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Publication Years
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Lesotho’s predominantly rural population faces significant health challenges within a setting of inadequate human resources for health. It is ess
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ential that nurses and nurse-midwives, who together make up the largest health workforce in the country, be adequately prepared to address Lesotho’s Health Priorities according to the Poverty Reduction Strategy Paper (PRSP) in the settings where they work. Under the HRAA project, Jhpiego conducted a task analysis study to obtain data on job duties or tasks performed by these cadres, as well as information about how often the tasks are performed, if and where tasks were learned, and the self-perceived level of competence in performing the tasks.
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Thesis presented in partial fulfilment of the requirements for the degree of Master of Nursing Science in the Faculty of Health Sciences at Stellenbosch University.
The mobile clinic health care s
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ervices fulfil an essential role in delivering primary health care to the dwellers in the rural communities of the Western Cape. However, occupational health and safety, as well as quality assurance are issues that need to be addressed urgently. It is thus recommended that policy makers take cognizance of the specific needs of every individual mobile clinic team.
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The compendium is designed for use by staff working directly with communities - e.g. health workers and community volunteers working with disabled and older people and their families in rural areas
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of sub-Saharan Africa.
A few examples of technologies are presented that families can adapt to suit their needs and budgets. Many more options are possible. Most of the ideas are suitable for disabled and older people, but are not only for them. As we get older, many of us find it increasingly difficult to squat and balance, or we might be injured or sick. These technologies might also make facilities easier and more comfortable to use by everyone in the family. The ideas are designed to be suitable for household facilities, not for institutional facilities - e.g. schools and clinics - although some ideas might also be useful in these settings
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Video: 10 STEPS TO A CLEAN DELIVERY (CORD CUT USING A NEW RAZOR BLADE) (SOMALI)
Medical Aid Films
(2014)
This film follows Neema, a village birth attendant, while she helps to deliver a baby in a rural setting where there is no access to trained health workers.
It teaches 10 key steps that will lead
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to a clean delivery, including cutting the cord with a new clean razor blade.
This film is aimed at women in the communities where this situation is most likely to occur and traditional birth attendants.
http://medicalaidfilms.org/our-films/somali-films/?v=39329974
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DHS Working Papers No. 69
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant ec ... onomic change in India. The main predictor is a new measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level. more
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant ec ... onomic change in India. The main predictor is a new measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level. more
Provision of integrated RH/FP/STI/HIV services
In Togo, the limited access of populations, especially women, young girls and children to Reproductive Health (RH), Family Planning, treatment of sexually transmissible infections (STI) and struggl ... e against HIV quality services is responsible for the continuously low indicators in these areas. To remedy the problem, UNFPA Togo, in partnership with the Department of Family Health, the Health districts and the NGOs 3ASC and ATBEF, support the initiative of the Mobile Clinic to bring RH/FP/STI/HIV quality services closer to the women, the young girls and children living in rural areas in its intervention areas, with the aim of reaching MDG 4 and 5. more
In Togo, the limited access of populations, especially women, young girls and children to Reproductive Health (RH), Family Planning, treatment of sexually transmissible infections (STI) and struggl ... e against HIV quality services is responsible for the continuously low indicators in these areas. To remedy the problem, UNFPA Togo, in partnership with the Department of Family Health, the Health districts and the NGOs 3ASC and ATBEF, support the initiative of the Mobile Clinic to bring RH/FP/STI/HIV quality services closer to the women, the young girls and children living in rural areas in its intervention areas, with the aim of reaching MDG 4 and 5. more
Des efforts considérables ont été menés pour apporter aux
populations rurales du continent africain des soins de base. Mais
la qualité de ces soins reste aujourd’hui peu satisfaisante car le
médecin généraliste est le plus souvent absent en première
ligne. Cette situation est paradoxa
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le en regard du nombre de
médecins formés dans les facultés en Afrique francophone et à
Madagascar. Le déficit en médecin généraliste, exerçant dans les
zones rurales, reste particulièrement préoccupant alors que
les jeunes médecins sans emploi se multiplient dans les villes.
L’ONG Santé Sud, depuis plus de vingt ans, propose un concept
– la médecine générale communautaire – qui, associé à un dispositif
d’accompagnement, a permis l’installation de plus de deux
cents médecins généralistes communautaires au Mali et à
Madagascar. Ce concept a pour intérêt d’associer, dans une même
pratique, la médecine de famille et les Soins de Santé Primaires.
S.F.S.P. | « Santé Publique »
2014/HS S1 | pages 59 à 65
Considerable effort has been made to provide rural African
populations with basic health care, but the quality of this care
remains unsatisfactory due to the absence of first-line GPs. This is
a paradoxical situation in view of the large number of physicians
trained in medical schools in French-speaking Africa and
Madagascar. of the lack of GPs working in rural areas is a real
concern, as many young doctors remain unemployed in cities.
For more than 20 years, the NGO Santé Sud has proposed a
Community General Medicine concept, which, combined with
a support system, has allowed the installation of more than
200 community GPs in Mali and Madagascar. The advantage of
this concept is that it provides family medicine and primary health
care in the same practice.
