Six months in, the indirect impacts of COVID-19 take a toll on health, social and economic outcomes.
Trastornos de ansiedad
Capítulo F.4
Editor: Daniel Martínez, Matías Irarrázaval
Traducido por Beatriz Garcia Parreño, Nieves Hermosín Carpio, Sandra Alonso Bada
Otros trastornos
Capítulo H.2
Editores: Matías Irarrázaval, Daniel F. Martínez Uribe, Andres Martin
Traducción: Jaime J. Gómez Alamán, Begoña Arenas Tuzón, Beatriz Ortega
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Misceláneo
Capítulo J.2
Edición: Matías Irarrázaval & Andres Martin
Traductores: Fernanda Prieto-Tagle & Montserrat Pamias
These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living w...ith HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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Vitamin D deficiency is thought to be common among pregnant women, particularly during the winter months, and has been found to be associated with an increased risk of pre-eclampsia, gestational diabetes mellitus, preterm birth, and other tissue-specific conditions.
This guideline is intended for ...a wide audience including policy-makers, their expert advisers, and technical and programme staff at organizations involved in the design, implementation and scaling-up of nutrition actions for public health.
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e rapport conjoint de l’Organisation mondiale de la Santé(OMS) et du Programme des Nations unies pour lesétablissements humains (ONU-Habitat), intitulé La Face cachéedes villes : Mettre au jour et vaincre les inégalités en santé enmilieu urbain, montre que certains habitants des villes sont...particulièrement exposés à une multitude de maladies et deproblèmes de santé. Ce rapport propose des informations et des outils dont lespouvoirs publics et les responsables locaux peuvent se servirpour lutter contre les inégalités en santé dans leur ville. Il n’apas pour objectif de comparer les inégalités en santé entrepopulations rurales et citadines. De fait, étant différentes depar leur ampleur et leur distribution, les inégalités en santédans les zones urbaines appellent des actions spécifiques.
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Working towards better COVID-19 outcomes in the WHO European Region.From the first COVID-19 cases in Europe reported on
24 January 2020, the pandemic reached 1 million cases
within 3 months, 10 million cases within 8 months, and
100 million cases in Europe alone within 2 years. Over
the course o...f its two years, COVID-19 has claimed over
1.6 million lives across Europe and Central Asia. The
World Health Organization (WHO) European Region has
accounted for close to a third of the cumulative global
COVID-19 cases and deaths.
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Objectives and scope of the document
This document was developed to provide recommended management strategies for problems and disorders that are specifically related to the occurrence of a major stressful event. The recommended strategies will form the basis of a new module to be added to the WHO ...(2010) mhGAP Intervention Guide for use in non-specialized specialized health-care settings.
The scope of the problems covered by these guidelines is:
symptoms of acute stress in the first month after a potentially traumatic event, with the following subtypes:
- symptoms of acute traumatic stress (intrusion, avoidance and hyperarousal) in the first month after a potentially traumatic event;
- symptoms of dissociative (conversion) disorders in the first month after a potentially traumatic event;
- non-organic (secondary) enuresis in the first month after a potentially traumatic event (in children);
- hyperventilation in the first month after a potentially traumatic event;
- insomnia in the first month after a potentially traumatic event;
posttraumatic stress disorder (PTSD);
bereavement in the absence of a mental disorder.
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Refugee children with disabilities experience a reality of exclusion and marginalisation that makes them among the most vulnerable displaced persons in the world. Excluded from participation in social activities and access to school, not only because of their disability, but especially because of so...cial, cultural, and political barriers that prevent them from enjoying the same opportunities as their peers.
Daniela Bruni, a specialist in education in emergency contexts, who has overseen JRS’s related projects for the past two years, has developed a guide on inclusive education.
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This report brings attention to achieving gender equality in the context of women, girls, and the HIV response. This six-month consultation in 2016 with adolescent women and young girls found that #WhatWomenWant is: collaboration and joint action by all to invest in women's HIV and Sexual and Reprod...uctive Health and Rights (SRHR), to be leaders and articulate the priorities of women and girls in all their diversity, and to speak to the new Political Declaration on AIDS and the SDG framework as a tool for civil society to meet their agenda to achieve gender equality in the HIV and SRHR response.
