For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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No rumo certo para acabar com a SIDA como ameaca à saúde pública até 2030. This new Road Map charts a way forward for country-level actions to achieve an ambitious set of HIV prevention targets by 2025. Those targets emerged from the 2021 Political Declaration on HIV and AIDS, which the United N...ations General Assembly adopted in June 2021 and they are underpinned by the Global AIDS Strategy (2021–2026). The Strategy sets out the principles, approaches, priority action area and programmatic targets for the global HIV response
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Mental disorders impose an enormous burden on society, accounting for almost one in three years lived with disability globally. •In addition to their health impact, mental disorders cause a significant economic burden due to lost economic output and the link between mental disorders and costly, po...tentially fatal conditions including cancer, cardiovascular disease, diabetes, HIV, and obesity.•80% of the people likely to experience an episode of a mental disorder in their lifetime come from low- and middle-income countries.• Two of the most common forms of mental disorders, anxiety and depression, are prevalent, disabling, and respond to a range of treatments that are safe and effective. Yet, owing to stigma and inadequate funding, these disorders are not being treated in most primary care and community settings.
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This is the sixth of our 11-paper supplement entitled “Community Health Workers at the Dawn of New Era”. Expectations of community health workers (CHWs) have expanded in recent years to encompass a wider array
of services to numerous subpopulations, engage communities to collaborate with and to... assist health systems in responding to complex and sometimes intensive threats. In this paper, we explore a set of key considerations for training of CHWs in response to their enhanced and changing roles and provide actionable recommendations based on
current evidence and case examples for health systems leaders and other stakeholders to utilize.
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Spread of resistance to antimicrobial agents (AMR) does not know national borders and has reached dimensions, which require immediate actions at the national, regional and global levels.
Antibiotic resistance is a natural biological response to improper use of antimicrobial agents (AMA); increasing... number of essential drugs, which become ineffective, contributing to selection, survival and replication of resistant strains of microorganisms. When chosen antimicrobials prove to be ineffective, the second- or third-line drugs need to be used although
in the majority of cases these drugs are more expensive, less safe and not always available.
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The emergence and transmission of zoonotic diseases are driven by complex interactions
between health, environmental, and socio-political systems. Human movement is considered
a significant and increasing factor in these processes, yet forced migration remains an
understudied area of zoonotic res...earch–due in part to the complexity of conducting interdisciplinary
research in these settings.
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To provide a foundation for the strategic policy and programme development needed to ensure the sustainable implementation of effective interventions for reducing the global burden of PPH
Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health coverage? As the proactive arm of the health services, community health workers teams provide ho...usehold and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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This publication explores how housing, land and property rights issues have been addressed in peace agreements concluded over the past three decades. It provides practical guidance for peace negotiators on all sides in Myanmar and outlines how addressing these rights in the peace process will build ...the groundwork needed for an eventual peace agreement or agreements in the country.
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These toolkits were produced and used as part of the Moyo ndi Mpbamba project in Malawi to guide the community mobilization process in target districts.
The key aim of this guideline is to present recommendations based on a critical evaluation of the evidence on emerging digital health interventions that are contributing to health system improvements, based on an assessment of the benefits, harms, acceptability, feasibility, resource use and equity... considerations.
This guideline urges readers to recognize that digital health interventions are not a substitute for functioning health systems, and that there are significant limitations to what digital health is able to address
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O PEN IV reune informação de inquéritos, estudos epidemiológicos e comportamentais, tendo como objetivo estabelecer os objetivos e metas no combate à epidemia do HIV/SIDA em Moçambique através de uma abordagem que reforça e dinamiza o envolvimento de todos os setores do Estado, Sociedade... Civil e Sector Privado.
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The recommendation in this document thus supersedes the previous WHO recommendation for the prevention of PPH as published in the 2012 guideline
As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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The recommendation in this document thus supersedes the previous WHO recommendation for the prevention of PPH as published in the 2012 guideline, WHO recommendations for the prevention and treatment of postpartum haemorrhage.