Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by the presence of hyperglycaemia in the absence of treatment. The heterogeneous aetiopathology includes defects in insulin secretion, insulin action, or both. The long-term specific complications of diabe...tes include retinopathy, nephropathy, and neuropathy. People with diabetes are also at increased risk of other diseases, including cardiac, peripheral arterial and cerebrovascular disease, cataracts, erectile dysfunction, and nonalcoholic fatty liver disease. They are also at an increased risk of some infectious diseases such as tuberculosis, and are likely to experience poorer outcomes.
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Objectives and scope of the document
This document was developed to provide recommended management strategies for problems and disorders that are specifically related to the occurrence of a major stressful event. The recommended strategies will form the basis of a new module to be added to the WHO ...(2010) mhGAP Intervention Guide for use in non-specialized specialized health-care settings.
The scope of the problems covered by these guidelines is:
symptoms of acute stress in the first month after a potentially traumatic event, with the following subtypes:
- symptoms of acute traumatic stress (intrusion, avoidance and hyperarousal) in the first month after a potentially traumatic event;
- symptoms of dissociative (conversion) disorders in the first month after a potentially traumatic event;
- non-organic (secondary) enuresis in the first month after a potentially traumatic event (in children);
- hyperventilation in the first month after a potentially traumatic event;
- insomnia in the first month after a potentially traumatic event;
posttraumatic stress disorder (PTSD);
bereavement in the absence of a mental disorder.
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The guidelines begin with an overview of the determinants of mental health among children and adolescents before reviewing related South African policies and legislation. The document then discusses strategies to build skills among caregivers, teachers and other frontline providers of mental health ...interventions as well as those for counselling professionals. The guidelines conclude by identifying priority areas for mental health services among children and adolescents, including the prevention of child and substance abuse as well as services for those living with intellectual disabilities
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there... is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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The Global status report on violence prevention 2014, which reflects data from 133 countries, is the first report of its kind to assess national efforts to address interpersonal violence, namely child maltreatment, youth violence, intimate partner and sexual violence, and elder abuse. Jointly publis...hed by WHO, the United Nations Development Programme, and the United Nations Office on Drugs and Crime, the report reviews the current status of violence prevention efforts in countries, and calls for a scaling up of violence prevention programmes; stronger legislation and enforcement of laws relevant for violence prevention; and enhanced services for victims of violence.
You can download summaries in different languages, single chapters and graphics
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Hurricane Matthew has displaced around 175,500 people. Serious protection concerns in these shelters put at risk some highly vulnerable people due to their age, gender, disability, sexual orientation, or a combination of factors. Separated and unaccompanied children, single mothers or single-headed ...households, pregnant or lactating women and girls, families at risk of separation, and people with chronic illnesses have also been identified. Psychosocial distress and lack of privacy, electricity, water, sanitation and hygiene create a situation in which girls and boys face exploitation, abuse, aggression, and sexual and gender based violence.
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The most frequent health problems of newly arrived refugees and migrants include accidental injuries, hypothermia, burns, gastrointestinal illnesses, cardiovascular events, pregnancy- and delivery-related complications, diabetes and hypertension. Female refugees and migrants frequently face specific... challenges, particularly in maternal, newborn and child health, sexual and reproductive health, and violence. The exposure of refugees and migrants to the risks associated with population movements – psychosocial disorders, reproductive health problems, higher newborn mortality, drug abuse, nutrition disorders, alcoholism and exposure to violence – increase their vulnerability to noncommunicable diseases (NCDs)
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The Global Sexual and Reproductive Health Service Package for Men and Adolescent Boys has been developed to support providers of sexual and reproductive health (SRH) services to increase the range and quality of services to meet the specific and diverse needs of men and adolescent boys. This package... focuses specifically on the provision of such services integrated
within clinical and non-clinical contexts and follows a gender-transformative approach. It covers men and adolescent boys in all their diversity and takes a positive approach to SRH, seeing this not just as the absence of disease, but the positive expression of one’s gender, sex and sexuality. In doing so, this service package contributes to efforts to ensure universal access to sexual and reproductive health and rights (SRHR) as prioritized in the Sustainable Development Goals. This package is in no way intended to detract from the sexual and reproductive health and rights of women and adolescent girls, nor to divert resources, funding or attention from much-needed SRH services and programmes for women and adolescent girls.
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Overview
Learning objectives
• Understand the mental health treatment gap in low-, middle- and high-income countries.
• Understand the principles and aims of the Mental Health Gap Action Programme.
• Acquire an introduction to mhGAP Intervention Guide (mhGAP-IG).
• Learn about mhGAP ToH...P training methodology and what to expect from mhGAP ToHP
training.
• Prepare group training ground rules.
• Know the common presentations of mental, neurological and substance abuse (MNS)
conditions.
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A publication about girls escaping natural disasters and violent conflict in Eastern Africa
Children are on the move. In East Africa region, it is estimated that over 5 million children have migrated across borders or been forcibly displaced in their own country.
Forcable displacement is p...ushing more and more children out of their homes and communities, escaping the violence of war and conflict, only to fall vulnerable to other forms of violence. Girls are particularly vulnerable and need extra protection.
