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 h...ealth systems has proved to be complex and continues 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.
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DHS Working Papers No. 104.
Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The ...quality of prescribing depends mostly on those prescribers belonging to clinical medical specialties having direct contact with patients. These doctors, who comprise the majority of antibiotic prescribers,undergo long-term undergraduate and postgraduate training that shapes their professional knowledge and behaviour
J Antimicrob Chemother2019;74: 3611–3618doi:10.1093/jac/dkz375 Advance Access publication 3 September 2019
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The purpose of these guidelines is to help health workers to participate in the process of continuous surveillance of safety and efficacy ...ss="attribute-to-highlight medbox">of the pharmaceutical products which are used in clinical practice, thus help to achieve the ultimate goal to make safer and more effective treatment available to patients. This guideline addresses specifically the issues on what to report, why to report, when to report, where to report and how to report.
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The purpose of cancer screening tests is to detect pre-cancer or early-stage cancer in asymptomatic individuals so that timely diagnosis and early treatment can be offered, where this treatment can lead to better outcomes for some people.
The aim... of a cancer screening programme is either to reduce mortality and morbidity in a population by early detection and early treatment of a cancer (for example, breast screening) or to reduce the incidence of a cancer by identifying and treating its precursors (such as cervical and colorectal screening).
This short guide is designed to be a quick reference that contains the important ideas about cancer screening. Readers should refer to other publications for comprehensive discussion and detailed guidance on cancer screening programmes.
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The intention of this document is to clarify and outline the steps to effective cholera surveillance. It discusses when,
where and why surveillance for cholera is needed and how to establish a useful and cost-effective surveillance
system for ch...olera. To make comments, corrections and additions, please contact the authors at stopchol@jhsph.
edu or jhsph.stopchol@jhu.edu.
Check also: DOVE Project www.stopcholera.org
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