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Publication Years
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Toolboxes
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1
The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach for monitoring and evaluation of the global action
...
plan on AMR. This report analyses the results of the second tripartite self-assessment survey
more
This booklet provides an overview of all findings from the Global Burden of Disease 2017 study. Published in The Lancet in November 2018, GBD 2017 provides for the first time an independent estimation of population, for each of 195 countries and ter
...
ritories and the globe, using a standardized, replicable approach, as well as a comprehensive update on fertility. Produced with the input of 3,676 collaborators from 146 countries and territories, GBD 2017 incorporates major data additions and improvements, and methodological refinements. GBD 2017 also includes estimates at the subnational level for selected locations.
more
Rabies is entirely preventable, and vaccines, medicines, tools and technologies have long
been available to prevent people from dying of dog-mediated rabies. Nevertheless, rabies still
kills about 60 000 people a year, of whom over 40% are children under 15, mainly in rural areas
of economically
...
disadvantaged countries in Africa and Asia. Of all human cases, up to 99% are
acquired from the bite of an infected dog.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We condu
...
cted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
International Perspectives and Future Directions
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c
...
ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
more
Little is known about the patterns of development assistance (DA) for each component of reproductive, maternal, newborn, child and adolescent health (RMNCAH) in conflict-affected countries nor about the DA allocation in relation to the burden of dis
...
ease
more
Using Theory of Change in the development, implementation and evaluation of complex health interventions. A practical guide
Mary De Silva, Lucy Lee& Grace Ryan
The Centre for Global Mental Health &the Mental Health Innovation Network
(2015)
C1
This guide provides a practical overview of the process of developing a Theory of Change, focusing on using a stakeholder-driven, workshop approach to achieve this.
ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability
...
and affordability of CVD medicine, and service delivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
more
Monitoring and Evaluation Toolkit: HIV, TB and Malaria and Health Systems Strenghtening
The Global Fund
(2011)
The TB section of the toolkit presents selected (a) programmatic output and (b) outcome and impact indicators for TB. In addition to recommended monitoring programs and measuring the outcomes and impact of TB programs, indicators for the strengthening of h
...
ealth systems, strengthening of community systems and some indicators that measure quality of services are also included.
more
The meningitis road map has been designated as a flagship global strategy of the WHO’s Thirteenth General Programme of Work, 2019–2023 and is an essential component in achieving universal health
...
coverage.
The road map will reinforce and combine with wider initiatives, such as those aimed at strengthening primary health care and health systems, increasing immunization coverage, improving global health security, fighting antimicrobial resistance and advocating for the rights of persons with disabilities. It will complement other global control strategies, such as those addressing sepsis, pneumonia, tuberculosis and HIV. Implementation will be a challenge for all countries across the world, but especially in resource-poor settings where the burden of meningitis is greatest. The targets for the visionary and strategic goals will be adapted to regional and local contexts.
more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and
...
outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
more
Lancet Glob Health 2022 Published Online May 24, 2022 https://doi.org/10.1016/S2214-109X(22)00185-1
Many commercial actors use a range of coordinated and sophisticated strategies to protect business interests— their corporate playbook—but many
...
of these strategies come at the expense of public health. To counter this corporate playbook and advance health and wellbeing, public health actors need to develop, refine, and modernise their own set of strategies, to create a public health playbook. In this Viewpoint, we seek to consolidate thinking around how public health can counter and proactively minimise powerful commercial influences.
more
This Mpox SPRP Global Monitoring & Evaluation (M&E) Framework, also referred to as the Framework, aims to monitor and report on global progress towards these objectives, including information about
...
country-level response efforts and WHO support to Member States. Regular collection and analysis of data on these objectives, alongside the ongoing tracking of the epidemiological situation, are key to informing decision-making, operational adjustments, as well as ensuring transparency and accountability for achieving the goal to stop the Mpox outbreak. This document suggests reporting indicators for monitoring of the global response to the Mpox PHEIC as articulated in the Mpox SPRP and Operational Planning Guidelines for countries.
more
Trachoma, caused by particular serovars of Chlamydia trachomatis, is the leading
infectious cause of blindness. Infection is transmitted within ocular and nasal secretions that are passed from person to person on fingers, fomites (such as clothing) and eye-seeking flies (particularly Musca sorbens)
...
.
Ophthalmic infection is associated with an inflammatory conjunctivitis known as “active trachoma”. Repeated episodes of active trachoma can scar the eyelids. In some individuals this leads to trachomatous trichiasis (TT), in which one or more eyelashes on the upper
eyelid touch the eye. TT is extremely painful. It can be corrected surgically, but, if left untreated, may lead to corneal opacification, resulting in vision impairment and blindness.
more
