive children with disabilities of their rights and keep them from participating fully in society. The report also lays out some of the key elements of inclusive societies that respect and protect the rights of all children, regardless of disability, and progress in helping all children to flourish and make their contribution to the world.
more
The core of the strategy is the goal for all patients to have better overall care, so that the numbers of deaths and cases of disability are reduced by 50% before 2030. For this
...
to be achieved, four strategic aims will be pursued.
Empower and engage communities,
Ensure safe, effective treatment,
Strengthen health systems, and
Increase partnerships, coordination and resources Strong collaboration
more
Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical i
...
mpacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance while maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
more
very woman has the right to the highest attainable standard of health, which includes the right to dignified, respectful health care.
Many women e
...
xperience disrespectful and abusive treatment during childbirth in facilities worldwide. Such treatment not only violates the rights of women to respectful care, but can also threaten their rights to life, health, bodily integrity, and freedom from discrimination. This statement calls for greater action, dialogue, research and advocacy on this important public health and human rights issue
Available in different langugages
more
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major
...
barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (AEs) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
more
The publication is designed to provide Ipas staff, trainers, partners and other health-care providers with access to up-
...
to-date, evidence-based recommendations. In general, the recommendations are the same as those in the World Health Organization’s 2012 Safe Abortion: Technical and Policy Guidance for Health Systems, Second edition. In rare cases, the recommendations have been modified due to the settings where Ipas works. In addition, if there is more current evidence to inform the recommendations, they will be updated here.
more
Managing possible serious bacterial infection in young infants when referral is not feasible
recommended
It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral care, but can be managed in outpatient
...
settings by an appropriately trained health worker. The guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
more
Security Survey for Health Facilities
recommended
The purpose of the survey is to identify the level of preparedness required by a health-care facility to be able
...
to continue operating during, or following a conflict-related security event.
The survey method provides a measure of the security and preparedness of a given health facility in its specific context. Such a measure offers evidence-based guidance to assess whether urgent action needs to be taken and, if so, in what form.
Decision-makers can prioritize the most effective actions to mitigate specific risks and, eventually, will be able to rank the importance of needs faced by multiple facilities.
The survey covers three modules: the hazards affecting the facility, the current management procedures in place and the state of the physical infrastructure. Each of these modules is further divided into categories, and each category contains the questions – or indicators ‒ that cover the actual issues addressed in the survey. A detailed description of each indicator is provided in this manual. more
The survey method provides a measure of the security and preparedness of a given health facility in its specific context. Such a measure offers evidence-based guidance to assess whether urgent action needs to be taken and, if so, in what form.
Decision-makers can prioritize the most effective actions to mitigate specific risks and, eventually, will be able to rank the importance of needs faced by multiple facilities.
The survey covers three modules: the hazards affecting the facility, the current management procedures in place and the state of the physical infrastructure. Each of these modules is further divided into categories, and each category contains the questions – or indicators ‒ that cover the actual issues addressed in the survey. A detailed description of each indicator is provided in this manual. more
This report aims to estimate the economic cost of providing regular access to healthcare for migrants in an irregular situation, compared with the cost of providing treatment in emergency cases only
...
. Two specific medical conditions – hypertension and prenatal care – were selected as examples, and their associated costs were calculated using an economic model. This model was then applied to three EU Member States: Germany, Greece and Sweden. The testing suggests that providing access to regular preventive healthcare for migrants in an irregular situation
would be cost-saving for governments.
more
Guidelines for the Prevention and Containment of Antimicrobial Resistance in South African Hospitals
These guidelines form part of efforts to institutionalise the prevention and containment of antimicrobial resistance (AMR) in health care facilities in South Africa, as outlined in the Antimicrobial
...
Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interrelated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level.
more
Strategic communication is used to raise awareness of issues among specific target populations. It aims to provide timely, evidence-based, authoritative information and
...
guidance needed for public health action. Proper implementation of strategic communication leads to sustained behaviour change and is essential in overcoming barriers to access to services or generating demand for such services.
more
TB heroes
Hello, my name is Nurse X
My job is to promote integrated HIV and TB prevention, care, treatment and support. This ensures that we, and my team of health
...
care service providers treat everyone who is living with HIV and TB to have all the antiretroviral therapy (ART) and HIV care services are provided with TB diagnosis and treatment at one facility. Services that we provide include * Infection control education * TB screening and diagnosis * HIV testing * Treatment for those who require it * Adherence support
Accessed November 2017
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