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This brief summarizes current evidence and guidance for maintaining safe and effective care across the spectrum of maternal, newborn
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and infant care while protecting mother and child and health care providers during COVID-19. Furthermore, implications of the principle of “do no harm” are reviewed for maternal, newborn and infant care delivery during COVID-19, so that this information is conveniently and readily available to clinical and health system policy leaders and stakeholders in countries and communities. Additionally, considerations for safe oxygen delivery as well as key Infection Prevention and Control (IPC) measures at home and in healthcare facilities for pregnant women, newborns and children are described in detail in the brief.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of car
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e for critically ill patients, especially in low-staffed and low-resourced settings, and mortality rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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This study, and similar studies in Kenya, Mozambique, Swaziland, Uganda, and Zambia is the outcome of close collaborative by a team in Swaziland, with technical
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and financial support from the UNAIDS Regional Support Team for Eastern and Southern Africa, UNAIDS Geneva, and the World Bank's Global HIV/AIDS Program (Global AIDS Monitoring and Evaluation Team). The study entailed using existing data and collecting new data to better know the country's HIV epidemic, know the country HIV response and how funding was allocated, so as to improve the HIV response and strengthen prevention based on evidence on what works to prevent new infections.
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This document synthesizes key elements of the World Health Organization (WHO) normative guidance on health policy and system support for community health worker (CHW) programmes and their applicatio
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n for HIV programmes. Building on relevant elements of HIV guidelines, tools and evidence identified by experts, it provides recommendations on tasks and roles that can be performed by CHWs (including for HIV), identifies the policy and system supports to optimize CHW performance, and gives examples of best practice. Its purpose is to inform the optimal design and delivery of CHW programmes targeting – either specifically or as part of a broader approach – the scale-up and sustainability of HIV services.
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This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access
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to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describe decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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Recent Trends in HIV-Related Knowledge and Behaviors in Rwanda, 2005-2010: Further Analysis of the Demographic and Health Surveys.
Hong, Rathavuth, Jean de Dieu, Jeanine Umutesi Condo, Muhayimpundu Ribakare, and Egidie Murekatete
Calverton, Maryland, USA: ICF International
(2013)
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DHS Further Analysis Reports No. 89 - The 2010 Rwanda Demographic and Health Survey shows that 3 percent of Rwandan adults age 15-49 have been infected with HIV. The prevalence was much higher in ur
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ban areas, among women, and among adults who had multiple lifetime sexual partners and used a condom at last sexual intercourse. The
level of and differences in HIV prevalence in Rwanda in 2010 are very similar to those observed in 2005. Using data from the two recent Rwanda Demographic and Health Surveys, implemented in 2005 and
2010, this study examined changes in key HIV-related knowledge, attitudes, and sexual behavior indicators. Significant changes in selected indicators during 2005 and 2010 were determined by Student ttest with p-values less than 0.05.
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2017)
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage presents a complete analysis of the resources available for heal
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th in 184 countries, with a particular focus on development assistance for health (DAH). DAH was estimated to total $37.6 billion in 2016, up 0.1% from 2015. After a decade of rapid growth from 2000 to 2010 (up 11.4% annually), DAH grew at only 1.8% annually between 2010 and 2016. In low-income countries, where much DAH is targeted, DAH made up 34.6% of total health spending in 2016. In upper-middle- and high-income countries, which generally do not receive DAH, DAH accounted for only 0.5% of total health spending. The other 99.5% of health spending – government, prepaid private, and out-of-pocket spending – is the subject of our further analysis.
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This pocket book is a 317 page summary of the emergency components of obstetrics and resuscitation of the newborn infant from our textbook "International Maternal & Childhealth Care - A practical ma
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nual for hospitals worldwide". The reader is referred to the textbook when more details on the medical problem under consideration are required.
If you work in a hospital in a low income country - providing free care - you are probably intitled to FREE copies of these books. MCAI will send them to you, all you have to do is to read our Flyer and fill in the request form.
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This document provides training and guidance on legal capacity and how supported decision making, recovery plans and advance plans help
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to avoid involuntary detention and treatment and ensure people are able to exercise their right to legal capacity.
