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Publication Years
1552
4007
593
24
3
1
Category
2730
452
372
366
224
127
50
6
3
1
Toolboxes
500
446
365
291
223
214
209
138
137
129
115
108
97
97
96
87
75
70
29
27
26
21
21
6
2
1
The objective of this guideline is to present the complete set of all WHO recommendations and best practice statements relating to abortion. While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommen
...
dations and best practices described in this document aim to enable evidence-based decision-making with respect to quality abortion care.
This guideline updates and replaces the recommendations in all previous WHO guidelines on abortion care
more
WHO recommendations on maternal and newborn care for a positive postnatal experience. Presentation
recommended
This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a
...
“positive postnatal experience” as a significant end point for all women giving birth and their newborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
more
Palliative care for older people: better practices
Hall, S.; H. Petkova, A.D. Tsouros, et al.
World Health Organization WHO, Regional Office for Europe, et al.
(2011)
C_WHO
This publication aims to provide examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately a
...
nd effectively. Examples have been identifi ed from literature searches and from an international call for examples through various organizations, including the European Association of Palliative Care and the European Union Geriatric Medicine Society. Some examples consider how to improve aspects within the whole health system; specifi c smaller examples consider how to improve palliative care education, support in the community, in hospitals or for specifi c groups of people, such as people in nursing homes and people with dementia and their families. Some examples await rigorous evaluation of effectiveness, and more research is needed in this fi eld, especially the cost–effectiveness and generalizability of these initiatives.
more
Good primary care may lead to fewer avoidable hospitalizations, but unsafe primary care can cause avoidable illness and injury, leading to unnecessary hospitalizations, and in some cases, disability
...
and even death.Implementing system changes and practices are crucial to improve safety at all levels of health care. Recognizing the paucity of accessible information on primary care, World Health Organization (WHO) set up a Safer Primary Care Expert Working Group. The Working Group reviewed the literature, prioritized areas in need of further research and compiled a set of nine monographs which cover selected priority technical topics. WHO is publishing this technical series to make the work of these distinguished experts available to everyone with an interest in Safer Primary Care.The aim of this technical series is to provide a compendium of information on key issues that can impact safety in the provision of primary health care.
more
The portable diagnostic imaging technology covered by this document will serve not only the pressing demands for tuberculosis screening and triage but also other diseases. Therefore, the requirements, accessories, hardware and software packages listed in the following specifications are described in
...
detail in order to serve also other pathologies and conditions, like trauma and pneumonia.
Through the definition of "minimum technical requirements", this document is recommended to support decision-making regarding the selection, incorporation, allocation and use of portable X-ray systems and is intended for health care providers, managers of imaging departments, procurement and regulatory agencies, policymakers and planning officers in ministries of health, as well as biomedical engineering professionals, medical physicists, the private health sector, medical device industry and intergovernmental and international agencies.
more
This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a
...
“positive postnatal experience” as a significant end point for all women giving birth and their newborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
more
Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel
...
erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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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
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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
National Guidelines on Nutrition, Care, Support, and Treatment (NCST) for Adolescents and Adults
These guidelines are intended to:
• Establish a consistent set of nutrition interventions and recommendations aimed at managing and preventing und
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ernutrition and overnutrition in adolescents and adults, with a focus on people with HIV/AIDS and tuberculosis (TB) patients.
• Provide simple and clear guidance to service providers and managers on how to implement the nutrition interventions and recommendations at the various health care delivery contact points.
• Provide a framework for policymakers and development partners to use when planning nutrition interventions for adolescent and adults.
more
The Early Essential Newborn Care Pocket Guide was developed by the WHO Regional Office for the Western Pacific for introducing and scaling-up Early Essential Newborn Care. This step-by-step Guide is
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intended to provide a portable and practical summary of the up-to-date global evidence for newborn care focusing on the first hours and days of life, including infection prevention and control measures during COVID-19. This Guide can be used in all health-care settings by skilled birth attendants (midwives, nurses and doctors) who care for newborns, also by managers to ensure all system measures are put in place for optimal quality of care.
more
Updated recommendations on simplified service delivery and diagnostics for hepatitis C infection
recommended
Policy Brief. 24 June 2022. This policy brief, one of two on the updated hepatitis C (HCV) guidelines, focuses on the new recommendations on simplified service delivery for a public health approach
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to HCV testing, care and treatment. These recommendations include decentralization, integration and task-sharing, in addition to the use of point-of-care (POC) HCV viral load assays and reflex viral load testing.
