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This article unites the latest guidelines on the management of arterial hypertension in primary health care in Portuguese speaking countries includ
...
ing Brazil, Angola, Mozambique, São Tomé e Príncipe, Cape Verde, among others.
more
The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries. It comprises six modules and an implementation guide. This package supports Ministries of Health
...
to strengthen CVD management in primary health care settings. The practical, step-by step modules are supported by an overarching technical document that provides a rationale and framework for this integrated approach to the management of NCDs.
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
...
terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis,
...
care and management of CVD diseases. Affordable essential medicines and technologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
more
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, pri
...
mary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (which may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
more
Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for prev
...
enting and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
more
HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance im
...
plementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
more
Schistosomiasis is a chronic disease linked to poverty and is widely endemic, particularly in sub-Saharan Africa. For decades, the World Health Organization has called for a larger role of the primary
...
health care system in schistosomiasis control, and its integration within the routine activities of primary health care facilities. Here, we reviewed existing studies on the integration of schistosomiasis control measures within the primary health care system, more precisely at the health centre, and we analysed their outcomes.
more
Defining Disability - A Guideline for Medical Doctors and Primary Health Care Workforce
Prof. AHM E. Hussain; Dr. N. Mohammad; Dr. Md. R. Karim; et al.
Government of the People's Republic of Bangladesh DGHS Directorate General of Health Services Ministry of Health and Family Welfare ; NCDC; drra; et al.
(2019)
C2
January 2019
Non Communicable Disease Control Programme Directorate General of Health Services Health Services Division, Ministry of Health & Fa
...
mily Welfare
more
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive
...
predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
In March 2018, they convened a global meeting with the aim of establishing an action plan to develop new diagnostic solutions for Buruli ulcer and to create a framework of collaboration to address unmet needs in diagnostics for the disease. The participants agreed to develop a target product profile (TPP) to address the need for a rapid diagnostic test for use at the primary health-care level.
more
The course aims to cover the types of NCDs and risk factors, the challenges of delivering NCD services in primary health care, elements of WHO tech
...
nical packages (PEN and HEARTS) for NCDs and how to adapt these packages in primary health care.
SEARO NCD PEN-HEARTS is a series of four courses with the other three courses focusing on NCDs interventions, diabetic foot care and palliative care that will enable the learner to plan and deliver NCD services.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health
...
care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
This publication aims to provide an overview of the state of developmental monitoring in selected countries across the Europe and Central Asia region (ECAR), to document the existing evidencebased approaches and models for developmental monitoring and to identify the key considerations necessary to
...
guide discussions around introducing and enhancing developmental monitoring as a part
of primary health care.
more
This book is one of fifteen modules of the “Noncommunicable disease education manual for primary health care professionals and patients”. This
...
manual is intended to provide health information on the prevention and control of hypertension and diabetes. This will be used in the form of a flip chart for health professionals to educate their patients with either hypertension or diabetes.
more
The course aims to cover the types of NCDs and risk factors, the challenges of delivering NCD services in primary health care, elements of WHO tech
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nical packages (PEN and HEARTS) for NCDs and how to adapt these packages in primary health care.
more
Petersenet al.International Journal of Mental Health Systems2011,5:8http://www.ijmhs.com/content/5/1/8
In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit
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y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
more
In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors
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ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
more
The incidence of circulatory disorders is increasing worldwide, affecting both low- and middle-income countries and some high-income countries. There is evidence of rising incidence and prevalence rates, even among younger individuals, along with an increasing prevalence of risk factors such as high
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blood pressure, diabetes, and obesity. These indicators suggest that current approaches are not
effective in managing and reducing the burden of conditions affecting circulatory health.
more
2006-2008 programme report
Infant Psychiatry
Chapter B.2
The objective of Critical Considerations and Actions for Achieving Universal Access to Sexual and Reproductive Health in the Context of Universal Health Coverage through a
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Primary Health Care Approach is to provide guidance to WHO Member States for ensuring progress towards universal access to comprehensive sexual and reproductive health (SRH) in the context of primary health care (PHC)- and universal health coverage (UHC)-related policy and strategy reforms.
more
The Primary Care Innovator’s Handbook
recommended
Voices from Leaders in the Field
Primary Care 101
recommended
Symptom-based integrated approach to the adult in primary care.
