The Government of Malawi, in fulfilling its primary role of protecting the lives of its vulnerable citizens during disasters
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and reducing their exposure to risk through preparedness, led the development of a National Coronavirus Disease (COVID-19) Preparedness and Response Plan.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to und
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erserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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Promoting health and preventing disease is a critical component of the effort required to achieve Universal
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Health Coverage (UHC). to date, efforts to achieve UHC have focused mostly on strengthening health systems and their capacities to provide curative care. However, experience from the COVID-19 pandemic has reaffirmed the need for resilient health systems, emphasizing primary health care, including preventive and promotive health and well-being.
Emerging from the eye of the storm as the global health lead agency during the pandemic, WHO is equipped with the required insights and actions for a holistic approach to “building back fairer and better” after COVID-19.
The Healthier Populations (UHP) Cluster in the African Region is designed to support Pillar 3 of WHO’s 13th Global Programme of Work (GPW13) which aims to make 1 billion people healthier by reducing health inequities, preventing diseases and injuries, addressing health determinants, and promoting partnerships for collaborative actions amongst all stakeholders.
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging
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(MRI), ideally supported by serology. These facilities are not available in all settings, especially in rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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An approach to emergency situations. Relief workers face rapidly changing and complex environments, new disease patterns, enormous humanitarian needs and relatively limited resources. The authors
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of this book use their experience in the area to produce an operational manual of the issues involved in refugee health programs. This book is aimed at professionals involved in public health assistance to refugees and displaced persons. It deals with a variety of specific refugee health issues at the decisional level, and discusses the priorities of intervention during the different phases of a refugee crisis, from emergency to repatriation.
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The National Guideline for Neonatal Care and Establishment of Neonatal Care Unit aims to provide health workers with all basics
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and necessary knowledge and skills to provide appropriate care at the most vulnerable period in a newborn’s life. This guideline will be available to all health facilities as a reference book for health workers. The book contains up-to-date evidence-based information and management of newborns with a range of needs in the initial newborn period
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PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal
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and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to determine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
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Physical distancing measures are important to reduce COVID-19 transmission. However, when stringently applied, they can result in negative health and socio-economic impacts. This report draws on a r
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apid review of available literature, case studies from across Africa and expert knowledge to make recommendations on adapting classic physical distancing measures to the contextual realities in Africa and on mitigating potential negative impacts.
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The African Regional Convening of the Global Initiative to Support Parents (GISP) stimulated the interest or engagement of almost 1500 individuals from 742 unique organizations in the fields
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of health, education, social welfare, women’s affairs, early childhood, water and sanitation, mental health, violence prevention, innovative finance, climate, and many others. The convening united representatives across governments, civil society organizations, programme implementers, philanthropies, multilateral organizations, bilateral funders, private companies, universities, schools and day care centres, and hospitals around the common cause of supporting parents and caregivers.
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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions
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of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford their bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
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Case Study on Improving HIV Testing and Services for Children Orphaned or made Vulnerable by HIV (OVC)
Social Protection Policy Analysis, Tanzania
This National Action Plan addresses actions needed to be taken in order to combat antimicrobial resistance (AMR) in the country. It is obligatory to raise awareness of antimicrobial resistance and p
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romote behavioral change through public communication
programmes that targets human, animal and plant health. Inclusion of the use of antimicrobial agents and resistance in school curricula will further promote better understanding and awareness from an early age. Antimicrobial Resistance knowledge, surveillance and research will be strengthened through establishing a national surveillance system for antimicrobial resistance, establishing and building capacity for a national reference laboratory and designated laboratories for AMR surveillance, developing a national research agenda on AMR and establishing and supporting a coordinated mechanism that will ensure harmonized AMR guidelines, data management and sharing systems in human, animal and plant health settings.
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The Millennium Development Goals (MDGs) showed
that global commitment and collective action
could significantly reduce the disease burdens of
th
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ree deadly communicable diseases: HIV/AIDS,
tuberculosis (TB) and malaria. The MDGs helped
focus efforts on these three deadly diseases
and leveraged disease-specific programmes and
financing, thus achieving significant progress.
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