Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the...y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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This comprehensive book has established itself as the most useful text for the medical practitioner in poor-resource settings who is obliged to manage surgical cases. It is particularly adapted for those whose surgical experience is basic or minimal. Importantly, it has extensive advice about pitfal...ls to avoid, and what to do if things go wrong. It is written in simple style, particularly for those whose mother tongue is not English. It is not a text which discusses the latest up-to-date technology, but it is not out-of-date being a synthesis of the best advice from a myriad of surgeons practicing for many years in low- and middle-income countries.
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Environment International Volume 146, January 2021, 106245.
We use soils to provide 98.8% of our food, but we must ensure that the pressure we place on soils to provide this food in the short-term does not inadvertently push the Earth into a less hospitable state in the long-term. Using the planeta...ry boundaries framework, we show that soils are a master variable for regulating critical Earth-system processes. Indeed, of the seven Earth-systems that have been quantified, soils play a critical and substantial role in changing the Earth-systems in at least two, either directly or indirectly, as well as smaller contributions for a further three.
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The social impacts of Covid-19 in Brazil: vulnerable populations and responses to the pandemic
Passados os primeiros meses da pandemia do novo coronavírus no Brasil, o Observatório Covid-19 Fiocruz, em parceria com a Editora Fiocruz e com o apoio da Rede SciELO Livros, traz para o público leitor... um conjunto de livros instantâneos sobre as análises nele realizadas desde que foi criado para subsidiar o seu combate. Nesta série Informação para Ação na Covid-19 será apresentado um balanço do conjunto de documentos (notas e relatórios técnicos, boletins, ensaios, informes, recomendações, ensaios, artigos, entre outros) produzidos em resposta à pandemia. Cada volume da série se estrutura em torno de um tema: aspectos globais da pandemia e da diplomacia em saúde; cenários epidemiológicos e vigilância em saúde; as políticas e a gestão dos serviços e sistemas de saúde; orientações para os cuidados e a saúde dos trabalhadores da saúde; impactos sociais e desigualdades sociais na pandemia. Com a publicação destes estudos em livros instantâneos e de acesso aberto colocamos à disposição do público o conjunto de informações e conhecimentos gerados no âmbito do Observatório Covid-19 Fiocruz, realizamos um balanço e uma reflexão sobre como chegamos ao cenário atual e apontamos caminhos para um futuro próximo. E, ao mesmo tempo, mantemos o registro histórico desse conhecimento produzido a quente, no calor da hora.
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BMJ Open 2021;11:e042279. doi:10.1136/bmjopen-2020-042279. Neglected tropical diseases tend to cluster in the same poor populations, and to make progress with their control, they will have to be dealt with in an integrated manner. Peptide microarrays may be a solution to tese problems, where diagnos...is for co-infection can be detected simultaneously using the one tool.
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This codebook outlines the set of TUFF procedures that have been developed, tested, refined, and implemented by AidData staff and affiliated faculty at the College of William & Mary. We initially employed these methods to achieve a specific objective: documenting the known universe of officially fin...anced Chinese projects in Africa (Strange et al. 2013, 2017). We have since then employed these methods to track Chinese official finance to five major world regions: Africa, the Middle East, Asia and the Pacific, Latin America and the Caribbean, and Central and Eastern Europe (Dreher et al. 2017). Additionally, other social scientists have adapted and applied the TUFF methodology to identify grants and loans from Gulf Cooperation Council (GCC) members (Minor et al. 2014), under-reported humanitarian assistance flows from traditional and non-traditional sources (Ghose 2017), foreign direct investment from Western and non-Western sources (Bunte et al. 2017), and pre-2000 foreign aid flows from China (Morgan and Zheng 2017). However, this codebook focuses specifically on TUFF data collection and quality assurance procedures to track Chinese official finance between 2000 and 2014.
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People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. Th...is case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.