Primary Care 101 is a comprehe
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nsive clinical practice guideline that aims to equip nurses and other clinicians to diagnose and manage common adult conditions at primary level.
Tb; HIV; Asthma/COPD; cardiovascular disease; diabetes; Mental health conditions; Epilepsy; Musculoskeletal disorders; Women’s health
more
Technical Series on Safer Primary Care
Good primary care may lead to fewer avoidable hospitalizations, but unsafe primary care can caus
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e 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.
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The purpose of this manual is to provide guidance in the design, implementation and evaluation of a course that aims to build and strengthen the capacity of health personnel to manage eye patients at prima
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ry-level health facilities in the African Region. The course falls within the remit of continuous professional development in its broadest sense. Its content focuses on simple evidence-based practice that can be easily carried out in primary-level health facilities all over Africa.
This manual is intended for use by course directors and facilitators. Its intended audience includes all persons who wish to commission, support or offer a course serving the above aims, including pre-service training. This manual sets out the requisite steps for the preparation and organization of such a course.
more
Primary care can play a significant role in the COVID-19 response by differentiating patients with respiratory symptoms from those with COVID-19, making an early diagnosis, helping vulnerable people
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cope with their anxiety about the virus, and reducing the demand for hospital services. This document provides national and subnational health managers, as well as staff at primary care facilities, with interim guidance on timely, effective and safe supportive management of patients with suspected and confirmed COVID-19 at the primary care level; and delivery of essential health services at the primary care level during the COVID-19 outbreak
more
The WHO Training Resource on Primary Ear and Hearing Care is a new set of four training manuals aimed at equipping primary
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health care workers in
developing countries with simple and effective methods to reduce the burden of ear and hearing disorders.
more
The recently published World Health Organization (WHO) Strengthening infection prevention and control in primary care document collates existing st
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andards, measurement and implementation approaches, and resources for infection prevention and control (IPC) in primary care. During its development, it became apparent that a number of already existing tools and resources have the potential to support facility-level implementation of IPC in primary care.
This toolkit brings together in one place a number of these tools and resources from WHO and other organizations, with a focus on those most relevant to primary care. These tools and resources have been compiled to support facility-level implementation in line with the recommended WHO IPC Hub and Task Force multimodal approach.
more
Patient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that reflect current best practice and WHO guidance. The m
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anual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritized and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
more
The objective of this book is to provide health workers with easily accessible information on important aspects of the medicines commonly used at primary
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care level in Zimbabwe. Medicines are a crucial part of the management of most of our patients, yet many medicines are potentially dangerous if not used correctly (by either prescriber or patient). It is important to have up-to-date information not only on the indications for, and the dose of a particular medicine, but also the contra-indications and reasons for special care, possible side effects and interactions with other medicine or medicines. The patient must also have information on how to use the preparation, what side effects may occur, and when to return for help.
more
The ICOPE guidance for person-centred assessment and pathways in primary care (ICOPE Handbook) helps community health and
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care workers put the recommendations outlined in the ICOPE Guidelines into practice. The Handbook assists with setting person-centred goals, screening for loss in a range of domains of intrinsic capacity and assessing health and social care needs to develop a personalised care plan. The care plan may include multiple interventions to manage declines in intrinsic capacity, provide social care and support, support self-management and support caregivers. The domains of intrinsic capacity include cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss and depressive symptoms.
more
The manual has been designed in a comprehensive manner, the aim being to provide a holistic approach to the short-term development of human resources, with a focus on primary care physicians. This i
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s a reference manual meant for primary care physicians who will provide care to older people in primary health care facilities. The information on old age care is meant to be incorporated into the everyday clinical practice of primary care physicians. This manual will help to enhance the knowledge and skills of physicians. It is expected that the use of the manual will improve the approach to issues of old age and promote holistic care of older people, which will ultimately improve their quality of life.
more
Updated 19 March 2020
WHO alcohol brief intervention training manual for primary care
World Health Organization (Europe)
(2017)
C_WHO
Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important
...
role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions.
