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Publication Years
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2754
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Category
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Toolboxes
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1
The Abuja declaration identifies that the prevention and control of HIV/AIDS, tuberculosis and related infectious diseases must come with additional financial resources. Therefore, African governments agreed on setting the target of allocating at least 15 per cent of each country’s annual budget
...
to the improvement of the health sector. Moreover, the declaration demands donor countries to assist by fulfilling the target of delivering official development assistance (ODA) in the amount of 0.7 per cent of gross national product (GNP).
more
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.
more
Worldwide, there are about 17 million deaths due to cardiovascular disease (CVD) each year and at least two or three times as many non-fatal events. Raised cholesterol greatly increases the risks of stroke and heart disease, causing a large
health
...
burden across the world. The World Health Organization has identified control of cholesterol as part of a Total Risk Approach to the prevention of CVD as a public health priority.
more
In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
...
miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
more
Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue.
Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased
...
health complications for older people, persons with disabilities and children. They also reinforce cycles of poverty, inequality and deprivation – particularly for women, children and marginalized groups, who are disproportionately impacted by a lack of equitable access to water and sanitation.
Launched on World Water Day, the guidelines address the knowledge gap on ways to practically implement inclusive approaches to WASH infrastructure development, particularly in developing countries and fragile contexts.
more
Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its management.
Newer technologies, including those driven by artificial intelligence, have the potentia
...
l to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
more
Global Development: Where Are We Now?
Today, we are facing a vital opportunity to change the profile of cardiovascular disease around the world.
The Millennium Development Goals (MDGs) are due to expire at the end of 2015, placing the cardiovascular heal
...
th community in a unique position to shape the priorities for the next development agenda, and save millions of lives.
Despite its devastating impact on people of all ages, genders and ethnicities, cardiovascular disease was excluded from the Millennium Development Goals (MDGs), which were announced by the United Nations in 2000. That oversight was far-reaching;
for well over a decade, non-communicable diseases were omitted from the global funding agenda and deprioritized by other mechanisms. During that period of muted government action, the prevalence and burden of non-communicable diseases increased in every region of the world.
Fifteen years later, as the successors to the MDGs are being negotiated, we are in a position to call for the prioritization of cardiovascular disease on the forthcoming global development agenda. Once we have ensured that CVD is recognised at the global policy level, our efforts will turn to encouraging governments to honour their commitments on
the prevention and control of CVD.
more
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
...
Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
more
Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions
...
(FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
more
The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge an
...
d practice at the date of publication. When assessing and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
more
Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries ove
...
r the last 30 or so years. LA is a highly diverse region in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
more
This manual details a collaboratively developed intervention to detect and refer Buruli ulcer, Hydrocele, Leprosy
and Lymphedema cases through the use of integrated approaches at community levels. This intervention has
been developed as part of the consortium in partnership with the Nigerian Feder
...
al Ministry
of Health, and Ogun and Kaduna State Ministries of Health. This manual is designed to assist community and
primary level health workers to identify, refer, diagnose and treat people affected by Buruli ulcer, Hydrocele,
Leprosy and Lymphedema, within the existing patient care pathway
more
Community led-monitoring is based on the principle that «Nothing that is done for us should
be done without us”. The combination of this principle with evidence shows that community-led
monitoring is an important driver of improved service delivery and
...
health outcomes that needs to
be re-emphasized. Thus, the community must participate at all stages of the fight against malaria.
This guide will be useful to CSOs working in the field of malaria in the conduct of community-led
monitoring of activities efficiently and allow these CSOs to know their role and responsibilities in this
exercise at each key stage. This guide will also provide CSOs and communities affected by malaria
with templates of monitoring tools adapted to key malaria programs.
more
The Guidelines for the Use of the APCA African Palliative Outcome Scale (POS) has been developed by the APCA, in collaboration with
stakeholders, to help appropriately trained health practitioners and researchers across the region to utilise t
...
he APCA African POS in their work place (Powell et al, 2007; Warria et al, 2007). Not only do the guidelines provide a clear rationale for measuring palliative care outcomes, but they also outline practical information on how to use the tool to collect data and analyse its results. So why is there a need for these guidelines?
