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Publication Years
2287
4821
721
42
4
1
1
Category
2823
811
441
403
211
185
99
3
3
2
Toolboxes
912
749
669
520
314
268
263
258
208
192
164
163
137
113
96
73
66
48
46
35
33
30
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1
Clinical and Laboratory Diagnosis of Buruli Ulcer Disease: A Systematic Review
Sakyi; S.A.; Aboagye, S. Y.; Otchere, I. D. ; et al
The Canadian Journal of Infectious Diseases & Medical Microbiology
(2016)
C1
Volume 2016 | Article ID 5310718 | https://doi.org/10.1155/2016/5310718. Buruli ulcer (BU) is a necrotizing cutaneous infection caused by Mycobacterium ulcerans. Early diagnosis is crucial to prevent morbid effects and misuse of drugs. We review developments in laboratory diagnosis of BU, discuss li
...
mitations of available diagnostic methods, and give a perspective on the potential of using aptamers as point-of-care.
more
The recommendations in this guideline are intended to inform development of national and subnational health policies, clinical protocols and programmatic guides. The target audience includes national and subnational public health policy-makers, impl
...
ementers and managers of maternal, newborn and child health programmes, health-care facility managers, supervisors/instructors for in-service training, health workers (including midwives, auxiliary nurse-midwives, nurses, paediatricians, neonatologists, general medical practitioners and community health workers), nongovernmental organizations, professional societies involved in the planning and management of maternal, newborn and child health services, academic staff involved in research and in the pre-service education and training of health workers, and those involved in the education of parents.
more
This handbook was designed primarily as a tool for district clinical specialist teams (DCSTs), and for the provincial specialists who will guide and support their work. This handbook will also be useful to managers of health facilities, heads of
...
clinical units and nurses, doctors and allied health workers at the coalface of clinical care. This handbook will be of interest to district managers and other members of the district management team who are dedicated to developing the capacity of the district health system to respond
effectively to the health needs of the population they serve. It will help them understand the role of the DCSTs and the type of
activities they need to engage in to improve the quality of care
more
WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses th
...
e use of Diphtheria Antitoxin (DAT) in the treatment of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
more
Quality of care in fragile, conflict-affected and vulnerable settings: tools and resources compendium
recommended
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.
more
The World Health Organization invites clinicians and patients to collect information on COVID-19 in a systematic way and contribute clinical data to the WHO Clinical Platform to expand our knowledge
...
on Post-COVID-19 condition, and support patient care and public health interventions.
WHO’s Post COVID case report form (CRF) has been designed to report standardized clinical data from individuals after hospital discharge or after the acute illness to examine the medium- and long-term consequences of COVID-19. The forms will be available in multiple languages.
more
Guide for clinical case management and infection prevention and control during ameasles outbreak. This guide has been developed to reduce the high morbidity and mortality seen in some of the current outbreaks of measles. This short guide outlines pr
...
actical clinical care interventions and is derived from previously published WHO documents.
more
The purpose of this guide is to provide practical advice for health staff undertaking infectious disease preparedness and response activities to ensure that access to safe abortion care (SAC) is maintained when an infectious disease outbreak occurs.
...
It is an operational guide which can serve to support health actors to maintain SAC services during outbreaks and ensure that necessary SAC considerations are integrated within outbreak responses; it is not a clinical guide. The locational focus of this document is humanitarian and fragile settings; however, recommendations may apply to infectious disease outbreaks in all low-resource populations. This guide is intended to complement Sexual and Reproductive Health and Rights During Infectious Disease Outbreaks: Operational Guidance for Humanitarian and Fragile Settings.
more
Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capability for burns
...
care from clinical, human resources and operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
more
This online learning course is for primary care of children witt TB. It covers clinical presentation, diagnosis, management and prevention of tb in children and HIV/TB co-infection
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 hea
...
lth system and resources available. These guidelines are intended to standardize care at both tertiary and secondary levels of service delivery across different socio economic stratifications of our society.
more
Guidelines for Good Clinical Laboratory Practices (GCLP) outlines the principles and procedures to be followed by medical laboratories involved in clinical research and/or patient
...
care so as to provide quality data which can be used for health research and patient treatment. As the use of laboratory tests (often expensive) are increasingly becoming a part of medical diagnosis and research, generation of quality data would be a cost-effective and ethically sound strategy.
more
This treatment guideline is intended to assist clinicians in the Behavioral Health department in treatment planning and service delivery for patients with Post Traumatic Stress Disorder (PTSD). It may also assist clinicians treating patients who have some of the signs and symptoms of PTSD but who do
...
not meet the full criteria of PTSD. The treatment guideline is not intended to cover every aspect of clinical practice, but to focus specifically on the treatment models and modalities that clinicians in our outpatient treatment setting could provide. These guidelines were developed through a process of literature review and discussion amongst clinicians in the Behavioral Health department and represent a consensus recommendation for service provision for this disorder. The guideline is intended to inform both clinical and administrative practices with the explicit goals of outlining treatment that is: effective, efficient, culturally relevant and acceptable to clinicians, program managers, and patients.
more
Patient-centred care (PCC) is a pillar of quality health services, where decision-making power is shared between the clinician and the patient. Although, this approach could be adopted with easiness in high income settings or in countries with unifi
...
ed health systems, in settings such as Peru, where universal access and other structural problems remain a challenge, the practice of PCC is not a priority. In Peru, research on PCC has been conducted for almost two decades, but this has not generated a need for development in academia, decision makers, health personnel or patients. Here, we give an overview of the road that PCC research has taken in Peru and the challenges that remain to translate it into clinical practice.
more
As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma
...
and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
more
Background: East African trypanosomiasis is an uncommon, potentially lethal disease if not diagnosed and treated in a timely manner. South Africa, as a centre for emergency medical evacuations from much of sub-Saharan Africa, receives a high proportion of these patients, mostly tourists and expatria
...
te residents.
