For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE...COVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
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As part of our commitment to training the global workforce, RCPCH Global runs educational opportunities, including online learning and UK-based face-to-face, practical courses.
Examining nursing practice guidelines to improve quality of care for patients with sepsis in low income countries is required. • A large amount of information about best practice standards in sepsis management is available for healthcare professionals; however, implementation and adherence to prac...tice guidelines recommended by the Surviving Sepsis Campaign remains low in low income countries.
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This document is a checklist CHW supervisors can use to ensure that CHWs are implementing high quality home visits.
Around the world, nurses are working under enormous pressure providing care to sick and dying patients during the pandemic. Many are faced with increased stress, and other negative effects on their mental health. They are also faced with the possibility of infection and death from COVID-19. Before t...he pandemic there was a global shortage of nurses, but this is likely to be exacerbated by the increased demands of caring during COVID-19 as well as the usual care of non-COVID patients.
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Tackling COVID-19 misinformation. Ensuring communities have access to lifesaving public health information from trusted sources and are not misled by misinformation is essential to ending the COVID-19 pandemic.
In an effort to empower doctors and nurses – some of the most effective and trusted... messengers of public health information – to actively address COVID-19 misinformation and build vaccine confidence globally, the WHO welcomes this social media toolkit for healthcare practitioners, developed by the Government of the United Kingdom.
This toolkit aims to provide healthcare workers with the tools, skills and content needed to effectively share authentic and reliable information online. Centered around three core vaccine confidence messages, Vaccine Safety, Vaccine Development and Vaccine Reducing Risk of Sickness; this toolkit sets out three approaches: creating your own posts, posting the images and videos provided in the toolkit, or resharing vaccine information from trusted sources.
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The National Guideline for Neonatal Care and Establishment of Neonatal Care Unit aims to provide health workers with all basics and necessary knowledge and skills to provide appropriate care at the most vulnerable period in a newborn’s life. This guideline will be available to all health facilitie...s as a reference book for health workers. The book contains up-to-date evidence-based information and management of newborns with a range of needs in the initial newborn period
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The standards for the care of small and sick newborns in health facilities define, standardize and mainstream inpatient care of small and sick newborns, building on essential newborn care and ensuring consistency with the WHO quality of care framework. The standards will guide countries in caring fo...r this vulnerable population and support the quality of care of newborns in the context of universal health coverage. They will provide a resource for policy-makers, health care professionals, health service planners, programme managers, regulators, professional bodies and technical partners involved in care
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MAMI refers to the management of small and nutritionally at risk infants under six months of age (infants u6m) and their mothers.
This standard Operating procedure (SOP) for JDWNRH is intended to describe and
address various important areas like admission procedure, on call process of the
doctors, interdepartmental consultation, patient discharge process and verity of
other areas which was so far solely based on verbal i...nstruction in the workplace by
the seniors which very often led to mishaps and other associate problems. This SOP,
though not comprehensive, would serve as a guidebook for newly recruited health
staff as well as a reference book for existing health professionals in JDWNRH while
delivering health care services
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Compliance with the standards is monitored as part of our Quality Improvement Program.
Practitioner refers to physicians or other health professionals who provide health care services.
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3026 (Published 11 August 2020)
The BMJ "practice pointer" inlcudes a one-page visual summary of assessment and initial management of patients with persistant symptoms following acute SARS-CoV-2 infection
Issue Brief no.15, September 2021, updated 19 October 2021
This quick guide offers basic information about COVID-19, the Sinovac-CoronaVac COVID-19 vaccine and what to
expect following vaccination: ...
As a Frontline Health Care Worker or a Vaccinator, you need to counsel pregnant women about the availability, value and precautions regarding the COVID-19 vaccine. This note provides you with the information that you need to educate and support pregnant women so that they can make an informed decisi...on about getting the COVID-19 vaccine. The note is structured in the form of questions-answers to make it easier for you to inform pregnant women and their families about the most important issues related to COVID-19 vaccination in pregnant women.
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