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 p
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ractical 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
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 bio
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logical process related to virus and host interactions.
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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Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment cri
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teria for adults but now also for adolescents; expanded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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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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Patients with suspected coronavirus disease 2019 (COVID-19) can infect others at any time, including during transfer and transport. COVID-19 is a new infectious disease that requires contact and droplet precautions; lapses in infection prevention and control (IPC) can easily happen at vulnerable mom
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ents such as during transfer. This guide aims to identify key steps to prepare the community and health system response to ensure IPC is maintained during transfer and transport. This guide is intended for personnel involved in coordinating and performing transfer and transport of patients with suspected COVID-19 requiring hospital care.
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July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and pe
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rson-centred approach.
These guidelines bring in the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C infection and the 2017 WHO Guidelines on hepatit
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is B and C testing. These priority areas are:
direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
simplified HCV service delivery (decentralization, integration and task sharing)
HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing.
These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.
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Ramped-up cancer services could save 7 million lives over the next decade—and addressing huge service gaps between rich and poor countries is key to success, according to this report.
In 2019, over 90% of high-income countries reported that comprehensive cancer treatment services were available
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through the public health system, compared to fewer than 15% of low-income countries, according to WHO.
But poorer countries can make substantial strides with a universal health coverage approach and use of the latest science to meet their particular needs.
The report lays out proven ways to prevent new cancer cases without breaking the bank, including tobacco-control measures and vaccines that protect against common cancers.
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A cross-sectional descriptive study design covering all states and regions was undertaken to:
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of ... health facilities,
2) To assess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of ... health facilities,
2) To assess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
Primary Care: The Community Health System
The health of the people and health services are in crisis, and together as partners this plan commits us to strategies aimed at achieving our goal of:
Strengthened primary ... health care for all, and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB more
Strengthened primary ... health care for all, and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB more
Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review
Maurice Bucagu, Jean M. Kagubare, Paulin Basinga, Fidèle Ngabo, Barbara K Timmons & Angela C Lee
Reproductive Health Matters
(2012)
CC
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal
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and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the literature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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Ukrainian decentralization reform has increased and democratized local government responsibility for health care at the level of local government closest to communities and has increased regional an
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d local government responsibility for public health. Decentralization affects health system reform in three important areas: health financing, individual health services and public health.
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This document presents an integrated strategy for mental health system development that will lead to enhanced service delivery, improved outcomes,
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and improved human rights for people with mental disorders.
By using the practical guidance provided in this document, countries can ensure that their mental health systems are not haphazard, but rather, the products of careful consideration and planning.
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The ASEAN Mental Health Systems Report
catalogues the situation of mental health in ASEAN
Member States. This report provides comprehensive
information on the progress made so far by AMS in
inte
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grating mental health into national health systems,
increasing access to care as well as challenges faced.
It also offers recommendations on how to improve the mental health system in
respective ASEAN Member States.
more
Slum population in India is growing fast (25.1% decadal growth – Census 2011). Its health and nutrition indicators are worse than that of the non slum urban areas and comparable to that of rural India.
The National Urban
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Health Mission (HUHM), launched in 2013, focuses on improving the health of urban slum population through a needs based, city-specific urban health care system that includes a revamped primary care system, targeted outreach, equitable access, and involvement of the community and urban local bodies (ULBs).
The HUHM recognizes that lack of disaggregated data collected at local and/or city level impedes efficient planning with focus on the urban poor, and that data availability is a critical need.
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Objectives of the Study:
To understand the community needs, behaviors and perception for MNH Iin urban poor settings.
To explore various factors (both demand and supply side) affecting care seeking for MNH.
To assess the preparedness of the urban
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health system for providing MNH services at various levels of care in terms of infrastructures at various levels of care, HR availability and capacity, logistics, drugs & equipment, referral, recording & reporting, supervision, governance and financial modalities.
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The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing
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key activities at each of these three levels. It highlights the need for a health systems approach to enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
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The Department of Health is committed to providing the best quality care to patients and users of health services, in order to meet their expectati
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ons and needs, and to improve service delivery.