Methods: The cases of East African trypanosomiasis patients evacuated to South Africa, for whom diagnostic and clinical management advice was provided over the years 2004–2018, were reviewed, using the authors’ own records and those of collaborating clinicians.
Results: Twenty-one cases were identified. These originated in Zambia, Malawi, Zimbabwe, Tanzania, and Uganda. Nineteen cases (90%) had stage 1 (haemolymphatic) disease; one of these patients had fatal myocarditis. Of the two patients with stage 2 (meningoencephalitic) disease, one died of melarsoprol encephalopathy. Common problems were delayed diagnosis, erroneous assessment of severity, and limited access to treatment.
Conclusions: The key to early diagnosis is recognition of the triad of geographic exposure, tsetse fly bites, and trypanosomal chancre, plus good microscopy. Elements for successful management are rapid access to specific drug treatment, skilled intensive care, and good laboratory facilities. Clinical experience and the local stock of antitrypanosomal drugs from the World Health Organization have improved the chance of a successful outcome in the management of East African trypanosomiasis in South Africa; the survival rate over the period was 90.5%.
more
Quality of the Indian clinical practice guidelines for the management of cardiovascular conditions
Dhurjati, R.; Sagar, V.; Kanukula, R. et al.
Journal of the Royal Society of Medicine Open
(2022)
CC
To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from incep
...
tion until August 2020, to identify Indian CPGs for the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures. Quality of the each included CPG was assessed using the AGREE II tool by four reviewers in duplicate, independently. Each AGREE II domain score and overall quality score was considered low (≤40%), moderate (40.1%-59.9%), and high (≥60%). Of the 23 CPGs included, six (26%) were reported to be adapted from other CPGs. Fourteen (61%) CPGs were produced by medical associations, six (26%) by individual authors and three (13%) by government agencies. Based on the AGREE II overall quality score, two (9%) CPGs were of high quality, four (17%) and seventeen (74%) CPGs were of moderate and low quality, respectively. Except for scope and purpose, and clarity of presentation all other domains were rated low. The quality of most Indian CPGs for managing CVD conditions assessed using the AGREE II tool was moderate-to-low. Combined efforts from different stakeholders are needed to develop, disseminate and implement high-quality CPGs while identifying and addressing barriers to their uptake to optimize patient care and improve outcomes.
more
Building capacity to improve respiratory care: the education strategy of the International Primary Care Respiratory Group 2014–2020
McDonnell, J.; Corella de Sousa, J.; Baxter, N.; et al.
npj Primary Care Respiratory Medicine
(2014)
CC2
The article discusses the education strategy of the International Primary Care Respiratory Group (IPCRG) for 2014–2020, focusing on building capacity to improve respiratory care globally. It highl
...
ights the significant burden of respiratory diseases and the role of primary care in addressing this issue. The IPCRG aims to enhance educational efforts, support healthcare professionals, and foster knowledge-sharing among its member countries. The strategy includes developing teaching programs, promoting leadership, and using innovative educational methods, such as distance learning and "teach the teacher" programs. The overall goal is to improve clinical practice and outcomes in managing respiratory conditions through targeted education and collaboration.
more
Antimicrobial resistance (AMR) is occurring everywhere in the world, compromising the ability to treat infectious diseases, as well as undermining many other advances in health and medicine. Underlying factors that drive AMR include; weak or absent surveillance and monitoring systems, inadequate sys
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tems to ensure quality and uninterrupted supply of medicines, inappropriate and irrational use of medicines including in animal husbandry, poor infection prevention and control practices, and depleted arsenals of diagnostics, medicines and vaccines as well as insufficient research and development of new products.
more
This new guideline on non-clinical interventions to reduce unnecessary caesarean sections incorporates the views, fears and beliefs of both women and health professionals about caesarean sections. It also considers the complex dynamics and limitatio
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ns of health systems and organizations and relationships between women, health professionals and organization of health care services.
more
Infectious diseases are constantly in transition. New diseases develop, known dis-eases become widespread or reemerge, and occasionally a disease is eradicated.Infectious diseases such as HIV, tuberculosis, and cholera are significant causes ofillness and death in many parts of the world. Health
...
care personnel are on thefront lines, helping to protect their clients from infectious diseases and treatingthem when infections occur. During the course of their work, health care person-nel perform clinical procedures or other activities that can expose both them andtheir clients to potentially infectious microorganisms. Many of their clients aresick and thus may be more susceptible to infections or may have infections thatcan be transmitted to others. Fortunately, all staff working at health care facilities can perform simple proce-dures to minimize risk—to themselves and clients—and reduce the spread ofinfections. These practices can be integrated at minimal cost into the routineworkday at clinics and hospitals around the world. This reference booklet isspecifically designed for use at all levels of the health care system, from thelargest hospitals to the smallest dispensaries or health posts, in settings whereresources are scarce. This booklet, which was first published in 1999, has now been updated. Whilemost practices remain the same, there have been a few important changes—forexample, in recommendations related to hand hygiene and standard precautions.Nonetheless, this booklet continues to present practical recommendations forsimple and relatively low-cost procedures that can be implemented anywhere,with basic supplies and little to no high-technology equipment.
more
USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (PHC) services provided by Primary Health
...
Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system through achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
more
It is Zika virus (ZIKV) that most often causes these neurological effects it appears to be the only arbovirus than can cause congenital malformations such as microcephaly. In any case, more scientific tests are needed to establish the causal relationship between the virus and this malformation (7-10
...
).
This document is a practical tool designed to help health workers improve clinical diagnosis and provide timely care for patients infected
with the dengue, chikungunya, or Zika virus. It is intended mainly for
health workers in primary care facilities where laboratory diagnosis of
arboviruses is not always available. However, this guide may also be
very useful in hospitals that provide second- and third-level care, as it
describes the clinical manifestations of each of the three most important
arboviral diseases currently found in the Region, the elements for
differential diagnosis, and their clinical behavior.
more
The objectives of these WHO guidelines are to provide updated evidence- based recommendations for the treatment of persons with hepatitis C infection using, where possible, all DAA-only combinations. The guidelines also provide recommendations on the preferred regimens based on a patient’s HCV gen
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otype and clinical history, and assess the appropriateness of continued use of certain medicines. This document also includes existing recommendations on screening for HCV infection and care of persons infected with HCV that were first issued in 2014
more
International Journal of Psychiatry in Clinical Practice, 2012; 16: 77–84
This module takes you through the NICE coronavirus disease (COVID-19) rapid guideline: critical care in adults, providing resources to support their recommendations and patient scenarios to demonstrate key learning points.
Learning outcomes
Afte
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r completing this module you should understand:
Actions to take when admitting patients to hospital with possible coronavirus disease 2019
Which groups of patients to consider for admission to critical care
When to start, review, and stop critical care treatment
Key principles for clinical decision making around critical care treatment
Key aspects of service organisation which may help manage the critical care workload within your hospital, including provision of telephone advice, coordination of resources within and between hospitals, and the role of extracorporeal membrane oxygenation (ECMO) services.
more
The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis
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B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
more
These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV
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; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
more
As the world population is growing and health care resources are in high demand the pressure on medical services is becoming higher. Developing countries are already at a crisis point in health care
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provision, and time demands a new approach in structuring medical resources. Primary care is the vital pillar for fundamental health care at community level and has been deemed as a cost-effective modality. In the West the primary care physician manages chronic medical conditions in communities and therefore reduces unnecessary hospital admissions. In the West, the primary care system is extremely well organised. Low-income countries must improve teaching, training and funding in primary care. In this article the urgent need for primary care is discussed in developing countries, and ways to minimise costs and improve clinical outcomes at community level.
more
Med Princ Pract 2021;30:17–28
An overview of ethics and clinical ethics is presented in this review. The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and justice, are defined and explained. Informed consent,
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truth-telling, and confidentiality spring from the principle of autonomy, and each of them is discussed. In patient care situations, not infrequently, there are conflicts between ethical principles (especially between beneficence and autonomy). A four-pronged systematic approach to ethical problem-solving and several illustrative cases of conflicts are presented. Comments following the cases highlight the ethical principles involved and clarify the resolution of these conflicts. A model for patient care, with caring as its central element, that integrates ethical aspects
(intertwined with professionalism) with clinical and technical expertise desired of a physician is illustrated
more
This manual is to assist health care providers and laboratory scientists to diagnose mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the clinical
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presentation and its diagnosis. The methods described are tailored to various levels of care and available resources to improve the diagnosis and surveillance of the disease.
more
Buruli ulcer : management of Mycobacterium ulcerans disease : a manual for health care providers
recommended
This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentat
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ion and its surgical management. The manual is aimed particularly at district health care providers. A comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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The socioeconomic factors and public health inadequacies that facilitated the rapid spread of this infection continue to exist. As it is a new and emerging disease it has not received sufficient coverage yet in the medical curricula of Member States. Specific treatment is not available, and there is
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no vaccine for the prevention of chikungunya fever. It has therefore become imperative to develop guidelines, based on the limited clinical experience gathered from managing patients so far, for appropriate management of patients in communities and in health facilities. Experts engaged in managing patients with chikungunya fever in the Region were brought together by the WHO Regional Office for South-East Asia to outline guidelines for managing various situations and stages of the disease.