more
This document aims to support those working in primary care to strengthen IPC, informed by existing WHO IPC guidance and implementation resources. Many of the existing WHO IPC guidance and implement
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ation resources initially developed for acute health care facilities have a potential utility for IPC in primary care. However, navigating these resources to locate relevant content for IPC in primary care can be challenging as some documents can span over 100 pages. This document extracts relevant content, bringing together existing WHO IPC standards, indicators and implementation approaches that are focused on, or directly relevant to IPC in primary care. It should also be used to identify resources suitable for use in primary care that can be embedded within relevant IPC or other health programmes.
more
The purpose of the Clinical Practice Guideline for Treatment of Patients with Anxiety Disorders in Primary Care is to provide professionals with practical recommendations based on scientific evidenc
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e to assist in the detection and effective treatment of these disorders
more
Kenya : Clinical Guidelines for Management and Referral of Common Conditions at Levels 2-3: Primary Care
Ministry of Medical Services, Kenya; Ministry of Public Health & Sanitation
World Health Organization WHO
(2009)
C_WHO
Clinical Management and Refferal Guidelines Vol. 2.
The purpose of the guideline is to provide evidence-based recommendations on nonsurgical interventions for chronic primary LBP (CPLBP) in adults, including older people, that can be delivered in primary
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and community care settings to improve CPLBP-related health and well-being outcomes. For this reason, the guideline does not consider interventions typically delivered in secondary or tertiary care settings (e.g. surgical or other invasive procedures) or workplace interventions.
more
The purpose of the guideline is to provide evidence-based recommendations on nonsurgical interventions for chronic primary LBP (CPLBP) in adults, including older people, that can be delivered in primary
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and community care settings to improve CPLBP-related health and well-being outcomes. For this reason, the guideline does not consider interventions typically delivered in secondary or tertiary care settings (e.g. surgical or other invasive procedures) or workplace interventions.
more
Bulletin of the World Health Organization; Type: Perspectives
Article ID: BLT.19.24843
Community health workers in Lesotho: Experiences of health promotion activities
T. Seutloali; L. Napoles; N. Bam
African Journal of Primary Health Care & Family Medicine; AOSIS
(2018)
C2
African Journal of Primary Health Care & Family Medicine
ISSN: (Online) 2071-2936, (Print) 2071-2928
Human resources for health in Botswana
Nkomazana, O., Peersman, W., Willcox, M., et al.
African Journal of Primary Health Care & Family Medicine (PHCFM)
(2014)
CC
The results of in-country database and reports analysis
Primary care visits may be a time that refugee families express concerns about their child’s functioning at home or school and/or providers may identify concerns about emotional or behavioral
...
health. Most refugee children have experienced trauma which may affect their emotional, behavioral, and physical development. However, many refugee children are resilient
and may not exhibit symptoms related to trauma.
more
This content provides concise, pragmatic guidance to front-line healthcare workers. The guidance is written by PCI’s Clinical Associates, who are themselves primary healthcare workers. It draws on up-to-date guidance from key sources including t
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he WHO, UNHCR and PCI’s own sister organisation Red Whale (a leading provider of medical education in the UK). The modules include: A guide to public health measures; The definition of a case of COVID-19 virus, Preparing the primary health care centre; Prevent the spread of COVID-19; Triage and management in primary care; Managing patients with NCDs; Mental health -patients and healthcare workers; and Case studies.
How to access the course:
Go to the ‘PCI Academy’ website homepage https://covid19.pci-academy.org/
Register for an account, Go to the ‘COVID-19’ course
more
The availability of water, sanitation and hygiene (WASH) services in health care facilities, especially in maternity and primary-
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care settings where they are often absent, supports core aspects of quality, equity and dignity for all people. This document describes an approach for conducting a national situational analysis of water, sanitation and hygiene (WASH) as a basis for improving quality of care. This document describes the process from the initial preparatory stages, including triggers for action, through data collection and analysis to the dissemination of results. Each element of the approach is described and possible limitations and mechanisms to mitigate these are explored.
