This document is one of eight PDF documents that comprise the Guidance on Child-focused Victim
Assistance. All are available in PDF at . The full document is also available.
This first section contains the Acknowledgements, Foreword, Acronyms and Chapters 1 th...rough 4: Chapter 1. Introduction: The Need for Child-focused Victim Assistance Guidance; Chapter 2. Mine Action, UNICEF and Guidance on Child Victim Assistance ;Chapter 3. Victim Assistance: Stakeholders and International Standards; Chapter 4. Principles, Coordination and Cross-cutting Aspects of Victim Assistance
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This comprehensive manual features practical suggestions and creative ideas for including, recruiting and accommodating people with disabilities in international exchange programs. Building Bridges also addresses cross-cultural issues and international service projects. Includes an extensive resourc...e section. Find each chapter in FREE downloadable PDF and RTF formats
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South Africa is a mineral-rich country. Although the mining of these minerals generates wealth for the country, it also causes diseases in the mine workers who are exposed to harmful dust. Pulmonary silicosis, the disease most commonly caused by exposure to crystalline silica dust, was described in ...South African gold miners in the early 1900s not many years after gold-mining commenced. Most studies since then have been cross-sectional, with only one large cohort study being conducted on white miners; long-term trends have not been reported. Currently, South Africa has one of the highest rates of silicosis in the world.
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Heart failure (HF) is a leading global public health problem with >64 million prevalent cases globally. Patients with HF with reduced ejection fraction (HFrEF) from low- and middle-income countries experience a 22% to 58% higher 1-year mortality rate than those in high-income countries.1 Guideline-d...irected medical therapy (GDMT) consisting of ACE (angiotensin-converting enzyme) inhibitors or ARB (angiotensin receptor blockers) or ARNI (angiotensin receptor-neprilysin inhibitors), β-blockers, MRA (mineralocorticoid receptor antagonists), and SGLT2 (sodium-glucose cotransporter 2) inhibitors substantially reduces mortality among patients with HFrEF. These medicines are among the most cost-effective interventions and are thus included as the highest priority health system interventions recommended by the Disease Control Priorities Project.2 Despite this high-quality evidence, GDMT remains widely underutilized in low- and middle-income countries resulting in widespread undertreatment of patients with HFrEF due to health system-, provider-, and patient-level barriers.1 National essential medicines lists (EMLs) promoted by the World Health Organization (WHO) guide countries on which medications to purchase in the setting of limited resources and have resulted in higher procurement and availability of essential medicines in the public sector.3 We provide a cross-sectional analysis of national EMLs in 53 low- and middle-income countries, and availability, price, and affordability of GDMT in select countries to identify potential barriers to access to these essential medicines for patients with HFrEF.
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Asthma, hay fever and eczema are three common chronic conditions. There have been no recent multi-country data on the burden of these three conditions in adults; the aims of this study are to fill this evidence gap.
The Global Asthma Network Phase I is a multi-country cross-sectional population-bas...ed study using the same core methodology as the International Study of Asthma and Allergies in Childhood Phase III. It provides data on the burden of asthma, hay fever and eczema in children and adolescents, and, for the first time, in their parents/guardians.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris...k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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Soil transmitted helminth (STH) infections are among the most common human infections worldwide with over 1 billion people affected. Many estimates of STH infection are often based on school-aged children (SAC). This study produced predictive risk-maps of STH on a more finite scale, estimated the nu...mber of people infected, and the amount of drug required for preventive chemotherapy (PC) in Ogun state, Nigeria. Georeferenced STH infection data obtained from a cross-sectional survey at 33 locations between July 2016 and November 2018, together with remotely-sensed environmental and socio-economic data were analyzed using Bayesian geostatistical modelling. Stepwise variable selection procedure was employed to select a parsimonious set of predictors to predict risk and spatial distribution of STH infections. The number of persons (pre-school ages children, SAC and adults) infected with STH were estimated, with the amount of tablets needed for preventive chemotherapy. An overall prevalence of 17.2% (95% CI 14.9, 19.5) was recorded for any STH infection. Ascaris lumbricoides infections was the most predominant, with an overall prevalence of 13.6% (95% CI 11.5, 15.7), while Hookworm and Trichuris trichiura had overall prevalence of 4.6% (95% CI 3.3, 5.9) and 1.7% (95% CI 0.9, 2.4), respectively. The model-based prevalence predictions ranged from 5.0 to 23.8% for Ascaris lumbricoides, from 2.0 to 14.5% for hookworms, and from 0.1 to 5.7% for Trichuris trichiura across the implementation units. The predictive maps revealed a spatial pattern of high risk in the central, western and on the border of Republic of Benin. The model identified soil pH, soil moisture and elevation as the main predictors of infection for A. lumbricoides, Hookworms and T. trichiura respectively. About 50% (10/20) of the implementation units require biannual rounds of mass drug administration. Approximately, a total of 1.1 million persons were infected and require 7.8 million doses. However, a sub-total of 375,374 SAC were estimated to be infected, requiring 2.7 million doses. Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, either for resource acquisition or identifying priority areas for delivery of interventions in Ogun State, Nigeria.