The socioeconomic factors and public health inadequacies that facilitated the rapid spread of this infection continue to exist. As it is a new and emerging disease it has not received sufficient coverage yet in the medical curricula of Member States. Specific treatment is not available, and there is no vaccine for the prevention of chikungunya fever. It has therefore become imperative to develop guidelines, based on the limited clinical experience gathered from managing patients so far, for appropriate management of patients in communities and in health facilities. Experts engaged in managing patients with chikungunya fever in the Region were brought together by the WHO Regional Office for South-East Asia to outline guidelines for managing various situations and stages of the disease. This publication is the end result of that exercise and is intended to assist health-care providers in planning and implementing appropriate care to patients with chikungunya fever according to their actual clinical conditions
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduc
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e clinical variability and, in essence, improve health and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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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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Delivery of comprehensive arrhythmia care requires the simultaneous presence of many resources. These include complex hospital infrastructure, expensive implantable equipment, and expert personnel. In many low- and middle-income countries (LMICs), a
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t least 1 of these components is often missing, resulting in a gap between the demand for arrhythmia care and the capacity to supply care. In addition to this treatment gap, there exists a training gap, as many clinicians in LMICs have limited access to formal training in cardiac electrophysiology. Given the progressive increase in the burden of cardiovascular diseases in LMICs, these patient care and clinical training gaps will widen unless further actions are taken to build capacity. Several strategies for building arrhythmia care capacity in LMICs have been described. Medical missions can provide donations of both equipment and clinical expertise but are only intermittently present and therefore are not optimized to provide the longitudinal support needed to create self-sustaining infrastructure. Use of donated or reprocessed equipment (eg, cardiac implantable electronic devices) can reduce procedural costs but does not address the need for infrastructure, including diagnostics and expert personnel. Collaborative efforts involving multiple stakeholders (eg, professional organizations, government agencies, hospitals, and educational institutions) have the potential to provide longitudinal support of both patient care and clinician education in LMICs.
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An integrated approach is particularly important for low-resource settings for efficient use of limited resources. The course contents will include risk factors, clinical course, guidance and protocols for diagnosis, management and referral as neede
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d for NCDs in PHC. SEARO NCD PEN-HEARTS is a series of four courses with the other three courses focusing on Hearts of NCD: an integrated approach to management of NCDs in PHC, diabetic foot care and palliative care that will enable the learner to plan and deliver NCD services.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
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diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
more
This book is a practical manual of mental health care for community health workers, primary care nurses, social workers and primary care doctors, p
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articularly in developing countries.Helpful features include: over 50 illustrations and case studies, jargon-free explanations and descriptions, flow-charts on common clinical problems, and a practical guide to the use of psychiatric medicines and simple psychological treatments.
Chapters 1, 9 and 10 can be found on the e-TALC CD-ROM number 2 (April 2003). See www.talcuk.org for details Links to Chapters 2 and 3 above. Printed copies of this book can also be obtained from the Royal College of Psychiatrists www.rcpsych.ac.uk/wnitp
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This document describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programmes, as new innovative POC technologies are being introduced into the market.
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The next steps taken to include these new innovations within the broader context of national diagnostic networks of conventional laboratories could influence the achievement of the 2030 Fast Track targets for ending the AIDS epidemic.
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
COVID-19 Guidance on use of personal protective equipment for different clinical settings and activities
recommended
This document provides guidance to African Union Member States based on a specific request from Member States for a checklist/guidance of the required personal protective equipment (PPE) needed by healthcare workers and care givers for the Coronavir
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us Disease 2019 (COVID-19) pandemic. This document has been synthesised from currently available evidence (1-6), with consideration to the African context, and as such, can be adapted to the country context.
more
Leishmaniasis is a complex vector-borne disease involving in its transmission several species of protozoan parasites called Leishmania, a wide variety of animal reservoirs and phlebotomine sandflies vectors. Cutaneous Leishmaniasis (CL) is the most common form of the disease, and its
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clinical manifestations vary from few papules to multiple ulcers affecting the skin but also the mucous membranes, leaving permanent scars and serious disability. It is a disfiguring and stigmatizing disease that often has a devastating psychosocial and economic impact on the affected resources limited communities.
more
Updated 10 August 2020
This document presents an essential medicines list (EML) to manage patients in intensive care units (ICUs) with suspected or confirmed COVID-19 diagnosis, which includes active ingredients with dosage form and concentration,
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and are preferably in the WHO Model Lists of Essential Medicines 2019; based on clinical presentations and symptoms identified and prioritized in World Health Organization (WHO) and Surviving Sepsis Campaign (SSC) guidelines and the evidence presented in these guidelines.
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In the area of nutrition and HIV, children deserve special attention because of their additional needs to ensure growth and development and their dependency on adults for adequate care. It was therefore proposed to first develop guidelines for chil
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dren and thereafter consider a similar approach for other specific groups.
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a biological process related to virus and host interactions. In trying to protect the nutritional well-being or reverse the undernutrition experienced by infected children, issues of food insecurity, food quantity and quality as well as absorption and digestion of nutrients are considered. Interventions are proposed that are practical and feasible in resource-poor settings and offer a prospect for clinical improvement.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
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This is a case-ascertained prospective investigation of all identified health care contacts working in a health care facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Stud
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y population) receives care. Note that this study can be done in health care facilities at all 3 levels of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers.
There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for:
To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level.
To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers.
