Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement integrated family planning and immunization services i...n all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.
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A guidance document in simple language for health personnel, setting out their rights and responsibilities in conflict and other situations of violence. It explains how responsibilities and rights for health personnel can be derived from international humanitarian law, human rights law and medical e...thics.The document gives practical guidance on:
- The protection of health personnel, the sick and the wounded; - Standards of practice; - The health needs of particularly vulnerable people; - Health records and transmission of medical records; - "Imported" health care (including military health care);
- Data gathering and health personnel as witnesses to violations of international law; - Working with the media
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In this entry we are looking at smoking, alcohol consumption and the use of illicit drugs. We are studying who is using these substances, how their use has changed over time, and we are presenting the estimates of their impact on health. Collectively, smoking, alcohol and illicit drug use kills 11.8... million people each year. This is more than the number of deaths from all cancers
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This summary highlights the experiences, results and actions from
the implementation of the Rapid Assessment Tool for Sexual and
The tool – developed by IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW and Young Positives in
2009 – supports national assessments of the bi-directional linkages
between sexu...al and reproductive health (SRH) and HIV at the policy,
systems and services levels. Each country that has rolled out the
tool has gathered and generated information that will help to
determine priorities and shape national plans and frameworks for
scaling up and intensifying linkages. Country experiences and best
practices will also inform regional and global agendas.
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Recommended actions at international and national levels
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidance for the CO...VID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges.
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The United Nations Population Fund (UNFPA) is the lead UN agency working to further gender equality and women’s empowerment in Sri Lanka. We are pleased to be a part of the joint effort with the Ministry of Health to develop the first ‘Standard Operating Procedures on sexual and gender-based vio...lence for first-contact-point healthcare providers’.
These operating procedures were developed alongside the ‘National guidelines on sexual and gender-based violence’, which aims to strengthen Sri Lanka’s health systems response to survivors of violence. We are grateful to the British High Commission in Colombo for their support in developing these guidelines and procedures as they mark an important milestone in creating a safer Sri Lanka for all women and girls. UNFPA is proud to be a part of this journey, and we stand ready to provide continued assistance to the Government of Sri Lanka and all key stakeholders to ensure women and girls receive essential services that support their safety, well-being and access to justice and to create a violence-free Sri Lanka.
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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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This report provides an overview of air pollution levels and associated health impacts in cities around the world. Since urban areas are often hotspots for poor air quality, city-level data can help to inform targeted efforts to curb urban air pollution and improve public health. This report draws o...n data from the Global Burden of Disease project and from peer-reviewed analyses led by Susan Anenberg of the George Washington University.
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The war in Ukraine will have direct and indirect health consequences on conflict affected people, including internally displaced people and refugees. Governments in countries receiving refugees are providing them with access to healthcare. This document aims to provide information to guide individua...l health assessment carried out by frontline health providers at border areas, reception centres, transit centres and individual clinics as well as national public health agencies/authorities in countries receiving refugees and third country nationals.
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The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportionally on low- and middle-income countries. Injury Pr...evention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year
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The purpose of this document is to provide agencies with a guide with three tools containing key assessment questions that are of common relevance to all actors involved in Mental Health and Psychosocial Support (MHPSS) independent of the phase of the emergency. This guide will be useful for rapid a...ssessments of MHPSS issues in humanitarian emergencies across sectors. The guide is designed for use by various humanitarian actors (governmental and non-governmental; local, national and global). It is based on the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (IASC, 2007).
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Antimicrobial resistance (AMR) is a global threat that requires urgent collaborative action within and among countries. AMR makes standard treatments ineffective and facilitates the spread of antimicrobial resistant infections rendering communities vulnerable. The Ministry of Health (MOH) and Minist...ry of Agriculture, Livestock, Fisheries & Blue Economy (MALF) recognized antimicrobial resistance as a priority following findings from status reports and studies from Ministries, Departments, Agencies and Stakeholders.
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Tuberculosis treatment failure results in increased risk of morbidity, drug resistance, transmission and mortality. There are few data about tuberculosis treatment outcomes in Burkina Faso. The current study investigated the factors associated with tuberculosis treatment failure in the central east ...health region of Burkina Faso.
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From February 22-23, 2023, the Wellcome Trust and the Global Task Force on Cholera Control (GTFCC) brought together researchers, decision makers, and public health implementers to participate in a virtual workshop focused on cholera and climate. Day 1 involved a technical workshop to identify key re...search themes as well as the challenges, gaps, and opportunities in using climate information for cholera decision making. Day 2 was an open forum focused on information-sharing and updates from countries and partners, including a call for stronger research and data on the connection between climate and cholera.
The overarching discussion outlined the complex relationship between climate and cholera. Materials from the event – including a recording of the Day 2 open forum, key findings/messages, and a final event report – can be accessed below
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The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider... settings. CIHS is funded jointly by the Substance Abuse and Mental Health Services Administration(SAMHSA) and the Health Resources and Services Administration (HRSA), and run by the National Council for Behavioral Health.
Despite the high prevalence of mental health and substance use problems, too many Americans go without treatment — in part because their disorders go undiagnosed. Regular screenings in primary care and other healthcare settings enables earlier identification of mental health and substance use disorders, which translates into earlier care. Screenings should be provided to people of all ages, even the young and the elderly
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicat...ed, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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PlosOne https://doi.org/10.1371/journal.pone.0196799; Zoonotic diseases continue to be a public health burden globally. Uganda is especially vulnerable due to its location, biodiversity, and population. Given these concerns, the Ugandan government in collaboration with the Global Health Security Age...nda conducted a One Health Zoonotic Disease Prioritization Workshop to identify zoonotic diseases of greatest national concern to the Ugandan government.
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