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2
Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t
...
reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
more
In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
...
miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
more
Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t
...
hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a
...
nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
more
Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati
...
ons.
These Guidelines, specifically tailored to small water supplies, build on over 60 years of guidance by the World Health Organization (WHO) on drinking-water quality and safety. They focus on establishing drinking-water quality regulations and standards that are health based and context appropriate; on proactively managing risks through water safety planning and sanitary inspections; and on carrying out independent surveillance. The guidance is intended primarily for decision-makers at national and subnational levels with responsibility for developing regulatory frameworks and support programmes related to these activities. Other stakeholders involved in water service provision will also benefit from the guidance in this document.
Designed to be practical and accessible, these Guidelines offer clear guidance that is rooted in the principle of progressive improvement. State-of-the-art recommendations and implementation guidance are provided, drawn from a comprehensive evidence review and established good practices. Additionally, case examples are provided from countries and areas around the world to demonstrate how the guidance in this publication has been implemented in practice in a wide variety of contexts.
Together with WHO’s 2024 Sanitary inspection packages – a supporting tool for the Guidelines for drinking-water quality: small water supplies, these Guidelines update and supersede WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. Key changes to this updated publication include a greater focus on preventive risk management and a broader range of small water supplies covered, including those managed by households, communities and professional entities.
more
The most widely-used health care manual for health workers, educators, and others involved in primary health care and health promotion around the world. Current edition includes updated information
...
on malaria, HIV, and more.
more
Hesperian Health Guides Nepali
recommended
Here you will find PDF downloads of our community health guides in Nepali, as well as information about how to order print copies from our translation partners. It is prohibited to sell or distribute these files in any format for profit without prio
...
r written consent from Hesperian and the translator
more
UNICEF and partners have trained over 10,000 community health workers in Rwanda to visit families and teach them how to prevent Ebola.
Get audience-specific toolkits for healthcare teams and community administrators.
MIHN is a community of mental health innovators - researchers, practitioners, policy-makers, service user advocates, and donors from around the world - sharing innovative resources and ideas to promote mental health and improve the lives of people w
...
ith mental, neurological and substance use disorders.
MHIN aims to facilitate the development and uptake of effective mental health interventions by: Enabling learning; Building partnerships; Synthesizing and disseminating knowledge; Leveraging resources
more
Schistosomiasis is one of the 17 ‘neglected tropical diseases’ as classified by the World Health Organization.
In order to better understand attitudes and practices surrounding schistosomiasis, Malaria Consortium carried out a survey in Nampula province, Mozambique, where the organisation is i
...
mplementing a community engagement intervention with a
focus on this disease. Findings suggest a need for greater efforts to improve knowledge of schistosomiasis in affected communities
in order to increase uptake of mass drug administration and ensure that communities take appropriate measures to prevent infection.
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Empoderar a las comunidades para brindar atención de emergencia
Sangath
(2019)
CC
Sangath is a non-governmental, not-for-profit organisation committed to improving health across the life span by empowering existing community resources to provide appropriate physical, psychological and social therapies. Its primary focus areas inc
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lude child development, adolescent and youth health, and adult health and chronic disease.
Started in 1996 by seven professionals in Goa, Sangath developed a vision to provide professional healthcare services for developmental disabilities and mental health problems. Today, it is one of the largest NGOs in the state, with more than 100 service providers, two centres in Goa, projects across India, collaborations with leading institutions in the world, and international recognition for its path-breaking research and intervention programmes in the community.
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A Manual for mid-level rehabilitation workers.
This manual is to support the work of mid-level rehabilitation workers on their work with children or adults with spinal cord injury and their families. It refers to the physical effects of this type of injury, the different levels of injury and the ba
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sic care of a person following a spinal cord injury. Available in Chinese and Mongolian, too
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The animation follows the story of a contact tracer, Mariam, as she goes about her work – visiting those who have come into contact with a sick Ebola patient, finding those who are showing symptoms, and arranging appropriate care for those who nee
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d it. The film will be used by the Government of Guinea and UNFPA in Guinea; and it is freely available in English and French for anyone to download and use, in both standard and mobile formats.
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The Community Health Nurse on the Go app aims to improve motivation among frontline health workers through a mobile technology application. By providing this mobile phone application to community he
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alth officers, nurses and their supervisors, CHN will combine virtual peer-to-peer support with improved connectedness to a professional network and supervisors for frontline health workers involved in maternal, newborn and child health service delivery.
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Practical Approach to Care Kit
Kit de Cuidados em Atenção Primária
Guia de manejo clínico da COVID 19 para Atenção Primária
O PACK Brasil é uma parceria entre a Unidade de Tradução do Conhecimento (KTU), Secretaria Municipal de Saúde d
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e Florianópolis/SC, BMJ e Fundação ProAR. A Fundação ProAR é a líder oficial das atividades do PACK no Brasil. Mais informações sobre a ProAR podem ser encontradas em: www.fundacaoproar.org.br
O PACK foi adaptado, traduzido, implementado e avaliado em serviços de atenção primária brasileiros entre 2015 e 2017. Um ensaio clínico randomizado concluiu que o PACK qualificou o atendimento clínico de pacientes adultos com doenças respiratórias crônicas na atenção primária e apoiou o compartilhamento do cuidado entre médicos e enfermeiros. Desde então, foi revisado anualmente, estando alinhado com as políticas públicas locais. Em 2021, foi desenvolvido conteúdos adicionais sobre o manejo da COVID-19.
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Practical Approach to Care Kit
Kit de Cuidados em Atenção Primária
Guia de manejo clínico da COVID 19 para Atenção Primária
O PACK Brasil é uma parceria entre a Unidade de Tradução do Conhecimento (KTU), Secretaria Municipal de Saúde d
...
e Florianópolis/SC, BMJ e Fundação ProAR. A Fundação ProAR é a líder oficial das atividades do PACK no Brasil. Mais informações sobre a ProAR podem ser encontradas em: www.fundacaoproar.org.br
O PACK foi adaptado, traduzido, implementado e avaliado em serviços de atenção primária brasileiros entre 2015 e 2017. Um ensaio clínico randomizado concluiu que o PACK qualificou o atendimento clínico de pacientes adultos com doenças respiratórias crônicas na atenção primária e apoiou o compartilhamento do cuidado entre médicos e enfermeiros. Desde então, foi revisado anualmente, estando alinhado com as políticas públicas locais. Em 2021, foi desenvolvido conteúdos adicionais sobre o manejo da COVID-19.
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Communities in snakebite endemic countries need to be properly educated on what to do in the event of a snakebite and what steps to take to lessen one from happening. These comprehensive prevention videos in multiple languages are resources YOU can share with school children, agricultural workers, h
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omemakers. Help spread these important videos right on down to the people and regions affected.
Minutes to Die released snakebite prevention videos in 12 languages made for sharing and aimed at community health workers in Africa and India, produced by the Lillian Lincoln Foundation, along with the WHO, MSF, and a host of other NGOs.
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Connecting Frontline Health Workers to resources and each other to expand their knowledge, organize content into courses, and share their learning with the community.
ORB offers frontline health workers and trainers access to quality assured openly
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licensed content that can be used on mobile devices and shared virally amongst communities.ORB has three unique features:
Brings into one space quality-assured, multimedia materials from multiple content developers, with a focus on maternal and child health.
Adaptation of existing content: ORB aims to reduce the practice of new content being developed unnecessarily.
A global collaborative network of organizations to share and review content, integrate content into programs and share user-experience.
By improving access to health content and mobile learning, ORB helps health workers access the vital content they need to do their work effectively and confidently.
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