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Enhancing disaster preparedness for effective response.
One of the most disaster-prone countries in the world, Bangladesh each year experiences a high degree of seasonal variety, including southwest monsoon and two cyclone seasons. With its long coastline on the Bay of Bengal and with a landscape
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consisting of flat deltaic plains and sandy hills, Cox´s Bazaar is highly exposed to natural hazards and extreme weather, including cyclones, torrential rain, landslides, flash floods, storm surges and extreme temperatures.
The 2018 Cyclone Preparedness Lessons Learnt Exercise aims to capture and analyse knowledge acquired by humanitarian actors during their cyclone preparedness efforts and operations in the Rohingya refugee camps during the 2018 cyclone seasons. The purpose is to provide a reference document for planning for future cyclone seasons, support evidence-based advocacy, and identify gaps in preparedness which need to be addressed in advance of the 2019 cyclone seasons. The report focuses on lessons learnt in the refugee camps, not host communities
Large File: 17 MB
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Troubles du Développement
Chapitre C.2
Health Services Insights Volume 10: 1–7
А.9 DSM-5. Основные изменения, касающиеся расстройств детского и подросткового возраста
Julia D Machado,Arthur Caye,Paul J Frick et al.
International Association for Child and Adolescent Psychiatry and Allied Professions
(2018)
C1
В данной главе мы рассмотрим изменения, реализованные в DSM5, касающиеся не всех психических расстройств. Ниже мы остановимся на модификациях, представляющих инт
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ерес для детских и подростковых психиатров, и на тех, которые вызывают полемику
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А.10 Формулировка случая и обобщение данных в детской и подростковой психиатрии
Schuyler W Henderson, Andrés Martin et al.
International Association for Child and Adolescent Psychiatry and Allied Professions
(2018)
C1
Умение формулировать случай является одним из ключевых навыков, которым должен обладать клиницист, работающий в детской и подростковой психиатрии, тем не менее,
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овладение этим навыком представляет определенные трудности. Формулировка случая подразумевает переработку информации, сообщаемой пациентом и полученной при проведении обследования, интервью с ним и с учителями, а также из медицинских заключений и школьных отчетов, в последовательное и необязательно длительное изложение, которое поможет разработать план лечения (Глава А.11)
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This report serves the specific purpose of collating legally relevant information on conditions in countries of origin pertinent to the assessment of claims for asylum. It is not intended to be a general report on human rights conditions. The report is prepared within a specified time frame on the b
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asis of publicly available documents as well as information provided by experts. All sources are cited and fully referenced.
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Информация о туберкулезной терапии для больных и их родственников.
Информация о диагностике туберкулеза для больных и их родственников.
Информация о туберкулезной терапии для больных и их родственников
Hесмотря на многочисленные международные договоры и обязательства по защите прав мигрантов в области здравоохранения, эта ключевая затронутая группа населения п
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прежнему испытывает серьезные затруднения в доступе к лечению от туберкулеза. Миграция вызвана рядом сложных экономических, социальных, политических и экологических факторов и является определяющим элементом плохого здоровья, а результаты лечения мигрантов находятся под воздействием различных измерений миграционного процесса.
Accessed on 2019
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Глобальная статистика свидетельствует о том, что бремя туберкулеза более актуально в городских регионах. Тем не менее, в тех странах, где большая часть населения п
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оживает в сельской местности в условиях крайней нищеты, туберкулез является доминирующей проблемой среди сельских жителей. Бедность и ограниченный доступ к медицинским учреждениям и медицинским работникам значительно снижают способность людей с туберкулезом, проживающих в сельской местности, получить своевременную диагностику и лечение.
Accessed on 2019
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
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terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
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echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh
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ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management
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and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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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
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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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Technical package for cardiovascular disease management in primary health care.
