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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
...
e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin
...
shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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This companion document to Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030 ("the road map") aims to support a range of stakeholders - including countries in which neglected tropical diseases (NTDs) are endemic, international organi
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zations and non-State actors - to achieve the road map targets through a transdisciplinary, cross-cutting One Health approach. Specifically, it provides guidance on the One Health actions needed by major stakeholders and how to support a paradigm shift towards One Health in national NTD programmes. Examples of common One Health challenges and how they can be overcome as well as illustrative cases studies are provided throughout. The companion document was developed through a global consultative process involving stakeholder interviews, interactive workshops, and online public consultation.
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This e-course will guide you through the essentials of latest existing WHO guidelines and policy recommendations on drug-resistant TB. You will also learn more about the rationale behind the WHO recommendations for the management of DR-TB, implementation considerations for different regimens for eli
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gible patient groups, adjunctive treatment, the active TB drug safety monitoring and management framework, and the analysis and interpretation of performance indicators.
The main focus of the e-course is programmatic; clinical aspects are only discussed when relevant to specific topics.
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Cancer centres are a major resource in ensuring a comprehensive approach to cancer treatment and its planning. As part of a new roadmap developed by WHO and IAEA to help countries design national cancer control programmes, this publication proposes a framework to develop a cancer centre and/or to st
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rengthen the provision of services in an existing cancer centre. The publication provides the features of multidisciplinary cancer care and details the infrastructure, human resources and equipment for different services. This framework is expected to be used as a guide to implementation, taking into consideration the local context and resources.
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Globally, the cancer burden is rising, exerting significant strain on
populations and health systems at all levels of income. There are
concerted efforts towards enhancing access to comprehensive
cancer prevention and control initiatives.
Globally, approximately 56.8 million people are in need of palliative care
services; 78% of them living in low and middle-income country yet only
about 12% have their needs being met causing great suffering for many.
Antimicrobial resistance (AMR) is a global threat that requires urgent
collaborative action within and among countries. As a result of the worldwide reports of the increasing rates of AMR to hospital and community-acquired infections and in the agricultural sector, the Global Action Plan on AMR was
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adopted in 2015. T
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- A Skills Building Program for Clinicians and Non-Clinicians. Adherence guidelines- slide deck- training course for health providers
The COVID-19 pandemic has impacted regular cardiovascular healthcare access and delivery. Service utilisation has declined, and excess cardiovascular mortality has been reported in several countries. We aim to estimate excess cardiovascular deaths in Chile during 2020.
28 September 2021
Less than half of required funding has been provided globally with dramatic consequences as
hundreds of thousands more die from TB
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3086
Using infectious diseases sensitive to climate as indicators of climate change helps stimulate and inform public health responses
AAll health workers deployed to measles outbreaks must complete the measles and rubella (MR) training to implement quality interventions and work safely and effectively in the field. This channel provides the essential preparedness, detection, investigation, response, and recovery skills required to
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contain the measles outbreak.
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Health educators have been advocating for the inclusion of climate and environmental education in medical and nursing curriculums for the past two decades. BMJ 2021;375:n2385 http://dx.doi.org/10.1136/bmj.n2385 Published: 06 October 2021
2016 ASCO EDUCATIONAL BOOK | asco.org/edbo
Este manual operativo determina los aspectos y las etapas primordiales de la ampliación programática del tratamiento preventivo de la tuberculosis, y proporciona herramientas de ejecución e instrumentos de trabajo para la adaptación al contexto local, así como indicadores de seguimiento y evalu
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ación de la gestión. En él se destacan los elementos clave que deben tenerse en cuenta en la atención al paciente, la planificación nacional estratégica y la movilización de recursos
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Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed
to support decision making. A countrywide mass vaccination campaign with the
use of an inactivated severe acute respiratory syndrome c
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oronavirus 2 (SARS-CoV-2)
vaccine (CoronaVac) was conducted in Chile starting on February 2, 2021.
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