more
ndependent of the current conflict, the health sector in Ukraine faces several critical shortcomings. In particular, the country has an oversupply of hospitals and an undersupply of primary
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care and diagnostic facilities. Addressing these limitations will require substantial amounts of capital investment, but constraints on public finances in the post-war context will reduce the Government’s ability to fund the needed reconfiguration. Multiple international financial institutions have stated their intention to support reconstruction in the aftermath of the war. The use of public–private partnerships (PPPs) may support the achievement of these outcomes and their use in Ukraine is likely to remain an important issue for Government policy-makers and their partners to consider in a variety of post-war scenarios.
more
This book is a practical manual of mental health care for community health workers, primary
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care nurses, social workers and primary care doctors, particularly in developing countries.Helpful features include: over 50 illustrations and case studies, jargon-free explanations and descriptions, flow-charts on common clinical problems, and a practical guide to the use of psychiatric medicines and simple psychological treatments.
Chapters 1, 9 and 10 can be found on the e-TALC CD-ROM number 2 (April 2003). See www.talcuk.org for details Links to Chapters 2 and 3 above. Printed copies of this book can also be obtained from the Royal College of Psychiatrists www.rcpsych.ac.uk/wnitp
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Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems persp
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ective and for people who use these interventions.
The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals.
more
2nd edition
WASH FIT is a risk-based, continuous improvement framework with a set of tools for undertaking water, sanitation and hygiene (WASH) improvements as part of wider quality improvements in health
...
care facilities. It is aimed at small primary, and in some instances secondary, health care facilities in low and middle income countries.
An app, for front line data collection is also available in the Android Google Play store or as a web app
more
A corruption event in 2009 led to changes in how donors supported the Zambian health system. Donor funding was withdrawn from the district basket mechanism, originally designed to pool donor and government financing for
...
primary care. The withdrawal of these funds from the pooled financing mechanism raised questions from Government and donors regarding the impact on primary care financing during this period of aid volatility.
more
Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system chall
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enge 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.
more
This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-
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care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes implementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
more
Investment in all the drivers and facilitators of hand hygiene action in health care to ensure that it occurs at the point of care and other critic
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al moments requires a multidisciplinary, multifaceted approach. WHO describes such an approach as a “multimodal improvement strategy” (MMIS) which is at the core of its implementation models for hand hygiene and infection prevention and control (IPC) programmes. The focus of this document is on the resource considerations for investing in hand hygiene improvement in health care (primary, secondary and tertiary) using the MMIS approach.
more
The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing
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common medical conditions at the primary healthcare level. This document includes treatment protocols for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
more
The toolkit offers advice on how national public health authorities could engage with primary care prescribers so as to promote appropriate a
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nd responsible use of antibiotics. The toolkit contains template materials and some suggested key messages for health professionals, ideas for awareness raising activities, and suggested tactics for getting the messages across to both primary care providers and patients regarding prudent use of antibiotics.
more
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 during the lockdown and up to 10% decline after the lo
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ckdown 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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Task Shifting for Scale-up of HIV Care: Evaluation of Nurse-Centered Antiretroviral Treatment at Rural Health Centers in Rwanda
Shumbusho, F., van Griensven, J., Lowrance, D., Turate, I., Weaver, M.A., et al.
PLoS Medicine
(2009)
CC
The shortage of human resources for health, and in particular physicians, is one of the major barriers to achieve universal access to HIV care and treatment. In September 2005, a pilot program of nu
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rse-centered antiretroviral treatment (ART) prescription was launched in three rural primary health centers in Rwanda. We retrospectively evaluated the feasibility and effectiveness of this task-shifting model using descriptive data.
more
This is a case-ascertained prospective investigation of all identified health care contacts working in a health
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care facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Study population) receives care. Note that this study can be done in health care facilities at all 3 levels of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers.
There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for:
To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level.
To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers.