To evaluate effectiveness of infection prevention and control measures among health care workers
To evaluate effectiveness of infection prevention and control programmes at health facility and national level
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Effectiveness of Education and an Antibiotic-Control Program in a Tertiary Care Hospital in Thailand
Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de
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veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
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Responding to Outbreaks of Antimicrobial-resistant Pathogens in Health-care Facilities: Guidance for the Western Pacific Region is developed following requests from Member States in the Western Pacific Region for additional information and support i
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n managing AMR outbreaks. It aims to provide: a step-by-step guide for health-care facilities to respond to AMR outbreaks; a practical resource for health-care workers to support AMR outbreak response in low- and middle-income countries; and practical guidance to implement effective AMR outbreak response policies and procedures in clinical settings.
more
Development of cardiovascular disease (CVD) is influenced by risk factors such as:
tobacco use, an unhealthy diet, physical inactivity, obesity (which can result from
a combination of unhealthy diet, physical inactivity, and other factors), elevated
blood pressure (hypertension), abnormal blood l
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ipids (dyslipidaemia) and elevated blood glucose (diabetes mellitus). Continuing exposure to these risk factors leads
to further progression of atherosclerosis, resulting in clinical manifestations of these diseases, including angina pectoris, myocardial infarction, heart failure and stroke. Total CVD risk depends on the individual’s overall risk-factor profile.
more
Evidence shows that FGM can cause several physical, mental and sexual health complications in girls and women, and in newborns. Health-care providers play an important role in supporting girls and women living with FGM, and improving their health an
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d well-being. They are in a unique position to influence and change the attitudes of their patients about FGM.
WHO is committed to scaling up the health-sector response to address FGM prevention and care. One aspect is to strengthen the quality of FGM prevention and care services by building the capacity of health-care providers. Several guidance materials have been produced to target health-care providers. These include FGM content for training curricula, clinical guidelines and a clinical handbook.
This training manual complements previous publications by building person-centred communication skills specifically for FGM prevention.
more
Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
...
diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
more
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
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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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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical c
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riteria. CHD presents with a myriad of clinical manifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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A systematic approach to holistic wound care is essential for the delivery of high quality wound care. Holistic wound assessment considers the whole person and should comprise the components of the
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generic wound assessment minimal data set. Therefore holistic assessment is key to gathering information on the
patient and their wound. This information should be documented at each review so that it can act as a baseline against which wound progress can be tracked and used to guide management decisions.
Inaccurate or lack of assessment can result in appropriate care and delays in healing, unnecessary patient suffering, poor outcomes and the inappropriate use of resources
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Epilepsies: diagnosis and management
recommended
Clinical guideline | Published: 11 January 2012 | nice.org.uk/guidance/cg137
Clinical Guideline
Expert international faculty present weekly, concise MedicalMinute updates, host biweekly Question and Answer Webinars, and author a continually updated downloadable slideset including the latest data on COVID-19 epidemiology and clinical management
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; specific topics include best practices and ongoing research in screening, prevention, diagnosis, disease management, and treatment for diverse patient populations.
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Recognition, Assessment and Treatment
National Clinical Guideline Number 159
An essential participant in antimicrobial stewardship who has been unrecognized and underutilized is the“staff nurse.”Although the role of staff nurses has not formally been recognized in guidelines for implementing and operating antimicrobial stewardship programs (ASPs) or defined in the medica
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l literature, they have always performed numerous functions that are integral to successful antimicrobial stewardship. Nurses are antibiotic first responders, central communicators, coordinators of care, as well as 24-hour monitors of patient status, safety, and response to antibiotic therapy. An operational analysis of inpatient admissions evaluates these nursing stewardship activities and analyzes the potential benefits of nurses’formal education about, and inclusion into, ASPs.
Clinical Infectious Diseases - CID 2016:62 (1 January)•CLINICAL PRACTICE
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There is a crucial need to initiate and sustain fistula programs that increase access and strengthen the capacity of the health care system to provide high quality services for repair and care of wo
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men living with female genital fistula. Therefore, it is important to pay particular attention to the quality of training, and to proactively determine how this training fits into the health care system. Furthermore, the quality of training is improved by committing adequate resources to ensure competent trainers, able to train and follow-up their trainees. Women with genital fistulae, their families and the community need to have confidence in the health care system. It is therefore necessary to have pro-active discussions about the quality of training with relevant stakeholders. These fistula training guidelines and standards go towards harmonizing the training approach and to improving the quality of training and hence, service delivery.
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The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project
Kirenga, B.J.; Chakaya, J.; Yimer, G. et al.
Journal of Allergy and Clinical Immunology: Global
(2024)
CC
Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence,
mortality, and activity and work impairment) of severe asthma in 3
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countries in East Africa: Uganda, Kenya, and Ethiopia using the American Thoracic Society/European Respiratory Society case definition of severe asthma.
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The global burden of asthma: executive summary of the GINA Dissemination Committee report
Masoli, M.; Fabian, D.; Holt, S.; Beasley, R.
European Journal of allergy and clinical immunology: Volume59, Issue5 May 2004 Pages 469-478
(2004)
CC2
It is estimated that as many as 300 million people of all ages, and all ethnic backgrounds, suffer from asthma and the burden of this disease to governments, health care systems, families, and patients is increasing worldwide. In 1989 the Global Ini
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tiative for Asthma (GINA) program was initiated in an effort to raise awareness among public health and government officials, health care workers, and the general public that asthma was on the increase. The GINA program recommends a management program based on the best available scientific evidence to provide effective medical care for asthma tailored to local health care systems and resources.
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Hypertension in adults: diagnosis and management
the National Institute for Health and Care Excellence (NICE)
the National Institute for Health and Care Excellence (NICE)
(2023)
CC
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di
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agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
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Position statement on endoscopic lung volume reduction in South Africa: 2022 update
Koegelenberg, C.F.; Van Zyl-Smit, R.N.; Dheda, K. et al.
