The number of COVID-19 cases is on the rise again, with South Africa nearing half of all confirmed cases in the WHO African Region. Threats of new variants loom and low vaccination coverage raises questions on the future of the response to COVID-19. Prevention remains the key strategy in most sub-Sa...haran countries. Five National Centres (NCs) from the African Health Observatory Platform on Health Systems and Policies (AHOP), based in Ethiopia, Kenya, Nigeria, Rwanda and Senegal, reflect on lessons to be learnt from their containment responses in the initial phases. They construct timelines to highlight the policies and challenges associated with introducing a range of public health containment measures and
discuss the extent to which these measures continue to be valuable given the ever-changing nature of the pandemic.
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The overview of findings from five Latin American countries
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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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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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
Facilitator's Manual - Inter-action Review on the response to COVID-19 - 28 April 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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Guideline for the development of a national plan for the operationalization of vaccination against COVID-19
Em vista do aumento repentino do número de hospitalizações causadas pela pandemia de COVID-19 na América Latina e no Caribe, bem como da escassez de recursos humanos e materiais, como equipes médicas e gases medicinais, é necessário reformular os modelos de atenção na Região de modo a otim...izar o que já está disponível e garantir que mais pacientes recebam oxigênio na quantidade necessária e com a qualidade adequada O oxigênio consta na lista de medicamentos essenciais da Organização Mundial da Saúde sendo usado na atenção a pacientes em todos os níveis das redes integradas de serviços de saúde. Considerando que já está comprovada a eficácia do uso de oxigênio no tratamento de pacientes com afecções respiratórias causadas pela COVID-19, há uma grande oportunidade de melhorar a efetividade caso se promova seu uso racional, sustentável e seguro.
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El Salvador Humanitarian Response Plan - August 2021 to December 2022
User's guide for teachers and community educators Indigenous Early Childhood .
MaterialLa presente guía es un instrumento para la implementación de los materiales para docentes y educadoras comunitarias y el cuadernillo para niños y niñas del Nivel Inicial, dicho cuadernillo está pensado para... niños y niñas de 3 y 4 años específicamente, y el material para docentes correspondiente podrá ser utilizado hasta el preescolar.
La guía surge de la necesidad de contar con orientaciones sencillas y claras a fin de facilitar al docente y a la educadora comunitaria la aplicación de los contenidos de manera flexible para que en cada pueblo indígena pueda ser adecuado y contextualizado a su realidad cultural y lingüística.
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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
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 2021 WHO health and climate change global survey report provides a valuable snapshot of the overall progress governments have made in addressing the health risks of climate change. The findings on key health and climate change indicators aim to empower policy makers to: make informed decisions o...n the implementation of policies and plans; identify evidence gaps; and better understand the barriers to achieving adaptation and resilience priorities in the health sector while maximizing the health benefits of sector-wide climate mitigation efforts.
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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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Clinical guidelines for the comprehensive care of patients with drug-resistant tuberculosis
Clinical guideline for paediatric care of tuberculosis and TB-HIV co-infection
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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