This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health... goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
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Background
Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death.
Methods
This review is based on articles retrieved by a selective search in PubMed, as well as on r...elevant guidelines.
Results
Evidence-based treatment options are available only for congestive heart failure with a low ejection fraction. Pharmacotherapy is based on neurohumoral inhibition of the renin-angiotensin-aldosterone system and the adrenergic system. The prognosis of patients with this condition has been further improved recently through the introduction of combined angiotensin receptor antagonists and neprilysin inhibitors. Modern implantable devices are a further component of treatment. Implantable defibrillators and special pacemakers for cardiac resynchronization are well established; the utility of alternative devices (baroreflex modulation or cardiac contractility modulation) needs to be investigated in further studies. It was recently shown that the catheter-based treatment of secondary mitral regurgitation with a MitraClip improves the outcome of selected patients.
Conclusion
The treatment of chronic systolic heart failure as recommended in the relevant guidelines, with drugs and implanted devices if indicated, can significantly improve the clinical outcome.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-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.
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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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An interdisciplinary approach to address global health challenges such as the Covid-19 pandemic, climate change, loss of biodiversity, human migration has been framed by the One Health approach. This approach is promoted at global level by the Tripartite of the World Health Organisation, the World A...nimal Health Organisation, the Food and Agriculture Organisation of the United Nations, recently joint by the United National Environment Program to form the Quadripartite. The German government through its Ministry of Economic Cooperation and Development supports this approach with its One Health strategy and investment in several technical cooperation projects.
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Zika and dengue viruses remain significant public health threats. These viruses share the same Aedes (Stegomyia) mosquito vectors and geographic distributions but infections cannot be readily distinguished clinically and need to be differentiated from each other, and from other circulating arboviral... and non-arboviral pathogens, using laboratory tests. This document provides guidance on current testing strategies for Zika and dengue virus infections with updates to the previous interim guidance for laboratory testing for ZIKV, addressing pregnant and non-pregnant patients respectively, and incorporates current guidance for dengue virus diagnostic testing. The choice of laboratory assays and interpretation of test results require careful consideration of epidemiology, patient history, and limitations of existing diagnostic tests.
This interim guidance is for use by staff of laboratories testing for Zika and dengue virus infections and for clinical practitioners and public health professionals providing clinical management or surveillance.
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The EHSP in Botswana seeks to attain universal coverage of high-quality package of essential health services. The EHSP is an integrated collection of cost-effective interventions, promotive, preventive, curative, and rehabilitative, that address the main diseases, injuries and risk factors that affe...ct the population. The EHSP has two key purposes:
1) Provide a standardized package of basic services which forms the core of service delivery in all primary health care facilities
2) Promote a redistribution of health services by providing equitable access, especially in underserved areas, population, etc.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapte...rs (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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In this article a cluster randomized cross-sectional survey, conducted in Albay Province in the Philippines in April 2016, was used to assess the prevalence of disability and access to support services. This was done with the purpose of generating representative data for local programme development.... A cross-sectional survey was carried out with the WG/UNICEF methodology to examine the prevalence of disabilities, and the accessibility and coverage of relevant services. The aim is for this information to be used for public policy formulation at all levels, as well as to improve communication and advocacy on disabilities.
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- Twenty-two joint integrated rapid response mechanism (IRRM) missions were conducted in 11 counties and reached 305,887 people including 65,432 children under 5 years of age.
- UNICEF’s Integrated Community Mobilization Network reached 345,219 households (total population 2.1 million) advoca...ting for child rights focused on child survival, birth notification, education and protection. Three million people have been reached with advocacy and life-saving messages through radio and community engagement activities, including activities focused on youth and faith leaders.
- On 27 June, discussions between President Salva Kiir and former First Vice President Riek Machar in Khartoum culminated in agreement to a permanent ceasefire and the opening of humanitarian corridors, effective 30 June.
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Each year, the WHO Global TB Report provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
The... 2021 edition of the report has been produced in a new and more web-centric format. This is designed to make the content available in smaller (more “bite-sized”) chunks that are easier to read, digest, navigate and use. There is a short and slim report PDF with 30 pages of main content plus six short annexes. This is accompanied by expanded and more detailed digital content on web pages. The total amount of content remains similar to that of previous years.
