Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurr...ing in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.
more
The guide helps network managers and technical experts navigate the steps necessary for gathering, structuring, analyzing and reporting information needed to make strategic plans that improve sustainability and equity.
Cureus. 2015 Nov; 7(11): e372.
Published online 2015 Nov 3. doi: 10.7759/cureus.372
PMCID: PMC4671837
PMID: 26677422
Geflüchtete Menschen in Aufnahmeeinrichtungen werden in bevölkerungsbezogenen Erhebungen, Routinedaten und amtlichen Statistiken bislang unzureichend berücksichtigt. Im Rahmen des Forschungs- und Entwicklungsvorhabens „Surveillance der Gesundheit und primärmedizinischen Versorgung von Asylsuch...enden in Aufnahmeeinrichtungen“ (PriCare) wurde daher ein Ansatz für ein Gesundheitsmonitoring durch Sekundärnutzung medizinischer Routinedaten in den Ambulanzen der Aufnahmeeinrichtungen für geflüchtete Menschen entwickelt. Hierzu wurde eine Dokumentationssoftware (Refugee Care Manager, RefCare©) zur Digitalisierung und Harmonisierung der Primärdokumentation entwickelt und in Aufnahmeeinrichtungen dreier Bundesländer implementiert. Der Ansatz des verteilten Rechnens in einem Surveillancenetzwerk ermöglicht durch dezentrale aber harmonisierte Analysen, die datenschutzkonforme Sekundärnutzung dieser medizinischen Routinedaten ohne zentrale Speicherung personenbezogener Informationen. Durch eine integrierte Monitoringfunktion können 64 Indikatoren zur Population, Morbidität sowie zu Versorgungsprozessen und -qualität routinemäßig und einrichtungsübergreifend ausgewertet werden. Der Beitrag beschreibt das konzeptionelle und praktische Vorgehen, das technische Verfahren sowie exemplarische Ergebnisse dieses Monitoringsystems.
more
The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct ...definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
more
The World Health Organization (WHO) has recommended a universal antiretroviral therapy (ART) for all HIVinfected children before the age of two since 2010, but this implies an early identification of these infants. We described the Prevention of Mother-to-Child HIV Transmission (PMTCT) cascade, the ...staffing and the quality of infrastructures in pediatric HIV care facilities, in Ouagadougou, Burkina Faso.
more
Updated guidance. The guidance provides useful information to staff working in prisons, as well as to health and prison authorities, explaining how to prevent and address a potential outbreak of COVID-19. In addition, it aims to protect the health and well-being of all those who live and work in, an...d visit, these settings and the general population at large. People deprived of their liberty, and living or working in enclosed environments in close proximity, are likely to be more vulnerable to the COVID-19 disease than the general population. Moreover, correctional facilities may amplify and enhance COVID-19 transmission beyond their walls.
more
Sustainability 2020, 12, 1025
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
Up-to-date Literature review current through: Jan 2015. | This topic last updated: Jan 29, 2015.
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3086
Using infectious diseases sensitive to climate as indicators of climate change helps stimulate and inform public health responses
Nosocomial infections, or hospital-acquired infec-tions (HAI), are among the most significant causesof morbidity and mortality in healthcare settingsthroughout the world.Prevention of HAIs iscentral to providing high quality and safe health-care, even in settings with limited resources.Transmi...ssion of infectious agents between patientsby health workers and irrational use of antibioticsare two important preventable factors involved inmany HAIs.
more
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A...Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
more
Guidelines for Therapy and Management of Acute Coronary Syndrome in Indonesia
PLOS ONE | www.plosone.org 1
January 2014 | Volume 9 | Issue 1 | e86616
El objetivo de este artículo es analizar las condiciones de acceso a servicios de salud de las personas con tuberculosis en América
Latina y el Caribe (ALC), reflexionando desde la bioética sobre los aspectos de salud pública implicados. Se realizó una revisión
documental del contexto de la ...tuberculosis en ALC con base en datos epidemiológicos. Los resultados se analizaron a partir de su
relación con los determinantes sociales de la salud, los principios éticos que pautan la práctica médica y la responsabilidad social
more