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.
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Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the na...tional demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
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Failure to Credibly Investigate and Provide Redress for Unlawful Attacks in Yemen
Integrated Management of Acute Malnutrition National Guidelines
2017-2018
Republic of Albania
Lancet Oncol 2018 Published Online September 12, 2018 http://dx.doi.org/10.1016/S1470-2045(18)30447-9
Lancet Public Health 2018 Published Online September 12, 2018 http://dx.doi.org/10.1016/ S2468-2667(18)30138-5
Lancet Glob Health 2018 Published Online September 12, 2018 http://dx.doi.org/10.1016/S2214-109X(18)30407-8
Lancet Glob Health 2018 Published Online September 12, 2018 http://dx.doi.org/10.1016/S2214-109X(18)30409-1
Lancet Glob Health 2018, Published Online September 12, 2018 http://dx.doi.org/10.1016/S2214-109X(18)30387-5
The CB MHPSS operational guidelines were developed in response to emerging evidence on the determinants of children’s resilience, lessons learned from the evaluation of existing approaches, and the unique challenges that today’s crises pose for children’s safety, wellbeing and optimal developm...ent.
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UNICEF CHILD ALERT May 2018
As part of a UNICEF series highlighting the challenges faced by children in current crisis situations, this Child Alert examines the situation of children affected by violent conflict in Kasai region, Democratic Republic of the Congo. The alert outlines what UNICEF a...nd its partners have achieved to date in providing humanitarian assistance to children in Kasai affected by malnutrition and lack of access to health care, safe water and education. It calls upon all parties to the conflict – and the international community – to take urgent action protecting the lives and futures of children at risk, before it is too late.
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The UNFPA Zambia 2017 Annual Report highlights key milestones and achievements recorded with UNFPA support towards improving the health and well-being of women and young people in Zambia.
Commissioned by Plan International the report draws on data from research conducted in Bangladesh in April 2018. It explores how adolescent girls within two age brackets (10-14 and 15-19) understand the unique impact the crisis has upon them, and how they have responded to the challenges they face.<...br>
Despite the numbers of adolescent girls affected so profoundly by the ongoing Rohingya crisis, and of course, by many crises around the world, it is rare that either their own communities or the humanitarian sector at large pay much attention to them. This research is an attempt to rectify that: to acknowledge that girls and young women do have rights and that their ideas are worth listening to and acting upon.
Among the many learnings, we discovered that girls feel isolated. They have settled among strangers, and parents worry about their safety, keeping them even more trapped inside their new, makeshift homes.
75% of girls interviewed said they have no ability to make decisions about their own lives.
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The scope of this PPC document is to serve as a guide to address the unmet public health need for a PPE system that protects the HW-F in tropical climate
s while caring for patients and providing heavy duty essential health services.
The characteristics described in this guidance are targeted fo...r PPE used in
health clinics, hospitals and communities in low resource settings where there is lack of advanced environmental controls and equipment. The purpose is to ensure harmonization in PPE design and its use to avoid confusion and exacerbating the risk of infections in HW-F. The principles of this PPC document can also be considered in risk reduction strategies
in other healthcare settings.
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Qualitative study from Zambia on barriers to and facilitators of life-long learning