The main purpose of the National Core Standards is to:
• Develop a common definition of quality of care, which should be found in all health establishments in South Africa as a guide to the public and to managers and staff at all levels;
• Establish a benchmark against which health establishments can be assessed, gaps identified, strengths appraised; and
• Provide a national framework to certify health establishments as compliant with standards
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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 avail
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ability of appropriately
upgraded environment, which 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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(You need free registration to download the book)
Disasters and public health emergencies can stress health care systems to the breaking point and
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disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources
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The main goal of the National Health Plan (NHP) 2017-2021 is to extend access to a basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. I
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n order to extend service delivery to all communities, the NHP calls for all health workers (whether community-based, outreach-based or facility-based) involved in the delivery of health promotion, prevention and treatment services to be fully recognised and institutionalized within the health system to ensure efficient use of resources, necessary oversight and quality service provision (regardless of whether the health workers are voluntary or salaried). The first year Annual Operational Plan (AOP) of the NHP 2017-2021 calls for a comprehensive literature review of the situation of all Village Based Health Workers (VBHWs) in the country to inform the development of a comprehensive, institutionalized approach to community health for the country.
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Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards
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health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
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A Students' Toolkit.
How does the digital transformation of health care change the daily routine of a healthcare professional? Which knowledge and skills will healthcare professionals need? Are uni
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versities in Europe preparing their students well enough to work within a digitised health system?
This toolkit prepared by the European Medical Students’ Association (EMSA) provides an insightful context, an introduction to the topic of digital health and a framework to encourage future healthcare professionals to start activities and discussions at their university.
more
1 June 2020
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delive
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ry of health care for all conditions. Maintaining essential health services: operational guidance for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges. This document expands on the content of pillar 9 of the COVID-19 strategic preparedness and response plan, supersedes the earlier Operational guidance for maintaining essential health services during an outbreak, and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. It is intended for decision-makers and managers at the national and subnational levels.
This is an update to COVID-19: Operational guidance for maintaining essential health services during an outbreak: Interim guidance, 25 March 2020
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This special issue on Newborn Health in Global Health Action is being launched to share the experience of how to scale up a cost-effective package of newborn
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care that involves families, community health workers and health facilities. The results of this community randomized trial, the Uganda Newborn Study (UNEST), show that home visits in pregnancy and soon after delivery resulted in improved breastfeeding practices, skin-to-skin care immediately after birth, delaying a baby’s first bath, and hygienic care of the baby’s umbilical cord among the poorest households with lowest access to care.
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state that efficiency measurement can be a substantial c
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ontribution to saving lives. Therefore we analyse the performance of health centres in rural Burkina Faso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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This National Health Policy has 5 objectives, namely
i. To strengthen the healthcare delivery system to be resilient
ii. To encourage the adoptio
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n of healthy lifestyles
iii. To improve the physical environment
iv. To improve the socio-economic status of the population
v. To ensure sustainable financing for health
These objectives shall collectively ensure that there will be improved alignment, complementarity and synergies within and across all public sector ministries as well as with other stakeholders, towards achieving the national health goal.
The policy shall therefore ensure that MDAs and other identifiable organizations work within the principles of the Health-in-All Policy and the One-Health Policy frameworks (WHO), to achieve the desired healthy life status of people living in Ghana.
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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related c
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ardiovascular complications may worsen the CVD burden in this already highly affected and resource-limited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030 ... . In practice, this means that over the next 15 years the aim is to progressively ensure that all people in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC. more
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030 ... . In practice, this means that over the next 15 years the aim is to progressively ensure that all people in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC. more
Full eHandbook under: http://www.msh.org/resources/health-systems-in-action-an-ehandbook-for-leaders-and-managers
Effective supply management has the potential to make a powerful contribution to the reliable availability of essential medicines, whi
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ch are a crucial part of the delivery of highquality health care services. Because medicines are costly and poor management so often results in waste, good supply management is also crucial to the cost-effectiveness of providing medicines.
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Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of
...
health care for all conditions. Maintaining essential health services: operational guidance for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges.
more
This handbook is intended primarily for front-line health care providers who are likely to see children (among other clients) in their day-to-day practice. These may include general practitioners, n
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urses, midwives, gynaecologists,
paediatricians, mental health professionals, first responders and staff in emergency care.
Other professionals who may find it useful include social workers, those working in social welfare institutions, providers of psychosocial support, and those working in child care facilities and the education system.
Further, the content will benefit the work of policy-makers and managers to enable and support provision of clinical care to children experiencing, or who have experienced, child maltreatment.
