Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue...s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
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 of the Americas. In its final report on the Plan of Action to Accel...erate 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
more
Guía para la rehabilitación basada en la comunidad (RBC)
En el 2003, una Consulta Internacional para Revisar a Rehabilitación Basada en la Comunidad, celebrada en Helsinki, hizo un número de recomendaciones. Seguidamente, la rehabilitación basada en la comunidad se volvió a posicionar con una... propuesta de posición conjunta de la OIT, UNESCO y OMS, como una estrategia dentro del desarrollo comunal general para la rehabilitación, la equiparación de oportunidades, la reducción de la pobreza y la inclusión social de las personas con discapacidad.
more
The WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia. These WHO Guidelines are an important tool for health care providers as well as governments, pol...icy-makers and other stakeholders to strengthen their response to the dementia challenge.
Executive Summary available in Arabic, Chinese, French, Russian and Spanish at: https://www.who.int/mental_health/neurology/dementia/guidelines_risk_reduction/en/
more
El Comité Permanente entre Organismos (IASC) ha elaborado esta Guía para posibilitar que quienes participan en acciones de ayuda humanitaria planifiquen, establezcan y coordinen un conjunto mínimo de respuestas multisectoriales para proteger y mejorar la salud mental y el bienestar psicosocial de... las personas que atraviesan por situaciones de catástrofe. Las poblaciones afectadas por situaciones de emergencia humanitaria suelen padecer enormes sufrimientos.
more
Olashore et al.
Child Adolesc Psychiatry Ment Health (2017) 11:8 DOI 10.1186/s13034-017-0144-9
The achievable imperative for global progress
The Lancet Global Health, Vol. 6, No. 10 Published: August 29, 2018
[Updated 2015]
SCOPING QUESTION: What is the effectiveness of psychosocial interventions (including caregiver skills training) for behavioural disorders in children and adolescents?
Mental, Neurological, and Substance Use Disorders: Disease Control Priorities, Third Edition (Volume 4).
Patel V, Chisholm D, Dua T, et al., editors.
Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 Mar 14.
Handout presentations in PDF for illustrating lectures
Accessed May 2014
This study explores the knowledge of primary school teachers in
identifying children with learning disabilities.