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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 This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and
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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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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB patients. When appropriately implemented, the activity is cost effectiv
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e, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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The framework sets out a response to current mental health challenges arising from the negative impact that the COVID-19 pandemic has had on population mental health and well-being. The EFAMH provides a coherent basis for intensified efforts to mainstream, promote and safeguard mental well-being as
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an integral element of COVID-19 response and recovery; to counter the stigma and discrimination associated with mental health conditions;
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This publication is a companion document to the NDVP National Deployment and Vaccination Plans guidance, which provides a framework for countries to develop their national strategies. As countries face challenges with erratic vaccine supplies, use of multiple vaccine products with different charact
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eristics, and the size of populations and their diversity, this document provides operational guidance and information to support planners and immunization programme managers at the national and sub-national levels on microplanning for COVID-19 vaccination implementation.
This Guide is available in English, French, Arabic, chinese, Portuguese, Spanish, Russian
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The WHO End TB Strategy aims to end the global TB epidemic by 2030, in alignment with Goal 3 of the United Nations (UN) Sustainable Development Goals (SDGs). Member States of the World Health Organization (WHO) and the UN committed to ending the TB epidemic through adoption of WHO’s End TB Strateg
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y and the UN SDGs in 2014 and 2015, respectivel
Almost half of the deaths worldwide caused by TB in 2019 occurred in the WHO South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this Region is therefore essential if the global goal of ending the TB epidemic is to be realized. Despite substantial gains made in the Region, the threat to
health worldwide posed by the COVID-19 pandemic has the potential to reverse these gains and eclipse the focus on the global TB emergency.
While continuing to tackle COVID-19-related challenges, countries will need to rapidly and urgently deploy supplementary measures to address the large numbers of missed cases, poor treatment outcomes and, potentially, a higher TB burden.
The Regional Strategic Plan towards Ending TB in the Region 2021–2025 clearly articulates priority interventions, analyses the challenges, bottlenecks and opportunities, and focuses on implementation considerations in the Region.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal
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ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading
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to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin
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shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines
recommended
ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with
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authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
more
The roadmap describes the actions needed to
achieve the three development goals for TB
vaccines set by the WHO:
1. A safe, effective and affordable TB vaccine
for adolescents and adults.
2. An affordable TB vaccine for neonates and
infants with improved safety and efficacy.
3. A therapeutic v
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accine to improve TB
treatment outcomes
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This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to
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air pollution.
Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines (see the full report, Air pollution and child health: prescribing clean air. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under the age of 5 years in 2016.
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Front. Public Health, 30 April 2021 | https://doi.org/10.3389/fpubh.2021.628744
The consequences of the failing health system has immediate and longer-term impacts on children . April 2022
Available in English and Arabic
Cascading risks from rising prices and supply disruptions, April 2022.
Global resource markets are still reeling from the impacts of Russia’s invasion of Ukraine; the two countries are major suppliers of energy, food and fertilizers. Supply disruption and the sudden imposition, in response to the
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crisis, of unprecedented economic sanctions, trade restrictions and policy interventions have caused prices of commodities to skyrocket.
Before the conflict, demand for global resources already exceeded supply and drove up prices as economies rebounded after the COVID-19 pandemic. This gave rise to a global cost-of-living crisis, characterized by increasing levels of energy and food poverty. This situation is likely to become much worse as a consequence of the war in Ukraine, and poses a threat to human security, particularly among low-income and vulnerable populations.
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The Interim Guidance for Risk Communication and Community Engagement (RCCE) outlines recommendations, considerations and methods to raise awareness, manage risk perception, maintain trust and proactively support people at risk to make informed decisions to protect themselves and others from monkeypo
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x. The guidance includes recommendations on identifying and communicating with affected populations and key audiences and avoiding stigma in communications outreach. It also includes key messages about symptoms of monkeypox, transmission, prevention measures, and communicating about uncertainty. This document also provides RCCE guidance for managers and planners of gatherings and events, where close physical contact may create an environment conducive for the transmission of monkeypox. Additionally, this document includes a compendium of recommendations for RCCE methods and resources to support the monkeypox response.
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As a result of Russia’s invasion of Ukraine, the people of Ukraine, especially the most vulnerable, are paying an enormous price. Lives and livelihoods are being lost, with more than ten million people forced from their homes— and their country—in search of safety. The war has unleashed catast
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rophic damage to the country’s economy and threatens lasting increases in poverty and societal upheaval. The scale of the war and the devastation it has caused have jeopardized Ukraine’s hard-fought development gains, through destruction of production and property, disruption of trade, diminished investment due to amplified uncertainty, and erosion of human capita
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