Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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The CHW Toolkit assists the assessment, improvement, and planning of CHW programs by deepening understanding of the elements of successful programs and the use of best practices as an evidence-based approach to improvement. The toolkit is framed around ten key themes that describe the definition, en...try level, age, gender, recruitment, training, scope of work, supervision, career progression, entry level and remuneration of CHWs.
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there... is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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Des gouvernements, des ONG et les Nations Unies déclarent qu’il faut soutenir le leadership des communautés pour vaincre les pandémies CHIANG MAI, THAÏLANDE, le 15 décembre 2022—Les ripostes dirigées par les communautés sont un élément essentiel de la riposte à la pandémie de sida et ...les ressources doivent leur être accordées en priorité. Les représentants et représentantes ont déclaré que cette démarche, définie par des gouvernements, des organisations de la société civile et des organismes des Nations Unies lors d’une rencontre internationale sur le sida organisée à Chiang Mai en Thaïlande, sera également essentielle pour lutter contre d’autres pandémies et pour s’y préparer. Au cours de cette rencontre, la première définition internationale d’une riposte communautaire à une pandémie a été publiée. Elle est le fruit d’un processus de consultation de deux ans qui a réuni 11 gouvernements, représentant chaque région du monde, et 11 figures de la société civile. Cette équipe multipartite de l’ONUSIDA a travaillé sur les ripostes dirigées par les communautés. L’ONUSIDA, ainsi que l’Organisation mondiale de la Santé et le Programme des Nations Unies pour le développement l’ont organisée ensemble et les résultats ont été présentés lors de la 51e réunion du Conseil de coordination du Programme commun des Nations Unies sur le VIH/sida.
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This research is one case in a study commissioned by the World Food Programme to investigate the participation of recipient community in the targeting and management of humanitarian food assistance in complex emergencies. The study involved a substantial desk review of existing documentation, and th...ree weeks of field work in February and March 2008. The purpose of the study was to understand the ways in which participatory or community-based approaches to targeting have been attempted, within the definition of community-based targeting suggested by WFP. The study was not an evaluation of targeting methods, although some critical examination of targeting was necessary in order to understand the constraints on community participation.
Related resources
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Background: Timely reliable data on aid flows to maternal, newborn, and child health are essential for assessing the adequacy of current levels of funding, and to promote accountability among donors for attainment of the Millennium Development Goals (MDGs) for child and maternal health. We provide g...lobal estimates of official development assistance (ODA) to maternal, newborn, and child health in 2003 and 2004, drawing on data reported by high-income donor countries and aid agencies to the Organisation for Economic Development and Cooperation.
Methods: ODA was tracked on a project-by-project basis to 150 developing countries. We applied a standard definition of maternal, newborn, and child health across donors, and included not only funds specific to these areas, but also integrated health funds and disease-specific funds allocated on a proportional distribution basis, using appropriate factors.
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Sous ce rapport, le DPPD santé 2014 – 2016, premier du genre, va poursuivre les objectifs suivants : (i) Réduire le fardeau de la morbidité et de la mortalité maternelles et infanto juvéniles ; (ii) Accroître les performances du secteur en matière de prévention et de lutte contre la malad...ie ; (iii) Renforcer durablement le système de santé ; (iv) Améliorer la gouvernance du secteur de la santé et (v) Améliorer les conditions socio-économiques des groupes vulnérables. Après avoir décliné la place du secteur dans l’économie nationale, l’articulation des stratégies sectorielles avec les politiques nationales et la mission du secteur, le document se présente comme suit : le premier chapitre dresse les orientations stratégiques du secteur avec un diagnostic, les résultats de développement du secteur et une définition des Objectifs stratégiques. Au deuxième chapitre la programmation opérationnelle à moyen terme sera définie avec une présentation des Programmes et la budgétisation à moyen terme. Enfin, le troisième chapitre évoquera le dispositif de suivi-évaluation du DPPD.
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The United Nations (UN) adopted a new international legal instrument in November 2000, the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children, supplementing the UN Convention against Transnational Organized Crime. This contained a new definition of traf...ficking in persons and more particularly defined what was to be understood by child trafficking. The issue of human trafficking in general, and trafficking in children in particular, was highly relevant during the subsequent decade and anti-trafficking projects and initiatives attracted a great deal of funding. However, by the end of the decade, when funding declined, it was still not clear how much had been achieved.