Available in English, French, Arabic and Chinese
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Los servicios de emergencias médicas prehospitalarias (SEM) facilitan atención inicial de soporte vital básico y/o avanzado y traslado de heridos o enfermos desde el lugar donde ocurre la emergencia hasta el centro sanitario donde le van a prestar cuidados definitivos. Los SEM también pueden pre...star traslado de pacientes desde una instalación de salud a otra de mayor nivel o complejidad, en lo que se conoce como traslado interhospitalario. Los servicios de ambulancia es el componente más conocido y puede ser prestado por diferentes proveedores que pueden ir desde departamentos de bomberos, organizaciones de voluntarios o servicios adscritos a universidades hasta hospitales que cuentan con su propio servicio de ambulancias para cubrir a sus usuarios. Los SEM prehospitalarios también incluyen otros componentes como los centros tipo 911 o los Centro Reguladores de Urgencia y Emergencias (CRUE) y los programas de primer respondiente. Todos ellos deben integrase de una forma coordinada con las redes integradas de servicios de salud para asegurar una continuidad de los cuidados de salud prestados a la persona herida o enferma. Durante emergencias de salud pública, los servicios de emergencia medicas prehospitalarias pueden verse superados por el número de llamadas o demanda de traslados médicos.
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La evolución de los acontecimientos y el esfuerzo conjunto de la comunidad científica mundial, hangeneradogran cantidad de información que se modificarápidamente con nuevas evidencias. Este documento pretende hacer unresumen analítico de la evidencia científica dispo...niblehasta el momento en torno a la epidemiología, características microbiológicas y clínicas del COVID-19.En esta actualización se añaden los hallazgos acerca de la transmisiónen periodo asintomático y a partir de aerosoles y superficies inanimadas, así como las características de los principales grupos de riesgo. Para información relativa a medicamentos relacionados con COVID-19 se puede consultar la web de la Agencia Española del Medicamento y ProductosSanitarios: https://www.aemps.gob.es/
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El 31 de diciembrede 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo co...ronavirus que ha sido denominado SARS-CoV-2. Al igual que otros de la familia de los coronavirus, este virus causa diversas manifestaciones clínicas englobadas bajoel término COVID-19, que incluyen cuadros respiratorios que varían desde el resfriado común hastacuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multi-orgánico. La mayoría de los casos de COVID-19 notificados hasta el momento debutan con cuadros leves.Un punto de detección importante de casos de COVID-19es la urgencia hospitalaria. El triaje tiene como objetivo identificar y priorizar al paciente más grave. Al tratarse deuna enfermedad transmisiblese debenextremar las medidas deprecaución.
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4 April 2020
This interim guidance on oxygen sources and distribution strategies for COVID-19 treatment has been adapted from WHO and UNICEF’s technical specifications and guidance for oxygen therapy devices, which is part of the WHO medical device technical series. This guidance is intended for ...health facility administrators, clinical decision-makers, procurement officers, planning officers, biomedical engineers, infrastructure engineers and policy-makers. It describes how to quantify oxygen demand, identify oxygen sources that are available, and select appropriate surge sources to best respond to COVID-19 patients’ needs, especially in low-and-middle income countries.
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.... In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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Estima-se que 17,8 milhões de mulheres em todo o mundo com 18 anos ou mais viviam com o VIH em 2015, o equivalente a 51% dos adultos que viviam com o VIH. As raparigas adolescentes e as mulheres jovens são particularmente afectadas; em 2015 representavam 60 por cento dos indivíduos com idades com...preendidas entre os 15-24 anos que viviam com o VIH, e 58 por cento das infecções por VIH recentemente adquiridas entre a população jovem deste grupo etário. Em muitos países, as mulheres que vivem com o VIH não têm acesso equitativo a serviços de saúde de boa qualidade e enfrentam muitas formas de estigma e discriminação entrecruzadas. Além disso, estas mulheres são desproporcionadamente vulneráveis à violência, incluindo as violações dos seus direitos sexuais e reprodutivos.
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This document aims to provide guidance to healthcare facilities and healthcare providers in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK) on preparedness and infection prevention and control (IPC) measures for the management of possible and confirmed cases of COVID-1...9 in healthcare settings, including long-term care facilities (LTCFs). In addition, this document addresses the management of clinical diagnostic specimens at laboratories in the EU/EEA. This is the sixth update of the ECDC guidance on ‘Infection prevention and control and preparedness for COVID-19 in healthcare settings’, and replaces the document dated 6 October 2020.
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To evaluate the epidemiological evolution of patients with HIV (PtHIV), between 2002 and 2012, in a day-hospital that became an HIV reference centre for south-west Burkina Faso.
This was a retrospective study of PtHIV followed in the Bobo Dioulasso university hospital since 2002. The study was ba...sed on clinical data recorded using ESOPE software and analysed using Excel and SAS.
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Detecting breast cancer early improves survival, lowers morbidity and reduces the cost of care. Learn about the major breast cancer early detection strategies in this knowledge summary, including breast cancer education and awareness, and breast self-detection and clinical breast exams (CBE).