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3
Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
...
These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
more
Moral emotions are a key element of our human morals. Emotions play an important role in the
caring process. Decision-making and assessment in emergency situations are complex and they frequently result in
different emotions and feelings among health-care professionals.
Community health nurses have the potential to make significant contributions to meet the health care needs of various population groups in a variety of community settings. In order to assess the extent to which CHNs are achieving this potential, WHO conducted a study between 2010 and 2014 that exami
...
ned the status of community health nursing in 22 countries, 13 of which were experiencing a critical shortage of health care workers. The study revealed that the countries surveyed had the basic and operational framework for optimizing CHN in their health systems as evidenced by the availability of PHC structures to guide interventions. However, challenges were identified related to the education, practice and management of CHNs in these countries. The major challenges identified were: Limited availability of career opportunities; poor worker retention; low recognition for CHNs; inadequate and unsupportive working conditions and environments; absence of educational standards; varying educational entry-level requirements for CHN programmes; and a lack of consensus on the scope of practice for CHNs.
more
Medicina 2019, 55, 553; doi:10.3390/medicina55090553
Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated wit
...
h external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to
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essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB patients. When appropriately implemented, the activity is cost effectiv
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e, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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The Mtoto Mwerevu Stunting Reduction Toolkit is a resource for government and organisations involved in addressing stunting and broader nutrition issues in Tanzania. The toolkit was developed in conjunction with the Government of Tanzania (GoT) with funding from UK Aid as part of the Addressing Stun
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ting in Tanzania Early (ASTUTE) programme. Its goal is to provide government, donors, non-governmental organisations, and civil society organisations (CSOs) with programming recommendations and tools to help implement successful multi-sectoral social and behaviour change (SBC) interventions aimed at preventing and reducing stunting.
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Med Princ Pract 2021;30:17–28
An overview of ethics and clinical ethics is presented in this review. The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and justice, are defined and explained. Informed consent, truth-telling, and confidentiality spring from the
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principle of autonomy, and each of them is discussed. In patient care situations, not infrequently, there are conflicts between ethical principles (especially between beneficence and autonomy). A four-pronged systematic approach to ethical problem-solving and several illustrative cases of conflicts are presented. Comments following the cases highlight the ethical principles involved and clarify the resolution of these conflicts. A model for patient care, with caring as its central element, that integrates ethical aspects
(intertwined with professionalism) with clinical and technical expertise desired of a physician is illustrated
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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.
The primary audience of this report with the compendium of resources are youth engagement practitioners in the Red Cross Red Crescent National Societies as well as technical experts and policy makers across the humanitarian landscape that thrive for meaningful interventions with and for children, ad
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olescents, and young adults experiencing the impact of the COVID-19 pandemic.
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This document presents an evidence-informed Checklist for implementing rural pathways to train and support the rural
health workforce in low and middle income countries (LMIC). Rural areas are the most underserviced around the world.
Young people living in the Central African Republic, Chad, Nigeria, Guinea, and Guinea-Bissau are the most at risk of the impacts of climate change, threatening their health, education, and protection, and exposing them to deadly diseases. The report is the first comprehensive analysis of climate ri
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sk from a child’s perspective. It ranks countries based on children’s exposure to climate and environmental shocks, such as cyclones and heatwaves, as well as their vulnerability to those shocks, based on their access to essential services.
Additional translations of the Executive Summary are available in the following languages, with thanks to Climate Cardinals: English, French, Arabic, Hausa, Portuguese, Spanish, Somali, Yoruba
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On 25 August, UN agencies and partners launched a US$187.3 million Flash Appeal to reach 500,000 of the most vulnerable people affected by the 14 August earthquake.
Around 650,000 people are in need of emergency humanitarian assistance in the three most affected departments – Grand’Anse, Nipp
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es and Sud – where 634,000 were already in need of multisectoral assistance before the quake.
Based on lessons learned from past emergencies, humanitarian actors are aiming to capitalize on local and national level expertise, capacities and knowledge to promote a rapid and effective response tailored to the expressed needs of affected people.
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Almost 25% of deaths worldwide could be prevented if the actions in the compendium were fully implemented
This compendium provides a systematic compilation of published guidance from WHO and other UN organizations on health and environment. Guidance on policies and actions as well as awareness rais
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ing and capacity building interventions is presented for all major areas of health and environment. Guidance referring to priority settings for action such as cities and other urban settlements, housing, workplaces and health care facilities is also listed.
For greater practical relevance, each guidance is classified according to principally involved sectors, level of implementation and instruments for implementation.
The compilation of guidance for each area of health and environment or priority setting for action is accompanied, as available, by information on main sources, exposure assessment and existing guideline values. Important tools and further resources are presented alongside.
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The framework sets out a response to current mental health challenges arising from the negative impact that the COVID-19 pandemic has had on population mental health and well-being. The EFAMH provides a coherent basis for intensified efforts to mainstream, promote and safeguard mental well-being as
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an integral element of COVID-19 response and recovery; to counter the stigma and discrimination associated with mental health conditions;
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Drawing light from the pandemic: A new strategy for health and sustainable development (2021)
Available in English, French, German and Russian
In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti
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on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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This Fiji contextualized manual was initially drafted for CANDO partners as a result of the work done by the humanitarian arms of the various Christian denominations. However as the work progressed it became evidently clear that the training was needed for all responders, and not only Christian resp
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onders, and as such, the Christian component has been added as an Annex to this manual, whilst the entire manual is relevant and can be used to train all first responders in Fiji.
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