Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y 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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Jin et al. Military Medical Research (2020) 7:4 https://doi.org/10.1186/s40779-020-0233-6
Position Article und Guideline
This section deals with implementing and improving infection control practices in hospitals, health centres and other health services in the outbreak area. It explains the need for, and implementation of, effective triage procedures, and basic requirements for infection control and supporting activi...ties. Further guidance can be found in the MSF Infection Control Guideline
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Alcohol use is deeply embedded in the social landscape of many societies, and some 2300 million people drink alcoholic beverages in most parts of the world. At the same time, more than half of the global population aged 15 years and older reported having abstained from drinking alcohol during the pr...evious 12 months. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and implemented alcohol control measures. At the individual level the patterns and levels of alcohol consumption are determined by multiple factors that include gender, age and individual biological and socioeconomic vulnerability factors as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking may encourage alcohol consumption, delay appropriate health-seeking behaviour and weaken community action.
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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 Study population) receives care. Note that this study can be done in health care facilities at all 3 level...s 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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Standard Treatment Guideline
Eine Leitlinie zur Diagnostik und Therapie, einschließlich Chemoprävention und -prophylaxe des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose e.V. im Auftrag der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e.V.
Tuberculosis Guideline for Adults
Guideline for Diagnosis... and Treatment of Tuberculosis including LTBI Testing and Treatment of the German Central Committee (DZK) and the German Respiratory Society (DGP).
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This handbook is an adaptation from the WHO Clinical Handbook Health care for women subjected to intimate partner violence or sexual violence developed by the World Health Organization (WHO), UN Women and United Nations Population Fund. The handbook draws on the work from professionals who are dedic...ated to preventing and responding to Gender Based Violence.
The Handbook guides health care service providers to provide comprehensive services to survivors of intimate partner violence and/or sexual violence. It also guides health professionals with respect to relevant stakeholders for referral purposes. The purpose is to ensure that relevant authorities are informed timeously in order act and ensure that those affected by violence receive speedy service as required.
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The conditionality of this recommendation is largely driven by the current higher unit cost of pyrethroid-PBO ITNs compared
to pyrethroid-only LLINs and therefore the uncertainty of their cost-effectiveness. Furthermore, as PBO is less wash-resistant
than pyrethroids, its bioavailability declines ...faster over the three-year estimated life of an ITN; therefore, the added impact of
pyrethroid-PBO ITNs over that of pyrethroid-only LLINs may decline over time. The evidence comes from two sites in
eastern Africa with pyrethroid resistance and not from other geographies where transmission levels and vector characteristics
may vary. PBO acts by inhibiting certain metabolic enzymes, primarily oxidases, and so are likely to provide greater protection
than pyrethroid-only LLINs where mosquitoes display mono-oxygenase-based insecticide resistance mechanisms.
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O protocolo a seguir foi desenvolvido para investigar o alcance da infecção, conforme determinado pela soropositividade da população geral, em qualquer país com casos confirmados de infecção pelo COVID-19. Os países talvez tenham que adaptar alguns aspectos deste protocolo para os respectivo...s sistemas de saúde pública, bem como sistemas laboratoriais e clínicos, de acordo com a capacidade, disponibilidade de recursos e adequação cultural. No entanto, usando-se um protocolo padronizado, tal como o descrito abaixo, dados de exposição epidemiológica e amostras biológicas podem sercoletados de forma sistemática, e rapidamente compartilhados em um formato que facilite sua agregação, tabulação e análise em diferentes cenários globais, para estimar prontamente a gravidade as taxas de ataque da infecção pelo vírus COVID-19, bem como embasar respostas de saúde públicae decisões relativas a políticas públicas. Isso é particularmente importante no contexto de um novo patógeno respiratório, como o COVID-19.
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This study aimed to understand the patterns of HIV drug resistance in pregnant women in Mozambique. This might help in tailoring optimal regimens for prevention of mother to child transmission of HIV (pMTCT) and antenatal care.
Orientations provisoires
20 mars 2020
Ce document résume les orientations actuelles de l'OMS pour la surveillance mondiale de la COVID-19 chez l'homme, due à une infection par le nouveau coronavirus 2019. Ces orientations sont à lire en se référant aux orientations de l'OMS sur les activit...és de préparation opérationnelle et de riposte, dans lesquelles l'identification et le dépistage actifs des cas, ainsi que la recherche des contacts sont fortement recommandés dans tous les scénarios de transmission. La notification globale des cas doit être considérée comme une mesure provisoire uniquement lorsque la notification des cas individuels n'est pas possible. L’OMS continuera de mettre à jour ces orientations au fur et à mesure que de nouvelles informations sur la COVID-19 seront disponibles.
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