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Lesotho’s predominantly rural population faces significant health challenges within a setting of inadequate human resources for health. It is essential that nurses and nurse-midwives, who together make up the largest health workforce in the country, be adequately prepared to address Lesotho’s He
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alth 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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Q4: Can convulsive epilepsy be diagnosed at first level care by a non-specialist health care provider in low and middle income country settings?
Руководство по осуществлению mhGAP
recommended
The WHO Mental Health Gap Action Programme (mhGAP) aims at scaling up mental health services in non-specialized health settings to achieve universal health coverage. The mhGAP operations manual is an integral component of the mhGAP package and suppo
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rts district health managers and others responsible for integrating mental and physical health services. The manual offers practical guidance and necessary tools for planning, preparing, implementing, monitoring and evaluating mhGAP
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and
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comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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23 December 2020 This document summarizes WHO recommendations for the rational use of personal protective equipment (PPE) in health care settings and temporary strategies during acute supply shortages. This document also contains 2 Annex sections de
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scribing updated PPE use recommendations for health workers based on the transmission scenario, setting, and activity in the context of COVID-19 (Annex 1), and updated considerations for the decontamination or reprocessing of PPE (Annex 2). This guidance is intended for public health authorities, organizations, and focal persons involved in decisions regarding PPE distribution, management, and use by health workers.
Available in Arabic, French, English, Spanish and Russian
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This guidance note developed by UNICEF explains how the WASH sector can implement infection prevention and control measures in households and community settings. It focuses on reducing the exposure to the disease in vulnerable community
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settings and public spaces, and the transmission of the disease in home and community settings hosting patients and contacts. This brief is available in English, Spanish, and French here.
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Primary Surgery Vol. One: Non-Trauma
recommended
Cotton, M., et al.
Global Healp; Deutsche Gesellschaft für Tropenchirurgie; International Coll. Essential Surgery
(2016)
CC
This comprehensive book has established itself as the most useful text for the medical practitioner in poor-resource settings who is obliged to manage surgical cases. It is particularly adapted for those whose surgical experience is basic or minimal
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. Importantly, it has extensive advice about pitfalls to avoid, and what to do if things go wrong. It is written in simple style, particularly for those whose mother tongue is not English. It is not a text which discusses the latest up-to-date technology, but it is not out-of-date being a synthesis of the best advice from a myriad of surgeons practicing for many years in low- and middle-income countries.
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April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American
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settings where the disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the health care
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settings. It aims to rationalize the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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The Camp Managment Toolkit
recommended
Applicable to both IDP and refugee scenarios, the Toolkit incorporates a wide range of relevant information on managing displaced populations living in communal settings (collective centres, spontaneous sites, established camps, etc.). Large scale d
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isplacements caused by recent conflict and natural disaster events have created a high demand for the Toolkit, which has proven an invaluable resource for field practitioners, government actors and displaced populations since its original release in 2004.
Available in other languages
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The health of the people and health services are in crisis, and together as partners this plan commits us to strategies aimed at achieving our goal of:
Strengthened primary health care for all, and improved service delivery for the rural majority and the ... urban disadvantaged.
Original file: 67 MB more
Strengthened primary health care for all, and improved service delivery for the rural majority and the ... urban disadvantaged.
Original file: 67 MB more
This technical report contains the results from the FEEDcities Project – Eastern Europe and Central Asia, a cross-sectional survey of the local urban food environment conducted in Chișinău, Republic of Moldova between June and August 2016. It ch
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aracterizes the vending sites, the food offered and the nutritional composition of both industrial and homemade street foods. It also describes the nutritional composition of foods sold in supermarkets and fast-food outlets.
The study was conducted within a bilateral partnership between the World Health Organization and the Institute of Public Health of the University of Porto, in collaboration with the Faculty of Medicine, the Faculty of Nutrition and Food Sciences and the Faculty of Pharmacy of the University of Porto (WHO registration 2015/591370 and 2017/698514). The study was funded through a voluntary contribution of the Ministry of Health of the Russian Federation.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE
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CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu
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s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, ma
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lnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice
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Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia
The 80-page report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimina
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tion, lack of access to inclusive HIV prevention education, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services.
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The primary audience for the guideline is health programme managers, including governmental and non-governmental organizations, and policy makers who are responsible for designing maternal, newborn and child health programmes, primarily in low-income setti
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ngs. The guideline is also aimed at health providers and teaching institutions, to increase knowledge of interventions. Development programmes and organizations supporting women’s empowerment and rights will also find this guideline of use.
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The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settin
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gs. The guideline will also be useful to those directly providing care to pregnant women and preterm infants, such as obstetricians, paediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth.
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This paper brings together lessons from interviews with humanitarians and local responders, as well as existing literature, about the use of quarantine in urban environments during the humanitarian response to the Ebola Crisis
Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak health systems and poor infrastructure. Low-carbon appro
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ach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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