This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, preliminary studies and pilot testing, budgeting and accounting, intervention costing and economic analysis, and Phase IV studies. Before new interventions... are released into disease control programmes, it is essential that they are carefully evaluated in ‘field trials’. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. This manual was designed to provide guidance on the practical issues in great detail
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Le Manuel de formation psychosociale pour la Protection des enfants de Terre des hommes répond
aux besoins des programmes de protection de l’enfance menés par Terre des hommes et peut être utilisé
en parallèle à la publication précédente de Terre des hommes: Protection des enfants: manue...l d’intervention
en cas de crise humanitaire. Ce manuel de formation a été conçu pour le terrain afin de former le
personnel qui travaille directement ou indirectement avec les enfants.
Les modules de ce manuel ont été regroupés selon les catégories suivantes:
• Niveau 1: Animer une formation / un atelier
• Niveau 2: Concepts de base pour une intervention
• Niveau 3: Compétences des animateurs
Chaque module contient les rubriques suivantes:
• Qu’est-ce que c’est?
• A quoi ça sert?
• Comment l’utiliser?
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War Child put forward a specific request for comparative study, addressing the following questions: •What are the key types of intervention for psychosocial assistance that are being applied to children in war-affected areas? •What are the results of (scientific) research into the effects of th...e most relevant programmes? •Which NGOs operate in this sector and what is their practical experience with specific methods? •How does the War Child methodology relate to developments in the sector; what is known about the effects of War Child’s programme and how can these be measured? How will War Child work towards the development of additional evidence?
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WHO Guideline. Since 2010, countries in the meningitis belt have started to introduce a new serogroup A meningococcal conjugate vaccine conferring individual protection and herd immunity. Following the successful roll-out of this vaccine, epidemics due to Neisseria meningitidis serogroup A (NmA) are... disappearing, but other serogroups (e.g. NmW, NmX and NmC) still cause epidemics, albeit at a lower frequency and of a smaller size. Due to these changes, WHO organized the review of the evidence to provide recommendations for epidemic control, related to operational thresholds for investigation and response to outbreaks, the use of rapid diagnostic tests, antibiotic regimens in epidemics, and prophylaxis for household contacts of cases
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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The main objectives of the training module
- facilitate communication and understanding between the two disciplines of epidemiology and laboratory (medicine) for disease surveillance and outbreak investigation;
- provide the field epidemiologist with a better understanding of basic microbiolo...gy techniques and analysis and interpretation of results;
- convey the laboratory perspective of public health investigations to field epidemiologists in order to improve collaboration between these two disciplines and to enhance.
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Background: Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at-risk youth. We used a meta-analytic approach to examine longitudinal changes in youth PTSD prevalence and symptom...s over the first 12 months posttrauma.
Journal of Child Psychology and Psychiatry57:8 (2016), pp 884–898
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Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201...6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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Outstanding child and adolescent TB priorities include the need to: find the missing children with active TB and link them to TB care; prevent TB in children who are in contact with infectious TB cases (through implementation of active contact investigation and provision of preventive treatment); an...d advance integration within general child health services, including maternal and child health/ reproductive, maternal, newborn, child and adolescent health, HIV, nutrition and other programmes.
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Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.
Method: This was a mixed- methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 que...stions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data were analysed using SPSS Version 22.0. Qualitative data were analysed through thematic content analysis and open coding to identify emergent themes.
Results: 40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.
Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.
Implications: This study was inclusive of all types of disability. Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings.
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The 2012 NDRMP lays out the Disaster Risk Management (DRM) architecture of the country and provides guidance for DRM intervention at all levels. However, implementation has been slow and resource challenges exist throughout the government.
The PNG government’s policy and institutional framework... for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks.
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Senegal’s substantial and sustained progress against malaria is an inspiring public health success story, and a source of potential lessons for other countries on the path to elimination. This case study describes three major success factors—(1) outstanding leadership and partner engagement, (2)... the achievement and maintenance of high intervention coverage levels, and (3) a thriving data culture—and explores several exciting new opportunities to consolidate and expand upon Senegal’s two decades of impact.
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The number of confirmed COVID-19 cases detected and reported in each country is influenced by
many factors including limited access and/or utilization of healthcare and COVID-19 testing, limited
surveillance, lack of knowledge amongst the population about when to seek testing, an asymptomatic pres...entation, and other unknown issues. This is true in all countries of the world, and not Africa specific, however there are factors unique to Africa which may also affect the way the virus behaves there. COVID-19 prevalence data are critical for planning effective mitigation strategies and understandingthe true impact of the disease and relevant intervention measures in Africa, which might be quite different from regions with a different population age distribution or risk factor profile.
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Orientations provisoires, 27 mai 2021
The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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All health workers deployed to measles outbreaks must complete the measles and rubella (MR) training to implement quality interventions and work safely and effectively in the field. This course provides the essential preparedness, detection, investigation, response, and recovery skills required to c...ontain the measles outbreak.
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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford th...eir bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
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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.
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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.
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Childhood Respiratory Diseases & the Environment learning objectives
•To understand how the respiratory tract is affected by the environment
•To describe respiratory diseases linked to the environment
•To list one population-level intervention and one personal-level intervention for d...ecreasing risk of respiratory diseases
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