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This is a case-ascertained prospective investigation of all identified health care contacts working in a health care facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Stud
...
y population) receives care. Note that this study can be done in health care facilities at all 3 levels of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers.
There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for:
To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level.
To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers.
To evaluate effectiveness of infection prevention and control measures among health care workers
To evaluate effectiveness of infection prevention and control programmes at health facility and national level
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This report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of power dynamics and power reorientation towards individuals with lived experience; informed decisio
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n-making and health literacy; community engagement across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights.
It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives,inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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Catholic hospitals and other health services provide invaluable care to many in the community. This article accentuates the pastoral nature of Catholic he
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alth care, which is definitive to its Catholic identity. Discussing contemporary Catholic health care in conjunction with the works of Henri Nouwen we explore the challenges faced by today’s Catholics in Catholic health care and respond to these issues. In support of the discussion are the results of qualitative research into the perceptions Perth parishioners have of Catholic health care’s pastoral nature and Catholic identity. This research aims towards understanding the challenges facing Catholic health care providing pastoral care within its Catholic identity.
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Evaluation of Community Management of Acute Malnutrition (CMAM)
Sheila Reed, Camille Eric Kouam, Krishna Belbase et al.
United Nations Children’s Fund (UNICEF) Evaluation Office
(2013)
This evaluation is the first systematic effort by UNICEF to generate evidence on how well its global as well as country level Community Management of Acute Malnutrition (CMAM) strategies have worked, including their acceptance and ownership in vario
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us contexts and appropriateness of investments in capacity development and supply components. Overall, the evaluation recommends that UNICEF continue to promote and support CMAM as a viable approach to preventing and addressing severe acute malnutrition (SAM), with an emphasis on prevention through strengthening community outreach and integrating CMAM into national health systems and with other intervention
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CORE Group has developed a module to improve preparedness for and response of communities in countries at risk of a cholera epidemic. The module consists of four lesson plans with accompanying flipcharts, intended to be delivered through community
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health workers. The lessons target mothers and caregivers of children under age five, a group that is at particular risk of death if infected. The module shares information about symptoms and risks; what families can do to prevent infection; how, when, and where to seek care; and what actions to take in the aftermath of an outbreak.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- a
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nd middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only
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violates the rights of people with disabilities under international law, but UHC and SDG 3 cannot be attained without better health services for the one billion people with disabilities.
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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocol
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s. Team-based care uses multidisciplinary teams (which may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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The toolkit presents step-by-step guidance that district health teams (DHTs), district leaders, MOH/UNEPI, immunisation partners, and civil society organisations (CSOs) can use to engage NHS and maximise the benefits of their participation in streng
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thening RI through activities such as community dialogue meetings. Tables and annexes outline this process
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care syst
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ems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited peopl
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e's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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The document "Combating False Information on Vaccines: A Guide for Health Workers" is designed to help health workers address vaccine misinformation. It begins by defining misinformation and explain
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ing why it spreads rapidly, often due to its emotional appeal and simplistic explanations. The guide identifies common sources of vaccine misinformation, including influential individuals who profit from spreading false information. The document outlines strategies for combating misinformation, emphasizing the importance of health workers as trusted sources. It provides tips for identifying misinformation online, such as checking URLs, dates, and author credentials, and recognizing tactics like evoking strong emotions or pushing conspiracy theories. Two main approaches to fighting misinformation are discussed: prebunking and debunking. Prebunking involves warning individuals about potential misinformation before they encounter it, while debunking aims to correct false information after it has been consumed. The guide offers practical examples for both methods. Additionally, the document highlights the role of health workers in supporting peers and patients to trust immunization. It suggests being kind, nonjudgmental, and transparent when addressing concerns, and using motivational interviewing techniques to understand and respond to patients' doubts. Overall, the guide emphasizes the critical role of health workers in maintaining trust in vaccines and provides comprehensive strategies to identify, address, and prevent the spread of vaccine misinformation in clinical and community settings. The guide is a valuable resource for health workers to enhance their ability to combat vaccine misinformation, support informed decision-making, and promote trust in vaccines within their communities, and it addresses a pressing issue with practical solutions, supports trusted health workers, and ultimately aims to protect public health by promoting accurate information and trust in vaccines.
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In March 2020 the IASC Reference Group on Mental Health and Psychosocial Support uniting 57 humanitarian organizations as member issued the Interim Briefing Note Addressing Mental Health and Psychos
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ocial Aspects of COVID-19 Outbreak. This document has proven to be very useful in the response and has till now been translated in 24 languages. It covers a set of recommended activities as well as messages for different target groups.
The current document is an annex to the Interim Briefing Note and is meant to support the MHPSS operational response within the various sectors of humanitarian work. Approaches and interventions to MHPSS are not confined to one sector, but need to be integrated within many existing sectors and clusters.This document contains a wealth of operational information and practical approaches that can be used for humanitarian programming in health, SGBV, community-based protection, nutrition, camp management and camp coordination.
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Health Systems for Outcomes Publication | The government of Rwanda has identified human resources for health as one of its policy priorities. This study aims to contribute to building a better under
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standing of health worker choice and behaviour, and to improve evidence based polcies.
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The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was used to collect information on the mental health syste
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m in Ghana for the year 2011. The goal of collecting this information is to improve the mental health system and to provide a baseline for monitoring the change. This will enable Ghana to develop information based mental health plans with clear base-line information and targets. It will also be useful to monitor progress in implementing reform policies, providing community services, and involving users, families and other stakeholders in mental health promotion, prevention and rehabilitation.
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The target audience for this training course is non-clinicians such as Home Based Carers, Community Caregivers, Youth Care Workers, Peer educators, Community
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Health Workers etc. primarily those who will be providing adherence counselling to clients with HIV, TB, Hypertension and Diabetes. This group of non-clinicians play a vital role in helping to reduce the workload of nursing staff. Amongst others, non- clinicians educate clients and provide emotional support in a manner that makes each client feel like they are receiving focused, individual attention. Non-clinicians are often in close contact with communities and, therefore, able to understand and play a role in alleviating health service barriers in the community.
Facility managers may also be part of the target audience in order to ensure that they understand the components of the minimum package of interventions to support linkage, adherence and retention in care.
Further, their attendance seeks to ensure that non-clinicians receive necessary assistance and support when they have to implement what they have learned back into their workplaces.
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations
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and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective and for people who use these interventions.
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The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals.
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A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia
Luwabelwa, M.; Banda, P; Palale M.; Chama-Chiliba, C.
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2017)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare ( ... PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole. more
The health services delivery system in Zambia is pyramid in structure, with primary healthcare ( ... PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole. more
In the course of implementing a recently funded network of hubs for building capacities in mental health service development, training, and research (RedeAmericas), the peer support workers are being introduced into the mental
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health workforce in three Latin American countries for the very first time. They will be part of a team, along with community mental health workers, that provides a modified Critical Time Intervention to individuals with severe psychiatric disorders living in the community. This article reviewed the background of this increasingly widespread development, and discussed its merits, as well as potential obstacles within local contexts.
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