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Background: Despite several cycles of Mass Drug Administration (MDA), however, the prevalence of Soil-transmitted helminthiasis (STH) remains high in Bangladesh. A clear understanding of local knowledge, attitudes, and practices (KAP) related to the acceptance and utilization of MDA is critical for ...effective implementation of this intervention.
Methods: This research, a cross-sectional descriptive study that utilized quantitative methods, was conducted between February and June 2017. A total of 380 questionnaire surveys were distributed to school-aged children (SAC), the parents of SAC, and school teachers.
Results: Out of 160 SACs, 81.9% knew of STH and 75.6% knew of MDA. SAC showed a high awareness of STH and recognized the importance of preventive measures and MDA. In terms of the parents of SAC and school teachers, close to half of the respondents were knowledgeable about STH and MDA. While nearly all of the participants held positive attitudes toward MDA, the respondents pointed out that school-based MDA presents severe limitations, as non-school-going children are neglected by this effort. A total of 68.3% of all school teachers and 56.8% of all parents of SAC found MDA efforts to be effective.
Conclusion: STH infections still remain a significant public health burden in Bangladesh. Reforming the MDA policy is necessary to achieve the target of STH elimination.
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The full-scale invasion of Ukraine has caused a deterioration in the level of access to health-care services and medicines in the country, particularly for people living in regions close to the front line and areas that are not partially or fully controlled by the Government of Ukraine, and for peop...le who have been internally displaced. Cost and time constraints involved in getting to and from health facilities, as well as limited transportation options were the main barriers to accessing essential health-care services. At the same time, the findings show that the country’s health system remains resilient and that overall access to health services is fairly high.This report is based on data collected through a quantitative cross-sectional survey of self-reported health needs of the general population in Ukraine. It presents results of the first round survey conducted in September 2022 and could help to address the specific health-care needs of the population groups concerned.
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Issue Brief 31: Antimicrobial resistance (AMR) can occur when viruses, bacteria, parasites and fungi change over time. There is no longer a response to medicines, and the infection treatment gets really difficult which increases the risk of a disesase spread, which can lead to severe health problems.... AMR is an increasing threat to global public health worldwide that requires cross-sectional and cross-disciplinary action. It is present in every country and is spurred by several human-made factors, including over- and/or inadequate use of antibiotics, poor hygiene and infection prevention control, and excessive usage of antibiotics outside the health care sector e.g. in life stock production.
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HIV-1 infection disproportionately affects women in sub-Saharan Africa, where areas of high HIV-1 prevalence and Schistosoma haematobium endemicity largely overlap. Female genital schistosomiasis (FGS), caused most frequently by S. haematobium egg deposition in the genital tract, has been associated... with prevalent HIV-1 infection in cross-sectional studies. The presence of S. haematobium eggs in genital tissue is also associated with vascularization and the accumulation of CD4+ lymphocytes and macrophages, making the granuloma-associated environment a potential contributor to HIV-1 vulnerability. In addition to modulation of the local cervicovaginal environment, FGS has also been associated with a higher frequency of systemic CD4 T-cells expressing the chemokine receptor CCR5. Tissue-entrapped eggs are also associated with clinically visible FGS-associated manifestations in the cervicovaginal mucosa. FGS lesions may breach the intact cervicovaginal immune barrier and are hypothesized to provide an entry point for HIV-1 infection. However, the underlying mechanism for potential HIV-1 vulnerability in FGS has not been fully characterized and requires further investigation.
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During the COVID-19 health crisis, community pharmacists had an enhanced role in supporting health-care systems that were overburdened by managing seriously ill patients. This study was undertaken to determine the patterns of community supply of antiviral and antibacterial agents from community phar...macies during the COVID-19 pandemic in selected countries in eastern Europe and central Asia. Nine countries – Armenia, Georgia, Kazakhstan, Kyrgyzstan, North Macedonia, the Russian Federation, Serbia, Tajikistan and Uzbekistan – participated in this cross-sectional study.
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The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W...e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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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.
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This report documents the findings from the Behavioral Surveillance Survey conducted among youuth aged 15-24 in Rwanda in 2009. The 2009 Youth BSS documented HIV knowledge, attitudes, and behaviors (KAB) among youth in Rwanda. The data provided a cross-sectional look at the current HIV KAB among yo...uth, and allowed for changes over time to be detected when analyzing these data against the results of the 2006 Youth BSS.
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The Georgetown Undergraduate Journal of Health Services (2), 2012.
Key Considerations
This brief focuses on cross-border movement in Eastern and Southern Africa (ESA) and its implications for development of risk communication and community engagement (RCCE) strategies aimed at preventing transmission of COVID-19 in the ESA region. Given the extensive risk of cross...-border transmission of the virus and the imminent reopening of borders, such strategies are essential to containment efforts
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In East Africa, the trend in cross-border FGM puts at risk the progress achieved in eliminating the practice. The only way we can reach zero FGM by 2030 is by concerted and immediate action to address all aspects of FGM.
This policy brief highlights the cross-border dimension of FGM (Ethiopia, Keny...a, Somalia, Tanzania and Uganda) in the East Africa region. The brief describes the factors that perpetuate cross-border FGM and the work that is being done to reduce the rates.
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