S.F.S.P. | « Santé Publique »
2014/HS S1 | pages 59 à 65
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Lancet Glob Health 2020; 8: e341–51
Francophone Africa still carries a high burden of communicable and neonatal diseases, probably due to the weakness of health-care systems and services, as evid
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enced by the almost complete attribution of DALYs to YLLs. To cope with this burden of disease, francophone Africa should define its priorities and invest more resources in health-system strengthening and in the quality and quantity of health-care services, especially in rural and remote areas. The region could also be prioritised in terms of technical and financial assistance focused on achieving these goals, as much as on demographic investments including education and family planning
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Rwanda’s mountainous topography makes ground transportation of medical supplies unreliable — some roads stretching into rural areas remain uncared for and unpaved. Between 25 and 40 per cent of all temperature-sensitive medical supplies sent fro
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m urban centres to rural health clinics are wasted because of an unreliable cold-chain infrastructure. Rural clinics are also often subject to stockouts, and patients in need of specialized blood products, drugs and other supplies are unable to acquire them. Zipline, a US-based health logistics company, aims to address the issue of access to medical supplies, largely leapfrogging traditional modes of transportation and various obstacles. Zipline uses drones to deliver blood and other routine and emergency medical supplies from distribution centres to district hospitals and rural health centres.
Although the company has been celebrated in the media for its operations, there is little scholarly work on its operations and performance. This has led to some confusion over its scale. We aimed to gain insight into the details of Zipline’s business model, including the infrastructure, regulations and government support that make Zipline possible, and to understand its impact on health outcomes in Rwanda. Our work was entirely based on published materials since our research was conducted during the COVID-19 pandemic.
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Medicinal plants occupied an important position in the socio-cultural, spiritual and medicinal arena of rural people of India. T
The present report is based on contribution made by members of the task force and many other experts on medicinal plant
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s. We hope the report on implementation will promote sustainable and equitable development of medicinal plants sector provide "Health for All", boost exports, and will improve livelihood of the people and green the country for the present and the
generation to come.
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimba
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bweans have worsened. Drought and crop failure, exacerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
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Snakebite envenoming constitutes a serious medical condition that primarily affects residents of rural communities in Africa, Asia, Latin America, and New Guinea. It is an occupational, environmental, and domestic
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health hazard that exacerbates the already impoverished state of these communities. Conservative estimates indicate that, worldwide, more than 5 million people suffer snakebite every year, leading to 25,000–125,000 deaths, while an estimated 400,000 people are left with permanent disabilities.
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Tanzania, like other developing countries, is facing a higher burden of cardiovascular diseases (CVDs). The country is experiencing rapid growth of modifiable and intermediate risk factors that accelerate CVD mortality and morbidity rates. In rural
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and urban settings, cardiovascular risk factors such as tobacco use, excessive alcohol consumption, unhealthy diet, hypertension, diabetes, hyperlipidemia, overweight, and obesity, are documented to be higher in this review. Increased urbanization, lifestyle changes, lack of awareness and rural to urban movement have been found to increase CVD risk factors in Tanzania. Despite the identification of modifiable risk factors for CVDs, there is still limited information on physical inactivity and eating habits among Tanzanian population that needs to be addressed. Conclusively, primary prevention, improved healthcare system, which include affordable health services, availability of trained health care providers, improved screening and diagnostic equipment, adequate guidelines, and essential drugs for CVDs are the key actions that need to be implemented for cost effective control and management of CVDs. Effective policy for control and management of CVDs should also properly be employed to ensure fruitful implementation of different interventions.
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The survey is representative of the Union Territory, its states and regions and urban and rural areas. It was conducted in all the districts and in 296 of the 330 townships of Myanmar. A total of 13,730 households were interviewed. It collects data
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on the occupations of people, how much income they earn, and how they use this to meet the food, housing, health, education and other needs of their families. The main focus of the survey is to produce estimates of poverty and living conditions, to provide core data inputs into the System of National Accounts and the Consumer Price Index and to support monitoring of the Sustainable Development Goals.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Centra
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l Africa, where access to proper health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Mycetoma is a slow-growing bacterial or fungal infection, most often of the foot, that may spread to other parts of the body and can cause severe deformity. It is a debilitating disease that most often affects poor people in rural areas with limited
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access to health care.
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (
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LMICs). Host (genetics, atopy) and environmental factors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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Epidemic Preparedness and Response in Africa | Guidelines for the Decentralization of Laboratory Capacity
recommended
New
The decentralization of laboratory capacities is a critical strategy for improving epidemic preparedness and response in Africa. Centralized systems often delay case confirmation, hinder timely interventions, and exacerbate the impact of outbreaks, especially in
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rural and hard-to-reach areas.
This Guidelines outlines a structured approach to decentralization, focusing on:
Strategic Goals: Strengthening laboratory capacity at subnational levels to ensure timely detection and control of epidemic-prone diseases.
Guiding Principles: Equity, country ownership, multisectoral collaboration and evidence-based decision-making.
Implementation Framework: Practical steps for planning, executing, and sustaining decentralized diagnostic networks, with intra- and post-implementation reviews for continuous improvement.
Integration: Alignment with existing surveillance, case management and infection prevention and control (IPC) systems, with a focus on the One Health approach.
While the Guidelines is informed by the Mpox outbreak response, it is adaptable to other priority diseases and aligned with the International Health Regulations (IHR 2005), the Africa CDC Strategic Plan (2022-2027), and the WHO Health Security Framework.
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Formularies are lists of antibiotics that are suggested for certain healthcare settings. In developing a recommended formulary, countries should consider the needs of patients and facilities where they receive care. For example, clinicians in rural
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or primary health centers may need wide access to first-line antibiotics (e.g., penicillin, ampicillin, TMP-SMX), but last resort antibiotics such as carbapenems or colistin might be limited to tertiary care hospitals. Efforts to create antibiotic formularies may be linked to efforts within countries to create or update essential medicine lists (EML).
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospita
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l stays, and the burden of antibiotic resistance while maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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