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 (no...n-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma 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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The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies
show high rates of depression and anxiety, among other psychological symptoms, particular...ly among women, young
people, those with pre-existing mental health conditions, health workers, and persons living in vulnerable condi-
tions. Mental health systems and services have also been severely disrupted. A lack of financial and human resource
investments in mental health services, limited implementation of the decentralized community-based care approach
and policies to address the mental health gap prior to the pandemic, have all contributed to the current crisis. Coun-
tries must urgently strengthen their mental health responses to COVID-19 by taking actions to scale up mental
health and psychosocial support services for all, reach marginalized and at-risk populations, and build back better
mental health systems and services for the future.
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Q14. SCOPING QUESTION: In adults with psychotic disorders (including schizophrenia), what is the comparative effectiveness and safety of second-generation antipsychotic medications?
Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the challenges identified. This emerging ...movement has not yet agreed upon a code of ethics to underpin the rapidly expanding body of research being carried out in its
name. However, a code of ethics might support the principles for planetary health set out in the Canmore Declaration of 2018. Phrases such as “Public Health 2.0”, “Human Health in an Era of Global Environmental Change”, or “A safe and just operating space for humanity” are often used in planetary health discussions, but are not always clearly defined and so far, the field lacks a strong guiding ethical framework. In this paper, we propose a starting point towards a code of ethics for planetary health that builds on the Canmore Declaration.
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COVID-19 is a serious disease and all people living with HIV should take all recommended preventive measures to minimize exposure to, and prevent infection by, the virus that causes COVID-19. As in the general population, older people living with HIV or people living with HIV with heart or lung prob...lems may be at a higher risk of becoming infected with the virus and of suffering more serious symptoms.
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Previous advocacy efforts have achieved tangible goals in terms garnering political commitments
to increase financing for TB—as seen at the 2018 UN High-Level Meeting on TB. The challenge
now is to ensure that these commitments are actually met within a global biomedical research
ecosystem that... is designed and incentivized to prioritize the health needs of wealthy populations
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People affected by impairments and disabilities associated with TB are even more likely to belong to marginalized segments of society and are more likely to have their human rights unprotected. The challenges faced by people affected by TB include t...he consequences of impairment and disability associated with the disease, its treatment as well as with the stigma and discrimination applied to people affected by TB. There is now compelling evidence that the disease and its treatment affect quality of life and life expectancy even after successful treatment.
The WHO Global Tuberculosis Programme has produced the first policy brief on TB-associated disability, building on the increasing evidence in recent years on the unaddressed needs of people with TB who experience impairment and disability while on TB treatment and after completing TB treatment.
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Despite high regional demand for vaccines valued at over US$ 1 billion annually, Africa’s vaccine industry provides only 0.1% of global supply. Vaccine inequity and hoarding at the start of the pa...ndemic, which resulted in delays in obtaining COVID-19 doses, stimulated new resolve to address future supply security. In 2021, the AU set a target to produce and supply more than 60% of the vaccine doses on the continent by 2040.
In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040*, demonstrating the potential for a thriving regional industry to emerge.
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MEDBOX Issue Brief no. 6
This issue brief gives you an overview of the most important documents on humanitarian aid and the WASH sector in MEDBOX
Infectious diseases cause over one billion human infections per year, with millions of deaths each year globally. Extensive health and financial burden is seen from both established and emerging infectious diseases. Infectious diseases also affect p...lants and animals, which may pose threats to agriculture and water supplies with additional impacts on human health. This Question and Answers, prepared by the World Health Organization (WHO) and Convention on Biological Diversity (CBD) Secretariat under their joint work programme on biodiversity and health, and launched of the occasion of the International Day for Biodiversity 2020, summarizes some of the interlinkages between biodiversity and infectious diseases.
WHO is continuously monitoring and responding to the COVID 19 outbreak. This Q&A will be updated as more is known about COVID-19, how it is affecting people worldwide, and the effectiveness of interventions against the disease.
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Given that the emergency has exceeded the worst-case scenario, this revised supplementary appeal for the Ukraine situation outlines UNHCR’s additional requirements of $1.246 billion for March to December 2022.
These guidelines – an update to the World Health Organization’s 2015 publication Consolidated strategic information guidelines – present a set of essential aggregate indicators and guidance on choosing, collecting and systematically analysing ...strategic information to manage and monitor the national health sector response to HIV.
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As the Burundi refugee crisis enters its fourth year, some 430,000 Burundian refugees are being hosted across the region by the governments and people of Tanzania, Rwanda, the Democratic Republic of... the Congo, and Uganda. Although the spectre of mass violence in Burundi has receded, with the political situation still unresolved and the persistence of significant human rights concerns, refugee arrivals are expected to continue in 2018, albeit at lower levels than in previous years.
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This publication provides directions for a logical, evidence informed approach to selecting, developing, implementing and monitoring population-based interventions within the context of the double-burden o...f malnutrition in South-East Asia. The focus of this guide is on processed or ultra-processed pre-packaged foods.
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The International Association for Child and Adolescent Psychiatry and
Allied Professions (IACAPAP) aims to promote the mental health and
development of children and adolescents worldwide. It seeks to achieve
this by contributing to the training a...nd professional development of the
child and adolescent mental health professionals by disseminating up-todate
and high-quality information through its publications, organization
of biennial international congresses, and study groups. IACAPAP has a
long tradition of publishing monographs released to coincide with the
congresses, with the first one published in 1970.
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The revised guidelines contain recommendations for specific administrative, environmental controls and respiratory protection, following the assessment made by an external group of experts convened as members ...ox">of the Guideline Development Group. Moreover, these guidelines focus on interventions specific to preventing transmission of Mycobacterium tuberculosis bridging with the core components of infection prevention and control programmes at the national and acute health care facility level
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During the past five decades, the incidence of dengue has increased 30-fold. Some 50–100 million new infections are estimated to occur annually in more than 100 endemic countries, with a documented further spread to previously unaffected areas; e...very year hundreds of thousands of severe cases arise, including 20 000 deaths; 264 disability-adjusted life years per million population per year are lost , at an estimated cost for ambulatory and hospitalized cases of US$ 514–1394, often affecting very poor populations. The true numbers are probably far worse, since severe underreporting and misclassification of dengue cases have been documented.
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The information contained in this document, be it guidelines, recommendations, diagnostic algorithms or treatment regimens, are offered in this document in the public interest. To the best of the knowledge ...>of the guideline writing team, the information contained in these guidelines is correct. Implementation of any aspect of these guidelines remains the responsibility of the implementing agency in so far as public health liability resides, or the responsibility of the individual clinician in the case of diagnosis or treatment.
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Recommendations from the American Nurses Association/Centers for Disease Control and Prevention Workgroup on the Role of Registered Nurses in Hospital Antibiotic Stewardship Practices
Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthc...are professionals in antimicrobial prescribing and stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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