Every day, girls on the move in East Africa face a variety of rights violations, including:
• Exploitation and violence
• Being separated from their families
• Deprivation of essential services
• Use and recruitment by armed groups
• Sexual abuse
• Child marriage
This report highlights concerns that girls in eastern Africa face and calls on international and national decision makers to prevent and end violence that children face when they are forced to flee their homes.
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Int J Bipolar Disord (2018) 6:6 https://doi.org/10.1186/s40345‑017‑0110‑8
In 2001, the WHO stated that: "The use of mobile and wireless technologies to support the achievement of health objectives (mHealth) has the potential to transform the face of health service delivery across the globe".... Within mental health, interventions and monitoring systems for depression, anxiety, substance abuse, eating disorder, schizophrenia and bipolar disorder have been developed and used. The present paper presents the status and findings from studies using automatically generated objective smartphone data in the monitoring of bipolar disorder, and addresses considerations on the current literature and methodological as well as clinical aspects to consider in the future studies.
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Music therapy can help traumatized children and adults to stabilize and to create a safe space for the expression of feelings and thoughts. In a 1 day international symposium on Friday May 26, presenting lectures and workshops, we’ll highlight the way music therapy research, methods and technique...s are applied to treating childhood trauma and sexual abuse, traumatized refugees, prisoners and victims of violence.
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By December of 2019, an estimated 5.3 million Venezuelans would have left the country, migrating in search of opportunities, health services and an overall search to improve the socio-economic conditions of themselves and their families. This is the largest migration in the history of the Americas. ...Migrants are one of the most vulnerable populations, exposed to human trafficking, abuse, exploitation and violence.
This Emergency Appeal seeks funds to reach this vulnerable population through a range of services that are aimed at preserving the dignity of migrant populations and increasing their wellbeing. These services are: shelter; livelihoods and basic needs; health services; water, sanitation and hygiene services; protection gender and inclusion. T
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Background. Children and adolescents can develop post-traumatic stress disorder (PTSD) after exposure to a range of traumatic events, including domestic, political or community violence, violent crime, physical and sexual abuse, hijacking, witnessing a violent crime and motor vehicle accidents. This... is particularly critical given the substantial challenge that PTSD poses to the healthy physical, cognitive and emotional development of children and adolescents.
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This report examines how urban living affects residents’ mental health and happiness, and ways to use this information to create saner and happier cities. Some often-cited studies suggest that urban living increases mental illness and unhappiness, but a critical review indicates that much of this ...research is incomplete and biased, and the issues are complex, often involving trade-offs between risk factors. City living may increase some forms of psychosis and mood disorders, drug addiction, and some people’s unhappiness, but tends reduce dementia, alcohol abuse and suicide rates, and many people are happier in cities than they would be in smaller communities. This report examines specific mechanisms by which urban living can affect mental health and happiness, and identities practical strategies that communities and individuals can use to increase urban mental health and happiness. This analysis suggests that it is possible to create sane and happy cities.
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The World Health Organization (WHO) defines mental health as ‘a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’. Mental illn...ess refers to all of the diagnosable mental disorders, which are characterised by abnormalities in thinking, feelings or behaviours. Mental illness is closely related to vulnerability, both in its causes and in its effects. Globally, 14 per cent of the global burden of disease is attributed to mental illness – with 75 per cent of those affected being found in low-income countries – which includes a broad spectrum of diagnoses, from common mental illnesses such as anxiety and
substance abuse, to severe illnesses like psychosis.
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Mental health problem is one of the growing major public health issues in the Asia Pacific region. It contributes to the high number of Disability Adjusted Life Years (DALYs), morbidity and mortality in the region. It is expected that leading mental health problems will occur in the low-and middle-i...ncome countries (LMICs) and majority of the countries which comes under this category are in the Asia Pacific region. In addition, mental health problem hamper the achievement of Millennium Development Goals (MDGs), particularly MDG 1, MDG 4 and MDG 5. The most common mental health problems in the region are depression, anxiety, posttraumatic stress disorder, suicidal behaviour and substance abuse disorder. Several modifiable and non-modifiable risk factors were identified for the cause of these major mental health issues. Interventions, programmes and policies need to be designed in order to curb mental health problems at all levels.
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In recent years Terre des Hommes Netherlands observed the steady rise of a new form of child sexual exploitation. One that is enabled and fuelled by rapid technological advances, increasing global connectivity, persisting poverty rates, and growing disparity in the global distribution of resources. ...Terre des Hommes Netherlands received alarming signals from collaborating project partners from the Philippines that new commercial child exploitation trades are evolving and spreading parallel to rising global Internet access rates and developments in communications technology.
Webcam child sex tourism is evidently growing, closely related to child prostitution, child trafficking and child abuse. What is not clear however, are the psychological and social consequences of this new phenomenon. To date, no research has been done on the psychosocial consequences of webcam sex for children. The aim of this research is therefore to gain more knowledge on the psychosocial consequences of webcam child sex tourism for children and to give insight into the antecedent factors that play a role.
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Overview
Learning objectives
• Understand the mental health treatment gap in low-, middle- and high-income countries.
• Understand the principles and aims of the Mental Health Gap Action Programme.
• Acquire an introduction to mhGAP Intervention Guide (mhGAP-IG).
• Learn about mhGAP ToH...P training methodology and what to expect from mhGAP ToHP
training.
• Prepare group training ground rules.
• Know the common presentations of mental, neurological and substance abuse (MNS)
conditions.
more