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1
This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and
...
people’s access 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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The role of an essential health benefit in health systems in east and southern Africa: Learning from regional research
R. Loewenson, M. Mamdani and others
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2018)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme ... of work. It presents the methods used, the context and policy motivations for developing EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. more
This report synthesises the learning across the full programme ... of work. It presents the methods used, the context and policy motivations for developing EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. more
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declar
...
ed at the end of March 2020. This has limited people's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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Child and adolescent Mental health in europe: infrastructures, policy and programmes
F. Braddick; V. Carral; R. Jenkins; E. Jané-Llopis
European Commission; Generalitat de Catalunya Department de Salud; Institute of Psychiatry; Kings College London; State Mental Health Center ; et al.
(2009)
C2
CAMHEE
As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by
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racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal c
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are recommendations at the health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes implementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs,
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and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding, knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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A focus on Cambodia and Ethiopia
o date, little evidence is available on how such integration occurs at country level. To address this knowledge gap, WHO has conducted several in-depth situational analysis in countries that are undertaking actions
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to improve WASH in Health Care Facilities as part of their quality of care improvement efforts. The purpose of the situation analyses was to capture mechanisms that “jointly support” WASH in HCF and quality of care improvements and also identify barriers and challenges to implementing and sustaining these improvements.
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Mali national action plan on antimicrobial resistance: review of progress in the human health sector
This policy brief aims to provide a review of the current progress on implementing the Mali national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progr
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ess in the human health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Mali.
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The Knowledge Guide provides guidance on how health workers can apply the Standards to their own practice. For each of the nine competencies and th
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eir specific behaviours in the Standards, the Knowledge Guide examines in detail how a health worker's knowledge, skills and attitudes can reach the stated benchmark for providing people-centred health services to refugees and migrants. The Knowledge Guide also details the learning outcomes that reflect the behaviours that a health worker will demonstrate once they have achieved the Competency Standards.
The Knowledge Guide is designed for educators and health workers to assist in designing or integrating learning content to enable attainment of the identified knowledge, skills and attitudes.
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Rabies is a global public health problem with important socioeconomic impacts. Human rabies is preventable; almost all cases are transmitted through the bite
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of a rabid dog. Elimination of human rabies is possible. Technical support and tools are available. This report covers:
- Why investment is needed: key rationale.
- Investment purpose: global elimination of rabies.
- Investment in action: four case examples in Philippines, Kwa-Zulu Natal, South Africa, United Republic of Tanzania, Bangladesh.
- Summary results of case examples: Programme similarities and differences, and Health impact success stories from case examples. more
- Why investment is needed: key rationale.
- Investment purpose: global elimination of rabies.
- Investment in action: four case examples in Philippines, Kwa-Zulu Natal, South Africa, United Republic of Tanzania, Bangladesh.
- Summary results of case examples: Programme similarities and differences, and Health impact success stories from case examples. more
A two-week mission was conducted by WASH and quality UHC technical experts from WHO headquarters and supported by the WHO Ethiopia Country Office (WASH an
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d health systems teams) in July 2016, to understand how change in WASH services and quality improvements have been implemented in Ethiopia at national, sub-national and facility levels; to document existing activities; and through the “joint lens” of quality UHC and WASH, to identify and seek to address key bottlenecks in specific areas including leadership, policy/financing, monitoring and evaluation, evidence application and facility improvements. Ethiopia has implemented a number of innovative and successful interventions.
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Human Resource Capacity Development in Public Health Supply Chain Management: Assessment Guide and Tool
USAID; Deliver Project
(2013)
this toolkit presents a structured, rating-based methodology designed to provide a rapid, comprehensive assessment of the capacity of the human res
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ource support system for a country’s supply chain. Data are gathered from a document review, focus group discussions, and in-country stakeholder interviews to identify the strengths, areas for improvement, opportunities, and challenges for a wide range of human resource inputs and components. The findings are transformed into specific recommendations and strategies for action based on an understanding of country priorities and programming gaps. It includes Word templates; PowerPoint templates and Exce-based Diagnostic Dashboard
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Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worl
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dwide, particularly for low-middle income countries where the problem seems to be worsening. Globally, research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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This policy brief aims to provide a review of the current progress on implementing the Malawi national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further pro
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gress in the human health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Malawi.
