Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic p...alliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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Humanitarian emergencies and crises (Humanitarian emergencies and crises) are large-scale events that may result in the breakdown of health care systems and society, forced displacement, death, and physical, psychological, social and spiritual suffering on a massive scale. Current responses to Human...itarian emergencies and crises rightfully focus on saving lives, but for both ethical and medical reasons, the prevention and relief of pain, as well as other physical and psychological symptoms, social and spiritual distress, also are imperative. Therefore, palliative care, should be integrated into responses to Humanitarian emergencies and crises. The principles of humanitarianism and impartiality require that all patients receive care and should never be abandoned for any reason, even if they are dying. Thus, there is significant overlap in the principles and mission of palliative care and humanitarianism: relief of suffering; respect for the dignity of all people; support for basic needs; and accompaniment during the most difficult of times
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People younger than 20 years comprise 35% of the global population and 40% of the global population of least-developed nations. The number of children - neonates, infants, children, and adolescents up to 19 years of age - who need pediatric palliative care (PPC) each year may be as high as 21 millio...n. Another study found that almost 2.5 million children die each year with serious health related suffering and that more than 98% of these children are in low- and middle-income countries (LMICs) (3). While estimates differ, there is no doubt that there is an enormous need for prevention and relief of suffering among children - for PPC.
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Lancet Public Health 2018 Published Online September 12, 2018 http://dx.doi.org/10.1016/ S2468-2667(18)30138-5
Singing to the Lions is a free training package (facilitator’s guide, supplement and video) by CRS, that is designed to help children and youth lessen the impact of violence and abuse in their lives. The main component is a three-day workshop where participants learn skills that can help them tran...sform their lives and no longer feel dominated by fear. Although the workshop is aimed at young people and includes games, art and songs, it can also be used to help adults take action on aspects of their lives that cause fear and, in so doing, become better parents and caregivers.
Singing to the Lions is available in English, French and Spanish, with Arabic and Hindi in process. See the links below. It can be easily adapted to different cultures, with different pictures and metaphors (e.g., “Singing to the Wolves” in Arabic; “Charming the Snakes” in Hindi.)
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Accessed Sept, 5 2018
Weekly epidemiological record, Relevé épidémiologique hebdomadaire : Vol.93 (2018) No.13
Healthy me, healthy us: a guide for community members about good health and staying healthy with chronic illness
Web annex 5: Oxytocin and ergometrine versus placebo or no treatment
Evidence to decision framework
This is an abridged version of the 2019 Standards containing the evidence-based recommendations most pertinent to primary care. The tables and figures have been renum-bered from the original document to match this version. The complete 2019 Standards of Care do...cument, including all supporting references, is available at professional.diabetes.org/standards.
This is an abridged version of the American Diabetes Association’s Standards of Medical Care in Diabetes—2019. Diabetes Care2018;42(Suppl. 1):S1–S194. The complete 2019 Standards supplement, including all supporting references, is available at professional.diabetes.org/standards.
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No Public Health without Refugee and Migrant health.
This report, the first of its kind, creates an evidence base with the aim of catalysing progress towards developing and promoting migrant-sensitive health systems in the 53 Member States of the WHO European Region and beyond. This report seeks to... illuminate the causes, conse-quences and responses to the health needs and challenges faced by refugees and migrants in the Region, while also providing a snapshot of the progress being made across the Region. Additionally, the report seeks to identify gaps that require further action through collaboration, to improve the collection and availability of high-quality data and to stimulate policy initiatives
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The scale of international migration in the WHO European Region has increased substantially in the last decade. The dynamics of large-scale migration pose specific challenges and opportunities to health systems, and responses will differ from country to country. Strengthening health system responses... is one of the priority areas in the 2016 Strategy and action plan for refugee and migrant health in the WHO European Region. Its agreed actions include the identification and mapping of practices for developing and delivering health services that respond to the needs of refugees, asylum seekers and migrants. This compendium aims to collect and present some of these practices in the form of case studies. Selected in 2016, the case studies reflect experience from different levels of administration in a variety of European countries, and during the different phases of the migration journey.
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Technical guidance.
This technical guidance aims to inform policy and practice development specifically related to improving the health of older refugees and migrants within the European Union and the larger WHO European Region. Both ageing and migration are in themselves complex multidimensional p...rocesses shaped by a range of factors at the micro, meso and macro levels over the life-course of the individual, but also with intertwined trajectories. Relevant areas for policy-making include healthy ageing over the life-course, supportive environments, people-centred health and long-term care services, and strengthening the evidence base and research
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The CB MHPSS operational guidelines were developed in response to emerging evidence on the determinants of children’s resilience, lessons learned from the evaluation of existing approaches, and the unique challenges that today’s crises pose for children’s safety, wellbeing and optimal developm...ent.
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This paper was commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ) in 2015, and produced by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, in cooperation with German civil society actors and freelance psychologists working in the field... of Mental Health and Psychosocial Support (MHPSS) with refugees and internally displaced people (IDP) in both the Middle Eastern region and Germany. The commission arose from BMZ’s wish for guidance on the characteristics of good working practices in MHPSS and the desire expressed by GIZ’s civil society partners in the regional programme Psychosocial Support for Syrian and Iraqi Refugees and Internally Displaced People for more intensive dialogue to promote MHPSS in the context of the Syria and Iraq crises.
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Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ...ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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