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Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community health... workers (CHWs) have limited knowledge to 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. more
Reducing the humanitarian impact of the use of explosive weapons in populated areas is a key priority for the United Nations, the International Committee ... the Red Cross (ICRC), civil society and an increasing number of Member States. The United Nations Secretary-General has expressly called on parties to conflict to avoid the use in populated areas of explosive weapons with wide-area effects. While the use of explosive weapons in populated areas may in some circumstances be lawful under international humanitarian law (IHL), empirical evidence reveals a foreseeable and often widespread pattern of harm to civilians, particularly from explosive weapons with wide-area effects. Many types of explosive weapons exist and are currently in use. These include air-delivered bombs, artillery projectiles, missiles and rockets, mortar bombs, and improvised explosive devices (IEDs). Some are launched from the air and others are surface launched. Whilst different technical features dictate their accuracy of delivery and explosive effect, these weapons generally create a zone of blast and fragmentation with the potential to kill, injure or damage anyone or anything within that zone. This makes their use in populated areas – such as towns, cities, markets and camps for refugees and displaced persons or other concentrations of civilians – particularly problematic. The problems increase further if the effects of the weapon extend across a wide-area either because of the scale of blast that they produce; their inaccuracy; the use of multiple munitions across an area; or a combination thereof. more
These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the ... of rural communities in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium Development Goals to reduce maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery, postnatal care, the integrated management of newborn and childhood illness, communicable diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases), family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene and environmental health, non-communicable diseases, health education and community mobilisation, and health planning and professional ethics. more
A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems Alliance Report Participation of community ... workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals. more
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the method... more
This strategy was developed to further support countries in their efforts to strengthen their capacity to implement key interventions to optimize their RHIS, enabling the monitoring and delivery of ... more
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service ... and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response more
The course aims to cover the types of NCDs and risk factors, the challenges of delivering NCD services in primary health ..., elements of WHO technical packages (PEN and HEARTS) for NCDs and how to adapt these packages in primary health care. SEARO NCD PEN-HEARTS is a series of four courses with the other three courses focusing on NCDs interventions, diabetic foot care and palliative care that will enable the learner to plan and deliver NCD services. more
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 ... 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. more
This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 ... more
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number ... deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola. With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans. more
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out ... date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation. more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health ... through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more
PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768 Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal a... more