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The overall goal of the Kenya Health Sector Referral Strategy is to improve client access to referral. The objectives of the strategy are to realise improved capacity of health providers to identify
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clients who require referral, develop protocols that will lead to referral system efficiency and effectiveness, and promote and facilitate information and communication technology (ICT) to manage referrals, improve care, enhance capacity of the referral system in Kenya, provide communication and related equipment, and promote research and innovation for referrals.
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This Eye health strategic plan presents the Ministry of Health’s five
year proposed strategies for eye care in Kenya. It sets the strategic
dir
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ection for the National Eye Health Care System and presents
information on the priorities, objectives and indicators that the
Ministry has adopted especially with regard to the main eye diseases
and conditions in the country and health system strengthening.
more
Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak
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health systems and poor infrastructure. Low-carbon approach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
more
Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health
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system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in the design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
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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
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nd pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to determine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
more
Objectives of the Study:
To understand the community needs, behaviors and perception for MNH in urban poor settings.
To explore various factors (both demand and supply side) affecting care seeking for MNH.
To assess the preparedness of the urban
...
health system for providing MNH services at various levels of care in terms of infrastructures at various levels of care, HR availability and capacity, logistics, drugs & equipment, referral, recording & reporting, supervision, governance and financial modalities.
more
The Asia-Pacific Community Mental Health Development (APCMHD) project has been established in 2005 to explore diverse leading models or approaches to community mental health service
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delivery in the Asia-Pacific region. The objective is to illustrate and promote best practice in mental health care in the community through use of information exchange, current evidence and practical experience in the region.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services dur
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ing the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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A practical handbook. This Health Cluster Guide (2nd edition, 2020) provides practical advice on how WHO, Health Cluster Coordinators and partners can work together during a humanitarian crisis to a
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chieve the aims of reducing avoidable mortality, morbidity and disability, and restoring the delivery of and equitable access to preventive and curative health care.
It highlights key principles of humanitarian health action and how coordination and joint efforts among health and other sector actors can increase the effectiveness and efficiency of health interventions and promote better health outcomes. It draws on Inter-Agency Standing Committee and other expert guidance and includes lessons from field experience in acute and protracted crises.
The coordination principles and practice presented in Health Cluster Guide are equally valid for coordinators and members of health sector groups that seek to achieve effective health action in countries where the cluster approach has not been formally adopted.
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DHS Further Analysis Reports No. 108 - This report examines levels, trends, and inequalities in maternal health in Rwanda from 2010 to 2014-15 among women age 15-49 with a recent birth. The analysis uses Demographic and
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Health Survey (DHS) data for 15 key indicators of maternal health: 6 for antenatal care, 3 for delivery, 1 for postnatal care, and 5 for barriers to accessing medical care. Levels and trends in these indicators were analyzed overall and by three background characteristics: women’s education, household wealth quintile, and region.
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Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care
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system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to the trauma to which many were exposed. Several interventions were carried out with aims to integrate mental health into primary health care services. The interplay between socio-cultural beliefs and health (both mental and physical) in Haiti has been widely commented upon by both foreign aid and local caregivers. Observations frequently highlight barriers to the willingness of patients to seek care and to their acceptance of biomedicine over traditional Vodou beliefs. The perception of Haitian beliefs as barriers to the availability and acceptance of mental health care has intensified the difficulty in providing effective recommendations and interventions both before and after the earthquake. Argued in this review is the importance of considering the interactions between socio-cultural beliefs and mental health when developing models for the prevention, screening, classification and management of mental illness in Haiti. These interactions, especially relevant in mental health care and post-disaster contexts, need to be acknowledged in any healthcare setting. The successes and failures of Haiti’s situation provide an example for global consideration.
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Women and Health Initiative Working Paper No. 1. Women and Health Initiative
Improving maternal health in the context of the sub-Saharan African ... HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Improving maternal health in the context of the sub-Saharan African ... HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic burden on individuals, families, societies, and
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health care systems. The recent emphasis on the role of determinants of health, common risk factors and their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control efforts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WAS
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H) services in all health care facilities. Such services are needed to provide quality care, ensure adherence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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Mental disorders are a leading cause of the global burden of disease, and the provision of mental health services in developing countries remains very limited and far from equitable. Using the Creditor Reporting
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System, we estimate the amounts and patterns of development assistance for global mental health (DAMH) between 2007 and 2013. This allows us to examine how well international donors have responded to calls by global mental health advocates to scale up evidence-based services. Although DAMH did increase between 2007 and 2013, it remains low both in absolute terms and as a proportion of total development assistance for health (DAH). The average annual DAMH between 2007 and 2013 was US$133.57 million, and the proportion of DAH attributed to mental health is less than 1%. Approximately 48% of total DAMH was for humanitarian assistance, education, and civil services. More annual DAMH was channelled into the nonpublic sector than the public sector. Despite an expanding body of evidence suggesting that sustainable mental health care can be effectively integrated into existing health systems at relatively low cost, mental health has not received significant development assistance.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapte
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rs (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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Pakistan is on the verge of a public health disaster as a result of the massive monsoon rainfalls and unprecedented levels of flooding that are affecting 33 million people across the country.
