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June 2020In die Skriflig/In Luce Verbi 54(1)
DOI: 10.4102/ids.v54i1.2562
TheoreticalMedicine 6 (1985), 281-294. 0167-9902/85.10
WHO Guideline on use of ferritin concentrations to assess iron status in individuals and populations
This guideline provides global, evidence-informed recommendations on the use of indicators for assessing a population’s
iron status and application of the use of ferritin concentrations for monitoring and evaluating iron interventions.
Food and nutrition security in the Democratic Republic of the Congo is subject to the relentless impact of conflict, epidemics and climate events that have persisted in the country for decades, further compounded by the global COVID-19 pandemic. Lack of infrastructure and investment in agriculture,
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health and human capital development combine to impede progress towards the achievement of Sustainable Development Goals 2 and 17. While there are several legal instruments and policies that promote food and nutrition security, poor coordination, weak national capacity and exponential population growth present serious obstacles to the achievement of zero hunger. Political instability and siloed sectoral responses to humanitarian and development needs have also affected results to date.
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This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public health care. The Standards identify major components and features of effective systems for the tre
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atment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
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No country can claim to be free from health-care associated infections, therefore, improvement of infection prevention and control (IPC) strategies is essential. WHO recommends the use of multimodal improvement strategies to implement IPC interventions. These include each item of standard and transm
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ission-based precautions according to national guidelines or standard operating procedures and under the coordination of the national IPC focal point (or team, if existing). This publication consists of three focused improvement tools, called “aide-memoires”, which focus on 1) respiratory and hand hygiene, 2) personal protective equipment, and 3) environmental cleaning, waste and linen management, all elements of standard, droplet/contact and airborne precautions.
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Published OnlineJuly 14, 2021https://doi.org/10.1016/S2214-109X(21)00164-9. New Lancet research offers the first comprehensive analysis of the growing footprint of noncommunicable and injury-related neurological disorders to India’s overall disease burden.
Takeaways from 1990 to 2019 In terms
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of total disability adjusted life years:
• The share of noncommunicable neurological disorders doubled from 4% to 8.2%.
• Injury-related neurological disorders increased from 0.2% to 1.1%
• The contribution of communicable neurological disorders decreased from 4.1% to 1.1%
• Stroke, epilepsy, cerebral palsy, and headache disorders were among the largest contributors to DALYs.
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The manual has been designed in a comprehensive manner, the aim being to provide a holistic approach to the short-term development of human resources, with a focus on primary care physicians. This is a reference manual meant for primary care physicians who will provide care to older people in primar
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y health care facilities. The information on old age care is meant to be incorporated into the everyday clinical practice of primary care physicians. This manual will help to enhance the knowledge and skills of physicians. It is expected that the use of the manual will improve the approach to issues of old age and promote holistic care of older people, which will ultimately improve their quality of life.
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The steps reassert the sequence of the HPC, with needs analysis directly informing decisions about the response and monitoring, whether for the preparation of new plans or adjustments to existing ones. The steps of the HPC have a rationale and cannot be skipped. However, the depth of work under each
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step can and should be adapted to the realities of the operating environment and capacities.
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No education system is effective unless it promotes the health and well-being of its students, staff and community. These strong links have never been more visible and compelling than in the context of the COVID-19 pandemic. Towards making every school a health-promoting school: Let’s start with a
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shared vision based on the standards and indicators presented in this publication.
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This 400 page guide, created by PHI’s Center for Climate Change and Health and the American Public Health Association (APHA), with support from the California Department of Public Health helps local health departments prepare for and mitigate climate change effects—from drought and heat to flood
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ing and food security—with concrete, implementable suggestions.
The guide: Provides a basic summary of climate change and climate impacts on health; Prioritizes health equity, explains the disproportionate impacts of climate change on vulnerable communities, and targets solutions first to the communities where they are most needed, including low-income, elderly and people of color communities; Connects what we know about climate impacts and climate solutions with the work of local health departments; and Offers specific examples of how local health departments can address and ameliorate the impacts of climate change in every area of public health practice.
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
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y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society a
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pproach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
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Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasison healthy lifestyle and prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of prima
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ry care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing. Substitution of nurses for doctors is one strategy used to improve access, efficiency, and quality of care. This is the first update of the Cochrane review published in 2005.
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Modern healthcare has given rise to extremely complex and multifaceted ethical dilemmas. All too often physicians are unprepared to manage these competently. This publication is specifically structured to reinforce and strengthen the ethical mindset and prac
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tice of physicians and provide tools to find ethical solutions to these dilemmas. It is not a list of “rights and wrongs” but an attempt to sensitise the conscience of the physician, which is the basis for all sound and ethical decision-making. To this end, you will find several case studies in the book, which are intended to foster individual ethical reflection as well as discussion within team settings.
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This guide assumes the reader already has a general understanding of the Care Group methodology. It is highly recommended that all Care Group implementers familiarize themselves with the contents of theCare Groups: A Training Manual for Program Design and Implementation,and, ideally,to participate i
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n an in-person training on Care Groups, before commencing Care Group activities. This guide is meant to serve as a companion to the Care Group Training Manual; and additional details on all topics covered in this guide are provided in the Training Manual. This guide may also be used by program evaluators, as a means to assess the extent to which Care Groups were implemented in accordance with theevidence-based model and their potential contribution to program outcomes.
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Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focu
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s on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit
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h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in
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community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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