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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mo
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rtality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest levels of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, use
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d on its own, is not enough to understand the complexities of sanitation, hygiene, water, and health. It explores pastoralists’ views and perspectives on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.
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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians)
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and 13 million IDPs in the Region as of 2018. These populations are often vulnerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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This report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of
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power dynamics and power reorientation towards individuals with lived experience; informed decision-making and health literacy; community engagement across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights.
It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives,inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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Nepal: Human Resource Strategy Options for Safe Delivery
Kolehmainen-Aitken R.L., Shrestha I.B.
Ministry of Health and Population Government of Nepal
(2009)
C1
Standards for Prosthetics and Orthotics Service Provision. 2015-2017 work plan
Department of Essential Medicines and Health Products (EMP) and NVI
World Health Organisation (WHO); USAID; ISPO
(2015)
C_WHO
The Ideal Clinic manual has been developed to assist managers at various levels of healthcare service provision to correctly interpret and understand the requirement for achieving the elements as de
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picted in the Ideal Clinic framework/dashboard. It can therefore be regarded as a reference document which guides the managers to determine the status of Ideal Clinic framework/dashboard elements in a facility.
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Human resources for health in Botswana
Nkomazana, O., Peersman, W., Willcox, M., et al.
African Journal of Primary Health Care & Family Medicine (PHCFM)
(2014)
CC
The results of in-country database and reports analysis
The health of the people and health services
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are in crisis, and together as partners this plan commits us to strategies aimed at achieving our goal of:
Strengthened primary health care for all, and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB more
Strengthened primary health care for all, and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB more
Report of the WHO/Bill & Melinda Gates Foundation Consultation. The Consultation was organized back-to-back with the first annual meeting of the International Coordinating Group
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of the BMGF-funded project for human and dog rabies elimination in developing countries, held at WHO headquarters, Geneva, Switzerland, from 5 to 7 October 2009. This allowed the Consultation to benefit from the participation of the national coordinators and advisers of the BMGF-funded projects in the Philippines, South Africa (KwaZulu-Natal) and the United Republic of Tanzania
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This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda,
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and examines the subsequent impact of the study on Rwanda’s policy environment.
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The Kenyan Health Sector has been playing a critical role in
providing health care services in response to the population
needs in line with the
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Kenya Health Policy, 2014-2030’s goal
of attaining the highest possible health standards in a manner
responsive to the population needs.
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Information note.
This information note provides a strategic overview of key implementation considerations for diagnostic integration using these devices, and is primarily intended for use by n ... ational laboratory services and TB, HIV, and hepatitis programme managers.
It may also be of interest to managers of maternal, newborn and child health programmes and sexual and reproductive health programmes, international and bilateral agencies, and organizations that provide financial and technical support to the relevant national health programmes. more
This information note provides a strategic overview of key implementation considerations for diagnostic integration using these devices, and is primarily intended for use by n ... ational laboratory services and TB, HIV, and hepatitis programme managers.
It may also be of interest to managers of maternal, newborn and child health programmes and sexual and reproductive health programmes, international and bilateral agencies, and organizations that provide financial and technical support to the relevant national health programmes. more
Standard Treatment Guidelines and Essential Medicines List for South Africa : Primary Healthcare Level 2020 edition
the Essential Drugs Programme, the PHCAdult Hospital Level Expert review Committee, the National Essential Medicines List Committee
National Department of Health South Africa
(2020)
CC
The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals.
P
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harmaceutical and Therapeutics Committees (PTCs) are responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as well as at higher levels of care.
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Government of Nepal has an obligation to ensure availability of affordable and high quality basic healt
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h care services to its population
more
Barriers to accessing and receiving mental health care in Eastern Cape, South Africa
Isabell Schierenbeck, Peter Johansson, Lena M. C. Andersson, Dalena van Rooyen
Health and Human Rights Journal
(2013)
C1
The right to the enjoyment of the highest attainable standard of physical and mental health is e
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nshrined in many international human rights treaties. However, studies have shown that people with mental disabilities are often marginalized and discriminated against in the fulfillment of their right to health. The aim of this study is to identify and reach a broader understanding of barriers to the right to mental health in the Eastern Cape Province in South Africa. Eleven semi-structured interviews were carried out with health professionals and administrators.
more
30 January 2020
This document outlines the standard operating procedures for detection and response to case/s of suspected novel coronavirus disease (2019-nCoV) in South Africa. The content
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of this document should inform provincial preparedness plans.
