Journal of the International AIDS Society 2016, 19:20926
There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low‐ and middle‐income settings. This article describes a public–private partnership ...that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community‐based non‐governmental organization (International HIV/AIDS Alliance).
https://doi.org/10.7448/IAS.19.1.20926
more
Research Article
BMC Infectious Diseases 2014, 14:91/1471-2334/14/91
Schizophr Bull. 2014 Jan;40(1):192-213. doi: 10.1093/schbul/sbs150. Epub 2012 Dec 17.
Challenged by the health emergency, Primary Health Care (PHC) professionals remodeled their work processes and realized that many of the innovations implemented in an emergency manner to respond to the pandemic of COVID are here to stay. The initiative APS Forte no SUS - no combate à pandemia de CO...VID-19 gathered experiences from all over the country, executed by engaged health workers who, despite the difficulties imposed by the new disease, fight daily to improve the offer and care in health in the Unified Health System (SUS). With the help of digital technologies, teams and professionals of the Family Health Strategy overcome daily one of the main challenges of APS in this pandemic: ensuring access to health services. Digital tools gain strength in the agenda for strengthening the SUS, so well represented in this initiative.
more
Neglected tropical diseases tend to cluster in the same poor populations, and to make progress with their control, they will have to be dealt with in an integrated manner. Peptide microarrays may be a solution to tese problems, where diagnosis for co-infection can be detected simultaneously using th...e one tool.
more
South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South A...frica’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
more
Research Article
PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002374 August 8, 2017
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
more
Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
more
Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an...d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
more
Lancet Planet Health 2020; 4: e271–79
Lancet Planet Health 2019; 3: 469–77
Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r...egion in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
more
Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue...s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
Research Article
Hindawi
BioMed Research International
Volume 2018, Article ID 9619684, 10 pages https://doi.org/10.1155/2018/9619684
The Lay Counselor Cadre in Botswana
Epilepsia, 55(4):475–482, 2014
doi: 10.1111/epi.12550
Dans cette perspective, nous espérons que notre expérience pratique dans ces domaines constituera un apport aux prochaines éditions de ce guide. Et si le renforcement des systèmes de santé peut ne pas être une science exacte et que l’approche universelle n’existe pas, cette publication dé...montre que la quantité de connaissances empiriques et les bonnes pratiques peuvent grandement contribuer à accélérer et à affiner les initiatives nationales du mieux possible afin d’adapter les besoins, les compétences et les circonstances.
more