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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HTC COUNTRY REPORT | LESOTHO
Singing to the Lions is a free training package (facilitator’s guide, supplement and video) by CRS, that is designed to help children and youth lessen the impact of violence and abuse in their lives. The main component is a three-day workshop where participants learn skills that can help them tran...sform their lives and no longer feel dominated by fear. Although the workshop is aimed at young people and includes games, art and songs, it can also be used to help adults take action on aspects of their lives that cause fear and, in so doing, become better parents and caregivers.
Singing to the Lions is available in English, French and Spanish, with Arabic and Hindi in process. See the links below. It can be easily adapted to different cultures, with different pictures and metaphors (e.g., “Singing to the Wolves” in Arabic; “Charming the Snakes” in Hindi.)
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The Handbook is a guide to the normative framework for humanitarian action and the operational approaches, coordination structures, and available tools and services that facilitate the mobilization of humanitarian assistance.
PLOS ONE | https://doi.org/10.1371/journal.pone.0183180 October 9, 2017
Since February 24th, 2022, the beginning of Russia’s aggression against Ukraine, more than 80,000 women were expected to give birth. Therefore, understanding the impact of war on the perinatal health of women is an important requisite to improve perinatal care. This narrative synthesis has two mai...n purposes: on one hand, it aims to summarize the current evidence available based on perinatal health outcomes and care among perinatal women; on the other, it attempts to identify the gaps still present in research in relation to perinatal care.
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Digital health technology can make health systems more efficient and sustainable, facilitating the provision of high-quality
care across a wide range of contexts and for diverse population health needs. The pace of innovation in digital health is
rapid and constant, with new interventions bein...g developed, implemented, tested and refined against a diversity of contexts,
constraints and challenges to address a variety of health and health system needs.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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The use of explosive weapons, such as bombs, rockets, and mortar and
artillery shells, in cities, towns and villages and in other populated areas
has devastating humanitarian consequences. Explosive weapons act mainly
through the projection of blast and fragmentation wi...thin an area. Their use,
in populated areas, causes severe suffering to civilians, both in terms of
death and serious injury resulting directly from the explosion, and in terms
of damage to property and public infrastructure, which can indirectly affect
civilian well-being and survival, sometimes for many years after a conflict
has ended. Explosive weapons also leave behind explosive remnants that
pose a threat to populations until those remnants are removed. [...] The study finds that the regulation of explosive weapons under international
law and policy is fragmentary and incoherent.
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Interim Guidance October 2022. This addendum addresses some of the methodological aspects of VE evaluations that have been learned during the past year, as well as those that have become relevant in the current epidemiological setting of the COVID-19 pandemic. For some of the COVID-19 vaccine method...ology issues there are still insufficient data to make a recommendation, in which case different options for approaching VE evaluations are presented.
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Conflict, climate crisis and COVID-19 pose great threats to the health of women and children.
COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under di...fferent epidemiological scenarios.
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Background: Several studies have demonstrated that South African children and adolescents are
exposed to high levels of violent trauma with a significant proportion developing PTSD, however,
limited resources make it difficult to accurately identify traumatized children.
Conclusions: Our result...s indicate that trauma exposure and PTSD are prevalent in South African
youth and if appropriate cut-offs are used, self-report scales may be useful screening tools for
PTSD.
Annals of General Psychiatry 2005, 4:2doi:10.1186/1744-859X-4-2
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WHO QualityRights is an initiative which aims to improve the quality of care in mental health and related services and to promote the human rights of people with psychosocial, intellectual and cognitive disabilities, throughout the world.