To evaluate effectiveness of infection prevention and control measures among health care workers
To evaluate effectiveness of infection prevention and control programmes at health facility and national level
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
...
diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
more
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of
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care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s
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(WHO) mental health Gap Action Programme (mhGAP) released evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
more
Following the 2014 Euromaidan Revolution, Ukraine embarked on a national reform program to reduce widespread corruption within government. In the health sector, the government introduced several complementary reforms that aimed to improve the
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health outcomes of Ukrainian citizens, but designed in such a way that they would also reduce corruption. The reforms included reconfiguring primary care financing and essential medicines reimbursement under the newly formed National Health Service of Ukraine; raising the remuneration of health professionals; introducing a transparent, merit-based, process for medical university admissions; and initiating development of an eHealth digital records system.
more
To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities
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for personal autonomy and self-realization. To promote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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Project Programs:
A. Medical Care Program
B. Community Health Promotion and Prevention Program
C. Maternal and Child Health P ... rogram
Target Population: 228,000 people living within the Mon, Kayah, Kayan, Karen,Shan, Kachin, Pa O, Chin and Arakan areas
Project Duration:January to December 2016 more
A. Medical Care Program
B. Community Health Promotion and Prevention Program
C. Maternal and Child Health P ... rogram
Target Population: 228,000 people living within the Mon, Kayah, Kayan, Karen,Shan, Kachin, Pa O, Chin and Arakan areas
Project Duration:January to December 2016 more
Undiagnosed tuberculosis in patients with HIV infection who present with severe anaemia at a district hospital
M. Mntonintshi; D. O’Mahony; S.Mabunda; et al.
African Journal of Primary Health Care & Family Medicine, AOSIS; NCBI (National Center for Biotechnology Information)
(2017)
CC
Original Research
African Journal of Primary Health Care & Family Medicine
ISSN: (Online) 2071-2936, (Print) 2071-2928
Open Access
Outcome of illustrated information leaflet on correct usage of asthma-metered dose inhaler
Wrench, W.; van Dyk, L.; Sirinivas, S.; Dowse, R.
African Journal of Primary Health Care & Family Medicine
(2019)
CC2
Research globally has shown that metered dose inhaler (MDI) technique is poor, with patient education and regular demonstration critical in maintaining correct use of inhalers. Patient information containing pictorial aids improves understanding of medicine usage; however, manufacturer leaflets illu
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strating MDI use may not be easily understood by low-literacy asthma patients.
more
The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six weeks after birth. The primary audience for these guide
...
lines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services.
more
This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, t
...
rachoma, and Chagas disease. It is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
more
This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, t
...
rachoma, and Chagas disease. It is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
more
PACK Nigeria (Adult and Child) provides a single, integrated, comprehensive, evidence-informed clinical guide to support all cadres working in primary healthcare in Nigeria: i.e. junior community health
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extension workers (JCHEWs), community health extension workers (CHEWs), community health officers (CHOs), nurses, midwives and medical officers. Colour-coding is used to clearly delineate the scope of practice of these different cadres and clarify referral pathways. This integration promotes a team-based approach to a patient’s care and enables patients to receive consistent and standardized care from whichever cadre treats them.
You can register for free and get the PACK Global Adult Guide for free
more
Standard Treatment Guidelines and Essential Medicines List for South Africa : Primary Healthcare Level 2020 edition
the Essential Drugs Programme, the PHCAdult Hospital Level Expert review Committee, the National Essential Medicines List Committee
National Department of Health South Africa
(2020)
CC
The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals.
Pharmaceutical and Therapeutics Committees (PTCs) ar
...
e responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as well as at higher levels of care.
more
Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
...
diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
more
It is Zika virus (ZIKV) that most often causes these neurological effects it appears to be the only arbovirus than can cause congenital malformations such as microcephaly. In any case, more scientific tests are needed to establish the causal relationship between the virus and this malformation (7-10
...
).
This document is a practical tool designed to help health workers improve clinical diagnosis and provide timely care for patients infected
with the dengue, chikungunya, or Zika virus. It is intended mainly for
health workers in primary care facilities where laboratory diagnosis of
arboviruses is not always available. However, this guide may also be
very useful in hospitals that provide second- and third-level care, as it
describes the clinical manifestations of each of the three most important
arboviral diseases currently found in the Region, the elements for
differential diagnosis, and their clinical behavior.
more
Primary Care: The Community Health System
Primary care health centers and providers who care for individuals with hypertension and cardiov
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ascular disease have an important role to play in ensuring continued access to care, reducing the risk of coronavirus infection, and appropriately managing people with these co-morbidities who acquire COVID-19. This guidance includes these considerations
more