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Notre étude porte sur les agents de santé et la perception de leur rôle, précisément le cas des infirmiers du centre hospitalier universitaire pédiatrique Charles De Gaulle. Au Burkina Faso, tout comme ailleurs dans le monde, les infirmiers dispensent près de 80% des services de santé. Cepen...dant, dans la pratique leur pouvoir de responsabilité et leur autorité sont très
limités, de même qu’il existe un écart entre rôle défini et celui accompli. Ainsi on y dénote de l’ambiguïté, liée au manque de clarté des missions de son service et de précision dans leur rôle, faisant qu’ils en sont parfois désabusés. Ce qui révèle aussi que le problème pour les diverses catégories de personnel infirmier soit beaucoup lié au manque de définition précise
des rôles, et à la sous-utilisation de leurs compétences.
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Un kit de communication et sensibilisation
A la demande du gouvernement togolais, nous avons produit un Kit de communication sur les maladies infectieuses et Ebola, appuyé sur les résultats d'une enquête anthropologique qui a identifié les représentations de la population sur la maladie et s...a perception des messages de communication.
Les outils du kit sont présentés et téléchargeables ci-dessous, mais nous vous fournirons sur demande des fichiers haute définition pour impression et pour diffusion des vidéos
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Cholera is an acute diarrhoeal infection caused by ingestion of contaminated water or food. This course provides a general introduction to cholera and is intended for personnel responding to outbreaks in complex emergencies or in settings where the basic environmental infrastructures have been damag...ed or destroyed. It includes materials that can be accessed in English, Arabic and Hausa.
Free Online Course. Learning objectives: By the end of this course, participants should be able to: describe the case definition and alerts for cholera; describe main transmission routes; list list the key preventive actions; and explain how cholera control is multisectoral.
Course duration: Approximately 1 hour.
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This content provides concise, pragmatic guidance to front-line healthcare workers. The guidance is written by PCI’s Clinical Associates, who are themselves primary healthcare workers. It draws on up-to-date guidance from key sources including the WHO, UNHCR and PCI’s own sister organisation R...ed Whale (a leading provider of medical education in the UK). The modules include: A guide to public health measures; The definition of a case of COVID-19 virus, Preparing the primary health care centre; Prevent the spread of COVID-19; Triage and management in primary care; Managing patients with NCDs; Mental health -patients and healthcare workers; and Case studies.
How to access the course:
Go to the ‘PCI Academy’ website homepage https://covid19.pci-academy.org/
Register for an account, Go to the ‘COVID-19’ course
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The ethical values and behaviors are not only abstract terms, but they are refined and conceptualized byreal-life experiences. The societal context where the actions of humans can be analyzed by ethicaldecision-making is entirely relevant to deliberate on what is the right thing to do and what the m...oralagent should do, since the ethical values and principles response to the actual practices of life and to theneeds of humans in the society. This elaboration takes us to the realm of social ethics.This article reviews the definition and contextual meaning of social ethics at a broader level by givingspecial emphasis to the ethical theories and principles, focusing on the societal and public setting. Ethicswill be deliberated with social and community aspects. Based on the principle of justice and public healthethics, the concept of social ethics has been investigated concisely through the relationship between man,as a moral person, and the society in exemplification of the issues of healthcare ethics. It is argued that thetension between individualism and communitarian needs can be reconciled with the perspective of socialethics by respecting the individual autonomy without disregarding the common good and social justice.By promoting the values of social responsibility, solidarity, and social utility, social ethics has beenproposed as the basis of a rational, moral, egalitarian, pluralistic, democratic society rising on the pillars ofhuman rights and human dignity.
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Orientations provisoires
26 mars 2020
Plusieurs pays ont montré qu’il était possible de ralentir voire de stopper la transmission interpersonnelle de la COVID-19. Les principales mesures pour arrêter la transmission sont le dépistage actif des cas, les soins et l’isolement, la recherche... des contacts et la quarantaine. L’OMS a publié des recommandations pour la surveillance mondiale de la COVID-19, qui donnent la définition des cas et des contacts pour la déclaration à l’OMS. En plus de la recherche active des cas et du dépistage, il est essentiel d’intensifier les activités de surveillance pour déterminer si la COVID-19 se transmet au sein de la communauté et pour suivre l’évolution de la transmission communautaire.
