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.
more
Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries
more
Working towards better COVID-19 outcomes in the WHO European Region.From the first COVID-19 cases in Europe reported on
24 January 2020, the pandemic reached 1 million cases
within 3 months, 10 million cases within 8 months, and
100 million cases in Europe alone within 2 years. Over
the course o...f its two years, COVID-19 has claimed over
1.6 million lives across Europe and Central Asia. The
World Health Organization (WHO) European Region has
accounted for close to a third of the cumulative global
COVID-19 cases and deaths.
more
In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a...nd grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
more
Le Burkina Faso est un pays sahélien sans littoral d’une superficie de 274 000 km2 et une
population estimée à 17,4 millions d’habitants en 2013 avec une croissance démographique de
3,1%. C’est l’un des pays les plus pauvres du monde avec un Produit intérieur brut par tête de
684 US...$ (Banque Mondiale, 2013), un indice de développement humain (IDH) de 0,388 et une
incidence de la pauvreté de 46,7% (INSD, 2009). Environ 80% de la population vit directement
ou indirectement de l’agriculture de subsistance au gré des aléas climatiques.
more
The COVID-19 pandemic is having far reaching impacts, well beyond the health crisis and needs, with the most severe impacts experienced in the poorest countries and those most vulnerable to humanitarian crises including natural disasters, such as Nepal.
This study emphasizes the contribution that women can play in the prevention of violent extremism within the family and society and analyzes the drivers and roles of women taking part in violent extremism and supporting violent and extremist groups.
UNDP Iraq is pleased to make this study and its r...ecommendations available to national and international partners and to all interested experts and researchers working in the field of preventing violent extremism to contribute to enriching the discussion and strengthening programmes to prevent violent extremism in the Arab region.
more
This manual is to assist health care providers and laboratory scientists to diagnose mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the clinical presentation and its diagnosis. The methods described are tailored to various levels of care and avail...able resources to improve the diagnosis and surveillance of the disease.
more
Manuel destiné au personnel soignant.
Ce manuel s'adresse aux professionnels de la santé confrontés à la maladie à Mycobacterium ulcerans (ulcère de Buruli). Il vise à mieux faire comprendre la maladie, sa présentation clinique et sa prise en charge chirurgicale. Il s'adresse en particuli...er aux prestataires de soins de santé des districts. Il présente un protocole complet, adapté à chaque forme et à chaque stade de la maladie, ainsi que des commentaires sur les niveaux de ressources et de capacités nécessaires pour raccourcir la durée du traitement.
more
Working Document, September 2017
Introduction
Chapitre A.4
Edition en français Traduction : Eleanor O’Boyle
Sous la direction de : Priscille Gérardin
Avec le soutien de la SFPEADA
Accessed: 02.05.2020
These consolidated guidelines provide recommendations for comprehensive prevention and case management strategies in Kenya
Scope of the Guidelines: Infection prevention and control Patient triage Emergency Medical Services Case management Laboratory testing algorithm
Target... Audience: Health care workers taking care of patients suspected or confirmed to have COVID-19
These guidelines combine both preventive and clinical management of the disease in Kenyan context. The protocol borrows various international recommendations including the World Health Organization, from experience of other countries such as China that has struggled with the outbreak for a longer time and from principles of virology and infectious disease management.
more
In this paper, we review the most significant health and environmental facts and explain why — from a medical perspective — a proper understanding of what nuclear weapons will do invalidates all arguments for continued possession of these weapons and requires that they urgently be pro...hibited and eliminated as the only course of action commensurate with the existential danger they pose.
more
USAID/Afghanistan’s $443 million investment in the Afghan Sustainable Water Supply and Sanitation (SWSS) activity is one of the Agency’s largest single investments in sustainable rural water supply delivery. The project installed about 2,123 wells with hand pumps across Afghanistan from 2009–2...012. This report presents findings from a retrospective evaluation of a random selection of wells with hand pumps installed under the SWSS project.
This evaluation’s key purpose is to identify factors that support and hinder sustainable water service delivery in different contexts.
more