"Explosions can produce unique patterns of injury seldom seen outside combat.
When they do occur, they have the potential to inflict multi-system life-threatening injuries
on many persons simultaneously. The injury patterns following such events are a product of
the composition and amount of the ...materials involved, the surrounding environment,
delivery method (if a bomb), the distance between the victim and the blast, and any
intervening protective barriers or environmental hazards. Because explosions are relatively
infrequent, blast-related injuries can present unique triage, diagnostic, and management
challenges to providers of emergency care. "
accessed 2018/03/29
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Reducing the humanitarian impact of the use of explosive weapons in populated areas is a key priority for the United
Nations, the International Committee of the Red Cross (ICRC), civil society and an increasing number of Member States.
The United Nations Secretary-General has expressly called on... parties to conflict to avoid the use in populated areas of
explosive weapons with wide-area effects.
While the use of explosive weapons in populated areas may in some circumstances be lawful under international
humanitarian law (IHL), empirical evidence reveals a foreseeable and often widespread pattern of harm to civilians,
particularly from explosive weapons with wide-area effects.
Many types of explosive weapons exist and are currently in use. These include air-delivered bombs, artillery projectiles,
missiles and rockets, mortar bombs, and improvised explosive devices (IEDs). Some are launched from the air and
others are surface launched. Whilst different technical features dictate their accuracy of delivery and explosive effect,
these weapons generally create a zone of blast and fragmentation with the potential to kill, injure or damage anyone
or anything within that zone. This makes their use in populated areas – such as towns, cities, markets and camps for
refugees and displaced persons or other concentrations of civilians – particularly problematic. The problems increase
further if the effects of the weapon extend across a wide-area either because of the scale of blast that they produce; their
inaccuracy; the use of multiple munitions across an area; or a combination thereof.
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The main objective of the 2014-15 RDHS was to obtain current information on demographic and health indicators, including family planning; maternal mortality; infant and child mortality; nutrition status of mothers and children; prenatal care, delivery...n>, and postnatal care; childhood diseases; and pediatric immunization. In addition, the survey was designed to measure indicators such as domestic violence, the prevalence of anemia and malaria among women and children, and the prevalence of HIV infection in Rwanda. For the first time, this 2014-15 RDHS also includes indicators to monitor HIV testing among children age 0-14 as well as domestic violence for males age 15-59.
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The 2007 Rwanda Service Provision Assessment (RSPA) was a national representative survey conducted in 538 health facilities throughout Rwanda. The survey covered hospitals, health centers, dispensaries and
health posts, including all public facilities such as government and government-assisted heal...th facilities. The 2007 RSPA used interviews with health service providers and clients and observations of provider client consultations to obtain information on the capacity of facilities to provide quality services and the existence of functioning systems to support quality services. The areas addressed were the overall facility
infrastructure, maternal and child health, reproductive health, tuberculosis, malaria services; and services for sexually transmitted infections and HIV/AIDS. The objective was to assess the strengths and
weaknesses of the infrastructure and systems supporting these services, and to assess the adherence to standards in the delivery of services.
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A national overview with a case study from Tanahun district. The overall aims of this study are (1) to assess the extent to which social protection systems in Nepal address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, in th...e design and delivery of social protection for people with disabilities. As most social protection programmes in Nepal are targeted to various groups considered to be a high risk of poverty or marginalisation (e.g. orphans, widows), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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A national overview with a case study from Cam Le district
The overall aims of this study are (1) to assess the extent to which social protection systems in Vietnam address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, ...in the design and delivery of social protection for people with disabilities. As most social protection programmes in Vietnam are targeted to various vulnerable groups (e.g. orphans, widows, single parents), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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The Global Vaccine Action Plan (GVAP) 2011-2020, endorsed by Member States during the May 2012 World Health Assembly, has set ambitious targets to improve access to immunization and tackle vaccine-preventable diseases. This responsibility has been translated into firm commitments in February 2016, t...hrough the signature of the Addis Declaration on Immunization (ADI) by African Ministers and subsequently endorsed by the Heads of States from across Africa at the 28th African Union Summit held in January 2017. This commitment from the highest level of government comes as a catalyst to immunization efforts on the continent to deliver on the promise of universal immunization
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The guidelines presented in this document are designed to provide a useful resource for healthcare professionals involved in clinical case management. They were developed taking into consideration services provided at different levels within the health system and resources available. These guideline...s are intended to standardize care at both tertiary and secondary levels of service delivery across different socio economic stratifications of our society.
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This CPD Policy relates to all health professionals in the four Health Professional Councils in Rwanda namely; RMDC, NCNM, RAHPC, and RPC. The policy requires all health professionals to participate in the CPD Programs. The purpose of this CPD Policy is to support the professionals in the respective... councils to develop a culture of continuing learning, acquire new knowledge and skills, and ensure efficient regulation and appropriate delivery of healthcare services to the community.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in Nepal after the era of the Millennium Development G...oals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
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The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering quality care services to patients over a long time. The new National Guidelines for Prevention and Ma...nagement of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for developing EHBs; how they are being defined, costed, di...sseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced.
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.
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The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition.
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WHO’s Ambition and Action in Nutrition 2016-2025 is anchored in the six global targets for improving maternal, infant and young child nutrition and the global diet-related NCD targets.
In support of the 2030 Agenda for Sustainable Development, particularly SDG2 and SDG3, and in concert w...ith the 2016-2025 UN Decade of Action on Nutrition, WHO’s Ambition and Action in Nutrition 2016-2025 aims for “A world free from all forms of malnutrition where all people achieve health and well-being”. It defines the unique value of WHO for advancing nutrition: the provision of leadership, guidance and monitoring and proposes a theory of change. Finally, following a set of guiding principles, it proposes priority actions for WHO, the delivery model and a clear allocation of roles across the Organization.
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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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NUDOR’s first strategic plan (2010-2016) focused on establishing NUDOR as a viable, well-run organisation. Significant progress has been made towards these aims and therefore the strategy and has been reviewed by NUDOR board, secretariat and member organisations. The updated strategic plan now cov...ers the period 2015 – 2020 for which three strategic aims have been agreed.
1. Representation and accountability: NUDOR will be accountable to and effectively represent members’ interests through the delivery of projects and priorities agreed by member organisations, and by facilitating joint working amongst members.
2. Capacity building and resource mobilization: NUDOR and its member organisations are strengthened to fulfil its mandates by developing its technical skills, research and insight, sustainability and outreach.
3. Advocacy and influencing: NUDOR will work to ensure that the needs and rights of all persons with disabilities are recognised by all, mainstreamed in laws and policies at all levels of government, and in programmes of other institutions focusing on areas of education, health and poverty reduction.
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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CBM’s approach is based on the principles of the UN Convention on the Rights of Persons with Disabilities (CRPD) and on CBM’s responsibility to promote accessibility and the principles of universal design in all spheres of its work, including CBM’s digital content and communications. With this... toolkit, we want to provide a guide and practice resource to people working with and for CBM so that together we produce accessible digital content and communications, and place accessibility at the centre of our Information and Communication Technologies (ICT) procurement processes. The toolkit contains a selection of tools for producing accessible content in electronic documents, videos, figures and tools to ensure web accessibility. It also provides tools and information for accessible ICT procurement including tips and resources on how to communicate CBM’s accessibility requirements for products and services being purchased; and how to evaluate what providers promise and deliver.
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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