Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work t
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hey do. However, few have examined their experiences and identity and how that might influence how they view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
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sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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This report’s central premise is that diagnostics and therapeutics, and associated test to treat strategies, are fundamental components of the pandemic response, both for COVID-19
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and for future health threats. Two years into the COVID-19 pandemic, this report reflects on the main challenges and key solutions on the road to equitable access to diagnostics and therapeutics.
This report draws from experience gained through the Access to COVID-19 Tools (ACT) Accelerator Diagnostics and Therapeutics pillars, and includes the perspectives of collaborating stakeholders (countries, civil society representatives and the private sector). Building on these findings, this report proposes sixteen recommended actions to address what have been identified as key structural challenges and specifies a potential owner for each action.
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What recommendations did the assessment produce?
• Developing guidelines and plans to further the process of SRH and Hiv integration.
• Training stakeholders at different levels of the hea
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lth system on how to integrate activities.
• Establishing mechanisms for collaboration/coordination on SRH and Hiv at different levels.
• Developing plans for SRH and Hiv integration that include: situation analysis; feasibility studies; assessment of needs for reorganizing and reorienting services towards better integration; necessary tools (e.g. job descriptions, work plans); and tools to evaluate service quality and user satisfaction in relation to integration.
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Since the launch of the 2012–2020 World Health Organization (WHO) road map for the control, elim-ination and eradication of neglected tropical diseases (NTDs) (1), considerable progress against NTDs has been made. Between 2010
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and 2020, the number of people requiring interventions against NTDs globally fell by 600 million, and 42 countries, areas and territories eliminated at least one NTD (2). In January 2021, a new NTD road map for 2021–2030 (2) was launched, setting future targets and mile-stones for 20 diseases and disease groups. The road map also sets cross-cutting targets, including for strengthened capacity of national health systems to deliver interventions through existing infrastructure.
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No publication year indicated
In the context of the floods in August 2015 in Myanmar, the Disaster Risk Reduction Working Group (DRR WG) was requested to provide clear recommendations to the DMH (Department of Hydrology and Meteorology)to stre
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ngthen preparedness activities, in particular for the next Monsoon season. UNDP as the lead of the DRR WG’s Policy Technical Task force carried out a desk review on EW (Early Warning) from all the DRR WG’s members at national and community levels. The document synthesizes the received information related to baseline surveys, lessons learned from the 2015’s floods, studies, project documents and initial recommendations on EW. Those serve as a base to this analysis and its overall recommendations.
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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic h
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as exacerbated the mental health crisis in the Region, necessitating urgent action at the highest levels of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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Analysis
Accessed: 14.03.2019
Further Analysis of the 2011 Ethiopia Demographic and Health
Survey. DHS Further Analysis Reports No. 82
Further Analysis of the 2000, 2005, and 2011 Demographic and Health Surveys. DHS Further Analysis
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Reports No. 80
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Practically, planetary health presents a new way to approach and solve problems. For example, there is
alignment at the highest levels with global policy frameworks – primarily the Convention on Biological
Diversity Aichi Biodiversity Targets, t
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he Paris Climate Agreement, and the Sustainable Development
Goals – which will require collaboration across sectors to make progress. While this alignment validates
integrated concepts like planetary health, it also highlights the need for these concepts to be much
more actionable, so that they can be easily taken up by government decision makers as a way to
achieve goals.
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As a high-burden neglected tropical disease, soil-transmitted helminth (STH) infections remain a major problem in the world, especially among children under five years of age. Since young children are at high risk of being infected, STH infection can have a long-term negative impact on their life, i
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ncluding impaired growth and development. Stunting, a form of malnutrition in young children, has been long assumed as one of the risk factors in acquiring the STH infections. However, the studies on STH infection in children under five with stunting have been lacking, resulting in poor identification of the risk. Accordingly, we collected and reviewed existing related research articles to provide an overview of STH infection in a susceptible population of stunted children under five years of age in terms of prevalence and risk factors. There were 17 studies included in this review related to infection with Ascaris lumbricoides, Trichuris trichiura, hookworm, and Strongyloides stercoralis from various countries. The prevalence of STH infection in stunted children ranged from 12.5% to 56.5%. Increased inflammatory markers and intestinal microbiota dysbiosis might have increased the intensity of STH infection in stunted children that caused impairment in the immune system. While the age from 2 to 5 years along with poor hygiene and sanitation has shown to be the most common risk factors of STH infections in stunted children; currently there are no studies that show direct results of stunting as a risk factor for STH infection. While stunting itself may affect the pathogenesis of STH infection, further research on stunting as a risk factor for STH infection is encouraged.
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DHS Further Analysis Reports No. 101
DHS Further Analysis Reports No 102
Climate change, increasing population densities, and intensified globalisation in trade, travel and migration are among the most important factors shaping the 21st century. Each impacts upon populat
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ion health and the risk of infectious disease, particularly those originating at the human-animal-environmental interface. The recognition that many risk drivers of infectious disease fall outside of the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security. In response, the One Health concept has emerged, as have related initiatives addressing Planetary Health and Biodiversity and Human Health. From a public health perspective and operationally speaking, the One Health approach offers great potential, emphasising as it does cooperation and coordination between multiple sectors. Yet despite having been a focal point for discussion for over a decade, numerous challenges facing the implementation of One Health preparedness strategies remain. While some are technical, related to the requirement for innovative early warning systems or new vaccines, for example, others are institutional and cultural in nature, given the transdisciplinary nature of the topic. There have thus been calls to address One Health from multiple perspectives, from ecology to the social sciences. In order to further explore this issue and to identify priority areas for action for strengthening One Health preparedness in Europe, ECDC convened an expert consultation on 11–12 December 2017.
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This companion to the ALNAP EHA Guide offers protection-specific insights for evaluators and evaluation commissioners across the humanitarian sector. It covers the planning, data management and
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analysis phases of evaluation and addresses a range of challenges that – whilst not all unique to protection – are often exacerbated by the contexts in which protection activities typically take place. Challenges addressed include those arising from the multi-faceted nature of protection activities, the difficulty understanding cause-effect relationships underlying protection risks, and the challenges of accessing and managing very sensitive data, sometimes drawn from communities in conflict.
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