Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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La détection directe des protéines virales du SRAS-CoV-2 (antigènes) dans les écouvillons nasaux et autres sécrétions respiratoires à l'aide de tests immunologiques à flux latéral (également appelés tests de diagnostic rapide, TDR) offre une méthode plus rapide et moins coûteuse pour te...ster le SRAS-CoV-2 que la méthode de référence, les tests d'amplification des acides nucléiques (TAAN). Ces lignes directrices provisoires offrent des recommandations sur les utilisations prioritaires des tests de diagnostic rapide à détection d'antigène (TDR-Ag) dans des populations et des contextes spécifiques, notamment (i) pour la détection primaire des cas chez les personnes symptomatiques suspectées d'être infectées et les personnes asymptomatiques à haut risque de COVID-19, (ii) pour la recherche des contacts, (iii) pendant les enquêtes sur les épidémies et (iv) pour surveiller les tendances de l'incidence de la maladie dans les communautés. Les TDR-AG répondant aux exigences minimales de performance peuvent être utilisés en dehors des milieux cliniques et des laboratoires, y compris dans les communautés, par des opérateurs formés conformément aux instructions. Le guide fournit en outre des recommandations sur la mise en œuvre, la sélection des produits et le stockage
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Chaque année, 2,6 millions de bébés meurent avant l’âge d’un mois. Un million d’entre eux rendent leur dernier souffle le jour même de leur naissance. Pourtant, des millions de jeunes vies pourraient être épargnées chaque année si les mères et les bébés avaient accès à des soins ...de santé abordables et de qualité, à une nutrition correcte et à de l’eau potable. Ce rapport appelle à une coopération solide entre les gouvernements, les entreprises, les prestataires de soins de santé, les communautés et les familles pour donner à chaque enfant une chance de vivre et travailler collectivement pour atteindre une couverture sanitaire universelle et un monde dans lequel aucun nouveau-né ne meurt d’une cause évitable.
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Guidance for health care workers.
Mosquito-borne diseases are expanding their range, and re-emerging in areas where they had subsided for decades. The extent to which climate change influences the transmission suitability and population at risk of mosquito-borne diseases across different altitudes and population densities has not be...en investigated. The aim of this study was to quantify the extent to which climate change will influence the length of the transmission season and estimate the population at risk of mosquito-borne diseases in the future, given different population densities across an altitudinal gradient.
The Lancet Planetary Health Volume 5, ISSUE 7, e404-e414, July 01, 2021
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Rev. Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153
Worldwide, over 6 million people are infected with Trypanosoma cruzi, the pathogen that causes Chagas disease (CD). In the Americas, CD creates the greatest burden in disability-adjusted life years of any parasitic infection. In Co...lombia, 437 000 people are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy. Colombia’s annual costs for treating patients with advanced CD reach US$ 175 016 000. Although timely etiological treatment can significantly delay or prevent development of cardiomyopathy—and costs just US$ 30 per patient—fewer than 1% of people with CD in Colombia and elsewhere receive it.
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Global food insecurity has markedly increased over the last two-years due to conflict, economic and political instability, displacement, environmental degradation and disasters, and major disruptions to global food systems because of the Covid-19 pandemic. In 2021, levels of hunger surpassed all pre...vious records with close to 193 million people acutely food insecure and in need of urgent assistance across 53 countries and territories. This represents an increase of nearly 40 million people compared to what was previously considered a record level high in 2020.
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Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s...tudy aimed to test both interventions in low-income and middle-income countries.
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Published Online: 29 February 2016. DOI: http://dx.doi.org/10.1016/S0140-6736(16)00562-6
Please download directly from the webpage: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2816%2900562-6.pdf
BMJ Global Health 2022;7:e008007. doi:10.1136/ bmjgh-2021-00800
Guide for clinical case management and infection prevention and control during ameasles outbreak. This guide has been developed to reduce the high morbidity and mortality seen in some of the current outbreaks of measles. This short guide outlines practical clinical care interventions and is derived ...from previously published WHO documents.
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Deporte Formativo Y Actividad FÍSica En Entornos Diferentes Al Hogar, En El Marco De La Pandemia Por Covid-19 En Colombia
Genre et Sécurité : Orientations pour l’intégration du genre à la gestion des risques de sécurité propose aux ONG des lignes directrices complémentaires pour intégrer la dimension genre à la gestion des risques de sécurité, afin de combler un vide dans les publications existantes et d...émettre des recommandations vitales au niveau opérationnel. Les objectifs de ce document sont les suivants : 1. Encourager une prise de conscience générale sur la notion de genre et sur sa pertinence dans le contexte de la gestion des risques de sécurité. 2. Attirer l’attention sur les aspects du genre à prendre en compte et fournir des recommandations, tant au niveau du siège d’organisations qu’au niveau pays et du terrain, qui peuvent être intégrées au cadre de gestion des risques de sécurité existant ou sont susceptibles de le compléter.
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The handbook is the first comprehensive collection of practical tips for journalists on how to report on GBV in the context of Syria crisis, building upon internationally recognised ethical principles. It gives an overview of techniques to guarantee the safety, confidentiality and dignity of survivo...rs, their families and communities. It includes terms, ethical questions and practical concerns associated with covering GBV, as well as an overview of some of the organisations involved in both combatting GBV and providing support services for survivors.
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Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program’s strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant servi...ces. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts.
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