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Identifying characteristics associated with performing recommended practices in maternal and newborn care among health facilities in Rwanda: a cross-sectional study
Sipsma, H.L., Curry, L.A., Kakoma, J.P., Linnander, E.L., & Bradley, E.H.
Human Resources for Health
(2012)
CC
This study examined the quality of facility-based maternal and newborn health care by describing the implementation
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of recommended practices for maternal and newborn care among health care facilities to determine whether increased training, supervision, and incentives for health workers were associated with implementing these recommended practices.
more
Towards Sustainable Community Health and Social Welfare Services
Leaving No One Behind. This Operational Guideline for Community-Based
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Health Services (CBHS)
in line with the CBHS Policy Guideline map an integrated and coordinated
national approach to community-based health services in Tanzania. The
approach builds on and furthers national priorities for decentralization,
community empowerment and strengthened systems for expansion of
access to essential health services at the village level and below.
more
Malawi Integrated Guidelines and Standard Operating Procedures for Providing HIV Services. 3rd edition 2016
The Policy Guidelines and Service Standards for National Sexual and Reproductive Health Programme document outlines the steps on how to offer
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and deliver services. Improving quality of care is critical to improving clients' health status as well as increasing access to, and utilization of Sexual and Reproductive Health services. Service Standards and Guidelines are intended to be used by programme managers, implementers, trainers, surpervisors, and service providers as a tool for delivering quality care measures.
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The purpose of this strategy is to guide the planning, management and development of human resou
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rces for health in Rwanda for the period 2011 - 2016. The overall aim of the plan is to increase the number of appropriately skilled, motivated and equitably distributed health service providers for Rwanda.
more
Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation
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of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance while maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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The Government of Botswana’s SRH Policy Guidelines and Service Standards document provides the framework for developing a responsive strategy and
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an implementation plan for SRHR and HIV&AIDS Linkages and Integration. The global call on governments to demonstrate commitments to intensify linkages between sexual and reproductive health and HIV&AIDS at the policy and programme level is therefore an added opportunity for the government to review the current service provision model and optimize current resources to provide more integrated, comprehensive coordinated SRHR and HIV&AIDS services.
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The revision of the SRHR Policy is based on the results of the analysis of the implementation process o
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f the past policy, which has provided evidence to
ensure that the revised policy is relevant and effective. The revision has also been done with the participation of all national stakeholders who have
also international experience on SRHR issues. The Ministry urges all public and private institutions to use this policy as a guide in the implementation of
SRHR services in the country.
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Adolescence, defined as the period between 10 and 19 years of age, is a developmental stage during which many psychosocial and mental
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health challenges emerge. There is a well-established link between mental health and HIV outcomes. Adolescents and young adults living with HIV typically have additional mental health needs linked to their experiences of living with and managing a chronic illness, along with prevailing stigma and discrimination. Mental health promotion and prevention is thus a critical priority for this group.
more
In recognition of the growing problem of antimicrobial resistance (AMR), its increasing threat to human, animal
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and plant health, and the need for a One Health approach to address this issue, the 39th Session of the Codex Alimentarius Commission (CAC) agreed it was important for the food safety community to play its part and re-established the ad hoc Codex Intergovernmental Task Force on Antimicrobial Resistance (TFAMR) ). The objectives of the Task Force were
to revise the current Codex Code of Practice to Minimise and Contain Antimicrobial Resistance and to develop new guidance on surveillance programmes relevant to foodborne AMR.
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Accessed: 02.05.2020
These interim IPC recommendations for health settings have been developed through the contributions of many individuals and i
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nstitutions, such as the Centers for Disease Control-Kenya; ITECH; US Agency for International Development (USAID) Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program; and WHO that are committed to ensuring that the transmission of COVID-19 to HCWs and the public within the health care setting is limited. The Ministry of Health (MOH) through the Directorate of Health Standards Quality Assurance and Regulations wishes to thank all the contributing authors led by the sub-committee on case management and IPC for the COVID-19 response for their expertise and time given to writing these guidelines.
