Orientations provisoires, 2 février 2021
e document est une mise à jour des orientations provisoires de l’Organisation mondiale de la Santé (OMS) intitulées Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations... for occupational safety and health,publiées le 18 mars 2020(1). La présente version, qui se fonde sur les données récentes disponibles, fournit des conseils sur les mesures de santé et de sécurité au travail pour les agents de santé et les services de santé au travail dans le contexte de la pandémie de COVID-19. De plus, elle actualise les droits et responsabilités en matière de santé et de sécurité au travail des agents de santé conformément aux normes de l’Organisation internationale du Travail (OIT).
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This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20...20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W...e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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Our spiritual health profoundly impacts our physical health, well-being, and quality of life. Just as medical professionals care for our bodies and minds, spiritual care practitioners care for our spirits. The increasing need for spiritual care makes these practitioners even more crucial. However, m...any of us have limited access to quality, professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.Investigators and researchers are creating a growing body of evidence for the innumerable benefits of professional spiritual care, yet many people still do not have a lot of accurate information about these practitioners. To create this publication, the six largest healthcare chaplaincy organizations in North America collaborated to share the facts about spiritual care and practitioners’ roles, training, and standards.By providing evidence and dispelling myths, the thousands of spiritual care practitioners represented by these organizations hope to increase access to spiritual care for the benefit of all.
accessed July 2020
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Concentrations of the major greenhouse gases, CO2 , CH4 , and N2 O, continued to increase despite the temporary reduction in emissions in 2020 related to measures taken in response to COVID-19.
2020 was one of the three warmest years on record. The past six years, including 2020, have been the si...x warmest years on record. Temperatures reached 38.0 °C at Verkhoyansk, Russian Federation on 20 June, the highest recorded temperature anywhere north of the Arctic Circle.
The trend in sea-level rise is accelerating. In addition, ocean heat storage and acidification are increasing, diminishing the ocean’s capacity to moderate climate change.
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Accessed on 03.03.2020
Cet article documente le processus de mise en œuvre du Traitement préventif intermittent TPI), une stratégie de prévention du paludisme dont l’administration est couplée au Programme élargi de vaccination (PEV) dans les services de santé, les réactions des prestat...aires, des populations et leurs facteurs explicatifs. Les résultats montrent que l’absence de connaissances adéquates à propos du TPI n’a pas empêché son appropriation par les communautés, dans la mesure où les perceptions lui accordent une valeur pratique et l’intègrent dans les besoins ressentis. C’est pourquoi les enfants ont reçu, dans la grande majorité, les médicaments administrés. Certains comportements en décalage s’expliquent plus par des contraintes, des insuffisances du système de santé et de vaccination que par un refus. Chez les prestataires de soins, l’information a été plus disponible du côté les infirmiers étatiques. Cependant, les processus de détournement et les attitudes d’indifférence étaient plus visibles chez ces derniers.
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Female genital mutilation is a harmful traditional practice that violates girls’ right to health
and overall well-being. Most research cites social acceptance, marriageability, community
belonging, proof of virginity, curbing promiscuity, hygiene, and religion as motivations for the
practice. I...t is generally assumed that individual attitudes of parents and other family mem-
bers have an impact on decisions related to the cutting of girls, and that such attitudes are
influenced by social norms. The aim of this study is to understand how parental attitudes
towards the practice of female genital mutilation influence decision making related to the cut-
ting of girls.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance...), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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Intensive Care Med (2009) 35:9–29DOI 10.1007/s00134-008-1336-9
Although thousands of papers have been devoted tohospital-acquired pneumonia (HAP), many controversiesremain, and management of HAP is probably often sub-optimal. Several reviews or guidelines have been pub-lished rec...ently, mostly by North American initiatives(CDC, ATS). Three European Societies (ERS, ESCMID andESICM) were interested in producing a document thatcould complement in some way the last IDSA/ATS guidelines published 3 years ago. In addition, the Helics
working group supported this initiative.
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Climate change (CC) impacts on health outcomes, both direct and indirect, are sufficient to jeopardize achieving the World Bank Group’s visions and agendas in poverty reduction, population resilience, and health, nutrition and population (HNP). In the last 5 years, the number of voices calling for... stronger international action on climate change and health has increased, as have the scale and depth of activities. But current global efforts in climate and health are inadequately integrated. As a result, actions to address climate change, including World Bank Group (WBG) investment and lending, are missing opportunities to simultaneously promote better health outcomes and more resilient populations and health sectors. Accordingly, with the financial support of the Nordic Development Fund (NDF), the World Bank Group set out to develop an approach and a 4-year action plan, outlined in this paper, to integrate health-related climate considerations into selected WBG sector plans and investments.