The risk of disease outbreaks is extremely high and maln
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utrition rates are rising.
WHO requires US$ 81.5 million to respond to this health crisis in flood-affected Pakistan, to ensure a coordinated delivery of essential health care services, efficient management of severe acute malnutrition, and stronger outbreak detection and control.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NC
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Ds) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care and treatment in Ghana. The purpose of this analysis was to identify the gaps within the current
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delivery of paediatric HIV care and support system and develop a road map for effective implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept). more
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept). more
The EHSP in Botswana seeks to attain universal coverage of high-quality package of essential health services. The EHSP is an integrated collection of cost-effective interventions, promotive, preventive, curative, and rehabilitative, that address the
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main diseases, injuries and risk factors that affect the population. The EHSP has two key purposes:
1) Provide a standardized package of basic services which forms the core of service delivery in all primary health care facilities
2) Promote a redistribution of health services by providing equitable access, especially in underserved areas, population, etc.
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The main objective of the 2014-15 RDHS was to obtain current information on demographic and health indicators, including family planning; maternal mortality; infant and child mortality; nutrition status of mothers and children; prenatal
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care, delivery, and postnatal care; childhood diseases; and pediatric immunization. In addition, the survey was designed to measure indicators such as domestic violence, the prevalence of anemia and malaria among women and children, and the prevalence of HIV infection in Rwanda. For the first time, this 2014-15 RDHS also includes indicators to monitor HIV testing among children age 0-14 as well as domestic violence for males age 15-59.
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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.
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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.
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Interim guidance. 12 May 2021. The Continuity of essential health services: Facility Assessment Tool can be used by countries to rapidly assess the capacity of health facilities to maintain the prov
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ision of essential health services during the COVID-19 pandemic. It can help to alert the authorities and other stakeholders about where service delivery and utilization may require modification and/or investment. This assessment tool covers the following aspects of essential health services:
health workforce (numbers, absences, COVID-19 infections, health workforce management, training and support);
financial management and barriers;
service delivery and utilization (facility closures, changes in service delivery, community communication campaigns, changes in service utilization and catch-up strategies);
IPC capacities (protocols, safety measures, guidelines and the availability of personal protective equipment (PPE) for staff);
availability of therapeutics, diagnostics and supplies, and vaccine readiness; and
provision of COVID-19 primary care services.
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The 2019-2023 Strategy for UNU-IIGH, developed in
2018, built on UNU-IIGH’s strategic advantage and
position vis-à-vis the UN and global health ecosystem.
The Strategy set a goal to advance evidencebased policy on key issues related to sustain
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able
development and health and shifted the Institute’s
body of work from investigator-driven global health
projects to three priority-driven, policy-relevant pillars
of work, each reflecting UNU-IIGH’s unique value
position.
When the COVID-19 pandemic hit in 2020, the
Institute adapted and reprioritised its areas of work
while continuing to deliver on the main strategic
objectives of translating evidence to policy, generating
policy-relevant analyses on gender and health, and
strengthening capacity for local decision making
especially in the Global South.
The new strategic plan encompasses four work packages:
1. Gender Equality and Intersectionality: through this work, we will aim to improve the quality of health care through a human-centred approach, by ensuring the health system is responsive to the needs of structurally excluded individuals and communities; and by advancing a positive and enabling environment for the frontline health workforce—e.g. addressing the experience of gender-based violence.
2. Power and Accountability: through this work, we will catalyse equitable shifts in power and address key accountability deficits that prevent the equitable and effective functioning of the global health system and prevent adequate responsiveness to the needs of states and populations in the Global South.
3. Digital Health Governance: through this work, we will address the colonial legacies and power asymmetries that negatively impact robust digital health governance, identify ways to strengthen health data governance with a particular focus on SRHR and promote diversity in technology design and development.