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This report aims to outline the current available knowledge on the health and wellbeing of older persons in the Region
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of the Americas during the United Nations Decade of Healthy Ageing (2021-2030). It also seeks to guide political actions towards ensuring the human rights of older persons, and describes the negotiation and drafting process behind the Inter-American Convention on Protecting the Human Rights of Older Persons. It reports on the doctrinal and legal developments that led the Region of the Americas to draft the Convention and describes its action areas and guaranteed rights, as well as the obligations assumed by the States Parties. The Convention is an essential tool to advance the strategies of the Decade of Healthy Ageing. This publication reflects on the importance of having a major legal instrument for this purpose at the international level. The demographic transition in Latin America and the Caribbean will continue to shape the ability of countries and health systems to respond to the needs of the population. Given this reality, international instruments will be needed to guarantee the full enjoyment of the human rights of older persons. In order to design inclusive and sustainable systems, accurate, updated, and effective information is required. The Decade of Healthy Ageing––the initiative that constitutes the framework for this document––is a strategic period in which to focus on data generation and monitoring.
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The Department of Nutrition, HIV and AIDS (DNHA) in Ministry of
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Health and Population is grateful to all stakeholders who contributed to the development of the Nutrition Education Communication Strategy II. The DNHA acknowledges the financial and technical support from the World Bank and USAID through the Nutrition, HIV and AIDS project and Food and Nutrition Technical Assistance Project (FANTA III)/FHI 360, respectively. The participation of several partners including Irish Aid, the European Union (EU), Gesellschaft für Internationale Zusammenarbeit (GIZ), United Nations Children’s Fund (UNICEF), World Food Programme (WFP), World Health Organisation (WHO), Food and Agriculture Organisation (FAO), Civil Society Organisation Nutrition Alliance (CSONA), Concern Worldwide and the Clinton Health Access Initiative(CHAI).
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STGs are designed to assist health care professionals in making decisions about appropriate, effective patient care. However, health managers often have trouble setting
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and meeting the high standards required of modern, developed health care systems. With stakeholders expressing concern over issues such as strength of evidence, transparency, conflicts of interest, and effective implementation, it is clear that many health care professionals need further guidance in developing and making use of STGs.
This manual guides health professionals through the process of establishing and implementing STGs, placing special emphasis on the low- and middle-income country (LMIC) context. By including tools, templates, and success stories as well as hyperlinks to useful resources, the manual helps health practitioners understand not only important concepts of treatment guidelines, but also how they can best be used in practice.
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Zambia has about 1.2 physicians, nurses, and midwives per 1000 population while the minimum acceptable density threshold is 2.3 per 1000 population. The estimated shortage of doctors, nurses
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and midwives in Zambia is about 14,960. However, with the projected population growth the deficit more than doubles disproportionately to, 25,849 in 2020, and 46,549 in 2035, at the current rate of HRH production. Worryingly, the human resources for health crisis has persisted for over 20 years. The efforts before and leading up to the development and implementation of the 2013 – 2016 National Training Operational Plan (NTOP) and the National Human Resources for Health Strategic Plan (2011 – 2016) yielded certain achievements, however, the HRH numbers and skill-mix gap remained disturbingly enormous.
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National Strategy and Action Plan for Clubfoot Care in Bangladesh
Dr. A. M. Z. Hussain; Dr. Rizvi; Dr. Qavi; et al.
Government of the People's Republic of Bangladesh DGHS Directorate General of Health Services Ministry of Health and Family Welfare ; Sustainable Clubfoot Care in Bangladesh
(2015)
C2
December 2015
National guidelines for of Clubfoot
This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn hea
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lth services.
more
Indiscriminate attacks on health care have contributed to an epic humanitarian catastrophe in Yemen. A new report tracks these attacks in the hope of holding perpetrators on all sides accountable.
