For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal health indicators in this study, while other highpriority counties consist...ently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care.
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The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South Africa.
The NCS define fundamentals for quality of care based on six ...dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
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Vaccins antirabiques: Note de synthèse de l’OMS – avril 2018
Weekly epidemiological record / Relevé épidémiologique hebdomadaire
20 APRIL 2018, 93th YEAR / 20 AVRIL 2018, 93e ANNÉE
The Global Health Security Agenda programme develops national capacity to prevent zoonotic and non-zoonotic diseases while quickly and effectively detecting and controlling diseases when they do emerge. The Emerging Pandemic Threats programme improves national capacity to pre-empt the emergence and ...re-emergence of infectious zoonotic disease and to prevent the next pandemic.
Action against emerging pandemic threats is taken through projects on: Avian influenza, Middle East respiratory syndrome, Africa Sustainable Livestock 2050 and Emergency equipment stockpile. With high-impact diseases that jump from animals to humans on the rise, these programmes are reducing the risk to lives and livelihoods from national, regional and global disease spread.
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Qualitative study from Zambia on barriers to and facilitators of life-long learning
SRHR, HIV AND AIDS Governance Manual
In the post-colonial history of the Central African Republic, violence has often been the shortest way to presidential power. President Bozizé presented little deviation from this narrative after coming to power after a coup d’état in 2003. Whilst he faced armed opposition and a conflict-affecte...d northwest from the outset, it is not until the rise of the Séléka, that the CAR entered into an era of unprecedented violence.
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The framework is to be used as a reference guide, applied according to local priorities and needs, and targeted at academic institutions, educators, accreditation bodies, regulatory agencies and other users. The ultimate aim is to ensure that all health workers are equipped with the requisite compet...encies at pre-service education and in-service training levels to address AMR in policy and practice settings.
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Руководство ВОЗ по политике и практике информирования о рисках при чрезвычайных ситуациях (ИРЧС)
The global burden of disease due to mental disorders continues to rise, especially in low- and middle-income countries (LMIC). In addition to causing a large proportion of morbidity, mental disorders – especially severe mental disorders (SMD) – are linked with poorer health outcomes and increase...d mortality. SMD are defined as a group of conditions that include moderate to severe depression, bipolar disorder, and schizophrenia and other psychotic disorders. People with SMD have a two to three times higher average mortality compared to the general population, which translates to a 10-20 year reduction in life expectancy. While people with SMD do have higher rates of death due to unnatural causes (accidents, homicide, or suicide) than the general population, the
majority of deaths amongst people with SMD are attributable to physical health conditions, both
non-communicable and communicable.
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SIGN 143. A national clinical guideline
Published May 2015, Revised 2018
Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise ...potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
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Current Opinion in Psychiatry: May 2018 - Volume 31 - Issue 3 - p 256–257
In northern Myanmar, nearly 100,000 people continue to live in displacement camps in Kachin and northern Shan States. Most were first displaced by fighting between the Myanmar military and the Kachin Independence Army in 2011, and many have been displaced multiple times, including in recent months. ...Approaching seven years of displacement, and despite ongoing and often increasing needs, displaced persons in northern Myanmar face decreasing aid and protection services. Over the past two years, the Government of Myanmar has dramatically increased restrictions on delivery of aid to this displaced population at the same time that the overall amount of aid provided by international donors has decreased.
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Persons with disabilities are one of the most vulnerable and socially excluded groups in any crisis-affected community. They may be in hidden in homes, overlooked during needs assessments and not consulted in the design of programs.4 While gender-based violence (GBV) affects women, girls, men and bo...ys, the vast majority of survivors globally are women and girls.5 Persons with disabilities have difficulty accessing GBV programs, due to a variety of societal, environmental and communication barriers, increasing their risk of violence, abuse and exploitation.
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