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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of
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the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental
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health conditions. Meanwhile, those with pre-existing mental health conditions may experience a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
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Training Manual
The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. Th
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e maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families.
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Interim guidance. 12 May 2021. The Continuity of essential health services: Facility Assessment Tool can be used by countries to rapidly assess the capacity
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of health facilities to maintain the provision of essential health services during the COVID-19 pandemic. It can help to alert the authorities and other stakeholders about where service delivery and utilization may require modification and/or investment. This assessment tool covers the following aspects of essential health services:
health workforce (numbers, absences, COVID-19 infections, health workforce management, training and support);
financial management and barriers;
service delivery and utilization (facility closures, changes in service delivery, community communication campaigns, changes in service utilization and catch-up strategies);
IPC capacities (protocols, safety measures, guidelines and the availability of personal protective equipment (PPE) for staff);
availability of therapeutics, diagnostics and supplies, and vaccine readiness; and
provision of COVID-19 primary care services.
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The WHO Quality Toolkit: Navigating tools to improve the quality of health services helps easy identification and access to a wide range of WHO pub
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lished materials to improve the quality of health services. These tools support the actions described in the Quality health services: a planning guide, which outlines a structured, systems-based approach to improving quality of health services. Whether you work at the facility, sub-national or national level, or in specific communities, you will find resources within the Quality Toolkit to help you carry out essential tasks to improve quality of care
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Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We
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aimed to better understand social norms and community perceptions of preterm infants and KMC (facility-initiated and community-continued) in Malawi, a country with a high preterm birth rate, to inform a pilot social and behavior change program.
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Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential
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health services, including those that address sexual and reproductive health and rights (SRHR), gender-based violence (GBV) and preventing harmful practices such as child marriage and female genital mutilation.
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The Atlas of health and climate is a product of this unique collaboration between the meteorological and public
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health communities. It provides sound scientific information on the connections between weather and climate and major health challenges. These range from diseases of poverty to emergencies arising from extreme weather events and disease outbreaks. They also include environmental degradation, the increasing prevalence of noncommunicable diseases and the universal trend of demographic ageing.
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Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals
Zulfiqar A. Bhutta, Zohra S. Lassi, George Pariyo and Luis Huicho
World Health Organization WHO; Global Health Workforce Alliance
(2010)
C_WHO
A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems
Alliance Report
Participation of community
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health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals.
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Lancet Glob Health 2015; 3: e396–409. Open Access
Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem with an impact
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on morbidity, mortality and quality of life. At any one time, up to 7% of patients in developed and 10% in developing countries will acquire at least one HAI. These infections also present a significant economic burden at the societal level. However, a large percentage are preventable through effective infection prevention and control (IPC) measures.
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The well-being of children in sub-Saharan Africa is under siege from all directions since the advent of the COVID-19 pandemic. The region is now su
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ffering its first-ever economic recession, pushing about 50 million people into extreme poverty, a majority of whom are children.
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This report is documenting the global incidence of attacks and threats against health workers, facilities, and transport around the world. The report cites 806 incidents
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of violence against or obstruction of health care in 43 countries and territories in ongoing wars and violent conflicts in 2020, ranging from the bombing of hospitals in Yemen to the abduction of doctors in Nigeria. Attacks -- including killings, kidnappings, and sexual assaults, as well as destruction and damage of health facilities and transports -- compounded the threats to health in every country as health systems struggled to prepare for and respond to the outbreak of the COVID-19 pandemic.
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