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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Preferred product characteristics” (PPCs) are key tools to incentivize and guide the development of urgently needed health products. The PPC published here describes the characteristics of new types of insecticide-treated nets (ITNs) to control malaria transmission in areas with insecticide-resist...ant mosquito populations. The document was developed to address the public health need caused by the evolution and spread of insecticide resistance, particularly to pyrethroids. Such resistance threatens the effectiveness of the current standard of malaria vector control in many countries, namely pyrethroid-only long-lasting insecticidal nets (LLINs).
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The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Repub...lic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014–2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly cost-effective and improves effectiveness of core pu...blic health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
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This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to ...air pollution.
Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines (see the full report, Air pollution and child health: prescribing clean air. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under the age of 5 years in 2016.
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It is too early to know the full impact of COVID-19 on Africa. To date the experience has been varied. There are causes for concern, but also reasons for hope. Early estimates were pessimistic regarding the pandemic’s impact on the continent. But the relatively low numbers of COVID-19 cases report...ed thus far have raised hopes that African countries may be spared the worst of the pandemic. While the virus is present in all African countries, most countries have recorded fewer than 1,000 cases. The African Union acted swiftly, endorsing a joint continental strategy in February, and complementing efforts by Member States and Regional Economic Communities by providing a public health platform.
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The purpose of this book is to provide an overview of Buruli ulcer (Mycobacterium ulcerans infection) for the medical and scientific communities and the general public alike.
The report presents the latest data on more than 50 health-related Sustainable Development Goal and "triple billion" target indicators. The 2021 edition includes preliminary estimates for global excess deaths attributable to COVID-19 for 2020 and the state of global and regional health trends from 2...000-2019. It also focuses on persistent health inequalities and data gaps that have been accentuated by the pandemic, with a call to urgently invest in health information systems to ensure the world is better prepared with better data.
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Across the Western Pacific Region COVID-19 is placing enormous strain on health and economic systems apart from direct threats to personal health safety and livelihood the pandemic also has significant implications on mental health and psychosocial well being adversity is an established risk factor ...for mental health problems thus the impact of COVID-19 on mental health is expected to be large diverse and far reaching mental health and psychosocial support mhpss are essential components of a public health response to COVID-19 this guidance note provides 10 activities that may be integrated in national COVID-19 response and mitigation plans
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This document provides additional guidance for the responsible and prudent use of antimicrobials in food-producing animals, and should be read in conjunction with the Recommended International Code of Practice for Control of the Use of Veterinary Drugs CAC/RCP 38-1993. Its objectives are to minimize... the potential adverse impact on public health resulting from the use of antimicrobial agents in food-producing animals, in particular the development of antimicrobial resistance.
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Accessed on 03.03.2020
Cet article documente le processus de mise en œuvre du Traitement préventif intermittent TPI), une stratégie de prévention du paludisme dont l’administration est couplée au Programme élargi de vaccination (PEV) dans les services de santé, les réactions des prestat...aires, des populations et leurs facteurs explicatifs. Les résultats montrent que l’absence de connaissances adéquates à propos du TPI n’a pas empêché son appropriation par les communautés, dans la mesure où les perceptions lui accordent une valeur pratique et l’intègrent dans les besoins ressentis. C’est pourquoi les enfants ont reçu, dans la grande majorité, les médicaments administrés. Certains comportements en décalage s’expliquent plus par des contraintes, des insuffisances du système de santé et de vaccination que par un refus. Chez les prestataires de soins, l’information a été plus disponible du côté les infirmiers étatiques. Cependant, les processus de détournement et les attitudes d’indifférence étaient plus visibles chez ces derniers.
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The toolkit provides practical guidance and tools that can support efforts, including planning and implementation activities, to create dementia-inclusive societies.
The toolkit is divided into two parts. Part I contains background information and a conceptual framework for creating dementia-incl...usive societies. Part II includes four practical modules, each featuring a series of practical steps and exercises. The four modules focus on: starting a new dementia-friendly initiative (DFI), integrating dementia into an existing initiative, monitoring and evaluation a DFI, and scaling a DFI. The modules can be used together or separately and offer guidance that can be adapted to suit local needs and settings.
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charities such as nongovernmental organizations (NGOs), armies, and international organizations such as the ...International Red Cross/Red Crescent movement. They comply with the classification and minimum standards set by the World Health Organization (WHO) and its partners and bring to an emergency their training and self-sufficiency so as not to burden the national health system. EMT initiatives strengthen national surge capacities and facilitate the deployment of internationally classified teams of health- care professionals to countries and territories during emergencies, particularly during disease outbreaks and natural disasters, providing immediate assistance when national health systems are overwhelmed . Considering that they aim to support the provision of quality clinical care services to populations affected by public health emergencies, the expectation is that financial resources and equipment will be available to enable the performance of the requested task.
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not improve outcomes, if funds are delivered in ways that undermine countries’ public financial managemen...t systems and incur high transaction costs for project implementation
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The primary audience for the guideline is policy makers and health programme managers of MNCH and immunization programmes in ministries of health where decisions are made and policies created on the use and implementation of homebased records.
The guideline is also aimed at health providers who use... home-based records as a tool for recording information and providing health education or communicating key information. Development and international agencies and non-governmental organizations that support the implementation of home-based records will also find this guideline of use.
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Climate changes lead to disasters and all of us must be prepared to support others as well as ourselves during such difficult times. Extreme weather events such as floods, wildfires, storms, or heat waves are stressful and the advice offered in the new one-pager reminds the general public of what th...ey can do to support their families, friends, neighbors, and community.
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Módulo 4
Líderes
Julio del 2017
Módulo 4: Líderes. Este módulo tiene por objeto informar y actualizar a los líderes y a los encargados de tomar decisiones sobre la PrEP. Proporciona información sobre los beneficios y las limitaciones de la PrEP para que puedan considerar cómo pueden a...plicar la PrEP de manera más efectiva en sus propios entornos. También presenta una serie de preguntas frecuentes acerca de la PrEP y las respuestas correspondientes.
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J Bras Pneumol. 2022;48(2):e20220082
The spread of Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV-2) continues to progress, causing damage in several countries of the world due to its rapid transmissibility and significant mortality rates, despite government measures to contain its tra...nsmission, such as movement control, the closing of schools, bans on travel and public gatherings, the mandatory use
of masks, and hand hygiene. The coronavirus disease (COVID-19) has clinical manifestations that are similar to those found in other infections also transmitted through the airways, such as pulmonary tuberculosis (TB) Although TB is a global health problem, it is a curable disease, with affordable treatment and prevention. Nonetheless, it remains one of the leading
causes of death from a single infectious agent worldwide, a situation threatened by COVID-19.
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