The application of digital health technology is growing at a rapid rate in Africa, with the goals of improving the delivery of healthcare services and more effectively reaching out to remote and underserved communities. The lack of enabling guidelines and standards across the continent, on the other... hand, makes it difficult to share data in a meaningful way across the continent.
Considering this, Africa Centres for Disease Control and Prevention (Africa CDC) established a task force of 24 members to provide expertise and guidance in the development of AU HIE guidelines and standards. Members of the task force were subject matter experts working in Africa and internationally on the collection, analysis, and exchange of health information. Some of these experts had been involved in previous consultations on defining Africa CDC’s health information systems strategy. A chairperson, co-chairperson, and secretary were elected to engage the task force members in different technical working groups.
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Adolescence, defined as the period between 10 and 19 years of age, is a developmental stage during which many psychosocial and mental health challenges emerge. There is a well-established link between mental health and HIV outcomes. Adolescents and young adults living with HIV typically have additio...nal mental health needs linked to their experiences of living with and managing a chronic illness, along with prevailing stigma and discrimination. Mental health promotion and prevention is thus a critical priority for this group.
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More than 40% of the world population is 24 years old or younger, the vast majority of whom live in low- and lower middle–income countries. Globally, a quarter of disability-adjusted life years (DALYs) for mental disorders and substance abuse is borne by this age group and about 75% of mental diso...rders diagnosed in adulthood have their onset before the age of
24 years . Most children and young people in developing countries, however, do not have access to mental health care.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall...y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc...ular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance...r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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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 mainta...in 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.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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First Global Patient Safety Challenge Clean Care is Safer Care
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to impro...ve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants.
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The target audience for this training course is non-clinicians such as Home Based Carers, Community Caregivers, Youth Care Workers, Peer educators, Community Health Workers etc. primarily those who will be providing adherence counselling to clients with HIV, TB, Hypertension and Diabetes. This group... of non-clinicians play a vital role in helping to reduce the workload of nursing staff. Amongst others, non- clinicians educate clients and provide emotional support in a manner that makes each client feel like they are receiving focused, individual attention. Non-clinicians are often in close contact with communities and, therefore, able to understand and play a role in alleviating health service barriers in the community.
Facility managers may also be part of the target audience in order to ensure that they understand the components of the minimum package of interventions to support linkage, adherence and retention in care.
Further, their attendance seeks to ensure that non-clinicians receive necessary assistance and support when they have to implement what they have learned back into their workplaces.
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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 care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infra...structure. 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 IMCI chart booklet is for use by doctors, nurses and other health professionals who see young infants and children less than five years old. It facilitates the use of the IMCI case management process in practice and describes a series of all the case management steps in a form of IMCI charts.
...These charts show the sequence of steps and provide information for performing them. The IMCI chart booklet should be used by all health professionals providing care to sick children to help them apply the IMCI case management guidelines. Health professionals should always use the chart booklet for easy reference.The chart booklet is divided into two main parts because clinical signs in sick young infants and older children are somewhat different and because case management procedures also differ between these age groups.
Sick child aged 2 months to 5 years
This part contains all the necessary clinical algorithms, information and instructions on how to provide care to sick children aged 2 months to 5 years.
Sick young infant aged up to 2 months
This part includes case management clinical algorithms for the care of a young infant aged up to 2 months.
Each of these parts contains IMCI charts corresponding to the main steps of the IMCI case management process.
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Guide for coordinators and data collectors - The WHO Operational Package for Assessing, Monitoring and Evaluating Country Pharmaceutical Situations is intended as a useful tool for researchers, policy-makers, planners and others who need to use standardized measurement tools to gather data and other... information. In addition, the operational package can be used by international agencies and donors, by professional groups and nongovernmental organizations (NGOs).
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The document is primarily meant to inform mental health and psychosocial support (MHPSS) staff, such as: psychologists, psychosocial counsellors, social workers, psychiatrists, psychiatric nurses, and others who are involved providing individual or group counselling, psychotherapy and/or psychiatric... treatment for Syrians
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NEPAL CHILDREN’S EARTHQUAKE RECOVERY CONSULTATION - To better understand the consequences of the Nepal Earthquake for children, four child-centred agencies, in coordination with the Ministry of Federal Affairs and Local Development (MoFALD) and the Central Child Welfare Board (CCWB), conducted a C...hildren’s Earthquake Recovery Consultation using Focus Group Discussions (FGDs) with more than 1,800 girls and boys from the 14 most severely-affected districts. The objectives of the consultation were to hear directly from children the challenges they are facing in the aftermath of the earthquakes; to assess the impact of the crisis on their roles, responsibilities and future opportunities; and to seek their views on and recommendations for recovery.
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This is the fifteenth edition of the lecture notes. They were first published in 1987 as a summary of the material used in the biannual epilepsy teaching weekend organised under the auspices of the UK Chapter of the International League against Epilepsy.
(Lecture series consist of a total of 59 cha...pters. Section one - introduction (chapter 1-2). Section two - basic science (chapters 3-5). Section (chapters 6-16). Section four - differential diagnosis (chapter 17-19). Section five - investigations (chapter 20-24). Section six - medical treatment of epilepsy (chapters 25-35). Section seven - outcome (chapters 36-40). Section eight - special groups (chapters 41-44). Section nine - surgical treatment of epilepsy (chapters 45-49). Section ten - social aspects (chapters 50-56). Section eleven - provision of care (chapters 57-59). All chapters available at: https://www.epilepsysociety.org.uk/lecture-notes-0#.Wq-cn8NubIU)
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This course describes the health effects of war, weapons and strategies of violent conflict. Beginning with weapons of mass destruction it then moves on to other weapons and strategies of war such as the use of landmines and mass rape. The course concludes with a number of lessons which give an hist...orical and practical analysis of the response of health professional groups to war and militarisation.
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Wheelchair Service Training Package - Basic level | The main purpose of the training package is to develop the minimum skills and knowledge required by personnel involved in wheelchair service delivery. An important aim of the training package is to get it integrated into the regular paramedical/reh...abilitation training programs such as physiotherapy, occupational therapy, prosthetics and orthotics, rehabilitation nursing. Towards this, WHO is posting the whole training package in the Website for the training institutes and wheelchair service providers. The easiest way to make use of the training package is to download the complete package (requires 3 GB space).
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This rapid compilation of data analyses provides a ‘stock-take’ of social science and behavioural data related to the on-going outbreak of Ebola in North Kivu, South Kivu and Ituri provinces. Based on data gathered and analysed by organisations working in the Ebola response and in the region mor...e broadly, it explores convergences and divergences between datasets and, when possible, differences by geographic area, demographic group, time period and other relevant variables. Data sources are listed at the end of the document.
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