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Publication Years
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2959
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Toolboxes
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1
To examine how health aid is spent and channelled, including the distribution of resources across countries and between
subsectors. Our aim was to complement the many qualitative critiques of health aid with a quantitative review and to provide ins
...
ights on the level of development assistance available to recipient countries to address their health and health development needs.
more
Background
Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death.
Methods
This review is based on articles retriev
...
ed by a selective search in PubMed, as well as on relevant guidelines.
Results
Evidence-based treatment options are available only for congestive heart failure with a low ejection fraction. Pharmacotherapy is based on neurohumoral inhibition of the renin-angiotensin-aldosterone system and the adrenergic system. The prognosis of patients with this condition has been further improved recently through the introduction of combined angiotensin receptor antagonists and neprilysin inhibitors. Modern implantable devices are a further component of treatment. Implantable defibrillators and special pacemakers for cardiac resynchronization are well established; the utility of alternative devices (baroreflex modulation or cardiac contractility modulation) needs to be investigated in further studies. It was recently shown that the catheter-based treatment of secondary mitral regurgitation with a MitraClip improves the outcome of selected patients.
Conclusion
The treatment of chronic systolic heart failure as recommended in the relevant guidelines, with drugs and implanted devices if indicated, can significantly improve the clinical outcome.
more
Over the last few years, there has been growing attention to health systems research in fragile and conflict-affected setting (FCAS) from both researchers and donors. In 2012, an exploratory literature review was conducted to analyse the main themes
...
and findings of recent literature focusing on health financing in FCAS.
more
The ethical governance of research assumes the existence of a national entity (or subnational if applicable, according to the constitution of a country) in charge of supervising the research ethics committees (RECs) that review and monitor research
...
with human beings. This supervision includes the accreditation of the RECs that authorize them to operate in the jurisdiction in question. This tool has the objective of facilitating the work of accreditation of RECs and ensuring that it is carried out in accordance with international ethical standards.
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Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies t
...
hat have been used to promote access, including providing medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies.
more
INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require substantial resources but little consideration has been given to which treatments are appropriate for les
...
s advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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Factors to take into account when choosing, reviewing and changing medicines.
Rescue therapy:
For symptomatic hyperglycaemia, consider insulin or a sulfonylurea and review when blood glucose control has been achieved.
Diet and lifestyle advice:
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At each point reinforce advice about diet and lifestyle.
more
This report is the first of a series of biennial progress reports on the implementation of the Global health sector strategies on HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030. It draws attention to areas of progress and gaps in preparation for the mid-term
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review of the strategies in 2026.
more
Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
CC
Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Met
...
hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
more
Diabetes is one of the leading causes of death globally. India is home to the second-largest population suffering from diabetes. This underscores the need to build capacity of primary care physicians (PCPs) for better disease management. This narrative rev
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iew article aims to describe the emergence of diabetes education and capacity-building programs for PCPs and its current situation in India. The review highlighted that major emphasis on diabetes was given only when the WHO estimated that morbidity and mortality due to diabetes would increase to 35% in India. As a result, National Diabetes Control Program was launched in 1987. Yet, very little attention was paid to diabetology in under-graduation. In the last decade, few public and private institutions have developed diabetes related capacity-building programs for PCPs independently or in collaborations. These programs include 16 fellowships, 4 diplomas, 12 certificate programs, and 6 other diabetes training programs, which have their own pros and cons. As medical science is changing rapidly, PCPs need to upgrade their skills and knowledge regularly to manage NCDs such as diabetes more effectively and efficiently. This can be possible only if scientific, evidence-based, and quality-oriented capacity-building programs are provided to the healthcare workforce.
more
Chronic obstructive pulmonary disease in over 16s: non-pharmacological management and use of inhaled therapies
National Institute for Communicable Disease (NICE)
National Institute for Health and Care Excellence (NICE)
(2019)
CC2
The document provides a summary of recommendations for the non-pharmacological management of chronic obstructive pulmonary disease (COPD) and the use of inhaled therapies in individuals over 16, emphasizing confirmed diagnosis, treatment options, and regular
...
review of treatment effectiveness and inhaler technique.
