The WHO Model List of Essential Medicines and Model List of Essential Medicines for Children are updated and published every two years, intended as a guide for countries or regional authorities to adopt or adapt in accordance with local priorities and treatment guidelines for the development and upd...ating of national essential medicines lists. Selection of a limited number of essential medicines as essential, taking into consideration national disease burden and clinical need can lead to improved access through streamlined procurement and distribution of quality-assured medicines, support more rational or appropriate prescribing and use and lower costs for both health care systems and for patients.
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PLoS ONE 18(5): e0285031. https://doi.org/10.1371/journal.pone.0285031
The study aims to integrate HPV vaccination into routine care in adolescent HIV clinics. To achieve success, we will co-design a package of implementation strategies using a previously successful implementation research approach... developed for cervical cancer prevention in LMICs: the Integrative Systems Praxis for Implementation Research (INSPIRE). INSPIRE is a novel, comprehensive approach to develop, implement, and evaluate implementation science efforts
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Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant
tuberculosis (XDR-TB) increasingly occur in resource-constrained settings.
In the context of a national response to MDR- and XDR-TB, health workers in
TB clinics (in district hospitals and some accredited health centres) wil...l need
to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB
treatment.
Management of MDR-TB: a field guide was created to help health workers
carry out these tasks. It is a job aid that medical officers and TB nurses
are meant use frequently during the day for quick reference. This module
is closely related to other clinical guideline modules in the Integrated
Management of Adolescent and Adult Illness (IMAI) series. In particular, the
approach to chronic disease management is taken from General principles
of good chronic care in the IMAI series.
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Pneumonia kills more children than any other illness – more than AIDS, malaria and measles combined. Over 2 million children die from pneumonia each year, accounting for almost 1 in 5 under five deaths worldwide. Yet, little attention is paid to this disease. This joint UNICEF/WHO report examines ...the epidemiological evidence on the burden and distribution of pneumonia and assesses current levels of treatment and prevention. It is a call to action to reduce pneumonia mortality, a key step towards the achievement of the millennium development goal on child mortality.
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A guide for community health workers, rehabilitation workers, and families.
This manual covers identifying primary and secondary disabilities, developing skills for daily living, and working through behavior problems. The new 2018 edition features new topics, including mental and developmental di...sabilities, microcephaly and Zika, causes of birth defects and childhood disability, epilepsy and seizures, hearing loss and vision problems, HIV, leprosy, and more, and has updated information on polio, cerebral palsy, juvenile arthritis, muscular dystrophy, and medications.
Readers will find instructions on how to build six different wheelchairs using local resources; useful therapy techniques, such as making fun and educational toys; ideas for improving playground accessibility for all children; and low-cost rehabilitation aids and adaptations for home and community.
You can download chapter 4 for free. The complete book is available at Hesperian Book STore
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Vol 5 No 27 | ISSN 2039-2117 (online) | ISSN 2039-9340 (print) | The rate of sexual victimization of mentally retarded children is alarming and it goes unnoticed because the perpetrators could be parents, step- parents, relatives, well-respected individuals by family members, neighbours and educator...s. Drawing from labelling theory that the mentally retarded have low IQ, majority of perpetrators tend not to get arrested because of lack of evidence. Research indicates that educators struggle to identify the psychological, behavioural and physical symptoms of sexual abuse owing to their limited training. Having employed systematic review as methodology, this research study found that mentally retarded children are prone to HIV/AIDS, PTSD and feelings of helplessness owing to uninvolvement of parents, dysfunctional communities, poverty and their inability to differentiate between abuse and affection. Based on the findings, the recommendations are that: (1) extensive training for professionals, families and community members be executed to protect children with intellectual disability. Furthermore, the rights of the mentally retarded children must be respected in the court of law when reporting sexual abuse.
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The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o...f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i...s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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This manual is designed to provide comprehensive malaria case management training for health workers at all levels, including clinical, nursing, dispensing, laboratory and records staff. The training covers the use of malaria rapid diagnostic tests (RDTs) and the treatment of severe malaria. The fiv...e-day training programme includes interactive modules supported by job aids. The ideal group size is 20–30 participants, supported by a team of three trainers. Trainers should thoroughly review the manual, including the 'Adult Learning Techniques' module, and follow the 'Facilitator's Guide', while participants should use the 'Simplified Participant's Guide'. The training includes pre- and post-tests to assess knowledge improvement. Continuing Medical Education (CME) is encouraged after the training, and resources are provided in the appendix.
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Prepared as an outcome of ICMR Subcommittee on Cancer Cervix | This consensus document on management of cervix cancer summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. It also interwe...aves clinical, biochemical and epidemiological studies.
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Prepared as an outcome of ICMR Subcommittee on Non Hodgkin’s Lymphoma (High Grade) | This consensus document on management of non- hodgkin’s lymphoma – high grade summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molec...ular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
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The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment a...nd care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.
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This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care. This publication addresses medical devices for six types of cancer: breast, cervical, colorectal, leukem...ia, lung and prostate. The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals. The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information. The third section lists the priority medical devices required to manage cancer in seven different units of health care services: 1. Vaccination, clinical assessment and endoscopy, 2. Medical imaging and nuclear medicine, 3. Surgery, 4. Laboratory and pathology, 5. Radiotherapy, 6. Systemic therapy and 7. Palliative and end of life care
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ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with... authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
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The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra...nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i...n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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