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WHO has issued a new recommendation on the length of bladder catheterization following surgical repair of a simple obstetric urinary fistula. Currently the length of catheterization is not standard and ranges from 5 to 42 days. The new guidance recommends a 7–10 day period of bladder catheterizati
...
on to allow complete healing. Longer periods of catheterization can be inconvenient for the woman, her family and care providers as it is associated with more discomfort and inconvenience. It also increases the risk of infection and erosion related to catheterization; requires more intensive nursing care and costs more per patient.
more
The 2012 NDRMP lays out the Disaster Risk Management (DRM) architecture of the country and provides guidance for DRM intervention at all levels. However, implementation has been slow and resource challenges exist throughout the government.
The PNG government’s policy and institutional framework ... for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks. more
The PNG government’s policy and institutional framework ... for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks. more
This article describes a Community-Based Participatory Approach (CBPA) for children with intellectual disability in Endosulfan affected areas of Kasaragod district in Kerala state of India. The CBPA strategy evolved from Community Based Rehabilitation (CBR) and was led by Local Self-Government (LSG)
...
members. It involves a four-pronged approach encompassing family, community, service centres and LSG, with a focus on income generation activities and creation of employment opportunities. The CBPA model considers the cultural
uniqueness and limited resources in areas where the unscientific and extensive use of pesticides has led to high prevalence of multiple deformities including intellectual disabilities.
more
Communities can play a critical role in suicide prevention. Facilitating community engagement in suicide prevention is an important task. The toolkit is a step-by-step guide for communities to engage in suicide prevention activities and have ownership of the process and keep efforts sustained. It is
...
hoped that the pilot version will be used, after necessary adaptation, in many countries and contexts, so that the final product can be strengthened and become more effective and user-friendly.
more
Practice Parameter on Disaster Preparedness
Pfefferbaum, B., Shaw, J.A. & American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI)
American Academy of Child and Adolescent Psychiatry (AACAP)
(2013)
CC
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
more
Some 32% of internally displaced persons (IDPs) in Ukraine suffer from post-traumatic stress disorder (PTSD) as a result of the conflict in the east.
Among the 2,203 respondents surveyed across Ukraine, the study also found a high prevalence of mental disorders such as depression (22%) and anxiety
...
(17%), particularly among women. This has a significant effect on family and community relations, the ability to work or even do basic tasks such as walking.
Moreover, the study noted that 74% of respondents in need of psychiatric care do not receive it, mainly due to a high cost of mental healthcare and medicine.
more
Of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens but the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria, which are spreading rapidly and require urgent solutions.
Gr
...
am-negative bacteria, such as Klebsiella pneumoniae and Escherichia coli, can cause severe and often deadly infections that pose a particular threat for people with weak or not yet fully developed immune systems, including newborns, ageing populations, people undergoing surgery and cancer treatment.
The report highlights a worrying gap in activity against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1), with only three antibiotics in the pipeline. NDM-1 makes bacteria resistant to a broad range of antibiotics, including those from the carbapenem family, which today are the last line of defence against antibiotic-resistant bacterial infections.
more
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.
more
The Lancet Regional Health - Americas 2022;00: 100248 Published online xxx https://doi.org/10.1016/j.lana.2022.100248.
The Lancet Countdown report, discuss the overlapping social, climate and health challenges in Latin America and the Caribbean, and urge multisectoral and political action to trans
...
form these challenges into opportunities through adaptation and mitigation measures that place peoples’ health and wellbeing at the centre of public policies. Latin American and Caribbean governments are called upon to promote climate-resilient health care systems with adaptation plans that are tailored to guarantee quality access to care for all in this viewpoint.
more
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co
...
untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
more
Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –
...
are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
more
The guide presents a structured framework covering assessment and planning, service delivery models, integration with broader health and social services, monitoring, and sustainability. It emphasizes community leadership, human rights, equitable access and
...
adaptation to local contexts, including closed settings. Practical tools are included to support implementation and accelerate progress towards global targets for controlling HIV and eliminating viral hepatitis epidemics.
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
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terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Connecting Frontline Health Workers to resources and each other to expand their knowledge, organize content into courses, and share their learning with the community.
ORB offers frontline health workers and trainers access to quality assured openly licensed content that can be used on mobile device
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s and shared virally amongst communities.ORB has three unique features:
Brings into one space quality-assured, multimedia materials from multiple content developers, with a focus on maternal and child health.
Adaptation of existing content: ORB aims to reduce the practice of new content being developed unnecessarily.
A global collaborative network of organizations to share and review content, integrate content into programs and share user-experience.
By improving access to health content and mobile learning, ORB helps health workers access the vital content they need to do their work effectively and confidently.
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An Advocate’s Guide: Strategic Indicators for Universal Access to Sexual and Reproductive Health and Rights
recommended
This guide was prepared to enable advocates to use data
when advocating for universal access to SRHR at the national,
regional and global levels. It is a direct outcome of the Strategic
SRHR Indicators workshop held in Kuala Lumpur, Malaysia on
21-22 August for the project “Strengthening the N
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etworking,
Knowledge Management and Advocacy Capacities of an AsiaPacific
Network for SRHR” supported by the EU.
One of the major objectives of the project is to develop
a comprehensive monitoring framework of indicators for
measuring government performance to fulfil their international
commitments, particularly to the ICPD and the MDGs, both in
the Asia-Pacific region and globally.
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This manual and its Excel tool are under revision. The revised edition will be published soon.
Health worker roles in providing safe abortion care and post-abortion contraception
World Health Organization
(2015)
Planned and regulated task shifting and task sharing can have a range of benefits. It can ensure a rational optimization of the available health workforce, address health system shortages of specialized health-care professionals, improve equity in access to health care and increase the acceptability
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of health services for those receiving them. This guideline provides a range of options for expanding of health worker roles in the provision of safe abortion care, the management of complications of abortion (also known as post-abortion care in some settings and provided as part of emergency obstetric care) and for post-abortion contraception provision.
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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be
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come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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