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published online April 13, 2016, DOI: 10.1056/NEJMsr1604338. Please download directly from the webpage: http://www.nejm.org/doi/pdf/10.1056/NEJMsr1604338
Review article published online March 30, 2016, DOI: 10.1056/NEJMra1602113. Please download directly from the webpage: http://www.nejm.org/doi/pdf/10.1056/NEJMra1602113
Accessed on 31.01.2020
Suivant les recommandations de la Stratégie Stop TB le Sénégal s’inscrit dans une optique de renforcement de la prise en charge de la tuberculose dans ce groupe vulnérable. Pour ce faire, la mise en place de documents standardisés et consensuels de référence, adap...tés au contexte sénégalais est indispensable. Ce guide s’adresse à tous les prestataires de soins impliqués dans la prise en charge des enfants. Il peut être utilisé aussi bien au niveau opérationnel qu’au niveau des hôpitaux.
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Dans cette perspective, nous espérons que notre expérience pratique dans ces domaines constituera un apport aux prochaines éditions de ce guide. Et si le renforcement des systèmes de santé peut ne pas être une science exacte et que l’approche universelle n’existe pas, cette publication dé...montre que la quantité de connaissances empiriques et les bonnes pratiques peuvent grandement contribuer à accélérer et à affiner les initiatives nationales du mieux possible afin d’adapter les besoins, les compétences et les circonstances.
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This website provides information and help for refugees whose well-being has suffered. Physical and mental problems can be frightening. Especially when you don’t know what these symptoms mean, what caused them and what can be done to stop them. It may help to read the information on the REFUGEEUM ...website and to talk about it with other people.
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Comment The Lancet Volume 397, ISSUE 10269, P72-74, January 09, 2021
Published:December 08, 2020DOI:https://doi.org/10.1016/S0140-6736(20)32623-4
Congenital transmission of Chagas disease has not been extensively studied in Colombia, and there are no standardized processes in the health system regarding
the specific diagnosis, treatment and follow-up of this disease. To generate recommendations on congenital Chagas disease and Chagas in wom...en of childbearing
age in Colombia, a consensus of experts was developed. An extensive literature search through the Medline database was carried out using the MeSH terms:
«Chagas disease/congenital», «prevention and control», «diagnosis», «therapeutics» and «pregnancy». Appropriate abstracts were selected and the full texts were
analyzed. The relevant information was synthesized, classified, and organized into tables and figures and was presented to a panel of experts, which was composed
of 30 professionals from various fields. Based on the Delphi methodology, three rounds of consultation were conducted. The first and second rounds were based
on electronic questionnaires that measured the level of consensus of each question among the participants. The third round was based on a face-to-face discussion focusing on those questions without consensus in the previous consultations. The evidence was adapted to national circumstances on a case-by-case basis,
and the content the final document was approved. These recommendations are proposed for use in routine medical practice by health professionals in Colombia.
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Health security funding is intended to improve capacities for preventing, detecting, and responding to public health emergencies. Recent years have witnessed substantial increases in the amounts of donor financial assistance to health security from countries, philanthropies, and other development pa...rtners. To date, no work has examined the effects of assistance on health security capacity development over time. This paper presents an analysis of the time-lagged effects of assistance for health security (AHS) on levels of capacity.
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A 2013 Plan study across 30 countries found that children with disabilities were on average 10 times less likely to go to school than children without disabilities. This report presents the findings of a follow-up second phase to the research with a qualitative study on barriers and enablers to educ...ation for children with disabilities in Nepal.
The Full Report and Executive Summary Reports in English, French and Spanish are now available for download at:
http://disabilitycentre.lshtm.ac.uk/include-us-education-study-available-now/
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A printable copy of the article published in Morbidity and Mortality Weekly Report (MMWR) can be found on the CDC Homepage. Follow the Download Link for redirection to CDC.
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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J Epidemiol Community Health 2011;65:1166e1170. doi:10.1136/jech.2009.097469