It provides insight into WHO’s work that aims to improve the health of the people of the United Republic of Tanzania in collaboration with key stakeholders.
Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans during acute instability in the Central African Republic (CAR) and Yemen.
Esta investigacion construire y evalua la cascada de atención de la tuberculosis pulmonar en la población indígena del departamento del Cauca (Colombia) e identifica las brechas existentes. Este es el primer estudio en Colombia que analiza la cascada de atención de la TB en población indígena.... Lo anterior cobra relevancia para la toma de decisiones a nivel local y aporta evidencia sobre este tema.
more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
According to 2014 Census data, almost a third of the population in Myanmar do not have adequate identity and civil documentation. Of these, 54 percent are women.
Women who live in remote or conflict affected areas, who are displaced or belong to stateless ethnic and religious minorities face the... consequences of an insecure legal identity. They cannot enrol their children in school, open a bank account, travel freely or register land.
The report provides an analysis of the gender aspects of citizenship legislation in Myanmar and its application in light of the standards set by the UN Convention on the Elimination of Discrimination Against Women (CEDAW). It analyses in detail women’s ability to acquire citizenship on an equal basis as men, their ability to acquire, retain or confer citizenship following marriage and their ability to confer citizenship to their children. The report highlights the normative and practical challenges faced by women and proposes ways forward.
more
African Journal of Laboratory Medicine | Vol 7, No 2 | a770 | 06 December 2018
Mención especial a la operatividad de los equipos de radioterapia y medicina nuclear, de la red pública de centros oncológicos (MPPS-IVSS)
The survey, conducted between March 1–10, 2018, assessed the performance of 104 public and 33 private hospitals in Venezuela. According to the figures, most laboratory services and hospital nutrition services are only available intermittently or are completely inoperative. Shortages of items such ...as basic medicines, catheters, surgical supplies, and infant formula are highlighted in the survey; 14% of intensive care units have been shut down because they are unable to operate and 79% of the facilities analysed have no water at all.
more
In the post-colonial history of the Central African Republic, violence has often been the shortest way to presidential power. President Bozizé presented little deviation from this narrative after coming to power after a coup d’état in 2003. Whilst he faced armed opposition and a conflict-affecte...d northwest from the outset, it is not until the rise of the Séléka, that the CAR entered into an era of unprecedented violence.
more
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.
more
PLoS ONE 13(8): e0202499. https://doi.org/10.1371/journal.pone.0202499
This was a school-based cross-sectional study conducted in 2015 among 305 school children aged 7–16 years from two primary schools located in Ilemela and Magu Districts, north-western Tanzania. Single stool and urine samples w...ere collected from each participant and examined for the presence of Schistosoma mansoni eggs, parasite antigen, and parasite DNA using KK thick smears, POC-CCA tests, and real-time PCR, respectively.
more
Lancet Glob Health 2018 Published Online September 12, 2018 http://dx.doi.org/10.1016/S2214-109X(18)30407-8
Noncommunicable diseases (NCDs) such as cancer, cardiovascular diseases, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Turkey. This report provides evidence through three analyses that NCDs reduce economic output, and di...scusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs are equivalent to 3.6% of gross domestic product. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment.
more