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People with asthma should be encouraged to take part in any sport they choose. If someone with asthma is having difficulty with sport, it means their asthma may not be under control. You will need to see your doctor to review your controller treatme
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nt and the way you use your medications in oder to allow you to live your life to the full with no limitations on activities or sport.
more
Overview and Practical Experiences from Ethiopia and Uganda. Slide set.
This webinar provides an overview of the new IEC & Social Mobilization NTD Tool Kit, which leads users through a step-by-step process to systematically review, revise, develop
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and adapt current IEC materials and social mobilization approaches towards stronger, evidence-based practices in support of positive behavior change for MDA programs in the control of NTDs. Experiences from Ethiopia and Uganda are shared.
more
This manual was developed based on the recommendations of a global technical consultation on child health in humanitarian emergencies co-organized by WHO and UNICEF at the end of 2003. WHO in collaboration with the Centre for Refugee and Disaster Response, Bloomberg School of Public Health, Johns Ho
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pkins University undertook a systematic review in 2004. It demonstrated that existing guidelines, including The Integrated Management of Childhood Illness (IMCI), do not cover all priority conditions in emergencies. The objective of this manual is to provide comprehensive guidance on child care in emergencies.
more
hese are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-East Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria pat
...
ients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region
more
Nutrition Topic Guide
Jessica Meeker, Stephen Thompson, Inka Barnett
The Health & Education Advice & Resource Team (HEART)
(2013)
This Topic Guide has been compiled to provide an overview of undernutrition in the context of development. The focus of the Guide is on undernutrition, defined as the outcome of insufficient (quantity and quality) of food intake (hunger) and repeated infectious diseases. Undernutrition includes bein
...
g underweight for one’s age, too short for one’s age (stunted), underweight for one’s height (wasted), and deficient in vitamins and minerals (micronutrient malnutrition). This review does not focus on the other component of malnutrition, which is overnutrition
more
In recent years, high prices of pharmaceutical products have posed challenges in high- and low-income countries alike. In many instances, high prices of pharmaceutical products have led to significant financial hardship for individuals and negatively impacted on healthcare systems’ ability to prov
...
ide population-wide access to essential medicines.
Pharmaceutical pricing policies need to be carefully planned, carried out, and regularly checked and revised according to changing conditions. Strong, well-thought-out policies can guide well-informed and balanced decisions to achieve affordable access to essential health products.
This guideline replaces the 2015 WHO guideline on country pharmaceutical pricing policies, revised to reflect the growing body of literature since the last evidence review in 2010. This update also recognizes country experiences in managing the prices of pharmaceutical products.
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In this guideline, natural ventilation is considered
among one the effective measures to control infections in health care. This guideline provides
a design and operation guide for hospital planners, engineers, architects and infection control
personnel. The recommendations in this guidelin
...
e followed a systematic
review of the literature on the association of ventilation and disease transmission, as well
as effective natural ventilation solutions for infection control.
more
Participant Handbook: contains all of the content that participants are trained on (text and illustrations) and also any case studies, scenarios, small group discussion questions, or role plays needed for training sessions. Participants use the handbook during training sessions and afterwards for
...
review.
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Historical analysis of the Ebola virus: prospective implications for primary care nursing today
Amundsen, Susan
(2014)
Clincial Excellence for Nursing Care, Vol. 2 (1998) no.6 pp.-343-351. Open Access with the permission of the publisher and the author.
Ebola continues to attract worldwide attention as a highly lethal virus of unknown origin that leaves victims bleeding to death and has no known vaccine or cure. Th
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e purpose of this historical research was to review and analyze the primary and secondary sources available on Ebola for use by primary care nurses in the event of future outbreaks.
You could send comments to the author: susanamundsen@comcast.net
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