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Publication Years
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of natio
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nal policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within national quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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Severe cases of COVID-19 are associated with rehabilitation needs related to the consequences of ventilatory support, and prolonged immobilization and bed rest. These may include: − Impaired lung
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function; − Physical deconditioning and muscle weakness; − Delirium and other cognitive impairments; − Impaired swallow and communication; and − Mental health disorders and psychosocial support needs. − Rehabilitation needs may be amplified by underlying health conditions and decrements in health associated with ageing, − Rehabilitation professionals play an important role in facilitating early discharge, which is especially critical in the context of hospital bed shortages. − Rehabilitation needs of people with severe COVID-19 exist during the acute, sub-acute and long-term phases of care; rehabilitation professionals should be positioned in ICUs, hospital wards, stepdown facilities and in the community. − Particularly in the acute phase, rehabilitation interventions for patients with severe COVID-19 requiring ventilatory support generally require a particular skill-set acquired through specialist training.
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The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy exper
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ience was first published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnancy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutritional interventions in pregnancy.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation
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of the five-year health sector development plans and the Health Sector Reform Strategy 2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy exper
...
ience was published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnancy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutrition in pregnancy.
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Aims of the CNS programme:
- To provide accessibility to quality nursing care and related services including clinical assessment and personalized car ... e for persons enrolled/entitled to CNS services.
- To enhance the independence and health outcomes of entitled persons by avoiding early admission to hospital and/or residential care by providing access to CNS.
- To provide nursing, midwifery and advanced/specialized care through CNS delivered by a skills mix of registered and enrolled nurses.
- To facilitate provision of preventive, promotive and rehabilitative services to the community. more
- To provide accessibility to quality nursing care and related services including clinical assessment and personalized car ... e for persons enrolled/entitled to CNS services.
- To enhance the independence and health outcomes of entitled persons by avoiding early admission to hospital and/or residential care by providing access to CNS.
- To provide nursing, midwifery and advanced/specialized care through CNS delivered by a skills mix of registered and enrolled nurses.
- To facilitate provision of preventive, promotive and rehabilitative services to the community. more
Depression is a leading cause of non-fatal disease burden worldwide, with a lifetime prevalence of 9% among European adult men and 17% among European adult women.
The task at hand requires substant
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ial investments in preventive mental health care, but the potential benefits can be equally rewarding. After all, mental wellbeing is a key resource for learning, productivity, participation and inclusion. Investing in proactive care to promote, protect and sustain mental health in the population is therefore likely to offer good value for money.
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A lack of knowledge about the threat of vaccine-preventable diseases, risks and benefits of vaccines, mistrust
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of government and health workers, poor service delivery and alternative health or religious beliefs play a role in lower uptake of some vaccines. These challenges underscore the importance of early integration and investment in a thoughtful communication plan for immunization programmes. This World Health Organization (WHO) report presents communication guidance and specific considerations for countries that plan to introduce human papillomavirus (HPV) vaccine into their national immunisation programme as part of an effort to prevent cervical cancer.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region
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of the Americas. In its final report on the Plan of Action to Accelerate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk
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of CVD is an important strategy to prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and proven interventions in Latin American and Caribbean countries. Four areas of work are identified with
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the respective guidelines or suggestions for action, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
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Accessed 21 July 2021:The Caregiver Booklet is designed to help patients,family members, and community caregivers in the home-based care of serious long term illness. Home
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care is best for many people with long term illnesses,including those who are close to the end of life. All patients being cared for at home should be first assessed and treated by a health worker, who will help caregivers provide high quality home care and ensure that medicines are taken correctly.
This booklet explains how to:
1. Deal with specific symptoms.
2. Provide care for terminal and bedridden patients at home.
3. Decide when to seek help from a health facility.
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Guidelines on hepatitis B and C testing
recommended
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepat
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itis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to receive the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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These guidelines group all recommendations on TB care and support in one document and are complemented by an operational handbook. The guidelines are to be used primarily by national TB programmes, or their equivalents in Ministries
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of Health, stakeholders and technical organizations working on TB care in the public and private sectors and in the community.
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The report reveals that good IPC programmes can reduce health care infections by 70 %. oday, out of every 100 patients in acute-
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care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one health care-associated infection (HAI) during their hospital stay. On average, 1 in every 10 affected patients will die from their HAI.
People in intensive care and newborns are particularly at risk. And the report reveals that approximately one in four hospital-treated sepsis cases and almost half of all cases of sepsis with organ dysfunction treated in adult intensive-care units are health care-associated.
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The IMCI chart booklet is for use by doctors, nurses and other health professionals who see young infants and children less than five years old. It facilitates the use of the IMCI case management p
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rocess in practice and describes a series of all the case management steps in a form of IMCI charts.
These charts show the sequence of steps and provide information for performing them. The IMCI chart booklet should be used by all health professionals providing care to sick children to help them apply the IMCI case management guidelines. Health professionals should always use the chart booklet for easy reference.The chart booklet is divided into two main parts because clinical signs in sick young infants and older children are somewhat different and because case management procedures also differ between these age groups.
Sick child aged 2 months to 5 years
This part contains all the necessary clinical algorithms, information and instructions on how to provide care to sick children aged 2 months to 5 years.
Sick young infant aged up to 2 months
This part includes case management clinical algorithms for the care of a young infant aged up to 2 months.
Each of these parts contains IMCI charts corresponding to the main steps of the IMCI case management process.
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Managing possible serious bacterial infection in young infants when referral is not feasible
recommended
It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral care, but can be managed in outpatient
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settings by an appropriately trained health worker. The guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
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The document describes the use of strategic information at various stages of the response in the context of strengthening broader
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health information systems. Strategic information can be defined as data collected at all service delivery and administrative levels to inform policy and programme decisions.
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No country can claim to be free from health-care associated infections, therefore, improvement of infection prevention and control (IPC) strategies
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is essential. WHO recommends the use of multimodal improvement strategies to implement IPC interventions. These include each item of standard and transmission-based precautions according to national guidelines or standard operating procedures and under the coordination of the national IPC focal point (or team, if existing). This publication consists of three focused improvement tools, called “aide-memoires”, which focus on 1) respiratory and hand hygiene, 2) personal protective equipment, and 3) environmental cleaning, waste and linen management, all elements of standard, droplet/contact and airborne precautions.
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iSupport
recommended
iSupport is a self-help skills and training programme for carers of people with dementia. Worldwide, around 55 million people have dementia. Dementia causes significant psychological and emotional impact on families and carers. iSupport aims to prev
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ent and/or decrease mental and physical health problems associated with caregiving and to improve the quality of life of those caring for people with dementia.
iSupport was conceptualized and developed as an online training programme. However, in areas of the world with limited internet bandwidth or low digital literacy, the iSupport hardcopy manual can be printed and used offline.
In five modules, iSupport teaches carers what dementia is and how to respond to common challenges of caregiving. The five modules are (i) introduction to dementia; (ii) being a caregiver; (iii) caring for me; (iv) providing everyday care; and (v) dealing with behaviour changes.
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