Nurses play a key role in the provision of primary health care (PHC) and the coordination and organization of medical care overall. Nurses are often the first point of contact with the health
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system and have an important role to play in leaving no one behind.
Large-scale reform of PHC in Ukraine started in 2018, and evolving and expanding practices have led to new challenges for both medical facilities and staff. It has become critically important to initiate new practices in the organization of the nursing profession, to adapt and increase their competencies, invest in skills development and create more nursing posts.
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It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care providers to coordinate the continued
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care of children and adolescents with long-term conditions and diseases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
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This document aims to encourage countries to develop and implement policies to maintain and strengthen IPC programmes and measures in health care facilities in the context of the current ongoing transmission of the SARS-CoV-2, with recognition that
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epidemiological trends may vary and the risk of transmission of other pathogens.
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This document provides an overview of key considerations for the provision of the HIV continuum of care in the context of displaced people from Ukraine in the EU/EEA. This document has two aims: firstly, to outline what is known of the Ukrainian HIV
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epidemic, and secondly, to use the HIV continuum of care as a framework to set out suggestions based on published evidence and expert opinion on the management of the HIV continuum of care, with special consideration for people living with HIV from Ukraine. The document will also address the needs of those at risk of acquiring HIV. The main findings of this document were presented during an ECDC webinar, ‘Key considerations on the continuum of HIV care for refugees from Ukraine,’ hosted on 19 May 2022.
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The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community engagement, disease control regulations, and multis
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ector approaches to improve resilience, EHS quality, and equity.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health
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care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma
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and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism
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for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six Afri
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can countries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term
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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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This document provides a summary of infection control recommendations when providing direct and non-direct care to patients with suspected or confirmed Filovirus haemorrhagic fever (HF), including Ebola or Marburg haemorrhagic fevers. These recommen
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dations are interim and will be updated when additional information becomes available.
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Chapter 8, Prison and Health, published
Position Statement
Diabetes Care2018;42(Suppl. 1):S1–S194.
Indiscriminate attacks on health care have contributed to an epic humanitarian catastrophe in Yemen. A new report tracks these attacks in the hope of holding perpetrators on all sides accountable.
It details how both Houthi forces—with their u
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se of wide-area impact weapons—and the Saudi-Emirati coalition—with their aerial attacks—have flagrantly disregarded the special status of health facilities and personnel in conflict zones.
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Our spiritual health profoundly impacts our physical health, well-being, and quality of life. Just as medical professionals care for our bodies and minds, spiritual care practitioners
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care for our spirits. The increasing need for spiritual care makes these practitioners even more crucial. However, many of us have limited access to quality, professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.Investigators and researchers are creating a growing body of evidence for the innumerable benefits of professional spiritual care, yet many people still do not have a lot of accurate information about these practitioners. To create this publication, the six largest healthcare chaplaincy organizations in North America collaborated to share the facts about spiritual care and practitioners’ roles, training, and standards.By providing evidence and dispelling myths, the thousands of spiritual care practitioners represented by these organizations hope to increase access to spiritual care for the benefit of all.
accessed July 2020
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This is an abridged version of the 2019 Standards containing the evidence-based recommendations most pertinent to primary care. The tables and figures have been renum-bered from the original document to match this ver
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sion. The complete 2019 Standards of Care document, including all supporting references, is available at professional.diabetes.org/standards.
This is an abridged version of the American Diabetes Association’s Standards of Medical Care in Diabetes—2019. Diabetes Care2018;42(Suppl. 1):S1–S194. The complete 2019 Standards supplement, including all supporting references, is available at professional.diabetes.org/standards.
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Burns are a global public health problem, accounting for close to 200,000 deaths annually. The majority of these occur in low- and middle-income countries, where a number of constraints complicate the public health task of addressing burns. While the primary prevention of burns in low- and middle-in
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come countries is a pressing need, the World Health Organization (WHO) also actively encourages further development of burn-care systems, including the training of health-care providers in the appropriate triage and management of people with burns.
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