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National Operational Guidelines
Tools and practical guidance for achieving high uptake
Against the backdrop of the COVID-19 pandemic, health is receiving unprecedented public and political attention. Yet the fact that climate change also presents us with a
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health crisis deserves further recognition. From more deaths due to heat stress to increased transmission of infectious diseases, climate change affects the social and environmental determinants of health in ways that are profound and far-reaching. The fundamental interdependency of human health and the health of the environment is encapsulated in the concept of planetary health, a scientific field and social movement that has been gaining force since the 2015 publication of the Rockefeller Foundation-Lancet Commission report “Safeguarding human health in the Anthropocene epoch”.
We see an urgent need for strategic communication to raise awareness of climate-health synergies in order to overcome the misperception that climate and health are two independent agendas. The fragmented and sector-focused nature of thinking and action remains a significant barrier to integrating health considerations into climate planning and project development. Inevitably, collaboration across sectors requires a community of practice. Despite recent efforts focused on the climate-health nexus, much work remains to be done to translate scientific findings for policymakers, mobilise climate financing resources in support of health co-benefits, and promote genderjust solutions within climate change projects.
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Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health
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coverage? As the proactive arm of the health services, community health workers teams provide household and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health car
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e system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how they view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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Healthy Settings, a key component of Malawi’s Health Sector Strategic Plan (HSSP) 2011–2016, is the World Health Organization’s (WHO) holisti
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c community-led approach to achieving health improvement by addressing social determinants of health, an approach which is central to the current WHO framework on integrated people-centred health services. Healthy Settings projects by their construct have many different components which vary from one group and community to another depending on their priorities: from housing, hospital improvements and waste management to “softer” interventions like leadership skills training and health promotion. It can be challenging to find relevant indicators to monitor and assess the impact of such a complex holistic project, this paper explores if social capital data can provide useful impact assessment indicators at the start of such a project.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these c
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ountries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Trends and Determinants of Unmet Need for Family Planning and Programme Options, Ethiopia.
Ayele, Wondimu, Habtamu Tesfaye, Roman Gebreyes, and Tesfayi Gebreselassie
ICF International
(2013)
C2
Further Analysis of the 2000, 2005, and 2011 Demographic and Health Surveys. DHS Further Analysis Reports No. 81
Life skills as a behaviour change strategy in the prevention of HIV and AIDS: Perceptions of students in an open and distance learning institution
B. J. Mohapia; E. M. Pitsoane
SAHARA J.: Journal of Social Aspects of HIVAIDS; PMC (US National Library of Medicine National Institutes of Health)
(2017)
C2
Journal of Social Aspects of HIV/AIDS VOL. 14 NO. 1 2017
SAHARA J. 2017; 14(1): 77–84.
Published online 2017 Sep 21. doi: 10.1080/17290376.20
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17.1374878
PMCID: PMC5639614
PMID: 28934916
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PeerJ PrePrints , http://dx.doi.org/10.7287/peerj.preprints.579v1 2 Nov 2014
Students' Toolkit: Social accountability in medical schools
The International Federation of Medical Students’ Associations (IFMSA); Training for Health Equity Network (THEnet)
(2017)
C2
This toolkit aims to provide you with a brief introduction of what SA and its core principles are, and how you as a student can apply several of the existing tools for your own school to
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really make a difference.
French, Spanish and Arabic Version available: https://ifmsa.org/social-accountability/
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Previous studies have highlighted a range of individual determinants associated with HIV testing but few have assessed the role of contextual facto
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rs. The objective of this paper is to examine the influence of both individual and community-level determinants of HIV testing uptake in Burkina Faso.
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Journal of Biosocial Science / Volume 34 / Issue 04 / October 2002, pp 525 - 539
DOI: DOI:10.1017/S0021932002005254, Published online: 24 September 2002
This paper examines determinants
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of one aspect of sexual behaviour – coital frequency – among 2188 married women in the Central African Republic using a secondary analysis of data from the Demographic and Health Survey of 1994–95. Female genital cutting (or circumcision) is practised in the Central African Republic and self-reported circumcision status was included in the questionnaire enabling it to be examined as a possible determinant of coital frequency. Multiple logistic regression was used to find a subset of factors independently associated with coital frequency.
Decreased coital frequency was found in those who had longer duration of marriage, those who were not the most recent wife in a polygamous marriage and those who had more surviving children. Coital frequency was higher in more educated women and those not contracepting because they wanted to get pregnant. After adjusting for confounders no association between
female genital cutting and coital frequency was found. The extent to which women can control coital frequency in this culture is not known and fertility desires may override any negative effects of circumcision on sexual pleasure.
It was therefore not possible to draw conclusions about how female genital cutting affects a woman’s desire for sexual intercourse and consequently there is a need to develop research methods further to investigate this question.
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BMC Public Health (2021) 21:299 https://doi.org/10.1186/s12889-021-10296-9
Lancet Glob Health 2020Published OnlineDecember 10, 2020 https://doi.org/10.1016/S2214-109X(20)30460-5
The report “Build back fairer: achieving health equity in the Eastern Mediterranean Region” provides ground breaking insights into the state of health
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inequities in the Region and urges countries to take action to address the social determinants of health to reverse the worsening trend of inequity – aggravated by the COVID-19 pandemic, ongoing conflict, mass movements of people, environmental challenges, gender inequities and unemployment.
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