Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and ...how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea...rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
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This guide assumes the reader already has a general understanding of the Care Group methodology. It is highly recommended that all Care Group implementers familiarize themselves with the contents of theCare Groups: A Training Manual for Program Design and Implementation,and, ideally,to participate i...n an in-person training on Care Groups, before commencing Care Group activities. This guide is meant to serve as a companion to the Care Group Training Manual; and additional details on all topics covered in this guide are provided in the Training Manual. This guide may also be used by program evaluators, as a means to assess the extent to which Care Groups were implemented in accordance with theevidence-based model and their potential contribution to program outcomes.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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This document outlines why and how nurses and midwives are important, not only for individual health optimization but also to achieve the thematic priorities of For the Future. More specifically, it provides case studies to showcase the amazing work that nurses and midwives across the Region are doi...ng to improve health. The document also provides future policy directions to strengthen the scope and leadership of the nursing and midwifery workforce, alongside actions to accelerate investment in their education, skills and employment.
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Key findings from a February 2021 survey from the Partnership for Evidence-Based Response to COVID-19 (PERC)
Almost half (46%) of the world’s 1.7 million children living with HIV were not on treatment in 2020 and 150 000 children were newly infected with HIV, four times more than the 2020 target of 40 000
The humanitarian situation in the Central African Republic (CAR) has further worsened over the past six months. Election-related violence that broke out in mid-December 2020 has had a devastating effect on civilians. Thousands of people have been forced to flee, human rights violations have surged, ...hundreds of schools and dozens of hospitals have been forcibly closed and food prices have skyrocketed. This deterioration occurred in an already alarming context, with more than half of the population (2.8 million people) in need of humanitarian assistance and protection and 1.9 million people in acute need. In the past five years, there have never been as many people in humanitarian distress in CAR as today.
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Healthcare 2020, 8(1), 26; https://doi.org/10.3390/healthcare8010026
The current article is an integrative and analytical literature review on the concept and meaning of empathy in health and social care professionals. Empathy, i.e., the ability to understand the perso...nal experience of the patient without bonding with them, constitutes an important communication skill for a health professional, one that includes three dimensions: the emotional, cognitive, and behavioral. It has been proven that health professionals with high levels of empathy operate more efficiently as to the fulfillment of their role in eliciting therapeutic change.The empathetic professional comprehends the needs of the health care users, as the latter feel safe to express the thoughts and problems that concern them. Although the importance of empathy is undeniable, a significantly high percentage of health professionals seem to find it difficult to adopt a model of empathetic communication in their everyday practice. Some of the factors that negatively influence the development of empathy are the high number of patients that professionals have to manage, the lack of adequate time, the focus on therapy within the existing academic culture, but also the lack of education in empathy. Developing empathetic skills should not only be the underlying objective in the teaching process of health and social care undergraduate students, but also the subject of the lifelong and continuous education of professionals
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Ghana's attempt to regulate health care waste management started in 2002 with the development of guidelines on health care waste manage-ment by the Environmental Protection Agency (EPA). In 2006, the Ghana Health Service (GHS) also developed the Health Care Waste Management Policy and Guidelines as ...a single document.
Although awareness on Health Care Waste Management (HCWM) has improved in recent years, there is the need for a systematic approach to improve on effective segregation, safe collection, and storage, as well as ultimate treatment before disposal.
This guideline seeks to ensure that HCW is managed effectively in compliance with existing International Conventions that Ghana is a signatory to, national laws and regulations, and others to be passed in future.
Recommendations for better management of HCW in the nation's health care facilities have been presented in this document. Also, standard operating procedures (SOPs) have been developed to provide
guidance to various levels of the health facilities.
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The overall goal of this strategy is to ensure accurate understanding of the
benefits of covid-19 vaccination and alleviate apprehension about the vaccine, to ensure its acceptance and encourage uptake across various audiences.
Objectives
x Create demand, promote acceptability and accessibility o...f COVID-19
vaccine among at least 90% of the general public.
x Develop appropriate messages and identify channels to communicate
the potential benefits and risks of the vaccine to all concerned parties,
including decision-makers at all levels.
x Provide timely and accurate information to address misinformation,
rumors and other crisis situations.
x Effectively mobilize and empower communities to ensure participation
and ownership of the vaccination process
x Strengthen communication mechanisms and partnerships among key
stakeholders to support the national communication effort.
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This toolkit was developed by the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention (DHDSP) to provide healthcare organizations, including those in resource-constrained settings, with the information and resources to implement the HMP and improve hyper...tension control among their patients. CDC DHDSP developed an online toolkit that consists of interactive e-learning modules that are designed to guide learners through the key features of the ten HMP components and prepare them for implementation at their health system. The online e-learning modules are accompanied by a PDF toolkit document that can be used as an additional resource for users.
The purposes of this toolkit and the associated online e-learning modules are to provide healthcare organizations:
An overview of the HMP, its ten core components, and suggestions for implementing the HMP in clinical settings.
Guidance to staff, administrators, and other healthcare professionals on how to implement and adapt the HMP for their unique clinical setting.
The online e-learning modules you can find here:
https://www.cdc.gov/dhdsp/pubs/toolkits/hmp-toolkit/index.htm
accessed 29.07.2021
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This guidance document provides basic principles for a spokesperson of any health authority on how to respond to vocal vaccine deniers. The suggestions are based on psychological research on persuasion, on research in public health, communication studies and on WHO risk communication guidelines.
When situations occur in which unwanted events are rightly or wrongly connected with vaccination, they may erode confidence in vaccines and the authorities delivering them. This document presents the scientific evidence behind WHO’s recommendations on building and restoring confidence in vaccines ...and vaccination, both in ongoing work and during crises. The evidence draws on a vast reserve of laboratory research and fieldwork within psychology and communication. It examines how people make decisions about vaccination; why some people are hesitant about vaccination; and the factors that drive a crisis, covering how building trust, listening to and understanding people, building relations, communicating risk and shaping messages to the audiences may mitigate crises. This document provides a knowledge base for stakeholders who develop communication strategies or facilitate workshops on communication and trust-building activities in relation to vaccines and immunization, such as immunization programme units, ministries of health, public relations and health promotion units, vaccine safety communication trainers and immunization advisory bodies.
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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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Moral emotions are a key element of our human morals. Emotions play an important role in the
caring process. Decision-making and assessment in emergency situations are complex and they frequently result in
different emotions and feelings among health-care professionals.
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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