African Journal of Thoracic and Critical Care Medicine
(2022)
CC
The article from the African Journal of Thoracic and Critical Care Medicine provides updated guidelines on endoscopic lung volume reduction (ELVR) for treating advanced emphysema, a severe form of chronic obstructive pulmonary disease (COPD), which
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is prevalent in South Africa and other low- and middle-income countries. The guidelines focus on identifying suitable patients based on specific criteria, such as age, lung function, and the presence of hyperinflation, while ruling out contraindications like pulmonary hypertension and recent smoking.
ELVR aims to reduce lung volume in the most damaged areas, improving breathing mechanics and quality of life. Various devices, including endobronchial valves, intrabronchial valves, and coils, are reviewed with evidence from clinical trials supporting their use. The guidelines emphasize careful patient selection and recommend only performing ELVR in specialized centers due to its high cost and risk of complications, such as pneumothorax.
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2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group
Cloutier, M. M.; Baptist, A.P.; Teach, S.J.; et al.
The Journal of Allergy and Clinical Immunology
(2020)
CC2
The2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group was coordinated and supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Healt
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h. It is designed to improve patient care and support informed decision making about asthma management in the clinical setting. This update addresses six priority topic areas as determined by the state of the science at the time of a needs assessment, and input from multiple stakeholders:
• Fractional Exhaled Nitric Oxide Testing
• Indoor Allergen Mitigation
• Intermittent Inhaled Corticosteroids
• Long-Acting Muscarinic Antagonists
• Immunotherapy in the Treatment of Allergic Asthma
• Bronchial Thermoplasty
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Clinical care for severe acute respiratory infection: toolkit: COVID-19 adaptation
Clinical care for severe acute respiratory infection: toolkit: COVID-19 adaptation
Guía clínica para la atención pediátrica de la tuberculosis y la coinfección TB-VIH
Alabí Montoya, F.J.; C.G. Alvarenga Cardoza, K.M. Díaz de Naves
Ministerio de Salud El Salvador
(2021)
CC
Clinical guideline for paediatric care of tuberculosis and TB-HIV co-infection
Lineamientos técnicos para la atención de personas con tuberculosis presuntiva y seguimiento de casos diagnosticados, en el marco de la pandemia por COVID-19
Dr. Francisco José Alabí Montoya, Dr. Carlos Gabriel Alvarenga Cardoza, Dra. Karla Marina Díaz de Naves
Ministerio de Salud El Salvador
(2021)
C1
Clinical guidelines for the care of persons with suspected tuberculosis and and follow-up of diagnosed cases, in the context of the COVID-19 pandemic
Guía clínica para la atención integral de pacientes con tuberculosis fármacorresistente
Alabí Montoya, F.J.; C.G. Alvarenga Cardoza, K.M. Díaz de Naves
Ministerio de Salud El Salvador
(2021)
CC
Clinical guidelines for the comprehensive care of patients with drug-resistant tuberculosis
Clinical Guidance across the continuum of care
Chapter 8_ARV Guidelines
This clinical job aid provides health care workers with information on how to collect specimens for early infant diagnosis on dried blood spots, as well as drying and packaging for transport.
Female genital schistosomiasis:
recommended
A pocket atlas for clinical health-care professionals
Coronavirus Clinical Management Protocol (COVID-19) in Primary Health Care (Version 7)
This NCEPOD report highlights the quality of mental health and physical health care for patients aged 18 years or older with a significant mental disorder who are admitted to a general hospital. The report takes a critical look at areas where the
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care of patients might have been improved. Remediable factors have also been identified in the clinical and the organisational care of these patients.
more
As care teams struggle to treat an increasing number of patients around the world, we have made the following Clinical Effectiveness COVID-19 resources available *at no charge* to anyone seeking the
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latest evidence-based information and clinical guidance. While we will update you via email when new resources are made available, please also bookmark this page, as the list will be updated regularly in response to new developments, evidence and guidance.
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Community-Based Management of Acute Malnutrition (CMAM) is a decentralised community-based approach to treating acute malnutrition. Treatment is matched to the nutritional and clinical needs of the child, with the majority children receiving treatme
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nt at home using ready-to-use foods. In-patient care is provided only for complicated cases of acute malnutrition. CMAM consists of four components: (1) stabilisation care for acute malnutrition with complications, (2) out-patient therapeutic care for severe acute malnutrition without complications, (3) supplementary feeding for moderate acute malnutrition and (4) community mobilisation.
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WHO clinical guidelines.
For the first time, WHO has published guidelines to help (primarily) front-line healthcare providers give high-quality, compassionate, and respectful care to children and a
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dolescents (up to age 18) who have or may have experienced sexual abuse, including sexual assault or rape.
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The guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection, and at community advocates responsible for promoting the best int
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erests and care of HIV-positive adults. They should be read in conjunction with other published BHIVA guidelines.
The 2016 interim update to the 2015 BHIVA antiretroviral guidelines has been published online to include tenofovir-alafenamide/emtricitabine as a preferred NRTI backbone for first-line therapy. Changes were based on new data and the consensus opinion of the writing committee. All changes to the guideline are highlighted and include updates to the chronic kidney disease and bone disease sections of special populations and some small changes to managing virological failure.
The 2019 interim statement provides updated advice on treatment with two-drug regimens
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Operational considerations for case management of COVID-19 in health facility and community
recommended
This document is intended to guide the care of COVID-19 patients as the response capacity of health systems is challenged; to ensure that COVID-19 patients can access life-saving treatment, without compromising public health objectives and safety of
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health workers.