Palliative care as a concept and discipline is not well understood across Africa, and its development is still embryonic in many countries. While there are many obstacles that hinder palliative care development on the continent, a key challenge is the lack of accurate information about the palliative care being provided and its outcomes. The APCA African POS is a useful tool to help us measure these outcomes and, given that
measuring palliative care outcomes remains a relatively new concept, it is important to guide people on how to use the tool. Of course, these guidelines are not intended to address everything related to the measurement of palliative care outcomes; they contain only essential information for providers. More detailed information on the use of outcome tools, and in particular within the research setting, can be gained from contacting relevantly trained professionals.
more
Rwanda’s mountainous topography makes ground transportation of medical supplies unreliable — some roads stretching into rural areas remain uncared for and unpaved. Between 25 and 40 per cent of all temperature-sensitive medical supplies sent from urban centres to rural
...
health clinics are wasted because of an unreliable cold-chain infrastructure. Rural clinics are also often subject to stockouts, and patients in need of specialized blood products, drugs and other supplies are unable to acquire them. Zipline, a US-based health logistics company, aims to address the issue of access to medical supplies, largely leapfrogging traditional modes of transportation and various obstacles. Zipline uses drones to deliver blood and other routine and emergency medical supplies from distribution centres to district hospitals and rural health centres.
Although the company has been celebrated in the media for its operations, there is little scholarly work on its operations and performance. This has led to some confusion over its scale. We aimed to gain insight into the details of Zipline’s business model, including the infrastructure, regulations and government support that make Zipline possible, and to understand its impact on health outcomes in Rwanda. Our work was entirely based on published materials since our research was conducted during the COVID-19 pandemic.
more
the Pocket Guide includes
information on HIV clinical care; growth and development; mental health; child protection;
counselling and communication; disclosure; loss, grief, and bereavement; adherence; sexual
and reproductive
...
health; transition of care; support systems; and monitoring and evaluation
of psychosocial services. The information provided in this Pocket Guide aims to serve as a
convenient clinical resource to equip health care providers (HCPs) with knowledge and skills
that will help them to maximise resiliency, minimise risk factors, and promote positive personal
growth among the children and adolescents they care for who are living with and affected
by HIV.
more
a comprehensive guide
for the HCPs who work in counselling and psychological care of children and adoles-
cents. The Handbook includes information on HIV clinical care; growth and development;
mental health; child protection; counselling and comm
...
unication; disclosure; loss, grief,
and bereavement; adherence; sexual and reproductive health; transition of care; support
systems; and monitoring and evaluation of psychosocial services. The material provided
in the Handbook aims to equip HCPs with important information that will help them to
maximise resiliency, minimise risk factors, and promote positive personal growth among
the children and adolescents they care for who are living with or affected by HIV.
more
The comic follows the story of Tiwale, a young girl from Malawi with dreams of becoming a football player. As she discovers that she is living with HIV, she learns to overcome her challenges with the support of her family and friends. This project i
...
nvestigates how the comic book is received by young people with HIV in Malawi and its effectiveness in improving their attitudes and behavior, with hopes of reaching more young people with similar concerns of living with HIV.
more
Our goal at Voices for Georgia’s Children is to help decision-makers craft and implement policies that ensure Georgia’s children grow up to be healthy, educated and productive citizens. To that end, we have developed a comprehensive policy agenda focused on early childhood, child
...
health and disconnected youth, which, if followed, can effectively prevent and offset some of the damaging experiences faced by our children. Many of our recommendations are aligned with those included in this policy brief.
more
The checklist and reference list has two parts: high-level cross-cutting content (Part A) and specific programme content (Part B). Part A applies to all countries and contains situation and response analysis, the NSP development process, the goal, targets and priority-setting of the NSP and the prin
...
ciples of human rights and gender equity and sustainability. Part B comprises the programme requirements of prevention, treatment and care, comorbidities and integration, social protection, health systems, community engagement, human rights and gender equity, efficiency and effectiveness, governance, management and accountability, HIV and the humanitarian response
more