In 1988, the Centre for Research on the Epidemiology of Disasters (CRED) launched the Emergency Events Database (EM-DAT). EM-DAT was created with the initial support of the World Health Organisation (WHO) and the Belgian Government.
The main objective of the database is to serve the purposes of h...umanitarian action at national and international levels. The initiative aims to rationalise decision making for disaster preparedness, as well as provide an objective base for vulnerability assessment and priority setting.
EM-DAT contains essential core data on the occurrence and effects of over 22,000 mass disasters in the world from 1900 to the present day. The database is compiled from various sources, including UN agencies, non-governmental organisations, insurance companies, research institutes and press agencies.
more
Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management ...and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
more
Refugee children and adolescents exhibit resilience despite a history of trauma. However, trauma can affect a refugee
child’s emotional and behavioral development. Mental health providers should consider how the refugee experience (e.g.,
exposure to hunger, thirst, and lack of shelter; injury an...d illness; being a witness, victim, or perpetrator of violence; fleeing
your home and country; separating from family; living in a refugee camp; resettling in a new country; and navigating
between the new culture and the culture of origin) may contribute to a child or adolescent’s emotional or behavioral presentation
in a clinic, school, or community setting.
more
Background: Post-Traumatic Stress Disorder (PTSD) develops following some stressful events. There has been increasing recognition that children who have been exposed to traumatic events like child sexual abuse can develop post-traumatic stress disorder just like adults.
Objective: To determine prev...alence of PTSD in sexually abused children seen at the Gender Based Violence Recovery Centre at Kenyatta National Hospital.
Design: A cross sectional descriptive study.
Setting: Gender Based Violence Recovery Centre – Kenyatta National Hospital. Subjects One hundred and forty-nine (n = 149) sexually abused children were recruited in the study.
more
Seizures constitute the most common neurological problem in children and the majority of epilepsy has its onset in childhood. Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in these children. Evidence-based clinical practice guidelines, modified to... the Indian setting by a panel of experts, are not available.
more
Background: Traumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term
violence. In South Afri...ca, the lifetime prevalence for PTSD in the general population is estimated at 2.3%.
Aim: To examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a community sample of adolescents.
Setting: Low-socioeconomic communities in KwaZulu-Natal.
more
Drinking-water quality regulations and standards developed or revised in accordance with this guidance will reflect the best practices identified in the WHO Guidelines for Drinking-water Quality to most effectively protect public health. Moreover, the regulations and standards will consider local ne...eds, priorities and capacities to ensure that they are realistic and appropriate. Topics covered include:
- Guiding principles
- Getting started
- Selecting parameters and parameter limits
- Setting out compliance monitoring requirements
more
Accessed July 4, 2019
Around one in four adults has at least one mental health need at any time, and in the next 20 years the number of British people expected to suffer from dementia will grow by 40 per cent. Even though you might not be working in a setting specifically caring for people with men...tal health conditions, dementia and learning disabilities, it is still important to have some awareness of the signs and symptoms. This will help you to show compassion and care when you observe any behaviour that seems unusual or difficult to understand, and to be aware of the need to consult more experienced staff about behaviours if necessary.
Chapter 5: Introducing practical healthcare
more
S Afr Med J 2018;108(7):546-550. DOI:10.7196/SAMJ.2018.v108i7.13149
Antimicrobial stewardship programmes have been introduced worldwide in response to the rise in antimicrobial resistance. The World Health Organization has mandated each Member State to produce a plan to address this problem. We rep...ort on the organic development of an antibiotic stewardship programme in a rural regional hospital in a resource-limited setting in South Africa. This has resulted in organisational change with increased awareness, participation, monitoring and education in antibiotic stewardship throughout the hospital
more
ecancer, Cardiff University and the African Palliative Care Association have developed an online course in palliative care contextualised for African healthcare professionals. The course has been created through the IAEA Programme of Action for Cancer Therapy, Virtual University of Cancer Control a...nd is available for free through ecancer as well as the VUCCnet online.
