Q4: Can convulsive epilepsy be diagnosed at first level care by a non-specialist health care provider in low and middle income country settings?
PERC produces regional and member state situation analyses, updated regularly.
Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue...s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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The World Health Organization (WHO) defines mental health as ‘a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’. Mental illn...ess refers to all of the diagnosable mental disorders, which are characterised by abnormalities in thinking, feelings or behaviours. Mental illness is closely related to vulnerability, both in its causes and in its effects. Globally, 14 per cent of the global burden of disease is attributed to mental illness – with 75 per cent of those affected being found in low-income countries – which includes a broad spectrum of diagnoses, from common mental illnesses such as anxiety and
substance abuse, to severe illnesses like psychosis.
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A module from the suite of health service capacity assessments in the context of the COVID-19 pandemic, Interim Guidance 20 October 2020.
This self-assessment tool is designed for acute health-care facilities (i.e. tertiary and secondary) but can be modified for the use in long-term care facilities..., to help identify, prioritize and address the gaps in infection prevention and control (IPC) capacity in managing their response to COVID-19. The tool should be used by IPC professionals and/or those responsible for disaster planning or outbreak management in the facility (such as the response to the COVID-19 outbreak) at the start of the improvement process. A sample workplan template is provided to address gaps identified and record required actions.
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This study highlights the challenges and areas in need of improvement as perceived by CHWs and beneficiaries, in regards to a nationwide scale-up of CHW interventions in a resource-challenged country. Identifying and understanding these barriers, and addressing them accordingly, particularly within ...the context of performance-based financing, will serve to strengthen the current CHW system and provide key guidance for the continuing evolution of the CHW system in Rwanda.
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Assessment of the quality of institutional care for adults with psychosocial and intellectual disabilities in the WHO European Region.
The specific objectives of the project were to address gaps in knowledge about the number and characteristics of such long-term institutions and to identify deficie...ncies in current care standards through the lens of the United Nations Convention on the Rights of Persons with Disabilities. This publication examines and rates the quality of care and protection of human rights in selected institutions in over 20 countries in the Region using the WHO QualityRights toolkit. It identifies steps to take to continue progress toward deinstitutionalization and to ensure respect for the rights of people with psychosocial and intellectual disabilities.
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Mental health disorders remain widely under-reported — in our section on Data Quality & Definitions we discuss the challenges of dealing with this data. Figures presented in this entry should be taken as estimates of mental health disorder prevalence — they do not strictly reflect diagnosis data... (which would provide the global perspective on diagnosis, rather than actual prevalence differences), but are imputed from a combination of medical, epidemiological data, surveys and meta-regression modelling where raw data is unavailable. Further information can be found here.
Accessed April 15, 2019
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Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focu...s on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Background: A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH) in two significant w...ays; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Studies. Methods: In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars) and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs) produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas—development assistance for health (in US Dollars) per DALY.
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More than 40% of the world population is 24 years old or younger, the vast majority of whom live in low- and lower middle–income countries. Globally, a quarter of disability-adjusted life years (DALYs) for mental disorders and substance abuse is borne by this age group and about 75% of mental diso...rders diagnosed in adulthood have their onset before the age of
24 years . Most children and young people in developing countries, however, do not have access to mental health care.
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Report on the nutrition and health situation of Nigeria
Data collection – 13th July to 13th September 2015
DHS Further Analysis Reports No. 89 - The 2010 Rwanda Demographic and Health Survey shows that 3 percent of Rwandan adults age 15-49 have been infected with HIV. The prevalence was much higher in urban areas, among women, and among adults who had multiple lifetime sexual partners and used a condom a...t last sexual intercourse. The
level of and differences in HIV prevalence in Rwanda in 2010 are very similar to those observed in 2005. Using data from the two recent Rwanda Demographic and Health Surveys, implemented in 2005 and
2010, this study examined changes in key HIV-related knowledge, attitudes, and sexual behavior indicators. Significant changes in selected indicators during 2005 and 2010 were determined by Student ttest with p-values less than 0.05.
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