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AACAP OFFICIAL ACTION | This Practice Parameter identifies best approaches to the assessment and management of children and adolescents across all phases of a disaster. Delivered within a disaster system of care, many interventions are appropriate for implementation in the weeks and months after a d...isaster. These include psychological first aid, family outreach, psychoeducation, social support, screening, and anxiety reduction techniques. The clinician should assess and monitor risk and protective factors across all phases of a disaster. Schools are a natural site for conducting assessments and delivering services to children. Multimodal approaches using social support, psychoeducation, and cognitive behavioral techniques have the strongest evidence base. Psychopharmacologic interventions are not generally used but may be necessary as an adjunct to other interventions for children with severe reactions or coexisting psychiatric conditions
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El desarrollo, desde 1991, de las Iniciativas Subregionales de Control de la Enfermedad de Chagas, y los avances de conocimiento en materia de diagnóstico y manejo de la infección/enfermedad de Chagas, llevan a la necesidad ética, y operativamente imperiosa, de estructurar el diagnóstico, atenci...ón y tratamiento de esta afección.
Una situación particularmente delicada, preocupante y alarmante, se constituye por la escasa einequitativa disponibilidad de los limitados recursos terapéuticos, actualmente disponibles, para el tratamiento etiológico de Chagas, en la mayor parte de los países endémicos de América.
En esta situación, se propone el desarrollo de la Consulta técnica regional OPS/MSF sobre organización y estructura de la atención médica del enfermo e infectado por Trypanosoma cruzi (enfermedad de Chagas), con los objetivos de:
- definir el alcance y estructura de la atención médica al paciente, tanto en diagnóstico, manejo como tratamiento;
- desarrollar modelos alternativos y optativos de atención, asimilables a las estructurassanitarias de los países;
- delinear la atención del chagásico, según su momento biológico-patológico evolutivo,dentro de los niveles de complejidad de la atención médica;
- establecer consideraciones sobre la atención pediátrica, materno-infantil, transfusional y mayor complejidad;
- definir las necesidades y alcances del diagnóstico de la enfermedad;
- establecer los alcances y facilidades que, dentro de los sistemas de atención, deben poseer estos pacientes;
- definir el panorama total de disponibilidad y accesibilidad de los pacientes al tratamiento etiológico de esta dolencia;
- proyectar conceptos y concepciones marco sobre el costo, impacto y efectividad del
desarrollo de este componente de morbilidad y atención en enfermedad de Chagas; y
- establecer las necesidades de investigación operativa y de gestión para avanzar en el
desarrollo de la atención médica a este grupo de pacientes.
Esta consulta, desarrollada en la ciudad de Montevideo, el 13 y 14 de octubre de 2005, pretende marcar la elaboración de una guía conceptual para comentarla y diseminarla en el año 2006, desde las cinco Iniciativas Intergubernamentales Subregionales de Control de Enfermedad de Chagas.
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This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effectiv...e implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
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What are the FP and CAC competencies?
Through the clear articulation of the family planning and comprehensive abortion care (FP and CAC) competencies for the primary health care workforce, the aim is to advance improvements in FP and CAC service delivery by aligning health worker education approach...es with population health needs and health system demands.
This document, which describes these competencies in detail, is intended to:
be a foundational tool to be adopted and adapted by educators and regulators for FP and CAC providers (students) with a pre-service training pathway of at least 12 months;
describe competencies that are relevant to current and future health practice;
enable widespread use of the competencies not only for curriculum development for pre-service education, but also for in-service education, regulation, qualifications, quality assurance, personal development, performance evaluation, recruitment, management and career progression;
focus on the core functions of FP and CAC providers within broader efforts towards achieving universal health coverage
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Accessed: 04.10.2019
The data collection process was organized by UCDC Director, Natalia Nizova, and M&E Department Head, Igor Kuzin, and implemented by M&E specialists from oblast AIDS Centers: Zhanna Antonenko, Oksana Gorbachuk, Volodymyr Zahorovskyi (Kiev City); Anna Lopatenko, Irina Kozina, I...ryna Chukhalova, (Dnipropetrovsk); Galina Vysotskaja, Iryna Petrovska, Oleksandr Guzieiev (Mykolayiv). Qualitative data collection as well as a desk review was done by the WB’s local consultants Anna Shapoval, Olesia Trofymenko, Anna Pisotska and Elena Dzyuba.
The report was prepared by a World Bank Task Team led by Iris Semini (seconded to the World Bank until July 2013, and now back with UNAIDS), and concluded by Emiko Masaki and Marelize Görgens (World Bank), with support and guidance provided by Daniel Dulitzky, Paolo Belli, Alejandro Cedeno, Alona Goroshko and Lombe Kasonde. Administrative support was provided by Anna Goodman, Mario Mendez and Uma Balasubramanian. When draft results were ready, an in-country workshop was held where stakeholders provided their inputs. Once a draft report was produced, written comments were received from World Bank colleagues, Son Nam Nguyen, Rosemary Sunkutu and Alona Goroshko.
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