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1
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
...
terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
...
echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
more
A healthcare worker manual. 2nd edition
The development of this National Manual for the Management of HIV-related Opportunistic Infections and Conditions for use by health care workers at the frontline of our fight against HIV/AIDS is intended to improve their understanding of the causes, preventio
...
n and appropriate management of opportunistic infections and conditions in adults and adolescents (OIs in children is covered effectively in the Integrated Management of Childhood Illnesses – IMCI – materials). It is also intended to be a practical guide at the clinic level, so as to improve quality of life, treatment outcomes and survival of PLHA. Crucially, this manual uses a “symptom-based” approach to support health care workers at the most basic primary level to be able to effectively initiate the care of PLHA with OIs and refer patients as appropriate (effective triage of patients at the primary care level). The result of this will be to move the management of OIs closer to the patient while ensuring that referral links with higher-level facilities and care is cultivated.
more
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe & neighbouring countries
C. Folch; P. Fernández-Dávila; J. Palacio-Vieira; et al.
European Commission; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT); European AIDS Treatment Group
(2020)
C2
Accessed: 07.03.2020
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe and neighbouring countries (D5.1)
Contract 2015 71 01 A behavioural survey for HIV/AIDS and assoc
...
iated infections and a survey and tailored training for community based health workers to facilitate access and improve the quality of prevention, diagnosis of HIV/AIDS, STI and viral hepatitis and health care services for men who have sex with men (MSM).
Pubic Health
more
As part of our commitment to the fight against NCDs, Nigeria was signatory to the political declaration at the UN General Assembly High Level Meeting on NCDs in September 2011. Thus, the purpose of this document is to develop and ensure the implementation of policies and p
...
rogrammes that will engender and guarantee a healthy lifestyle and quality health for all Nigerians. The core sections include background, scope of the policy, policy goal, strategic thrusts for implementation, programme management and coordination, roles of stakeholders and partnership coordination. It is expected that with the adoption of this policy, the control and prevention of NCDs and their associated risk factors will be well integrated at all levels of government and health care delivery system in Nigeria. This policy document is therefore a stepping stone towards the development of guidelines for the prevention and management of NCDs.
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Priority medical devices list for the COVID-19 response and associated technical specifications
recommended
23 February 2021
This document describes the medical devices required for the clinical management of COVID-19, selected and prioritized according to the latest available evidence and interim guidelines. This includes: oxygen therapy, pulse oximeters, patient monitors, thermometers, infusion and suc
...
tion pumps, X-ray, ultrasound and CT scanners as well as personal protective equipment. In order to facilitate access to quality assured priority medical devices, the document also includes technical and performance characteristics, related standards, accessories and consumables. It is intended for policy-makers and planning officers in Ministries of Health, procurement and regulatory agencies, intergovernmental and international agencies as well as the medical device industry.
This document is an update to the List of priority medical devices for COVID-19 case management and Technical specifications for invasive and non-invasive ventilators for COVID-19.
This document complements the Technical specifications of personal protective equipment for COVID-19.
more
The key areas covered are diagnosis, imaging, pathology, surgery, rehabilitation, palliative care and survivorship. It emphasizes a multi-disciplinary team approach which is paramount for quality cancer care. The specific cancers co
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vered are breast, central nervous system, gastrointestinal, gynecological, head and neck, hematological, Kaposi’s sarcoma, lung, prostate and pediatric cancers. They also complement the National Guidelines for Cancer Management in Kenya released in 2013.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u
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se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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The manual has been designed in a comprehensive manner, the aim being to provide a holistic approach to the short-term development of human resources, with a focus on primary care physicians. This is a reference manual meant for primary care physicians who will provide care to older people in primar
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y health care facilities. The information on old age care is meant to be incorporated into the everyday clinical practice of primary care physicians. This manual will help to enhance the knowledge and skills of physicians. It is expected that the use of the manual will improve the approach to issues of old age and promote holistic care of older people, which will ultimately improve their quality of life.
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
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y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasison healthy lifestyle and prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of prima
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ry care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing. Substitution of nurses for doctors is one strategy used to improve access, efficiency, and quality of care. This is the first update of the Cochrane review published in 2005.
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The Boston Medical Center Patient Navigation Toolkit
The Boston Medical Center AVON Foundation for Women
The Boston Medical Center AVON Foundation for Women
(2020)
C1
This toolkit is designed to help you plan and implement a Patient Navigation program with the best chance of reducing health disparities and improving health outcomes for your patients. It contains evidence-based and experience-based examples, case studies, practical tools, and resources to help you
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:
1. Establish an evidence-based patient navigation program tailored to reduce barriers for your patients
2. Incorporate best practices to enhance current patient navigation programs or services
3. Implement a patient navigation model to address any targeted medical condition
where disparities exist
4. Hire, prepare, supervise, support and retain effective Patient Navigators
5. Navigate patients who experience health disparities
6. Evaluate patient navigation programs with the aim of continuous quality
improvement
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This Global Competency Standards sets the benchmark for the health workforce in providing equality of care to refugees and migrants. Refugee and migrant populations are highly diverse, with significant variation in life experiences, health needs and access to health care. The standards described out
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line expected behaviours of health workers in delivering quality care to refugees and migrants and can be used to inform the outcomes of education programmes aligned with standards for care. The Competency Standards is designed to provide a foundation to support the development of competency-based curricula tailored to the local context and for health workers to achieve a minimum level of competence. The importance of person-centred, culturally responsive care is emphasized in the nine competency standards, which recognize the need for health workers to be trained, supported and empowered within strong health systems
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Regular physical activity is proven to help prevent and treat noncommunicable diseases (NCDs) such as heart disease, stroke, diabetes and breast and colon cancer. It also helps to prevent hypertension, overweight and obesity and can improve mental health,
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quality of life
and well-being.
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Int. J. Environ. Res. Public Health 2020, 17(23), 8849; https://doi.org/10.3390/ijerph17238849
The aim of building climate resilient and environmentally sustainable health care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable
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and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such health care facilities contribute to high quality of care and accessibility of services and, by helping reduce facility costs, also ensure better affordability. They are an important component of universal health coverage.
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The Department of Health (DOH) has developed a National Integrated Sexual and Reproductive Health and Rights (SRHR) Policy.1 This policy addresses the many cross-cutting issues relating to SRH service provision, drawing together the principles, rights, and guidance for planning and implementation th
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at underpin the provision of quality, comprehensive, and integrated SRHR services in South Africa. The National Integrated SRHR Policy is supported by several clinical and service delivery guidelines covering related programmatic
areas, including the National Contraception Clinical Guidelines.
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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe
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rent interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
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Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this condition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized
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as a disease by the American Medical Association and World Health Organization,
based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and
control of obesity would have a great impact in our society.
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More than 700 000 people lose their life to suicide every year. A core foundation of suicide prevention is the timely registration and regular monitoring of suicide and self-harm. Surveillance data can be used to show important progress towards reaching global targets, such as reducing the suicide r
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ate by one third by 2030 as articulated in the UN SDGs and in the WHO Mental Health Action Plan 2013-2030. However, there are considerable discrepancies in the quality of data on suicide and self-harm globally. The aim of this training manual is to equip fieldworkers and supervisors with the skills to collect and manage data on suicide and self-harm in the community via key informants, health-care facilities and police records. In doing so, the value and overall goal is to strengthen the surveillance of suicide and self-harm in communities, particularly in LMICs and hard-to-reach communities where CRVS systems are weak or absent.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report
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ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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