Primary care health centers and providers who care for individuals with hypertension and cardiovascular disease have an important role to play in ensuring continued access to care, reducing the risk of coronavirus infection, and appropriately managing people with these co-morbidities who acquire COV...ID-19. This guidance includes these considerations
more
Primary Care: The Community Health System
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 multisector...al 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
Global Conference on Primary Health Care From Alma-Ata towards universal health coverage and the Sustainable Development Goals
Astana, Kazakhstan, 25 and 26 October 2018
Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
more
This Clinic Supervisor’s Manual is helpful for focusing managers on the key elements of integrated primary health care as they simultaneously integrate new interventions for HIV/AIDS, tuberculosis, and malaria. This tool contains 12 sections. Section 1 explains how to use the manual. Section 2 hel...ps the clinic supervisors organize their supervisory visit. The remainder of the sections focus on a number of key areas during a clinic supervision visit.
more
Public Health & Primary Care / Research Article
Cogent Medicine (2018), 5: 1430197
Lefebvre et al., Cogent Medicine (2018), 5: 1430197 https://doi.org/10.1080/2331205X.2018.1430197
Manual for use in primary care.
There is substantial evidence for the benefits of screening and brief intervention in primary health care for alcohol problems. However, there is a need for screening and brief interventions with cross-cultural relevance for substances other than alcohol or tobacco,... such as cannabis, amphetamines, cocaine and opiates.
The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect and manage substance use and related problems in primary and general medical care settings. Primary health care professionals are well-positioned to provide interventions targeted to all substances irrespective of their legal status.
The ASSIST screening test version 3.0 is available in English and in 10 other languages (Arabic, Chinese, Farsi, French, German, Hindi, Portugüse, Russian, Spanish and Ukrainian).
more
Manual for use in primary care
Manual for use in primary care.
This manual explains the theoretical basis and evidence for the effectiveness of brief interventions and assists primary health care workers in conducting a simple brief intervention for clients whose substance use is putting them at risk.
The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to tho...se directly providing care to pregnant women and preterm infants, such as obstetricians, paediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth.
more
Part of Comprehensive Primary Health Care
Using Epidemiology to Support Primary Health Care. Updated version of the WHO handbook published in the early 1990's entitled: Manual of Epidemiology for District Health Management or those with an interest in applied epidemiology in primary health care and district health systems
This guidance is targeted to primary health care policy-makers and only addresses issues relevant for primary health care providers. It has been prepared on the basis of a systematic review of the best available evidence and emergent country practices in response to the COVID-19 outbreak in the WHO ...European Region. It will be updated on a regular basis as new information becomes available.
more
In a prospective cohort study in Bangwe primary care clinic, Blantyre, Malawi, all adults (18 years or older) presenting with an acute illness were screened for TB symptoms (cough, fever, night sweats, weight loss). Demographic characteristics were linked to exit interview by fingerprint bioidentifi...cation. Multivariable logistic regression models were constructed to estimate the proportion completing same-visit HIV testing, comparing between those with and without TB symptoms.
more
Ukraine: Russian invasion has forced older people with disabilities to endure isolation and neglect – new report
Many temporary shelters inaccessible to people with physical disabilities
Overburdened care system often provides few alternatives to institutions for older people
Authorities ...and humanitarian actors must ensure an inclusive response
Displaced older people with disabilities in Ukraine are physically and financially unable to access adequate housing and care amid Russia’s ongoing invasion, sometimes leaving few alternatives to being placed in residential institutions, Amnesty International said in a new report.
more
Indonesian Version of: Integrated care for older people (ICOPE): guidance for person-centred assessment and pathways in primary care. The ICOPE guidance for person-centred assessment and pathways in primary care (ICOPE Handbook) helps community health and care workers put the recommendations o...utlined in the ICOPE Guidelines into practice. The Handbook assists with setting person-centred goals, screening for loss in a range of domains of intrinsic capacity and assessing health and social care needs to develop a personalised care plan. The care plan may include multiple interventions to manage declines in intrinsic capacity, provide social care and support, support self-management and support caregivers. The domains of intrinsic capacity include cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss and depressive symptoms.
more
A Program To Improve The Care For Patients With Common Mental Disorders In Primary Health Care.
The essence of the MANAS model is to shift mental health care from mental health specialists to primarycare doctors and lay HCs (someone similar to other more widely available... health workers) working as aprimary care team to improve the coverage and efficiency in treating CMD. This manual has been prepared based on the experience gained through the MANAS program and incorporates feedback from doctors who were involved in the program implementation. It outlines the details of the MANAS model and provides information on treatments that are relevant to doctors working in Primary Health Clinics
more
Assessment and Guidance for Strengthening Integration of Mental Health into Primary Health Care and Community-Based Service Platforms in Ukraine
Technical package for cardiovascular disease management in primary health care.