Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Dissertation submitted in part fulfilment of the requirements for a Masters degree at the Centre for International Health and Development (CIHD) at University College London (UCL) Institute of Child Health (ICH)
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March - June 2018
Myanmar introduced Child Death Surveillance and Response (CDSR) in 2015 as an initiative to reduce child (under-5) mortality, an initiative that will contribute to the country’s efforts to meet the Sustainable Development Goals (SDG). Technical Guidelines for CDSR were devel...oped in 2015 followed by the development of Training Package in 2016. An Implementation Plan was made in 2016; and this led to all townships implementing CDSR in early 2017. After one year of implementation an assessment was carried out in early 2018.
The assessment was conducted in 3 region/states – Ayeyarwaddy, Magway, Shan South, with information gathered from the state/region, district, township and basic health unit levels. In addition a caretaker interview was conducted to see health-seeking behavior. In addition to these three regions/states, information was also gathered from three other regions/states but only at the region/state level – Mandalay, Yangon, Kachin.
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Antimicrobial resistance has become a serious public health threat for effective treatment of an ever increasing range of infections caused by bacteria, parasites, viruses and fungi. When infections can no longer be treated by first-line antibiotics, other antibiotics must be used, which are both mo...re expensive and more toxic. Treatment and hospitalization is prolonged, and patients undergoing operations and other medical procedures are more vulnerable to infections. All this imposes a huge burden on health care systems and on the economy of countries. This is a major challenge to the health system in Mauritius which provides health care free of user cost to the whole population.
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This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers associated with their overuse and misuse. It also includesmeasures to prevent and control infection that can stop people needing antimicrobials or spreadinginfection to o...thers. It aims to change people's behaviour to reduce antimicrobial resistance and thespread of resistant microbes.
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Guidelines for Handling Temperature Sensitive Vaccines and Pharmaceuticals
Post Graduate programme is essential to prepare nurses to improve the
quality of nursing education and practice in India. .
Post graduate programme in nursing builds upon and extends competence
acquired at the graduate levels, emphasizes application of relevant theories
into nursing practice, ed...ucation, administration and development of
research skills.
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The National Strategic Plan for HIV/AIDS and STIs 2017-2024 spells out the objectives and targets that we have jointly committed to achieve. The plan describes the strategies and activities that will need to be implemented on the ground across India's 36 States and Union Territories with the help of... AIDS Control Societies, District AIDS Prevention and Control Units, Regional Institutes, communities, development partners and the private sector. We must urgently scale up our efforts to avert new HIV infections and provide care and treatment to people living with HIV to materialise our commitment of ending AIDS in India by 2030.
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In many humanitarian emergencies, there is a serious lack of access to even the most basic materials needed for managing the blood in addition to a lack of appropriate sanitation facilities (including water), which are critical for addressing menstrual hygiene. Privacy in emergencies is often scarc...e, and even if toilets are available they often lack locks, functioning doors, lighting and separation between genders. These barriers are often intensified by cultural beliefs and taboos surrounding menstruation which can restrict the movements and behaviors of girls and women
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NICE guideline | This guideline covers recognising, assessing and treating post-traumatic stress disorder (PTSD) in children, young people and adults. It aims to improve quality of life by reducing symptoms of PTSD such as anxiety, sleep problems and difficulties with concentration. Recommendations ...also aim to raise awareness of the condition and improve coordination of care.
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Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many ...infections becoming increasingly limited, expensive, and, in some cases, non-existent.
Conscious of the public health threats of AMR to both humans, animals and the environment, the ministries of health and sanitation, agriculture forestry and food security and the environmental protection agency put together a national multi-sectoral coordinating group tasked with the responsibility of establishing mechanisms to integrate all initiatives into a single concerted action and development of the national AMR strategic plan (2018-2022). The National Strategic Plan on Antimicrobial Resistance is the first approach which addresses AMR specifically.
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Las olas de transmisión de la fiebre amarilla ocurridas en la Región de las Américas entre el 2016 y el 2018 causaron el mayor número de casos humanos y epizoóticos registrados en varios decenios. La fiebre amarilla es una enfermedad hemorrágica viral grave que representa un desafío para el p...rofesional de salud: exige el reconocimiento temprano de signos y síntomas muchas veces inespecíficos, que pueden parecerse a otros síndromes febriles agudos. La detección temprana de los casos sospechosos o confirmados, el monitoreo de los signos vitales y las medidas de soporte vital, y el tratamiento de la insuficiencia hepática aguda siguen siendo las estrategias recomendadas para el manejo de los casos. El presente informe es el resultado de las deliberaciones sobre la experiencia de expertos de la Región en cuanto al manejo clínico de pacientes con fiebre amarilla, especialmente en brotes y epidemias, mediante la contextualización de esa experiencia en el conjunto actual de la evidencia médico-científica y la consideración de las directrices técnicas ya disponibles en los países de la Región. Presenta flujogramas para la evaluación inicial del paciente con sospecha clínica de fiebre amarilla y sugiere un conjunto mínimo de pruebas de laboratorio que puede ser útil cuando hay pocos recursos; además, detalla aspectos de la organización de los sistemas de salud para enfrentar brotes y epidemias de fiebre amarilla.
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Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
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