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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Case Studies on Building Resilience in the Horn of Africa
CBM está comprometida con el principio de que las personas con discapacidad deben poder participar plenamente en la sociedad en igualdad de condiciones. Nuestro planteamiento se basa en los principios de la Convención de Naciones Unidas sobre los Derechos de las Personas con Discapacidad (CDPD) y ...en la responsabilidad de CBM de fomentar la accesibilidad y los principios del diseño universal en todos los ámbitos de su trabajo, incluyendo las comunicaciones y el contenido digital de CBM. La fnalidad de este set de herramientas es compartir una selección de herramientas y recomendaciones correspondientes a la accesibilidad de las Tecnologías de la Información y Comunicación (TIC). Basándose en estándares internacionales y en el análisis de las tecnologías disponibles, estas herramientas y recomendaciones tienen como objetivo contribuir a la inclusión social y económica de las personas con discapacidad garantizando que la información sea equitativamente accesible.
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Updated on 6 APRIL 2020
There are serious concerns that the situation might escalate in the next weeks modelling the epi curve of other regions. The interlinkages between human mobility and the current pandemic of COVID-19 are well established, and while international flights have been suspended i...n the region, the porous borders on land and water crossings remain difficult to control.
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Miscellaneous
Chapter J.3
Les modules de formation et d’orientation QualityRights ont été élaborés pour renforcer les connaissances, les compétences et la compréhension des principales parties prenantes sur la manière de promouvoir les droits des personnes en situation de handicap psychosocial, intellectuel ou cogni...tif, d'améliorer la qualité des services et des aides fournis dans le domaine de
la santé mentale et dans les domaines connexes, conformément aux normes internationales en matière de droits de l'homme, et en particulier la Convention des Nations unies relative aux droits des personnes handicapées et l'approche du rétablissement.
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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This document sets out, therefore, to explain the socioeconomic value of investing in the fight against NTDs and highlights priorities for global investment attention. Our work was guided by the need not only for
additional funding and funders but also for the need to understand the current funding... climate, in which value for money and the efficient use of resources to fill the most critical of gaps are more relevant than ever.
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Global Campaign Against Epilepsy
Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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NEUROLOGY ATLAS presents for the first time, the most
comprehensive collection and compilation of information on
neurological resources across 109 countries. The results confirm
that the available resources including services for neurological
disorders are markedly insufficient; in addition, the...re are large
inequities across regions and income groups of countries.
Urgent action is required to enhance the resources available
to address the increasing burden of neurological disorders.
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Lücken schließen – Angebote ergänzen
Der Kooperationsverbund Gesundheitliche Chancengleichheit hat eine Handreichung zur Gesundheitsförderung mit Geflüchteten veröffentlicht. Die Broschüre führt in das Thema ein und formuliert grundlegende Handlungsoptionen. Ergänzt wird die Veröffentli...chung durch eine Zusammenstellung rechtlicher Grundlagen
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Asbestos, the most frequent cause of occupational cancer, continues to be consumed ona massive scale, with millions of people exposed on a daily basis. This review explains why we havefailed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestosvictims are like...ly to remain high. Emerging and developed countries have to be reminded that asbestosexposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by thesurge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking andstimulated by manufacturers.
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Guidance has been updated on a number of chemicals: asbestos, bentazone, chromium, iodine, manganese, microcystins, nickel, silver, tetrachloroethene and trichloroethene. Guidance has also been added for chemicals not previously assessed in the Guidelines: anatoxin-a and analogues, cylindrospermopsi...ns and saxitoxins. The new guidance on organotins has replaced the prior guidance focused on dialkyltins. With these updates, the guideline values for tetrachloroethene and trichloroethene have been revised while new guideline values for cylindrospermopsins, manganese, microcystins, and saxitoxins have been established .
Updated information on cyanobacteria has been included, introducing an alert level framework for early-warning and to guide short-term management responses. Guidance has also been updated in the sections on adequacy of water supply, climate change, emergencies, food production and processing, and radiological aspects, particularly on managing radionuclides when exceeding WHO screening values and guidance levels.
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This manual is part of a series of guides devised by the Oxfam Public Health Engineering Team to help provide a reliable water supply for populations affected by conflict or natural disaster. The equipment is designed to be used with any or all of the following Oxfam water equipment: Water Pumping e...quipment, Water Storage equipment, Water Filtration equipment, Water Distribution equipment, Hand-dug Well equipment, and Water Testing Kit. All are designed using available, easily transported equipment which is simple, rapidly assembled, and fully self-contained, to provide an adequate, safe water supply at moderate cost. The principles used in these packages may often be useful in long-term development projects.
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International Journal of Basic & Clinical Pharmacology 5(6):2290-2294
DOI: 10.18203/2319-2003.ijbcp20164081
In the last quarter century, several projects emerged to reform mental health services in Latin American and Caribbean countries. Some did not survive the difficulties that inevitably arise in processes of change, and ended up disappearing before the intended changes could be introduced. Others, how...ever, as shown in this publication, were able to overcome difficulties and meet intended objectives, effectively transforming the structure and quality of services. All these projects, including the many that did not survive, were part of one of the richest experiences in the transformation of mental health care worldwide - the experience of mental health reform in Latin America and the Caribbean
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