Modern healthcare has given rise to extremely complex and multifaceted ethical dilemmas. All too often physicians are unprepared to manage these competently. This publication is specifically structured to reinforce and strengthen the ethical mindset and prac...tice of physicians and provide tools to find ethical solutions to these dilemmas. It is not a list of “rights and wrongs” but an attempt to sensitise the conscience of the physician, which is the basis for all sound and ethical decision-making. To this end, you will find several case studies in the book, which are intended to foster individual ethical reflection as well as discussion within team settings.
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BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3026 (Published 11 August 2020)
The BMJ "practice pointer" inlcudes a one-page visual summary of assessment and initial management of patients with persistant symptoms following acute SARS-CoV-2 infection
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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The Strategy to respond to antimalarial drug resistance in Africa is a technical and advocacy document, grounded in the best available evidence to date and aimed at minimizing the threat and impact of antimalarial drug resistance of Plasmodium falciparum parasites in Africa. Its objectives are to: i...) improve the detection of resistance to ensure a timely response; ii) delay the emergence of resistance to artemisinin and artemisinin-based combination therapy (ACT) partner drugs; and iii) limit the selection and spread of resistant parasites where resistance has been confirmed.
WHO Team
Global Malaria Programme
Editors
World Health Organization
Number of pages
87
Reference numbers
ISBN: 978 92 4 006026 5
Copyright
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Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination.
The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, ...including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.
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The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals.
Pharmaceutical and Therapeutics Committees (PTCs) are responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as... well as at higher levels of care.
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This document provides guidance for countries on how to implement activities to achieve the interruption of yaws transmission. It is intended for use by national yaws eradication programmes, partners involved in the implementation of yaws eradication activities and WHO technical staff who provide te...chnical support to countries in the eradication of yaws.
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa...cerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
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UNAIDS 2016, Reference
HIV care and support taking into account the 2016 WHO consolidated guidelines
The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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Women have less access to the development services and support – such as adequate healthcare, education and
modern technology – that make people more resilient to climate change and other shocks and stressors.2
Women’s unequal access to resources, their disproportionate responsibility for ca...re of dependents (typically unpaid),
and the insecurity and precariousness of their paid labour all contribute to the feminisation of poverty and women’s
heightened vulnerability to climate hazards. Climate change is a multiplier of existing vulnerabilities and threatens to
reverse hard-earned development gains for all people, and particularly for women.
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How to respond to Covid19 pandemic in West and Central Africa
In 2024, we need US$1.5 billion to provide live-saving health care to millions of people in emergencies. An alarming combination of conflict, climate-related threats and increasing economic hardship mean an estimated 166 million people require health assistance.
Prepared as an outcome of ICMR Subcommittee on Non Hodgkin’s Lymphoma (High Grade) | This consensus document on management of non- hodgkin’s lymphoma – high grade summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molec...ular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
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