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Ce manuel donne une vue d’ensemble des connaissances scientifiques actuelles sur l’infection à VIH ainsi que des technologies et des outils utilisés pour prévenir cette infection, pour améliorer la qualité de vie des personnes infectées et pour réduire les effets du VIH sur les enfants et... leur famille. Le manuel présente aussi les stratégies nécessaires pour atteindre les personnes ayant besoin de ces interventions et définit leurs normes.
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El objetivo fue determinar cuáles son las percepciones de distintos actores del sistema de salud
colombiano sobre los problemas del sistema que están detrás de la crisis. Se realizó un estudio
cualitativo a partir de entrevistas semiestructuradas y en profundidad con cuarenta agentes del
sect...or salud, en Bogotá, Cali, Ibagué, Espinal y Calima-Darién. Los resultados mostraron que la
corrupción, el incumplimiento de normas y los conflictos entre los intereses de diversos actores
del sistema debilitan la legitimidad de este último, atomizan la cooperación y cohesión de los
actores y fortalecen el interés particular.
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L'eau potable et les services d'assainissement et d'hygiène (WASH) sont essentiels à la prévention des 17 maladies tropicales négligées (MTN) pour lesquelles une intensification de la lutte ou l'élimination sont prévues à l'horizon 2020.
La fourniture d’eau potable et de services d’...assainissement et d’hygiène est l’une des cinq interventions clés inscrite dans la feuille de route mondiale contre les MTN. Pourtant, à ce jour, la composante WASH de la stratégie n’a reçu que peu d’attention et le potentiel lié à la mise en commun des efforts WASH et MTN reste largement inexploité.
Des efforts ciblés sur la composante WASH sont nécessaires de toute urgence pour atteindre les cibles de la feuille de route mondiale contre les MTN.
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Guide de poche pour l’agent de santé en première ligne
Ce guide s’intéresse plus particulièrement à certaines fièvres hémorragiques virales (FHV) Ebola, Marburg, FHCC, fièvre de Lassa [et Lujo] – qui surviennent en Afrique et risquent de donner lieu à une transmission interhumaine. I...l ne traite pas de la prise en charge d’autres infections virales, comme la dengue, la fièvre de la vallée du Rift et la fièvre jaune, qui entraînent également des manifestations hémorragiques, mais pour lesquelles il n’y a pas de transmission directe d’une personne à une autre
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Child friendly spaces (CFS) are safe spaces where
communities create nurturing environments in which
children can access free and structured play and
learning activities. CFS, also commonly referred to
as Child Centred Spaces or Safe Spaces for Children,
may provide educational and psychosocial... support
and other activities that restore a sense of normality
and continuity for children whose lives have been
disrupted by war, natural disaster or other emergency
situations.
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Dengue is a mosquito-borne viral disease that occurs mainly in the tropics and subtropics but has a high potential to spread to new areas. Dengue infections are climate sensitive, so it is important to better understand how changing climate factors affect the potential for geographic spread and futu...re dengue epidemics. Vectorial capacity (VC) describes a vector's propensity to transmit dengue taking into account human, virus, and vector interactions. VC is highly temperature dependent, but most dengue models only take mean temperature values into account. Recent evidence shows that diurnal temperature range (DTR) plays an important role in influencing the behavior of the primary dengue vector Aedes aegypti. In this study, we used relative VC to estimate dengue epidemic potential (DEP) based on the temperature and DTR dependence of the parameters of A. aegypti. We found a strong temperature dependence of DEP; it peaked at a mean temperature of 29.3°C when DTR was 0°C and at 20°C when DTR was 20°C. Increasing average temperatures up to 29°C led to an increased DEP, but temperatures above 29°C reduced DEP. In tropical areas where the mean temperatures are close to 29°C, a small DTR increased DEP while a large DTR reduced it. In cold to temperate or extremely hot climates where the mean temperatures are far from 29°C, increasing DTR was associated with increasing DEP. Incorporating these findings using historical and predicted temperature and DTR over a two hundred year period (1901-2099), we found an increasing trend of global DEP in temperate regions. Small increases in DEP were observed over the last 100 years and large increases are expected by the end of this century in temperate Northern Hemisphere regions using climate change projections. These findings illustrate the importance of including DTR when mapping DEP based on VC.
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La presente guía tiene además como objetivo, ser un respaldo y no una camisa de fuerza para los médicos, pues pretendemos con ella proveer evidencia sólida respecto a los riesgos, beneficios o consecuencias que puede generar la toma de una decisión en pacientes con tuberculosis. Como lo propone... el Ministerio Nacional de Salud en sus normas técnicas, se busca un manejo integral del niño con tuberculosis pulmonar, asegurando la oportunidad, la eficiencia y la calidad de la atención.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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