Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance...), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
more
Some observers have described the coronavirus pandemic as an 'Anthropocene disease,' thereby highlighting its connection with this new ecological era that is characterised by the considerable pressure human activities are exerting on ecosystems and the consequences on public health, society and the ...environment. This article focuses on the recent emergence of the 'Planetary Health' paradigm. Launched by the Rockefeller Foundation and the medical journal The Lancet, Planetary Health is one of the most ambitious attempts in recent years to systematize global health in the Anthropocene. While recognising the interest and necessity of reflecting on human health and the health of the planet, this article aims to show, however, that the Planetary Health paradigm is problematic and aporetic for two reasons. First, because it is based on a scientistic and depoliticised conception of the Anthropocene, which obscures capitalism's responsibility for the contemporary global and, especially, ecological crisis. Second, because this conception leads to a promotion of solutions that are essentially based on the financialization and technoscientific management of the living world - precisely the underlying cause of the degradation of ecosystems and living conditions that created the Anthropocene in the first place. A different kind of 'planetary health' remains possible and desirable.
more
Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to complement the development of a global plan, as articulated in the WHO’s draft resolution EB134/37 ...“Combating antimicrobial resistance including antibiotic resistance”, adopted by theWorld Health Assembly in May 2014. The overuse of antimicrobials is driving resistance. A return to appropriate, targeted antimicrobial use in humans, animals and the environment is critical if we are to conserve the antimicrobial armamentarium. Various interventions have been put in place to address antimicrobial resistance in South Africa. However, these are insufficient to effectively tackle the threat faced by the country. The strengths of the current system are outweighed by its weaknesses.
more
The extensive use of natural resources threatens to exceed the carrying capacity of the Earth. The concept of a
circular economy offers an avenue to sustainable growth, good health and decent jobs, while saving the environment
and its natural resources. Further, the change from a linear economy (t...ake, make, dispose) to a circular economy (renew, remake, share) is expected to support significantly the attainment of the Sustainable Development Goals
(SDGs), particularly SDG 12 on responsible consumption and production.
more
Esta quarta edição do manual se baseia no esquema de avaliação de risco apresentado na terceira edição. Uma avaliação completa, baseada em evidências e transparente dos riscos permite que as medidas de segurança sejam equilibradas com o risco real de trabalhar com agentes biológicos, caso... a caso. Isso permitirá que os países implementem políticas e práticas de biossegurança e biosseguridade laboratoriais economicamente viáveis e sustentáveis que sejam relevantes para suas circunstâncias e prioridades individuais.A necessidade de atualizar as diretrizes de biossegurança de laboratórios internacionais faz parte de uma iniciativa mais ampla para globalizar a biossegurança e enfatizar os princípios e as abordagens que são acessíveis a países que tenham ampla gama de recursos financeiros, técnicos e regulatórios. A OMS revisou o Regulamento Sanitário Internacional em 2005 “para ajudar a comunidade internacional a prevenir e a responder aos riscos agudos de saúde pública que tenham o potencial de cruzar fronteiras e ameaçar pessoas em todo o mundo”. Esses regulamentos exigem que todos os 196 estados-membros da OMS estejam bem preparados para surtos em potencial e novas doenças; isso inclui o diagnóstico precoce e a confirmação laboratorial para facilitar a prevenção e o controle de infecções.
more
Este documento incluye los resultados de un proceso de elaboración rápida de guías. La información incluida en esta guía refleja la evidencia a la fecha publicada en el documento. Las recomendaciones se basaron en la evidencia disponible y su calidad (metodología GRADE) en el momento en que s...e publicó la guía. Sin embargo, reconociendo que hay numerosas investigaciones en curso, la Organización Panamericana de la Salud actualizará de forma periódica estas revisiones y las recomendaciones correspondientes.
more
The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe...rent interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
more
Las infecciones del sitio quirúrgico (ISQ) constituyen una de las Infecciones Asociadas al Cuidado de la Salud (IACS) más frecuentes que ponen en riesgo a los pacientes llevando muchas veces al fracaso del procedimiento quirúrgico. Con una incidencia mucho mayor en países de medianos y bajos ing...resos, representa un desafío de la práctica médica cotidiana que compromete la salud y la seguridad de los pacientes. La indicación de profilaxis primaria con antibióticos en relación a los procedimientos invasivos, tiene como objetivo disminuir la incidencia de infecciones con la consecuente disminución de la morbimortalidad debiendo utilizarse únicamente en aquellos procedimientos en los que hay evidencia de efectividad. Cabe destacar que la indicación inadecuada, tiene potenciales efectos adversos tales como infecciones por Clostridium difficile, emergencia de resistencia
bacteriana, reacciones adversas a drogas e incremento de los costos en salud.
