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Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians
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Médecins Sans Frontières MFS (2023) CC

Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue. The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases. This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field. It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure. Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness. The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms). Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected. To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions. more

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Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso

Ouedraogo Y., Furlane G., Fruhauf T. et al. Global Health: Science and Practice (2018) CC

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

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Influencing food environments for healthy diets

Food and Agriculture Organization of the United Nations FAO (2016) C2

Food environments are usually defined as the settings with all the different types of food made available and accessible to people as they go about their daily lives. That is, the range of food in supermarkets, small retail outlets, wet markets, street food stalls, coffee shops, tea houses, s...chool canteens, restaurants, and all the other venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing, marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems and food environments are challenged in supporting consumer choices that are consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges. more

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Rwanda: FAMILY PLANNING STRATEGIC PLAN 2012–2016

Ministry of Health, Rwanda (2012) C2

In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv... more

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Guidelines for the management of adult lower respiratory tract infections - Summary

Woodhead M., F. Blasi, S. Ewig, et al. (2011) C2

The guidelines are to be used to guide the management of adults with lower respiratory tract infection (LRTI). As will be seen in the following text, this diagnosis, and the other clinical syndromes within this grouping, can be difficult to make accurately. In the absence of agreed definitions of th... more

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Training manual logistics of infection prevention and control and health care waste management commodities
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USAID, AIDS Free Nigeria, et al. (2016) C1

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Professionalizing Health Logistics in Burkina Faso: Challenges, Implementation and Sustainability

Silve B., A. Ouedraogo Public Health Research (2013) C2

The management of information and logistics is an essential component of health product systems. In a context of limited financial resources and morbidity and mortality sustained by persistent diseases, it is necessary to strengthen health systems through competent resources, especially human resour... more

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Using Last Mile Distribution to Increase Access to Health Commodities

Joseph McCord, Emily Bancroft and Jessica Crawford USAID Deliver Project (2011) C1

Last Mile delivery presents a unique challenge in making health commodities available in the developing world. This guide, designed for in-country practitioners and decisionmakers, uses a range of real world examples to support selection and design of last mile distribution approaches which respond ... more

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Operational principles for good pharmaceutical procurement

WHO (1999) C_WHO

This document introduces four strategic objectives and twelve operational principles for good pharmaceutical procurement. These objectives and principles have been developed and endorsed by the Interagency Pharmaceutical Coordination Group (IPC), involving the pharmaceutical advisers of the United ... more

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L'OMS rectifie les désinformations sur le coronavirus

Solé, E. Futura Santé (2021) C_WHO

21 Sept. 2021

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Interim statement on COVID-19 vaccine booster doses

World Health Organization WHO (2021) C_WHO

7 August 2021

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Vaccin contre le Covid-19 : une troisième dose est-elle nécessaire ?

Delign, E. Pour la Science (2021) C_WHO

21 Sept. 2021

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Aqueduct Projected Water Stress Country Rankings

Andrew Maddocks, Robert Samuel Young and Paul Reig World Resources Institute (2015)

Using an ensemble of climate models and socioeconomic scenarios, WRI scored and ranked future water stress—a measure of competition and depletion of surface water—in 167 countries by 2020, 2030, and 2040. We found that 33 countries face extremely high water stress in 2040 (see the full list). We... more

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COVID-19 Essential Supplies Forecasting Tool
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World Health Organization WHO (2020) C_WHO

This tool is designed to help governments, partners, and other stakeholders to estimate potential requirements for essential supplies to respond to the current pandemic of COVID-19. Although it gives users with an estimation of the number of cases, this calculator is not an epidemiological calculato... more