It promotes two key messages:
1. Key public health interventions regardless of transmission scenario; and
2. Key action steps to be taken by transmission scenario to enable timely surge of clinical operations.
more
This SOP describes specific step by step procedures in clinical management like OPD, IPD Housekeeping, Emergency services, OT services, Radiology Services & Pathology services. It should be used as a hands-on reference for service providers providin
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g services, thereby helping to standardize the practice in all hospitals, with the ultimate goal of optimizing the quality & standard patient care. The manual may also be used as a reference for health service providers for effective health management.
more
Over the last decade, there have been numerous disasters and major emergencies that have profoundly impacted the lives of millions of people worldwide. To support these crises, national and international emergency medical teams (EMTs) are often deployed to assist disaster affected populations. EMTs
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are teams of healthcare professionals composed most frequently of doctors, nurses, psychologists and others to provide direct clinical care to people affected by disasters and conflicts and to support local health systems. In agreement with the World Health Organization’s (WHO) Global Health Emergency Health Workforce programme, any health professional coming from another country to practice health care in a disaster setting must be part of a team that is qualified, trained, equipped, resourced, and meets minimum acceptable standards to practice.
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This document updates the 1999 World Health Organization (WHO) classification of diabetes. It prioritizes clinical care and guides health professionals in choosing appropriate treatments at the time
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of diabetes diagnosis, and provides practical guidance to clinicians in assigning a type of diabetes to individuals at the time of diagnosis. It is a compromise between clinical and aetiological classification because there remain gaps in knowledge of the aetiology and pathophysiology of diabetes. While acknowledging the progress that is being made towards a more precise categorization of diabetes subtypes, the aim of this document is to recommend a classification that is feasible to implement in different settings throughout the world. The revised classification is presented in Table 1. Unlike the previous classification, this classification does not recognize subtypes of type 1 diabetes and type 2 diabetes and includes new types of diabetes (“hybrid types of diabetes” and “unclassified diabetes”).
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Therapeutics for Ebola virus disease
recommended
The WHO Ebola Virus Disease (EVD) Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with EVD. Providing gui
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dance that is comprehensive and holistic for the optimal care of patients with EVD throughout their illness is important.
The living guidance is available in both pdf format (via the ‘Download’ button) and via an online platform in both French and English, and is updated regularly as new evidence emerges.
This first version of the Clinical management for EVD living guidance contains four new recommendations regarding use of therapeutics for EVD, this includes two strong recommendations for the use of monoclonal antibody therapies. This new living guideline is written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures (5, 6). The living guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.
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Aims of the CNS programme:
- To provide accessibility to quality nursing care and related services including clinical assessment and personalized car ... e for persons enrolled/entitled to CNS services.
- To enhance the independence and health outcomes of entitled persons by avoiding early admission to hospital and/or residential care by providing access to CNS.
- To provide nursing, midwifery and advanced/specialized care through CNS delivered by a skills mix of registered and enrolled nurses.
- To facilitate provision of preventive, promotive and rehabilitative services to the community. more
- To provide accessibility to quality nursing care and related services including clinical assessment and personalized car ... e for persons enrolled/entitled to CNS services.
- To enhance the independence and health outcomes of entitled persons by avoiding early admission to hospital and/or residential care by providing access to CNS.
- To provide nursing, midwifery and advanced/specialized care through CNS delivered by a skills mix of registered and enrolled nurses.
- To facilitate provision of preventive, promotive and rehabilitative services to the community. more
Getting Contraceptives To Health Facilities: 10 Questions For Community-Based Groups To Consider
recommended
This Guide helps all the health care providers in the non- public sector to explore alternative means of access to contraceptives and skills to determine quantities required and management of stock. Health
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care providers include community health workers, nurses and midwives, clinical officers and medical doctors.
more
Regulation of the Minister of Health of the Republic of Indonesia Number 5 Year 2014 about the Clinical Practice Guide for Physicians at Primary Health Care Facilities
Updated 17 April 2020
Improving care for women during pregnancy and around the time of childbirth to prevent and treat pre-eclampsia and eclampsia is a necessary step towards the achievement of the health targets of the Sustainable Development Goal
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s (SDGs). Efforts to prevent and reduce morbidity and mortality due to these conditions can help address the profound inequities in maternal and perinatal health globally. To achieve this, healthcare providers, health managers, policy makers and other stakeholders need up-to-date and evidence-informed recommendations to guide clinical policies and practices.
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INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require sub
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stantial resources but little consideration has been given to which treatments are appropriate for less advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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The document provides detailed clinical guidelines for the therapy of Type 1 Diabetes as developed by the German Diabetes Association (DDG). It focuses on individualized insulin therapy, structured patient training, and monitoring of blood glucose l
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evels. The guidelines emphasize preventing complications like ketoacidosis and hypoglycemia while improving patients' quality of life through education and tailored medical care. Recommendations include the use of both basal and bolus insulin, continuous glucose monitoring, and integrating psychosocial support into treatment plans. The document serves as a comprehensive resource for healthcare professionals managing Type 1 Diabetes.
