For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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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 care provision, and time demands a new approach in structuring medical resources. Primary care is t...he 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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In line with the National Mental Health Strategy for Lebanon (2015-2020), this guide answers the objective of the Mental Health and Psychosocial Support task force: “Development and provision of staff care interventions for persons working in the MHPSS and Protection sectors”. It aims at prevent...ing burnout, improving the wellbeing of staff, and managing difficult situations resulting from work conditions.
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Medicina 2019, 55, 553; doi:10.3390/medicina55090553
Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated wit...h external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.
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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB patients. When appropriately implemented, the activity is cost effectiv...e, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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The WHO and UNICEF-led Hand Hygiene for All Initiative aims at ensuring implementation for WHO's global recommendations on hand hygiene to prevent and control COVID-19 pandemic, and hand hygiene improvement sustainability in countries as a mainstay of wider infection prevention and control (IPC) and... water, sanitation and hygiene (WASH) efforts.
But how can hand hygiene implementation be successful? By implementing strategies and approaches proven through the successes of the WHO Save Lives: Clean Your Hands campaign and fostering integration between hand hygiene and WASH improvements. This brief draws on learning from legacy work and the current evidence based and summarizes how joint action and collaboration are essential for successful strategies, in the context of the COVID-19 response and beyond
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is... intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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For the purpose of this document, Interprofessional is defined as: Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communication, sharing of knowledge and coordination of services to provide... services to patients/clients and their care-giving systems. This best practice guideline, Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes is intended to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/clients, providers, teams, the organization and the system. This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.
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The purpose of this Guideline is to provide evidence-based recommendations that promote and sustain the undergraduate nursing student’s application of knowledge to practice in a variety of clinical learning environments. The Guideline explores the relationships among and between students and nursi...ng educators, nursing staff, preceptors, and diverse health-care team members, and it considers their influence on the quality of practice education, professional socialization, and nursing excellence.
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Wound care is a regular component of the package of care we offer in the majority of our health care facilities and represents a high volume of activities. The current practices in MSF projects are often based on the habits of each individual supervisor, the wound care material we off...er is partly outdated and does not allow optimal wound care. There is a need for standardization of wound care and it needs to be evidence based as much as possible, taking into account the realities of the field.
The scope of this document is to guide the caregiver in the wound care process. It does not intend to provide in depth information on wound healing or physiology. There is a wide range of literature and background information available for this purpose in the references and in the list of extra reading
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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 to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environme...ntal 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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This first edition of our national neonatal care clinical guidelines is an initiative that aims to ensure that all the neonates in the Kingdom of Eswatini are offered standard, best quality of care and the best possible start in life. The guidelines have been formulated from various global sources a...nd tailored to the needs and health practises of the country. They are designed to serve as a guide to all healthcare providers in the country to provide standardized quality neonatal care.
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39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response. The report shows that deliberate and proactive action is required to ensure that persons with disabilities from all constituencies are systematically included and meaningfully participate in DRR... and humanitarian preparedness, response and recovery. It draws lessons from field practices, but does not provide technical guidance. The newly published IASC Guidelines are the reference document to seek in-depth theoretical and technical information.
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Country Strategic Plan Evaluations (CSPEs) encompass the WFP strategy and entirety of WFP activities during a specific period. Their purpose is twofold: 1) to provide evaluation evidence and learning on WFP's performance for country-level strategic decisions, specifically for developing the next Cou...ntry Strategic Plan (CSP) and 2) to provide accountability for results to WFP stakeholders. These evaluations are mandatory for all CSPs and are carried out in line with the WFP Policy on Country Strategic Plans and the WFP Evaluation Policy.
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A technical and environmental comparative overview of common shelter typologies found in settlements across UNHCR operations
Due to Nepal’s difficult geographic structure, rapid urbanization, varied groundwater level, and increasing population the country is prone to earthquakes, floods, landslides, fires, lightning, hailstone, drought, epidemic, and other disasters. These disasters cause a huge
loss of li...fe and property every year.
In normal circumstances, persons with disabilities are at a higher risk than others. Hence, they may be more vulnerable and affected in an event of a disaster. Especially those with severe disabilities, women, children, and senior citizens are more at risk during disasters persons with disabilities must be kept at the forefront for disaster mitigation and
preparedness to protect them from disaster risk
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The plan aims to practice the preparedness measures and response functions which need to be coordinated among relevant departments and organizations to reduce the risk of earthquakes. The plan has two main parts: preparedness and response. The first part includes the preparedness measures which can ...be practically implemented in collaboration with relevant government departments and communities. The latter part includes the response functions by the National Disaster Management Committee and it’s Work Committees if a damaging earthquake were to occur.
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The international reconstruction effort in Afghanistan after 2001 created an opportunity to advance human rights, and women’s and girls’ rights in particular. Although its achievements have fallen short of what was envisioned, significant improvements in legal protections have emerged through th...e adoption of new and revised laws, the founding and growth of legal aid organizations, and the training of a cadre of women lawyers, prosecutors, and judges.
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On February 29, 2020, the United States and the Taliban signed an agreement outlining a phased withdrawal of US forces from Afghanistan in exchange for Taliban commitments not to allow attacks on the US or its allies from Afghan territory. The troop withdrawal is expected to take place in parallel w...ith negotiations between representatives from the Afghan government and other Afghan political groups and Taliban leaders aimed at achieving a political settlement after decades of armed conflict.
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