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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Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultur...al backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in
a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups.The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition.
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The purpose of the review was to assign a cause of death, to ascertain the fac-tors that contributed to the death and to identify any systemic issues that could be addressed to prevent future similar deaths. The perinatal mortality audit process in 2019 provided important insights and evidence-based... recommendations that can be used both to address system errors and barriers and to identify and praise points of strength. The aim is to pro-vide recommendations for better care for mothers and their infants during pregnancy, childbirth and the neonatal period and improve the quality of care provided throughout the health system.
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Defending Rights
Breaking Barriers
Reaching People with HIV Services
Global Aids Update 2019
Global Campaign Against Epilepsy
This study examined the quality of facility-based maternal and newborn health care by describing the implementation of recommended practices for maternal and newborn care among health care facilities to determine whether increased training, supervision, and incentives for health workers were associa...ted with implementing these recommended practices.
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Guidelines
June 2017
HIV strategic information for impact
In Deutschland leben ca. 200.000 Geflüchtete in Aufnahmeeinrichtungen und Gemeinschaftsunterkünften (Stand:31.12.2018). Massnahmen der physischen Distanzierung sind in der Sammelunterbringung für Geflüchtete meist nicht oder nur bedingt umsetzbar: Beengte Verhältnisse, Mehrbettzimmer und gemein...schaftliche Nutzung von Küchen und Sanitäranlagen stellen Kontexte dar, die eine Ausbreitung von Infektionserkrankungen begünstigen. Zunehmend werden in diesen Settings Infektionen mit dem neuartigen Coronavirus (SARS‐CoV‐2) bekannt. Die Ansätze zu Prävention und Management von SARS‐CoV‐2 sind regional unterschiedlich, Vorgaben fehlen bisher auf nationaler und internationaler Ebene. So werden vielerorts Aufnahmeeinrichtungen und Gemeinschaftsunterkünfte beim Auftreten einer SARS‐CoV‐2‐Infektion unter Geflüchteten kollektiv unter Quarantäne gestellt.
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Policy and Legal Opportunities for HIV Testing Services and Civil Society Engagement
Will COVID-19 vaccines be safe? Will all the COVID-19 candidate vaccines be successful? What are the different phases a vaccine must go through to be approved? This document provides responses to the most frequently asked questions about candidate vaccines and access to COVID-19 vaccination.
N95 or equivalent respirators are single-use personal protective equipment (PPE) designed for use by health workers that provide direct care to patients with diseases transmitted by aerosols or during aerosol generating procedures (AGP) for patients with acute respiratory disease, as is the case of ...COVID-19. • Given the current shortage of N95 and equivalent respirators, the World Health Organization (WHO) has suggested the possibility of their extended use by the same individual for up to 6 hours or the reprocessing of respirators when necessary.
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This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities. ...As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.
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