La profilaxis antibiótica como complemento de una buena técnica quirúrgica, es una medida costo efectiva de prevención de las ISQ representando alrededor del 30% de la indicación de antibióticos entre los pacientes hospitalizados. Dado que en algunos estudios el uso inapropiado de antibióticos se ve reflejado en el 40 al
80% de las indicaciones médicas, desde la Comisión de Infecciones Asociadas al Cuidado de la Salud y Seguridad del Paciente de SADI hemos realizado una actualización de la evidencia disponible. Este documento es una acción complementaria al consenso “Prevención de Infección del Sitio Quirúrgico” realizado entre SADI y el Instituto Nacional de Epidemiología “J. Jara” durante el Congreso de SADI 2015.
La posibilidad de contar con una guía actualizada de profilaxis quirúrgica adaptada a nuestro medio, constituye una herramienta de uso cotidiano por parte de los profesionales del equipo quirúrgico que permite la optimización de la utilización de fármacos restringiendo así la emergencia y diseminación de la resistencia bacteriana. Sin duda esperamos que pueda ser de utilidad para el equipo de salud.
more
Adapting community-led approaches . Three out of 10 people in urban areas do not use improved sanitation facilities, and one out of 10 people are forced to practise open defecation. Still higher proportions do not have access to safely managed sanitation facilities, where the fecal sludge
is contai...ned and either left in situ or safely emptied, transported, and delivered to a treatment plant.
more
The World Health Organization (WHO) convened a meeting of the Technical Advisory Group on Buruli ulcer at its headquarters in Geneva, Switzerland on 25 to 27 March 2019
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 Central Africa, where access to proper health care is lim...ited. 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.
more
This global progress report attempts to lay the groundwork for the kind of accelerated action needed. Section 1 presents key data, trends and developments in women’s, children’s and adolescents’ health and well-being. That is followed in Section 2 by a deeper dive into the impact of the COVID-...19 pandemic, which has created and contributed to many threats and challenges to progress for women, children and adolescents. In Section 3, the report concludes with recommendations for accelerating progress towards the achievement of the 2030 Agenda even in such challenging times, with an emphasis on partnership
and clear-eyed recognition of the consequences of failing to do better.
more
This document describes the ethical values that are most important to the nursing profession in Ontario. It also provides scenarios of ethical situations in which there is a conflict of values. Nurses are encouraged to use these scenarios for reflection and discussion. No solutions are offered becau...se there is no one solution that is best in all situations. The behavioural directives are intended to help nurses work through ethical situations and provide information about the College of Nurses of Ontario’s (CNO’s) expectations for ethical conduct. These are taken into account when CNO Committees assess nurses’ practices. Nurses need to consider behavioural directives carefully when making decisions about ethical care as this process will strengthen their practice.
more
An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, the WHO Global report on health equity for persons w...ith disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. Furthermore, the Sustainable Development Goals and global health priorities will not progress without ensuring health for all.
more
This Guidance Note is meant to help protection cluster coordinators apply nexus approaches in a practical way by, providing concrete steps and means to address prevalent or longstanding protection issues, risk patterns, trends and chronic vulnerabilities. The guidance calls for a practical, problem-...solving approach that seeks opportunities to identify and collaborate with actors beyond the humanitarian sphere to address deep-rooted protection issues
more
The WHO estimates that 19 million children aged 15 years or younger are visually impaired. Of these, 1.4 million are irreversibly blind and need visual rehabilitation interventions for full psychological and personal development. The remainder have visual problems that could be prevented or treated.... Identifying children with visual problems early in life so that they can benefit from medical and optical interventions remains a key challenge for most child eye health programmes. Reports from various low-and middle-income countries indicate that the age of children undergoing operation for cataract is frequently too high to achieve maximum benefit.
more
The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la...test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
more
The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs).
Cholera is a diarrheal disease caused by the bacterium Vibrio cholera. The infection primarily spreads through contaminated water and food. Symptoms include the onset of acute diarrhea and/or vomiting, muscle cramps, and body weakness. If untreated, the infection can result in rapid dehydration and ...death within hours.
more