4. Climate Justice and Determinants of Health: through this work we will leverage UNU-IIGH's position within the UN and network of UNU institutes, network experts, practitioners, policy-makers, and academics to advance evidence-based policy on the different dimensions of the climate emergency and its impact on health.
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Peru − Progress in health and sciences in 200 years of independence
Carrillo-Larco; R.M.; Guzman-Vilca, W. C.; Leon-Velarde, F.; et al.
The Lancet Regional Health - Americas
(2021)
CC
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and
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population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited peopl
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e's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also
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the importance of basing the response on existing structures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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The International Rescue Committee (IRC) is a leading humanitarian agency dedicated to helping people whose lives have been shattered by conflict and disaster to survive, recover, and gain control of their future. Health comprises nearly half of IRC
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’s program portfolio globally and encompasses three sectors: 1) Primary Health (including child health, sexual and reproductive health and rights, and mental health); 2) Nutrition; and 3) Environmental Health. IRC health programming across its portfolio, in terms of the size and breadth, responds to significant needs in crisis affected settings, improving health and wellbeing while reducing causes of ill-health.
This five-year Health Strategy sharpens our focus on where we can have the most impact. It guides our efforts in planning, technical assistance, business development, advocacy, and internal and external collaboration. Through this strategy, we will invest and grow in areas that will help us achieve high impact at scale for our clients. For the next five years these priorities will include: Nutrition; Immunization: Infectious Disease Prevention and Control; Last Mile Delivery of Primary Health Care: Clean Water.
Our strategy aligns with Strategy 100 (S100) and Strategy Action Plans (SAPs). It lays out how IRC, through health, nutrition, and Environmental Health (EH) programming, will advance the IRC’s S100 ambitions, respond to global trends, and capitalize on our value add. The strategy will be complemented by delivery plans that detail investments, actions, and roles and responsibilities to advance our priorities. At the end of FY24, we will take stock of the implementation of the strategy, measure progress towards achieving our goals, and review if it continues to be fit for purpose.
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Bangladesh has been going through incremental trend of GDP growth rates for a long time. The GDP is the key aspect to measure the economic growth of a country. But the current world wide pandemic due to the COVID-19 hardly affects the world’s economy as well as Bangladesh. The present
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lockdown make the wheel of the industries uncertain. The main source of the GDP of this country is ready made garment sector which has been shut down since mid of March 2020. Already 20 billion of cancellation of foreign order makes the situation worse. Also, the foreign remittance has been decline dramatically due to the loss of jobs of Bangladeshi workers in foreign countries. The overall economic situation declines in this country due to the COVID-19 which has huge impact on the health care system especially in maternal and child health. In this paper, the economic situation of Bangladesh before and during the COVID-19 has been shown. Also, how the COVID-19 would affect the condition
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This handbook builds on lessons learned from surveys implemented 2015-2017 and advice provided by the Global task force on TB patient cost surveys. It provides a standardized methodology for conducting health facility-based cross-sectional surveys t
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o assess the direct and indirect costs incurred by TB patients and their households. In addition, it provides recommendations on results dissemination, engaging across sectors in policy dialogue and enabling action and related research for effective modifications in care delivery models, in patient support, and wider cross-sectoral interventions.
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive
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health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Summary of National Priorities - Malawi
Community Health Roadmap
United States Agency for International Development; Bill & Melinda Gates Foundation; The Rockefeller Foundation; World Bank Group; community health acceleration partnership; unicef
(2021)
CC
Malawi’s first National Community Health Strategy (NCHS, 2017-2022) defines a new community health system in which community
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health cadres, both formal and non-formal, deliver services of the Essential Health Package, with a focus on child and maternal health. It envisages an integrated approach to service delivery and is embedded in Malawi’s Health Sector Strategic Plan (HSSPII).
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Policy Brief.
Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the
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mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk.
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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, charit
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ies such as nongovernmental organizations (NGOs), armies, 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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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60%
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of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disability and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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Nurses are key players in health promotion and disease prevention and the backbone of health care systems worldwide. Nurses work on the front lines
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of disease prevention, health promotion, and health management and are often the unsung heroes in health care facilities and emergency response. Despite the critical role they play in health care, there is a nursing shortage across the world that will affect the delivery of competent nursing care. This document highlights key action points for targeted investment in the nursing workforce and calls on Member States to strengthen nursing within the context of their own country efforts.
