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Español; 60 páginas (1.990Mb)
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Date
2024
ISBN
978-92-75-32867-5
DOI
https://doi.org/10.37774/9789275328675
Author
Organización Pan
...
americana de la Salud
Metadata
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Esta tercera edición (denominada “hoja de ruta del 2023”) de la Hoja de ruta para poner fin a la tuberculosis en la población infantil y adolescente es una actualización de las versiones de la Hoja de ruta del 2013 y del 2018. La versión 2023 reconoce los progresos realizados en los últimos cinco años y describe las prioridades y las acciones clave diseñadas para acelerar el progreso hacia los objetivos elaborados durante la Reunión de Alto Nivel de la Asamblea General de las Naciones Unidas sobre la lucha contra la tuberculosis de 2023. Se espera que la aplicación de estas medidas clave a nivel subnacional, nacional, regional y mundial en el contexto de la cobertura universal de salud permita encontrar y tratar más casos de enfermedad o infección por Tuberculosis (TB) en la población infantil y adolescente, a fin de prevenir la TB, mejorar los resultados del tratamiento y prevenir la discapacidad asociada a la TB. La hoja de ruta del 2023 se mantiene el fuerte énfasis en la TB infantil, al tiempo que se destaca la importancia de abordar la TB en la población adolescente y, por primera vez, en las mujeres durante el embarazo o el puerperio
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta
...
in 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.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
...
Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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WHO convened the fifth stakeholders meeting on the elimination of HAT due to infection with Trypanosoma brucei gambiense (g-HAT) and Trypanosoma brucei rhodesiense (r-HAT) in Geneva, Switzerland, on 7–9 June 2023. The meeting was held again in person after the coronavirus disease (COVID-19) pandem
...
ic and jointly for both forms of the disease. The previous meetings on g-HAT held in 2014, 2016 and 2018, as well as on r-HAT in 2015, 2017 and 2019, and jointly for g-HAT and r-HAT in 2021 (8) reinforced the partnership and commitment for HAT elimination and structured the mechanisms of collaboration within the WHO network for HAT elimination. The network includes NSSCPs, groups developing new tools, international and nongovernmental organizations involved in disease control, and donors.
Fewer than 1000 cases of HAT annually have been reported over the past 5 years, which is a historic achievement. The area at risk has been substantially reduced. The elimination of HAT as a public health problem at the global level has been achieved.
The new road map for neglected tropical diseases (NTDs) 2021−2030 (“the road map”) with the target to interrupt the transmission of g-HAT requires the strengthened and sustained efforts of all stakeholders, national authorities and partners, under WHO coordination. It will take disproportionally high efforts and innovative strategies to find the last cases of g-HAT and neutralize its transmission. Given the limited resources and other competing public health priorities, this is a challenge that requires our joint commitment.
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In this paper they make estimates of the potential short-term economic impact of COVID-19 on global monetary poverty through contractions in per capita household income or consumption.
The estimates are based on three scenarios: low, medium, and high global contractions of 5, 10, and 20 per cent;
...
we calculate the impact of each of these scenarios on the poverty headcount using the international poverty lines of US$1.90, US$3.20 and US$5.50 per day.
The estimates show that COVID poses a real challenge to the UN Sustainable Development Goal of ending poverty by 2030 because global poverty could increase for the first time since 1990 and, depending on the poverty line, such increase could represent a reversal of approximately a decade in the world’s progress in reducing poverty.
In some regions the adverse impacts could result in poverty levels similar to those recorded 30 years ago. Under the most extreme scenario of a 20 per cent income or consumption contraction, the number of people living in poverty could increase by 420–580 million, relative to the latest official recorded figures for 2018.
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The Western Pacific Region is the largest and most diverse region in the world, made up of 37 countries and territories in the Pacific, Oceania and parts of Asia, with a population of more than 1.9 billion people stretching over an area from China and Mongolia in the north to New Zealand in the sout
...
h. In 1999, 22 countries and territories in the Pacific joined together and launched the Pacific Programme to Eliminate Lymphatic Filariasis. Shortly after, the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000. In 2004, 12 countries in the Asia subregion of the Western Pacific Region and Southeast Asian Region joined and developed the Mekong-Plus Strategic Plan for Elimination of Lymphatic Filariasis. Since then, significant efforts have been made by all endemic countries, with annual mass drug administration (MDA) as a principal strategy, through strong partnership with the WHO and other donors and partners. As a result, by the end of 2019, 10 of 22 endemic countries in the region, including 8 of 16 countries in the Pacific and 2 countries in the Asia subregion, achieved WHO validation for elimination of lymphatic filariasis (LF) as a public health problem. All the other countries are either progressing with post-MDA surveillance or accelerating efforts by adoption of the new triple drug therapy strategy and enhancement of MDA campaigns to tackle persistent transmission. Some 85% of the originally endemic implementation units have stopped MDA and the number of people requiring MDA for LF in the Western Pacific Region was reduced by 72% from 2000 to 2018. This paper reviews the progress, key success factors and remaining challenges and indicates the way forward to achieve LF elimination in the Western Pacific Region.