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Die Würde des Menschen ist unantastbar – wird dieses Gebot auch bei der gesundheitlichen Versorgung von Geflüchteten eingehalten? Die gesundheitliche Versorgung von Asylsuchenden in Deutschland ist geregelt durch das bundesdeutsche Asylbewerberleistungsgesetz (AsylbLG). Die Bundesregierung sieht... allein die Länder in der Verantwortung für die Umsetzung des AsylbLG. Dabei kommt sie bei der Frage der Gesundheitsversorgung von Asylsuchenden jedoch ihren eigenen Hausaufgaben nicht nach: Seit 2015 ist in Deutschland zwingend die EU-Aufnahmerichtlinie von 2013 umzusetzen. Jedoch sind im AsylbLG weder die Leistungsansprüche besonders schutzbedürftiger Asylsuchender nach Definition der EU-Aufnahmerichtlinie geregelt, noch gibt es Hinweise zum Umgang mit erkrankten besonders schutzbedürftigen Asylsuchenden, die leistungsrechtlichen Sanktionen unterliegen. Das Policy Paper gibt einen Überblick über die rechtlichen Rahmenbedingungen auf nationaler und supranationaler Ebene und leitet unter Einbeziehung von wissenschaftlichen Forschungsbefunden Handlungsempfehlungen ab.
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Цей ознайомлювальний курс надає загальний огляд холери, включаючи принципи профілактики та боротьби з нею. Крім того, учасники курсу дізнаються про Глобальну робо...чу групу з боротьби з холерою (GTFCC) та стратегію «Ліквідувати холеру – глобальна дорожня карта до 2030 року». Цільовою аудиторією цього курсу є персонал, відповідальний за профілактику та боротьбу з холерою, зокрема тих, хто бере участь у реагуванні на спалах холери.
Free Online Course. Learning objectives: By the end of this course, participants should be able to: describe the case definition and alerts for cholera; describe main transmission routes; list list the key preventive actions; and explain how cholera control is multisectoral.
Course duration: Approximately 1 hour.
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En esta publicación se presenta un método integral para brindar apoyo a los Estados Miembros de la Organización Panamericana de la Salud (OPS) en la preparación para la respuesta a los riesgos para la salud relacionados con el calor en la Región de las Américas. Se basa en los documentos de al...cance mundial de la Organización Mundial de la Salud y la Organización Meteorológica Mundial, así como en los métodos de preparación para hacer frente a desastres aplicados en todos los países de la Región. La presente publicación forma parte de un esfuerzo coordinado por la OPS para ayudar a los Estados Miembros a prepararse para hacer frente a múltiples amenazas e incluye el fortalecimiento de los sistemas de alerta temprana; la caracterización de la amenaza; la definición de los procedimientos de activación y desactivación, y la coordinación institucional. Abarca diferentes disciplinas y reconoce la importancia de la colaboración intersectorial para responder a los riesgos para la salud relacionados con el calor. Procura sensibilizar a las autoridades de salud pública acerca de los efectos del calor sobre la salud de la población de la Región de las Américas y de esa manera fortalecer la prestación de los servicios de salud.
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El Plan Estratégico Colombia Hacia el Fin de la Tuberculosis, 2016 –2025 es un instrumento para la gestión de los programas en los nivelesnacional y local en su objetivo de respondera los compromisos adquiridos por los países, para adoptarla Estrategia Mundial Fin de la Tuberculosi...s. La Estrategia se suma a los Objetivos de Desarrollo Sostenible (ODS),una de cuyas metas es el fin de las epidemias de malaria, VIH y tuberculosis para el 2030 (ODS 3). El Plan establece las metas a alcanzar por el Programa Nacional de Tuberculosis en el periodo 2016-2025, los objetivos y actividades para lograrlo y la forma para determinar que se ha logrado. El Plan permite guiar la toma de decisiones sobre la asignación de recursos, el establecimiento de prioridades y la definición de acciones. Para su elaboración se tomó como base la Estrategia Mundial Fin de la Tuberculosis,de la OMS y los componentes y procesos propuestos por la Guía Metodológica para la Construcción de Planes Estratégicos de la OMS.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to ...prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds. The writing committee found strong evidence that silent cerebrovascular disease is a common problem of aging and that silent brain infarcts and white matter hyperintensities are associated with future symptomatic stroke risk independently of other vascular risk factors. In patients with cerebral microbleeds, there was evidence of a modestly increased risk of symptomatic intracranial hemorrhage in patients treated with thrombolysis for acute ischemic stroke but little prospective evidence on the risk of symptomatic hemorrhage in patients on anticoagulation. There were no randomized controlled trials targeted specifically to participants with silent cerebrovascular disease to prevent stroke. Primary stroke prevention is indicated in patients with silent brain infarcts, white matter hyperintensities, or microbleeds. Adoption of standard terms and definitions for silent cerebrovascular disease, as provided by prior American Heart Association/American Stroke Association statements and by a consensus group, may facilitate diagnosis and communication of findings from radiologists to clinicians.
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