This second edition of the “living paper” contributes to the global knowledge on how countries are responding to the pandemic by documenting real-time actions in a key area of response – that is, social protection measures planned or implemented by governments.
For the purpose of this revie...w, we organized interventions by social assistance, social insurance and labor market programs. For the latter measures, we deliberately focused on supply-side programs (e.g., mostly wage subsidies and other activation programs). In most cases, data sources include official information published in government websites, while in many cases we reported information from global and national news outlets. In some cases, information was provided directly by country-based experts, while the full database was validated and integrated by regional and country social protection teams at the World Bank. Overall, findings should be considered preliminary and interpreted with caution.
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These are integrated National Guidelines 2013 for Prevention and Management of HIV, STIs & Other Blood Borne Infections in accordance with the last guidelines of the World Health Organization (WHO) published in June 2013 and adapted to the Rwandan national context. It thus responds to the need by th...e Ministry of Health to improve skills of actors in the health sector as well as the quality of care and treatment offered in both public and private health facilities countrywide.
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Technical and operational ‘how-to’: practical considerations
Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia...ry education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
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A Guide for Low Resource Situations
Developed in collaboration with the International Council of AIDS Service Organizations (ICASO)
The Infant and young child feeding counselling: an integrated course includes this Director’s guide, a Trainer’s guide and Participant’s manual. Additional tools include: Course handouts; Guidelines for follow-up after training; Supportive supervision/mentoring and monitoring and an accompanyi...ng toolkit; a slide set for the trainer; a set of 24 Counselling cards and Guidance on the use of counselling cards. The course includes 79 sessions arranged within 8 modules, covering a range of topics, including breastfeeding, complementary feeding, growth assessment and monitoring, HIV and infant feeding, and infant and young child feeding counselling. Course facilitators can decide which sessions to cover, depending on the specific learning needs of the health workers in your community.
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