Filming and development of the modules took place in the UK and South Africa and involved input from 37 of Africa’s leading palliative care experts as well as Cardiff University’s team. Dr Fiona Rawlinson, who is a consultant in palliative medicine at the Princess of Wales Hospital, UK and the leader of Cardiff University’s team, worked closely with the African Palliative Care Association to ensure the content of the course was appropriate for the sub-Saharan cancer profile and resource setting
more
This publication describes an arduous campaign to tackle the use of antimicrobials - specifically antibiotics - in the Danish swine-producing sector thanks to the collaboration between the regulatory sector within the Ministry of Environment and Food, private veterinary practitioners and swine produ...cers. The document is a retrospective tribute to all those who had the foresight to make significant changes to ensure consumer protection - improving hygiene at primary sites, developing options for intervention, identifying sites for intervention, setting targets, restructuring the relationship between the veterinary services and farmers, and implementing changes in behaviour for greatest impact
more
Governments in Eastern European and Central Asian countries are responding to the COVID-19 pandemic with repressive and abusive measures which fall far short of their human rights obligations, Amnesty International said today. The organization has released a new briefing Eastern Europe and Central A...sia Confronted with COVID-19: Responses and Responsibilities setting out the responsibilities of governments in the region.
more
The ethical values and behaviors are not only abstract terms, but they are refined and conceptualized byreal-life experiences. The societal context where the actions of humans can be analyzed by ethicaldecision-making is entirely relevant to deliberate on what is the right thing to do and what the m...oralagent should do, since the ethical values and principles response to the actual practices of life and to theneeds of humans in the society. This elaboration takes us to the realm of social ethics.This article reviews the definition and contextual meaning of social ethics at a broader level by givingspecial emphasis to the ethical theories and principles, focusing on the societal and public setting. Ethicswill be deliberated with social and community aspects. Based on the principle of justice and public healthethics, the concept of social ethics has been investigated concisely through the relationship between man,as a moral person, and the society in exemplification of the issues of healthcare ethics. It is argued that thetension between individualism and communitarian needs can be reconciled with the perspective of socialethics by respecting the individual autonomy without disregarding the common good and social justice.By promoting the values of social responsibility, solidarity, and social utility, social ethics has beenproposed as the basis of a rational, moral, egalitarian, pluralistic, democratic society rising on the pillars ofhuman rights and human dignity.
more
Many people have questions about the new coronavirus disease 2019 (COVID-19) vaccines. As vaccine recipients’ most-trusted source of information on vaccines, you play a critical role in helping them understand the importance of COVID-19 vaccination, as well as if and when it is likely to be recomm...ended for them.
The materials include proven communication strategies and tips for effectively setting expectations and addressing questions from COVID-19 vaccine recipients.
more
The aim of the SATG was to produce a triage scale for use throughout South Africa. The group was multi-disciplinary and comprised doctors, nurses and paramedics. The result of the SATG’s activities is the South African Triage Scale (SATS), a physiology and symptom based scale which prioritises int...o one of four colours and can be used in hospital Emergency Centres as well as in the pre-hospital setting. The SATS has been validated in the public, private health care setting as well as pre-hospital.
more
Maintaining proper storage conditions for health commodities is vital to ensuring their quality. Product expiration dates are based on ideal storage conditions and protecting product quality until their expiration date is important for serving customers and conserving resources. Guidelines for the S...torage of Essential Medicines and Other Health Commodities is a practical reference for those managing or involved in setting up a storeroom or warehouse. The guide contains written directions and clear illustrations on receiving and arranging commodities; special storage conditions; tracking commodities; maintaining the quality of the products; constructing and designing a medical store; waste management; and resources. It was written to meet the needs of district-level facilities; however, the guidelines and information it contains apply to any storage facility, of any size, in any type of environment.
Available in English, French, Spanish and Russian
more
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
more
Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
more
The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over... 134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. Good control of blood sugar blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India
more
Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant ...asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
more