INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Antibiotics have been useful in fighting infectious diseases in our country for decades, but because of the overuse and misuse of these agents, an increasing number of organisms are now resistant to them. The Philippines, like other Southeast Asian countries, has already been encountering the many c...hallenges of antimicrobial resistance (AMR) which include increasing social and economic costs and rising patient mortality. Although considered a global threat, it is already an emerging local health concern which calls for an urgent collaboration among different sectors to provide solutions addressing this growing problem.
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New E-learning on health care responsibilities in times of conflict
Are you a doctor wondering how to interact with the media, or a nurse wondering how to treat patient information in difficult circumstances? Are you an ambulance driver unsure of what your responsibilities are? Are you a hospital a...dministrator wondering what to do with overwhelming numbers of deceased patients? If so, the Health Care in Danger project's new e-learning module on the responsibilities of health-care personnel is for you.
The module introduces health-care personnel to the principles underpinning ethical considerations when working in conflict situations and other emergencies. Using an engaging multimedia interface, the module presents various dilemmas that medical personnel face every day. Users can explore these issues in depth by interacting virtually with experts in the field, studying real-life issues, and receiving guidance that helps them to make decisions in difficult situations. The module allows learners freedom to explore, and for each chapter includes documents with more detailed information on topics of interest to the user.
Access is completely free, and no login is required. The module functions on Safari, Internet Explorer 9 and later, Firefox, and Google Chrome, as well as on tablet devices. Would you like to get started? The module is available online, and hosted by ICRC.
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Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should h...ave some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
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This report reviews and analyses the Affordable Medicines Programme, which was introduced in Ukraine in April 2017 to provide patients with improved access to 23 outpatient medicines for the treatment of chronic noncommunicable diseases. The evaluation combines both quantitative and qualitative anal...ysis. The findings confirm that the Programme has contributed to a significant increase in access to needed outpatient medicines in Ukraine. Further, while implementation was successful overall, uptake across regions was uneven. The report concludes by listing a number of policy options to support the sustainability and expansion of the Affordable Medicines Programme.
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A key component of elimination is to reduce the number
of unmanaged trachomatous trichiasis cases to less than
1 per 1,000 population in affected areas. This will require
not only a large increase in the number of surgeries
performed, but also improvements in the quality of surgery
and in the e...fficiency of surgery provision programs. It also
will require that we make special efforts to reach out to
women and the most marginalized populations, who are
disproportionally affected by trichiasis (TT).
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The core of the strategy is the goal for all patients to have better overall care, so that the numbers of deaths and cases of disability are reduced by 50% before 2030. For this to be achieved, four strategic aims will be pursued.
Empower and engage communities,
Ensure safe, effective trea...tment,
Strengthen health systems, and
Increase partnerships, coordination and resources Strong collaboration
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As care teams struggle to treat an increasing number of patients around the world, we have made the following Clinical Effectiveness COVID-19 resources available *at no charge* to anyone seeking the latest evidence-based information and clinical guidance. While we will update you via email when new ...resources are made available, please also bookmark this page, as the list will be updated regularly in response to new developments, evidence and guidance.
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March 2020
The number of African Union Member States reporting COVID-
19 cases is increasing and there is a likelihood of community transmission. The WHO recently modified the COVID-19 suspect case definition to include severe acute respiratory infection and advises testing of all severe acute res...piratory illness (SARI) cases.1 However, many Member States have not yet started implementing these changes, they are still focussing surveillance efforts on individuals with travel history to an area with local COVID-19 transmission. This means patients with similar symptoms, but no apparent contact, may not
be investigated.
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March 2020
The number of African Union Member States reporting COVID-
19 cases is increasing and there is a likelihood of community transmission. The WHO recently modified the COVID-19 suspect case definition to include severe acute respiratory infection and advises testing of all severe acute r...espiratory illness (SARI) cases.1 However, many Member States have not yet started implementing these changes, they are still focussing surveillance efforts on individuals with travel history to an area with local COVID-19 transmission. This means patients with similar symptoms, but no apparent contact, may not
be investigated.
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The purpose of this manual is to define a limited number of indicators that will objectively describe the management and use of antimicrobials in hospitals and to provide tools and step-by-step instructions for designing and carrying out an assessment of antibiotic use and management in hospitals. T...he indicators in this manual will complement the existing WHO (1993) indicators of outpatient antimicrobial use suggested in How to Investigate Drug Use in Health Facilities (including percentage of encounters in which an antibiotic was prescribed and percentage of medicine costs spent on antibiotics) and will address the need for antimicrobial indicators for inpatient conditions.
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The provision of safe and efficacious blood and blood components for transfusion or manufacturing use involves a number of processes, from the selection of blood donors and the collection, processing and testing of blood donations to the testing of patient samples, the issue of compatible blood and ...its administration to the patient. There is a risk of error in each process in this “transfusion chain” and a failure at any of these stages can have serious implications for the recipients of blood and blood products. Thus, while blood transfusion can be life-saving, there are associated risks, particularly the transmission of bloodborne infections.
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels.
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This an updated revised edition of the book which is published in 1986 ,The whole text has been updated and revised in line with current anaesthetic teaching. New chapters on hypothermia and acute pain relief added and some other chapters for easier reference have been amalgamated and re-arranged.A ...number of illustrations and diagrams have been added.
This text will continue to assist all anaesthetists in developing countries who, with limited support and training opportunities, are working hard to improve conditions for their patients.
http://www.book4doc.com/40629
Rar’d PDF 18.9 MB Password: DrWael
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Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. ...Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Antibiotics are among the most frequently prescribed classes of drugs and it is estimated that approximately 50% of antibiotic use, in both the outpatient and inpatient settings, is inappropriate. At the same time, in contrast to any other class of drugs, every antibiotic use has a potential public ...health consequence – inappropriate use may not harm only the individual patient, but contributes to societal harm by exerting an unnecessary selective pressure that may lead to antibiotic resistance among bacteria. This video based course will introduce learners to the basic principles of appropriate antibiotic use, demonstrate how to apply these principles to the management of common infections, and outline how to develop and maintain an antimicrobial stewardship program. We will offer a number of illustrative cases, recognizable to the practicing physician in his or her practice to engage learners in the thought processes that lead to optimal decision making, improved outcomes of individual patients, and harm reduction vis-a-vis the bacterial ecology.
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Training Manual for Doctors.
Cardiac deaths are highest cause of death in Bangladesh. Trauma, burn, poisoning and snake bite are commonly encountered in the emergency room of a hospital. Road traffic injuries, fire, collapse of a building etc. are sometimes bad to rush of a large number of patients... to the emergency department of the hospitals. All service provides them should be prepared to provide life saving services without any delay.
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Community health workers (CHWs) serve as a very important direct link between patients, communities and health services. As trusted on-the-ground support to community members, they therefore expand access to essential healthcare information as well as available treatment and prevention programmes.
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This course book provides appropriate, cost-effective, and sustainable targeted learning for the large numbers of emerging community health workers in South Africa.
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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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Creating Videos to train health workers and serve communities.
Global Health Media Project designs and develops videos that are tailored to the needs of health workers and populations in low-resource settings. Internet and mobile technology give us the power to reach large numbers, cost-effectively... and across vast distances, resulting in significant impact at minimal cost per patient.
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