Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoida...ble suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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This form includes quesitons to help evaluate the services provided, human resources, infrastructure, equipment, drugs and infection prevention at basic emergency obstetric care (BEmOC) sites.
Part... of the Malawi Maternal and Neonatal Health Toolkit
Accessed 12 Febr. 2015
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The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in health<.../span> care facilities. It also finds that 1 in 5 health care facilities has no sanitation service*, impacting 1.5 billion people. The report further reveals that many health centres lack basic facilities for hand hygiene and safe segregation and disposal of health care waste.
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Government of Nepal has an obligation to ensure availability of affordable and high quality basic health care services to its population
Achieving universal access to WASH in health care facilities requires political will and strong leadership at both national and facility levels, but is highly cost-effective, and would yield substan...tial health benefits. A global analysis estimated that universal basic WASH services in health care facilities could be achieved in 46 least developed countries (LDCs) by 2030 for less than US$10 billion, which represents additional expenditures of less than US$1 per person per year.
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The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care ...is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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The COVID-19 pandemic has brought the need for well-functioning primary health care (PHC) into sharp focus. PHC is the best platform for providing basic...span> health interventions (including effective management of non-communicable diseases) and essential public health functions. PHC is widely recognised as a key component of all high-performing health systems and is an essential foundation of universal health coverage
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Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-...ibute-to-highlight medbox">health including disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
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The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate m...anagement of diabetes into primary health care. It will serve as basis for development of simple algorithms for use by health care staff in primary care in low-resource settings, to reduce the risk of acute and chronic complications of diabetes. The guideline was developed by a group of external and WHO experts, following the WHO process of guideline development. GRADE methodology was used to assess the quality of evidence and decide the strength of the recommendations.
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PLOS Glob Public Health 2(8): e0000272. https://doi.org/10.1371/journal.pgph.0000272
Sepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient ...ute-to-highlight medbox">care requires that healthcare providers understand patients’ priorities and provide quality care within the confines of the context they work. We report the perspectives of patients, caregivers and healthcare workers regarding care quality for patients admitted for sepsis to public hospitals in Uganda and Malawi. This qualitative descriptive study in two hospitals included face-to face semi-structured interviews with purposively selected patients recovering from sepsis, their caregivers and healthcare workers. In both Malawi and Uganda, sepsis care often occurred in resource-constrained environments which undermined healthcare workers’ capacity to deliver safe, consistent and accessible care. Constraints included limited space, strained; water, sanitation and hygiene (WASH) amenities and practices, inadequate human and material resources and inadequate provision for basic needs including nutrition. Heavy workloads for healthcare workers strained relationships, led to poor communication and reduced engagement with patients and caregivers.
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Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge t...o fully utilise computerised clinical systems and mobile apps. The ‘Introduction to Information and Communication Technology and eHealth’ course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.
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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.
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This is the fifth report of the Global Evidence Review on Health and Migration (GEHM) series. The publication focuses on the mental health needs of refugees and migrants by providing an overview of ...the available evidence on patterns of risk and protective factors and of facilitators and barriers to care at all levels (individual, family, community and national government). It identifies five high-level themes, each of which has implications for research and policy and is relevant across refugee and migrant groups, contexts and stages of the migration process: self-identity and community support; basic needs and security; cultural concepts of mental health as well as stigma; exposure to adversity and potentially traumatic events; navigating mental health and other systems and services.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety a...nd quality of care. Such services are also essential for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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This updated manual provides a basic understanding of the principles of laboratory and point-of-care (POC) testing in the context of screening and diagnostic approaches, as well as antimicrobial sus...ceptibility testing, as components of sexually transmitted infections (STIs) control. As with previous editions, this manual covers each disease in a separate chapter which provides detailed information on specimen collection, transport and laboratory testing. Two useful annexes covering media, reagents, diagnostic tests and stains (recipes) and laboratory supplies are included at the end of the manual.
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This course aims to provide information on the basic understanding of palliative care and the elements of service program for delivering palliative care...span>. The course contents will also include the considerations in managing signs, symptoms and assessing the patient as well as communicating with the patient, family, and care giver, and the principles and management of respiratory, gastrointestinal, urogenital, nervous systems’ symptoms and conditions in palliative care.
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. Interim Guidelines. This interim guideline lays out some basic principles of optimal nutritional care for adults and paediatric patients during treatment and convalescence in Ebola treatment units..., community care centres or to other centres where Ebola patients are receiving care and support. It highlights the key clinical problems in patients affected by Ebola virus disease (EVD) that may interfere with their nutritional status and overall clinical support in the context of the current Ebola crisis, and summarizes their nutritional needs. It does not provide specific advice on fluid management in cases of vomiting, diarrhoea and dehydration or parenteral nutrition
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The guide contains valuable tools for wound care and the rehabilitation of people affected by Buruli ulcer. It is also helpful for peripheral health centres in areas where Buruli ulcer is endemic an...d to people and their families affected by the disease
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This compendium represents a curated, pragmatic and non-prescriptive collection of tools and resources to support the implementation of interventions to improve quality of care in such contexts. Relevant tools and resources are listed under five are...as: Ensuring access and basic infrastructure for quality; shaping the system environment; reducing harm; improving clinical care; and engaging and empowering patients, families and communities.
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Community Care Centres (CCCs) are small facilities (10 beds maximum), located within the community and run by community health workers. CCCs provide isolation facilities for Ebola patients in order ...to prevent further transmission of the virus within their households and communities. People with Ebola virus can also receive basic curative and palliative care in these centres in an environment supported by their family and communities. This document describes key principles and main considerations for implementation of a community approach.
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