In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multi...ple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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Health care-associated infection (HCAI) places a serious disease burden and has a significant economic impact on patients and health-care systems throughout the world. Yet good hand hygiene, the simple task of cleaning hands at the right times and in the right way, can save lives. World Health O...rganization (WHO) has developed evidence-based WHO Guidelines on Hand Hygiene in Health Care to support health-care facilities to improve hand hygiene and thus reduce HCAI.
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Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the propagation and dissemination of MDR TB.
The term "Programmatic Management of Drug Resistant TB" (PMD...T) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases.
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Population-Based Survey on Perceptions and Attitudes about Peace, Security and Justice in Eastern Democratic Republic of the Congo
For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max...imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur...e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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This report, examining the mood of a country that holds the top spot in the Fragile States Index, is based on field research conducted in South Sudan in April and May 2014.
DHS Further Analysis Reports No. 111
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delive...ry, and timely postnatal care (PNC).
This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12 regions. We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use. We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six weeks after birth. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, ...primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services.
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This manual outlines proposals for the insertion of housing, land and property restitution rights simultaneously within the context of the ongoing peace process and within broader national legal reform efforts, including work towards a national land law. The paper begins by emphasising that many cou...ntries emerging from both conflict and political reform processes have successfully implemented restitution programmes, and that the current, largely piecemeal, efforts towards restitution in Myanmar under the Central Land Grab Reinvestigation Committee processes are simply inadequate in securing restitution rights for everyone in and from Myanmar with a legitimate restitution claim.
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As part of a wider organisational undertaking to better capture and communicate the effectiveness of its work, Oxfam developed an evaluative method to assess the quality of targeted humanitarian responses. This method uses a global humanitarian indicator tool which is intended to enable Oxfam GB to ...estimate how many disaster-affected men and women globally have received humanitarian aid that meets establishes standards for excellence. This method was used after the independence of South Sudan, which was followed by political tensions with its neighbour on issues unresolved from the Comprehensive Peace Agreement (CPA) which include border demarcation, wealth-sharing and the fate of the disputed territory of Abyei.
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These standards for the quality of paediatric care in health facilities form part of normative
guidance for improving the quality of maternal, newborn, child and adolescent health care.
In view of the importance of the continuum of both the life-course and service delivery (1),
these standards bu...ild on the Standards for improving the quality of maternal and newborn
care in health facilities (2), during labour, childbirth and the early postnatal period.
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Working Document Nov. 2020
The COVAX Supply and Logistics workstream lead by UNICEF, Gavi and WHO have released a working copy of the COVID-19 Vaccination, Country Readiness & Delivery: Supply and Logistics Guidance. Countries might find this Guide useful when developing and strengthening their sup...ply chain strategies to receive, store, distribute and manage the COVID-19 vaccines and their ancillary products, in line with their national deployment and vaccination plan (NDVP). The document also provides links to the different tools and resources to aid countries in performing assessment, planning and capacity-building activities.
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As of 12 December 2022, over 645 million people worldwide have been diagnosed with COVID-19, with over 6.6 million deaths (4).
The Omicron variant, which emerged in late November 2021, and its subvariants, are now the dominant circulating viruses, contributing to the ongoing surge in several countr...ies (4). Vaccination has substantially reduced case numbers and hospitalizations in many countries,but limitations in global access to vaccines mean that many populations, including those in low- and middle-income countries, remain vulnerable. Even in vaccinated individuals, uncertainties remain about duration of protection and efficacy, and the degree of crossprotection with new variants.
There remains a need for more effective treatment and management for those affected by COVID-19. The pandemic – and the
explosion of both research and misinformation – has highlighted the need for trustworthy, accessible and regularly updated living
guidelines to place emerging findings into context and provide clear recommendations for clinical practice
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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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This compendium collates current tools and resources on quality improvement developed by the WHO Service Delivery and Safety Department and provides examples of how the tools and resources have been applied in country settings. The target audience for this document are ministries of health, facility... quality improvement teams, researchers and development agencies. WHO technical programmes, regional and country offices can also use the document in their technical cooperation work with the identified audience. Those working to improve the quality of health service delivery can also make good use of this resource
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More than half of Central African Republic’s population is in need of urgent humanitarian aid – amidst chronic underfunding, persisting violence across the country and unsuccessful peace agreements. Donors must step up their commitments and meet their fair share responsibility of funding to stab...ilize the fragile situation.
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Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver integrated preventive and curative package of care of services to manage common childhood illness in h...ard-to-reach communities in Bondo Subcounty, Kenya
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This Code of Conduct seeks to guard our standards of behaviour. It is not about operational details, such as how one should calculate food rations or set up a refugee camp. Rather, it seeks to maintain the high standards of independence, effectiveness and impact to which disaster response NGOs and t...he International Red Cross and Red Crescent Movement aspires. It is a voluntary code, enforced by the will of the organisation accepting it to maintain the standards laid down in the Code. In the event of armed conflict, the present Code of Conduct will be interpreted and applied in conformity with international humanitarian law. The Code of Conduct is presented
first. Attached to it are three annexes, describing the working environment that we would like to see created by Host Governments, Donor Governments and Inter-Governmental Organisations in order to facilitate the effective delivery of humanitarian assistance.
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This guideline aims to improve the quality of donations and the management thereof and serve as the basis for policies of the State and other organizations in the giving and receiving of donations of medicines, medical devices and IVDs.
Over the last three or four decades, there has been an enorm...ous increase in scientific knowledge about the mode of action, effects and side effects of medicines, medical devices and IVDs. It is important for all
stakeholders to understand that these products have both benefits and risks, that they have to be used carefully and appropriately and that some can do more harm than good.
There are many different scenarios for the donation of medicines, medical devices and IVDs. Donations may take place in acute emergencies or as part of development aid in non-emergency situations. They may involve donations (i.e. direct or through private voluntary organizations), aid by governments or persons authorized to sell medicines, medical devices and/or IVDs.
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