RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur...ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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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 the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, 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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Natural immunity against COVID-19
Scientific report 10 May 2021
The role of community health workers in the vaccination against COVID-19: guide to support the implementation of the vaccination programme
Definition and categorization of the time of vertical transmission of SARS-CoV-2
Scientific report 8 February 2021
Hypertension and COVID-19: Scientific report - 17 June 2021
Considerations on the implementation and adjustment of
public health and social measures in the context of
COVID-19
Interim guidance 14 June 2021
Interim recommendations for the use of ChAdOx1-S [recombinant] COVID-19 vaccine (AstraZeneca COVID-19 AZD1222 Vaxzevria™, SII COVISHIELD™ vaccine) - Last updated 30 July 2021
Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Resumo: o que é esta orientação dinâmica?
Pergunta clínica: qual é o papel dos medicamentos na prevenção da COVID-19?
Público-alvo: o público-alvo são os médicos e os tomadores de decisão na área da saúde.
Prática atual: o uso atual de medicamentos para prevenção da COVID-19 é ...variável, refletindo uma incerteza em grande escala. Numerosos estudos clínicos randomizados de muitos medicamentos estão em andamento para orientar melhor a prática. Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS contém novas
informações e uma recomendação sobre a hidroxicloroquina. (1) Segue-se a publicação de seis estudos sintetizados em uma meta-análise dinâmica de rede (NMA).
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Manual for Death Surveillance in the Context of Pediatric Multisystemic Inflammatory Syndrome (SIM-P) Associated with Covid-19. Publication updated on 24/09/2021
E-book Project Reab Post-Covid
O projeto Reab pós-Covid-19 foi elaborado em parceria entre Ministério da Saúde, Conselho Nacional de Secretários de Saúde (CONASS), Conselho Nacional de Secretarias Municipais de Saúde (Conasems) e o SírioLibanês. Uma das ações desenvolvidas foi a elaboraç...ão do material apresentado a seguir. Por meio dele buscamos facilitar a difusão do conhecimento sobre o tema e o que há de oficial no Brasil sobre o assunto de maneira prática, objetiva e compatível com a realidade do SUS.
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Rethinking Health with Covid-19 Lessons and Challenges
Este e-book que integra estratégias de três Projetos PROADISUS (Lean nas Emergências, Reab pós-COVID-19 e Cuidados Paliativos) e expõe temas relevantes, relacionados à necessidade de retorno seguro de atividades hospitalares, em paralelo ...à crise que a pandemia ainda impõe a todos os serviços de saúde. Abordaremos estratégias para a reativação ou retomada de serviços hospitalares em paralelo à presença do SARS-CoV-2.
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The Lancet Planetary Health Volume 5, ISSUE 7, e466-e478, July 01, 2021
Transmission of many infectious diseases depends on interactions between humans, animals, and the environment. Incorporating these complex processes in transmission dynamic models can help inform policy and disease control int...erventions. We identified 20 diseases involving environmentally persistent pathogens (ie, pathogens that survive for more than 48 h in the environment and can cause subsequent human infections), of which indirect transmission can occur from animals to humans via the environment.
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This report of the EFSA and ECDC presents the results of zoonoses monitoring activities carried out in 2020 in 27 EU Member States (MS) and nine non-MS. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically.
Wet markets have been implicated in multiple zoonotic outbreaks, including COVID-19. They are also a conduit for legal and illegal trade in wildlife, which threatens thousands of species. Yet wet markets supply food to millions of people around the world, and differ drastically in their physical com...position, the goods they sell, and the subsequent risks they pose. As such, policy makers need to know how to target their actions to efficiently safeguard human health and biodiversity without depriving people of ready access to food.
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Rev Panam Salud Publica. 2021;45:e74.
Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians’ and nurses’ knowledge about MDR-TB must be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the... subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome.
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The African Development Bank has launched a consultation process with health ministers and other partners as it develops a strategy to drive enhanced access to health services across Africa through 2030.
Input from ministers in the Bank’s 54 regional member countries, development partners and c...ivil society is expected to strengthen the Bank’s Strategy for Quality Health Infrastructure in Africa (2021-2030). A robust scoping study titled “Good Health and Well-being” underpins the strategy.
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Epidemiologisches Bulletin3 | 202121. Januar 2021 (online vorab)
Every year, nearly 250 million people move across borders temporarily or permanently for a job opportunity, studying, to flee a crisis back home, or for other reasons. Another 750 million move for similar reasons within the borders of their countries. With the understanding that human mobility affec...ts public health, and health affects human mobility and migrants, for decades, IOM has been providing critical health services to women, children and men on the move, while standing by governments for technical and operational support as needed. In 2019, in lower-income settings and in complex emergencies, along the world’s most perilous migration routes, in the aftermath of natural disasters or in response to disease outbreaks, IOM’s health teams have provided hundreds of thousands with primary health-care consultations, mental health and psychosocial support, sexual and reproductive health care, pre-migration health services, and much more.
This year, more than ever before, as the world reels from the socioeconomic impact of COVID-19, we have experienced that health is a cross-cutting component of overall human development and well-being.
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