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2nd edition. This new edition provides policy-makers, programme managers and health-service providers with the latest evidence-based guidance on clinical care. It includes information on how to esta
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blish and strengthen services, and outlines a human-rights-based approach to laws and policies on safe, comprehensive abortion care. This guidelines is available in English; French, Spanish; Japanese; Russian; Portuguese; Romanian and Ukrainian
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Prepared as an outcome of ICMR Subcommittee on Gastric Cancer | This consensus document on Management of Gallbladder cancers summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and
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molecular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
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The Ministry of Health together with its partners realizes that efficient and effective
delivery of clinical care is highly dependent on the availability of appropriately
upgraded environment, whi
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ch is in well facilitated space. Such facilities and utilities
should always be properly designed, built, and maintained, so as to ensure efficient
treatment in clean and safe from infection.
The main challenges in achieving this include the lack of, appropriate holistic and
futuristic management plans, human resource for facility/utility management and
maintenance, adequate budget funds for renovation/maintenance activities at all
levels which means daily and long-term of facility maintenance plans and executions.
It is hoped that the guidelines will help to standardise
design of medical facilities and utilities country wide and result in efficient and
effective establishment of these life-saving function
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Cryptococcal disease, particularly cryptococcal meningitis is a significant cause of morbidity and mortality among people living with HIV with advanced HIV disease. It is estimated that it is responsible for nearly 19% of AIDS-related mortality, second only to tuberculosis. Rapid screening, diagnosi
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s and linking to appropriate treatment are critical actions national programs must take to reduce the burden of disease.
WHO in 2022 introduced updated guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. This policy brief provides a summary of the key recommendations, clinical considerations, and also stresses the importance of ensuring access to life-saving antifungals. There is an urgent need for countries to scale-up management for not just cryptococcal meningitis, but address cryptococcal disease in the context of a package of care for advanced HIV disease as recommended by WHO.
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Interim rapid response guidance, 10 June 2022.
It includes considerations for certain populations such as patients with mild disease with considerations for community care, patients with moderate to severe disease, sexually active persons, pregnant
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or breastfeeding women, children and young persons. The guidance also addresses considerations for clinical management such as the use of therapeutics, nutritional support, mental health services, and post-infection follow-up.
The document provides guidance for clinicians, health facility managers, health workers and infection prevention and control practitioners including but not limited to those working in primary care clinics, sexual health clinics, emergency departments, infectious diseases clinics, genitourinary clinics, dermatology clinics, maternity services, paediatrics, obstetrics and gynaecology and acute care facilities that provide care for patients with suspected or confirmed monkeypox
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WHO-endorsed interagency mental health and psychosocial support guidelines for an effective response to emergencies recommend services at a number of levels – from basic services to clinical care.
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Clinical care for mental health should be provided by or under the supervision of mental health specialists such as psychiatric nurses, psychologists or psychiatrists.
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Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charities such as nongovernmental organizations (NGOs), a
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rmies, and international organizations such as the International Red Cross/Red Crescent movement. They comply with the classification and minimum standards set by the World Health Organization (WHO) and its partners and bring to an emergency their training and self-sufficiency so as not to burden the national health system. EMT initiatives strengthen national surge capacities and facilitate the deployment of internationally classified teams of health- care professionals to countries and territories during emergencies, particularly during disease outbreaks and natural disasters, providing immediate assistance when national health systems are overwhelmed . Considering that they aim to support the provision of quality clinical care services to populations affected by public health emergencies, the expectation is that financial resources and equipment will be available to enable the performance of the requested task.
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The IMCI model handbook provides a detailed explanation of the IMCI case management guidelines. It is organized into seven main parts: overview of the IMCI process; assess and classify the sick child age 2 months up to 5 years; assess and classify the sick young infant age 1 week up to 2 months; ide
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ntify treatment; treat the sick child or the sick young infant; communicate and counsel; and give follow-up care.
Teaching institutions are advised to adapt the handbook in two ways:
to ensure that all text, charts and illustrations are consistent with nationally-adapted IMCI clinical guidelines, and
to ensure that its content and format corresponds to the teaching approach used by the institution.
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Open Guidelines is brought to you on behalf of the paediatrics department of Queen Elizabeth
Central Hospital in Blantyre, Malawi. Our aim is to improve access to clinical guidelines for our
health care
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professionals.
Open guidelines has all the latest QECH clinical protocols and essential drug information. All
content can be downloaded and afterwards be accessed at any time. The app has a search function.
Total data volume for download is 15 MB. Also on the same app one can access COIN, an excellent neonatal and
infant training course.
more
9 April 2020
WHO has published the guidance “Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected” This document is intended for clinicians taking care
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of hospitalized adult and paediatric patients with severe acute respiratory infection (SARI) when COVID-19 infection is suspected. Optimized supportive care should be provided to ensure the best possible chance for survival of COVID-19 patients as described in the WHO guidance:
1. Management of severe COVID-19 requires oxygen therapy and monitoring. Supplemental oxygen therapy should be given immediately to patients with SARI and respiratory distress, hypoxaemia or shock.
2. Management of critical COVID-19 (acute respiratory distress syndrome (ARDS)) requires advanced oxygen/ventilatory support.
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This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative
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care, monitoring and end of life care. This publication addresses medical devices for six types of cancer: breast, cervical, colorectal, leukemia, lung and prostate. The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals. The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information. The third section lists the priority medical devices required to manage cancer in seven different units of health care services: 1. Vaccination, clinical assessment and endoscopy, 2. Medical imaging and nuclear medicine, 3. Surgery, 4. Laboratory and pathology, 5. Radiotherapy, 6. Systemic therapy and 7. Palliative and end of life care
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