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It details how both Houthi forces—with their use of wide-area impact weapons—and the Saudi-Emirati coalition—with their aerial attacks—have flagrantly disregarded the special status of health facilities and personnel in conflict zones.
more
This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and
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proven interventions in Latin American and Caribbean countries. Four areas of work are identified with the respective guidelines or suggestions for action, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, trea
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tment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
This field study to assess the pharmaceutical situation was undertaken in Ghana in May-June 2008 using a standardized methodology developed by the World Health Organization. The study assessed medicines availability
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and affordability, geographical accessibility, quality and rational use among other issues. The survey was conducted in six regions. In each region, 6 public health care facilities, 12 private pharmacies and 1 warehouse were surveyed.
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The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria are part of
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a group of agencies working together to accelerate progress towards the health-related SDGs through the Global Action Plan for Healthy Lives and Well-being for All. Understanding patterns of inequalities in these diseases is essential for taking strategic, evidence-informed action to realize our shared vision of ending the epidemics of HIV, TB and malaria.
This report presents the first comprehensive analysis of the magnitude and patterns of socioeconomic, demographic and geographic inequalities in disease burden and access to services for prevention and treatment.
The results confirm there have been improvements in service coverage and decreased disease burden at the national level over the past decade. But they also reveal an uncomfortable reality: unfair inequalities between population subgroups within countries are widespread and have remained largely unchanged over the past decade. For some disease indicators, inequalities are even worsening.
Moreover, the report points to the persistent lack of available data to fully understand inequality patterns in HIV, TB and malaria. Collecting data to improve the monitoring of inequalities in these diseases is vital to develop targeted responses for impact.
There are, encouragingly, isolated successes in reducing inequities. Change is possible when deliberate action is taken to reach disadvantaged populations.
more
Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies cause
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s tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog. Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
more
WHO recommends replacing western blotting and line immunoassays with simpler tests in HIV testing services. These simpler tests include rapid diagnostic tests (RDTs) that can be used at the point-
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of-care, and enzyme immunoassays (EIAs).
These tests get results to the client faster, produce accurate results more often, cost less, can be performed by various cadres of health providers, and can thus facilitate greater access and uptake of HIV testing services among those who need it most.
more
This document provides technical guidance on concepts, definitions, indicators, criteria, milestones and tools to assist leprosy programmes in their journey towards the goals of interruption
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of transmission and elimination of leprosy disease and through the post-elimination period. Importantly, it provides criteria with benchmarks, where possible, for all key aspects of leprosy programmes and services. Not only those related to elimination efforts, but also those related to diagnosis and management of leprosy, leprosy-related disabilities, mental wellbeing, stigma and discrimination and inclusion and participation of persons affected by leprosy. The document emphasises that the elimination of leprosy is a long-term, continuous journey on the one hand, while, on the other, clear milestones can be recognised on the way and programme implementation can be assessed against benchmarks, guiding appropriate action to keep the programme on track.
more
The objectives of the meeting were:
1. To step up the commitment of national authorities and technical
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and financial partners toWHO’s elimination objective for g-HAT.
2. To share achievements, challenges and views on the elimination goal among countries and implementing partners.
3. To assess the status of critical technical aspects to be solved in research and development of drugs and diagnostic tools, epidemiology, vector control and animal reservoirs.
4. To define the mechanisms for strengthening and organizing collaboration and coordination among stakeholders.
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A Training Curriculum for Multidisciplinary Healthcare Teams. This innovative training package aims to empower multidisciplinary health workers to have the confidence and skills to provide comprehen
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sive, youth-friendly HIV services that support adolescents’ healthy development, psychosocial well being, retention, adherence, sexual and reproductive health, and eventual transition to adult HIV services.
more
This document contains a series of desk reviews for the eight ENGAGE-TB priority countries supported by the Global Fund (DRC, Kenya, Indonesia, Mozambique, Myanmar, Nigeria, Pakistan and Tanzania).
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The document provides a situation assessment and gap analysis about the state of community based TB activities in these countries. The focus on these eight countries was justified by the high prevalence of TB and the very high number of missed/unreported cases.
more
National Guideline on Clinical Management of Chikungunya Fever
Prof. Dr. S. Tahmina; Prof. Dr. M. S. Flora; Dr. Md. N. A. Khan; Prof. A. K. Saha et al.