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Shadow Report - On the situation of women who use drugs, women living with HIV, sex workers, and lesbian, bisexual women and transgender people in Ukraine
Legalife-Ukraine; Insight; Positive Women; Svitanok; echo.net
(2017)
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Prepared by NGOs: “Legalife-Ukraine”, “Insight”, “Positive Women”, and “Svitanok”
For the submission to the 66th CEDAW Session Geneva, Switzerland
13 February 2017 - 03 March 2017
Migrants in an irregular situation: access to healthcare in 10 European Union Member States
recommended
European Union Agency for Fundamental Rights
(2011)
CC2
This report explores the access to healthcare granted to irregular migrants in 10 EU Member States. It focuses on migrants who are present in an ir
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regular situation, namely those who do not fulfil conditions for entry, stay or residence. Through interviews with a range of different sources including public authorities at the national and local level, health professionals, non-governmental organisations (NGOs) providing helathcare and irregular migrants themselves, this report documents the legal, economic and practical obstacles that hinder migrants' access to healthcare.
For versions in French, Polish, German and Swedish check also http://fra.europa.eu/de/publication/2012/migranten-einer-irregulren-situation-zugang-zu-medizinischer-versorgung-zehn
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Med Princ Pract 2021;30:17–28
An overview of ethics and clinical ethics is presented in this review. The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and jus
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tice, are defined and explained. Informed consent, truth-telling, and confidentiality spring from the principle of autonomy, and each of them is discussed. In patient care situations, not infrequently, there are conflicts between ethical principles (especially between beneficence and autonomy). A four-pronged systematic approach to ethical problem-solving and several illustrative cases of conflicts are presented. Comments following the cases highlight the ethical principles involved and clarify the resolution of these conflicts. A model for patient care, with caring as its central element, that integrates ethical aspects
(intertwined with professionalism) with clinical and technical expertise desired of a physician is illustrated
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data co
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llection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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WHO is launching a “Revised edition, 2021” for the Caring for women subjected to violence: A WHO training curriculum for health-care providers today. The revised edition includes 4 new modules t
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hree of which are for health managers to assess and strengthen health facility readiness and one module, which is for managers and providers to support prevention of violence against women. The earlier content published in 2019 remains unchanged. The 2021 edition is aimed at creating an enabling health systems environment for health workers to provide quality care to women subjected to violence.
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Baby-Friendly Hospital Initiative: revised, updated and expanded for Integrated Care - Section 2; Session 1: The national infant feeding situation
WHO, UNICEF
(2009)
The revised package of BFHI materials includes five sections: 1. Background and Implementation, 2. Strengthening and Sustaining the BFHI: A course for decision-makers, 3. Breastfeeding Promotion
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and Support in a Baby-friendly Hospital: a 20-hour course for maternity staff, 4. Hospital Self-Appraisal and Monitoring, and 5. External Assessment and Reassessment. Sections 1 to 4 are widely available while section 5 is for limited distribution.
Slides
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Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition
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to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environmental factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
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Social protection: a Fast-Track commitment to end AIDS
UNAIDS (Joint United Nations Programme on HIVAIDS); Unicef; World Health Organization; et al.
(2018)
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UNAIDS 2018 / Guidance
Guidance for policy-makers, and people living with, at risk of or affected by HIV
Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right
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and an indispensable condition for human dignity. The model outlined here demonstrates that it is within our reach to close the financing gap even for the poorest countries by 2020 if all governments, from the privileged and underprivileged parts of the world alike, just fulfil the commitments and recommendations for financing human development and health that already were agreed many years ago.
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The handbook on supply chain management for HIV/AIDS commodities was written to assist program managers to plan
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and implement day–to-day management of all drugs and medical supplies for an HIV/AIDS program. Many of the suggested techniques described in this handbook are helpful to program managers starting to plan or scale-up provision of drugs and supplies for a HIV/AIDS program. Additionally, some of the information may be helpful to readers who are implementing a new program and may not have robust logistics systems in place. For other readers, this handbook may serve as a checklist of systems and procedures that need to be in place in order to manage the many of the health commodities required for the HIV/AIDS program.
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As the world population is growing and health care resources are in high demand the pressure on medical services is becoming higher. Developing countries are already at a crisis point in health
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care provision, and time demands a new approach in structuring medical resources. Primary care is the vital pillar for fundamental health care at community level and has been deemed as a cost-effective modality. In the West the primary care physician manages chronic medical conditions in communities and therefore reduces unnecessary hospital admissions. In the West, the primary care system is extremely well organised. Low-income countries must improve teaching, training and funding in primary care. In this article the urgent need for primary care is discussed in developing countries, and ways to minimise costs and improve clinical outcomes at community level.
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