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Nurses are key players in health promotion and disease prevention and the backbone of health care systems worldwide. Nurses work on the front lines
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of disease prevention, health promotion, and health management and are often the unsung heroes in health care facilities and emergency response. Despite the critical role they play in health care, there is a nursing shortage across the world that will affect the delivery of competent nursing care. This fact sheet highlights key action points for targeted investment in the nursing workforce and calls on Member States to strengthen nursing within the context of their own country efforts. Suggestions for action and strategies for strengthening the nursing workforce in primary health care services are through investment in education, jobs, leadership, and service delivery are provided.
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care
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. Such policy and strategy can help clarify the structures, roles and responsibilities within national quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for c
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are. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice
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The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South Africa.
The NCS de
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fine fundamentals for quality of care based on six dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
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Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors
recommended
The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and
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strategies implemented by countries and health systems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall
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health situation in a country, including the state of the health sector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
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The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and
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strategies implemented by countries and health systems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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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 cli
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nical 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
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The purpose of the review was to assign a cause of death, to ascertain the fac-tors that contributed to the death and to identify any systemic issues that could be addressed to prevent future similar deaths. The perinatal mortality audit process in 2019 provided important insights and evidence-based
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recommendations that can be used both to address system errors and barriers and to identify and praise points of strength. The aim is to pro-vide recommendations for better care for mothers and their infants during pregnancy, childbirth and the neonatal period and improve the quality of care provided throughout the health system.
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The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering
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quality care services to patients over a long time. The new National Guidelines for Prevention and Management of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
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These guidelines for the prevention and management of cardiovascular diseases are a critical ingredient for streamlining care across the entire health services provision continuum. They
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are a strategic component in achieving universal health coverage, securing affordable health care and improving the livelihood of all Kenyans which in turn will guarantee a healthy nation working towards sustainable development and prosperity.These guidelines bring to the fore the need for availability of skilled human resource, sustained adequate funding and partnership building at all levels of governance. It provides clear roles for health workers at the different levels of our devolved system which will ensure a harmonized referral system with basic cardiovascular diseases treatment services available closest to the people while decongesting the county and national referral facilities.
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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
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of
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Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health services closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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INDEX-TB Guidelines - Guidelines on extra-pulmonary tuberculosis for India
Indian Council of Medical Research (ICMR), Global Health Advocates, Cochrane Infectious Diseases Group
World Health Organisation (WHO)
(2016)
C1
The main objective of these guidelines is to provide guidance on up-to-date, uniform, evidence-informed practices for suspecting, diagnosing and managing various forms of extra-pulmonary tuberculosis (EPTB) at all levels of healthcare delivery. They
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can then contribute to the National Programme to improve detection, care and outcomes in EPTB; to help the programme with initiation of treatment, adherence and completion whilst minimizing drug toxicity and overtreatment; and contribute to practices that minimize the development of drug resistance.
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In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population.
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This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five mortality, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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Since 24 February 2022, the war in Ukraine has caused widespread suffering to its people and serious damage
to the country’s infrastructure. Attacks on the country’s health system and its power
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network threaten people, compromise the provision of health care, and complicate the distribution of essential medicines and equipment.
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The military offensive by the Russian Federation in Ukraine which began February 2022 has triggered one of the world’s fastest-growing displacement and humanitarian crisis, with geopolitical and economic ripples felt across the globe. The ongoing war has caused large-scale disruptions to the
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delivery of health services and a near-collapse of the health system. But the crisis also saw an extraordinary mobilization and crisis response to a health emergency by WHO and its more than 100 partners.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidl
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y implemented in countries, in the short to medium term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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The key areas covered are diagnosis, imaging, pathology, surgery, rehabilitation, palliative care and survivorship. It emphasizes a multi-disciplinary team approach which is paramount for quality cancer
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care. The specific cancers covered are breast, central nervous system, gastrointestinal, gynecological, head and neck, hematological, Kaposi’s sarcoma, lung, prostate and pediatric cancers. They also complement the National Guidelines for Cancer Management in Kenya released in 2013.
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his Framework begins with a desired future scenario and considers actions and interventions necessary to get there. It advocates for holistic view to address tuberculosis. The Framework revisits challenges and actions in four layers: TB specific; challenges in
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health systems that influence TB care; challenges in sectors beyond health that determine TB; and overarching governance issues. Multisectoral action and accountability are embedded in the Framework. The Framework is based on the principles of people-centered care and system development.
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