This policy brief aims to provide a review of the current progress on implementing the Malawi national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing a...ctions to combat antimicrobial resistance in Malawi.
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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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Bulletin of the World Health Organization Volume 91, Number 4, April 2013, 237-312
While “sustainability” has become a central aspect of social action and responsibility around the world, its complex and multi-di-
mensional nature requires further explanation.
A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within n...ational quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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Physical and social distancing measures are associated with limiting contact between people during disease outbreaks. These measures when applied are often enhanced by lockdowns or shutdowns as part of broader risk communication and community engagement strategies to halt the transmission of disease... outbreaks.
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The African Centers for Disease Control and Prevention and the African Union together have called for a New Public Health Order which will safeguard the health and economic security of the continent as it strives to meet the aspirations of the Agenda 2063. A key pillar of this mandate seeks to expan...d the local manufacture of vaccines, diagnostics, and therapeutics. Presently, less than one percent of vaccines administered on the continent are manufactured locally. This places a great burden on the health systems of African countries and reduces their ability to respond to pandemics and other health crises.
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A Reference Guide for Program Managers and Policy Makers. Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them a...s effective as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale
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The purpose of this strategy is to guide the planning, management and development of human resources for health in Rwanda for the period 2011 - 2016. The overall aim of the plan is to increase the number of appropriately skilled, motivated and equitably distributed health service providers for Rwand...a.
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Post-traumatic stress disorder (PTSD) and anxiety are both prevalent in trauma-related populations. However, comorbidity of these 2 psychiatric disorders has not been investigated in flood survivors. This study aimed to estimate the extent to which PTSD and anxiety co-occur in flood survivors, and i...dentify shared risk factors for PTSD only and comorbidity of PTSD and anxiety. Individuals who experienced Dongting Lake flood in 1998 were enrolled in this study using stratified and systematic random sampling method. Information on social support, personality traits, PTSD, and anxiety was collected using self-report questionnaires. The intensity of exposure to the flood was measured by some questions. Logistic regression analyses were used to identify factors associated with PTSD only and comorbidity of PTSD and anxiety
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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