Government of the People's Republic of Bangladesh DGHS Directorate General of Health Services Ministry of Health and Family Welfare ; World Health Organization (Bangladesh); Disease Control unit (CDC); IEDCR; et al.
(2017)
C2
Disease Control Division,
Standard Management Guideline
Directorate General of Health Services, Ministry
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of Health & Family Welfare
First Published: 15th May 2017
more
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-
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income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
more
Accessed: 02.05.2020
These consolidated guidelines provide recommendations for comprehensive prevention and case management strategies in Kenya
Scope of the Guidelines: Infection prevention
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and control Patient triage Emergency Medical Services Case management Laboratory testing algorithm
Target Audience: Health care workers taking care of patients suspected or confirmed to have COVID-19
These guidelines combine both preventive and clinical management of the disease in Kenyan context. The protocol borrows various international recommendations including the World Health Organization, from experience of other countries such as China that has struggled with the outbreak for a longer time and from principles of virology and infectious disease management.
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The objectives of the meeting were:
1. To update the current status of the disease transmission, country capacities and plans for tackling the di
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sease.
2. To understand the epidemiology including disease distribution and risk, the models
for estimating under-detection, the geographical variations of in clinical presentation,
the roles of domestic and wild animal reservoirs and the subsequent different
transmission patterns and control approaches, including vector control.
3. To update current research and development efforts for improving diagnostic and
treatment tools.
4. To define the goals for achieving the control of r-HAT, the need for a multisectoral
approach and to discuss the strategy for controlling r-HAT and the coordination
mechanisms.
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The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and
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focus group discussions with adolescents, stakeholders, and young adults. Key findings include a preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
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Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritre
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a, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in refugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
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An overview of validation structures and responsibilities at national, regional and global levels.
This governance document supplements the global
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guidance document. Validation of elimination requires rigorous assessment at the national, regional and global levels of the impact and process indicators and the fulfilment of the four foundational requirements for (1) data quality, (2) strong programmes, (3) laboratory quality and (4) human rights, gender equality and community engagement.
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Consolidated guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection
recommended
2nd edition. These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) dr
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ugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care
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The new guidelines provide public health guidance on pharmacological agents for managing hyperglycaemia in type 1 and type 2 diabetes for use in primary h
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ealth-care in low-resource settings. These guidelines update the recommendations for managing hyperglycaemia in the WHO Package of Essential NCD Interventions (WHO PEN) for primary care in low-resources settings, reviewing several newer oral agents as second- and third-line treatment: dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and thiazolidinediones. The guidelines also present recommendations on the selection of type of insulin (analogue versus human insulin) for adults with type 1 and type 2 diabetes.
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The guidelines address timing, number and place of postnatal contacts, and content of postnatal
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care for all mothers and babies during the six weeks after birth. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services.
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This updated implementation guidance is intended for all those who set policy for, or offer care to, pregnant women, families and infants: governments; national managers of maternal
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and child health programmes in general, and of breastfeeding- and BFHI-related programmes in particular; and health-facility managers at different levels (facility directors, medical directors, chiefs of maternity and neonatal wards). The document presents the first revision of the Ten Steps since 1989. The topic of each step is unchanged, but the wording of each one has been updated in line with the evidence-based guidelines and global public health policy.
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces
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significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multiple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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This document is written for medical doctors, clinical officers, medical assistants, nurses, midwives, health surveillance assistants (HSAs), and medical records clerks who are working in public
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and private sector health facilities in Malawi. It is designed to be a practical guide for implementation of integrated HIV services.
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Improving medicines access and use for child health: a guide to developing interventions
Ross-Degnan, D., Vialle-Valentin, C., and Briggs, J.
USAID, SIAPS (Systems for Improved Access to Pharmaceuticals and Services)
(2015)
C1
Submitted to the US Agency for International Development by the
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program.
This manual provides a framework to identify problems
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and design interventions to improve access to and use of medicines for children. It is a resource for both health policy makers and health system managers and presents a structured approach to the steps introduced in the framework in the context of child health.
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The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care
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services and systems to deliver integrated care in community settings and support the development of ICOPE implementation action plans. There are 19 actions needed to implement ICOPE on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements
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Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to
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long-term care facilities, with figures being as high as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
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