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Mientras los países se esfuerzan por avanzar hacia los Objetivos de Desarrollo Sostenible (ODS) y lograr la cobertura sanitaria universal, las desigualdades sanitarias provocadas por la discriminación racial y los factores interrelacionados siguen estando omnipresentes. Las desigualdades que sufre
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n los pueblos indígenas, los afrodescendientes, los romaníes y otras minorías étnicas son preocupantes a nivel mundial; son injustas, prevenibles y remediables
Los propios sistemas de salud son determinantes importantes de la salud y la equidad sanitaria. Pueden perpetuar las desigualdades sanitarias al reflejar el racismo estructural y las prácticas discriminatorias de la sociedad en general. En este sentido, el racismo sistémico (por ejemplo, relacionado con la ubicación de los servicios o los requisitos para acceder a ellos), los prejuicios implícitos, la práctica clínica mal informada o la discriminación por parte de los profesionales de la salud contribuyen a las desigualdades sanitarias. Ahora bien, los sistemas de salud también pueden convertirse en una de las principales fuerzas para combatir las desigualdades a las que se enfrentan las poblaciones que sufren discriminación racial.
La atención primaria de salud (APS) representa la estrategia esencial que permite reorientar los sistemas de salud y las sociedades para que sean más saludables, equitativos, eficaces y sostenibles. En 2018, al cumplirse el 40.º aniversario de la Declaración de Alma-Ata, la Organización Mundial de la Salud (OMS) y el Fondo de las Naciones Unidas para la Infancia (UNICEF) renovaron el énfasis en la atención primaria de salud con su estrategia sobre la atención primaria de salud en el siglo XXI.
La OMS ha señalado 14 mecanismos estratégicos y operacionales con los que los responsables políticos pueden reforzar la atención primaria de salud. Cada mecanismo dispone de múltiples puntos de partida posibles para emprender acciones específicas dirigidas a combatir la discriminación racial, fomentar la atención de salud intercultural y reducir las desigualdades sanitarias que sufren los pueblos indígenas, los afrodescendientes, los romaníes y otras minorías étnicas
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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
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s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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La enfermedad de Chagas, también llamada tripanosomiasis americana, sigue siendo endémica en 21 países de América Latina. Sin embargo, como consecuencia de las migraciones, la urbanización, la intensificación del turismo, la modificación de las estrategias agrícolas y el cambio climático, l
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a enfermedad ha traspasado el marco rural y el ámbito latinoamericano que le dieron identidad durante decenios, y ha logrado instalarse en la periferia de las ciudades del área endémica y en países de América del Norte, Europa, Asia y Oceanía y transformarse en un problema de salud pública global. Teniendo en cuenta que el Chagas afecta a poblaciones en situación de pobreza en las que produce graves consecuencias para la salud y la economía de las personas infectadas, y que los recursos orientados a fomentar el desarrollo de proyectos de investigación, estrategias de control y planes de atención médica a los pacientes detectados son escasos, la Organización Mundial de la Salud (OMS) incorporó esta enfermedad al grupo de enfermedades infecciosas desatendidas (EID) en el año 2005. Se reconoce actualmente la naturaleza multidimensional de la enfermedad de Chagas, cuya caracterización contempla una intrincada trama de aspectos socioculturales, políticos, biológicos, ambientales y sanitarios. Parte sustancial de todo ello radica en el carácter zoonótico de la endemia y la consiguiente imposibilidad de su erradicación. Por ende, resulta muy complicada la construcción de la ruta crítica para enfrentar esta enfermedad, con la aspiración o el objetivo de su eliminación como problema de salud pública. El propósito de esta guía es ofrecer a los Estados Miembros un instrumento que permita actualizar y estandarizar los procesos de evaluación del control, verificación de la interrupción de la transmisión, y validación de la eliminación de la enfermedad de Chagas como problema de salud pública, en consonancia con: a) la Estrategia y plan de acción para la prevención, el control y la atención de la enfermedad de Chagas; b) el Plan de acción para la eliminación de las enfermedades infecciosas desatendidas y las medidas posteriores a la eliminación 2016-2022; c) el Plan de acción sobre entomología y control de vectores 2018-2023; d) guías o procedimientos operativos estandarizados existentes para la verificación o validación de la eliminación de otras enfermedades infecciosas desatendidas (EID) como la oncocercosis, la filariasis linfática y el tracoma, y e) Enfermedades tropicales desatendidas. Prevención, control, eliminación, erradicación.
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Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to
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measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated.
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Problem-solving in the clinic, Online course
midwaidwa
midwaidwa
Revision for Field Review
Online version of the manual: https://iawgfieldmanual.com/manual
Le manuel Sphère
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The BMJ has made all of its articles referring to the Ebola outbreak free to access.
The content includes latest guidance for healthcare workers, which 'will continue to update healthcare workers, outside of west Africa, with the latest guidance from the UK's Health Protection Agency and the US Cen
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ter for Disease Control'
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Supplément
Décembre 2016
Services de dépistage du VIH
These standards for the quality of paediatric care in health facilities form part of normative
guidance for improving the quality of maternal, newborn, child and adolescent health care.
In view of the importance of the continuum of both the life-course and service delivery (1),
these standards bu
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ild on the Standards for improving the quality of maternal and newborn
care in health facilities (2), during labour, childbirth and the early postnatal period.
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