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Publication Years
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15
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Category
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419
335
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59
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Toolboxes
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92
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69
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53
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18
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1
Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the
...
y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
more
Job satisfaction among healthcare workers in Ghana and Kenya during the COVID-19 pandemic: Role of perceived preparedness, stress, and burnout
Afulani PA, Nutor JJ, Agbadi P, Gyamerah AO, Musana J, Aborigo RA, et al.
PLOS Global Public Health
(2021)
CC
The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W
...
e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
more
In the region, it is estimated that there are over 650 million persons with disabilities. However, without accurate, timely and disaggregated data, countries are unable to develop effective policies and programmes, monitor the wellbeing of persons with disabilities and evaluate the equity and impact
...
of development efforts. This endangers country commitments to ‘leave no one behind’ and undermines their obligations to the Convention on the Rights of Persons with Disabilities.
This groundbreaking report demonstrates the importance of ensuring data is inclusive and provides recommendations for immediate action in order to improve the collection, analysis and reporting of disability data. We hope this report will be used as a tool for future advocacy and ultimately better data for all.
more
Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile,
...
coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
more
Global Report on assistive technology
recommended
The report notes that the number of people in need of one or more assistive products is likely to rise to 3.5 billion by 2050, due to populations ageing and the prevalence of noncommunicable diseases rising across the world. The report also highlights the vast gap in access between low- and high-inc
...
ome countries. An analysis of 35 countries reveals that access varies from 3% in poorer nations to 90% in wealthy countries.
Affordability is a major barrier to access, the report notes. Around two thirds of people with assistive products reported out-of-pocket payments for them. Others reported relying on family and friends to financially support their needs.
more
Cancer in sub-Saharan Africa
recommended
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mo
...
rtality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
more
The HHFA Comprehensive guide serves as the main reference document for planning and implementing a country HHFA. This guide will promote understanding of:
What the HHFA is and the information it can and cannot provide.
The HHFA modules, questionnaires and CSPro electronic data collection tool.
Th
...
e HHFA indicators, indices and their organization within the HHFA indicator inventory platform.
The HHFA data analysis platform.
The HHFA sampling and data collection methodologies.
The detailed steps involved in planning and implementing an HHFA.
Key concepts in review, interpretation and communication of HHFA findings.
more
Discrete typing units of Trypanosoma cruzi: Geographical and biological distribution in the Americas
Chagas disease caused by Trypanosoma cruzi is a public health issue in Latin America. This highly diverse parasite is divided into at least seven discrete typing units (DTUs) TcI-TcVI and Tcbat. Some DTUs have been associated with geographical distribution in epidemiological scenarios and clinical m
...
anifestations, but these aspects remain poorly understood. Many studies have focused on studying the parasite and its vectors/hosts, using a wide variety of genetic markers and methods. Here, we performed a systematic review of the literature for the last 20 years to present an update of DTUs distribution in the Americas, collecting ecoepidemiological information. We found that the DTUs are widespread across the continent and that there is a whole gamma of genetic markers used for the identification and genotyping of the parasite. The data obtained in this descriptor could improve the molecular epidemiology studies of Chagas disease in endemic regions.
more
The application of digital health technology is growing at a rapid rate in Africa, with the goals of improving the delivery of healthcare services and more effectively reaching out to remote and underserved communities. The lack of enabling guidelines and standards across the continent, on the other
...
hand, makes it difficult to share data in a meaningful way across the continent.
Considering this, Africa Centres for Disease Control and Prevention (Africa CDC) established a task force of 24 members to provide expertise and guidance in the development of AU HIE guidelines and standards. Members of the task force were subject matter experts working in Africa and internationally on the collection, analysis, and exchange of health information. Some of these experts had been involved in previous consultations on defining Africa CDC’s health information systems strategy. A chairperson, co-chairperson, and secretary were elected to engage the task force members in different technical working groups.
more
Each humanitarian setting provides distinct opportunities and challenges for actors to coordinate and collaborate at strategic and operational levels. The Health and Protection Joint Operational Framework has been developed to ensure that the health and protection response during humanitarian emerge
...
ncies can adapt to each environment and is adequately coordinated to ensure high-quality services to meet the needs of affected individuals and at-risk groups based on their situation or vulnerabilities.
The Health and Protection JOF was conceived in 2019 as a collaboration between the Global Health Cluster (GHC), the Global Protection Cluster (GPC) and its Areas of Responsibility (AoRs), the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG), and the Inter-Agency Working Group for Reproductive Health in Crisis (IAWG), in addition to key technical experts.
A Steering Group (SG) comprised of representatives from each of these entities guided the framework through a joint global analysis of good practices, gaps, and barriers to integrated and inter-sectoral response coordination. This included a mixed methods review of policy and practice, a survey of humanitarian experts, multiple case studies, structured stakeholder interviews, and field visits. This exercise produced a zero-draft which was then reviewed by field practitioners in three operational contexts to clarify and fully coordinate its operationally focused lens. Finally, the JOF was reviewed by the SG including via a series of consultations in early 2023 to consolidate the current framework.
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This report presents a framework to link science, policy and practice for a comprehensive assessment of climate mitigation and adaptation investments and their impact on human health.The framework proposes to use weather and climate data to forecast health impacts over time, as well as biophysical a
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nd economic models to quantify the outcomes of investments in climate change adaptation and mitigation for relevant sectoral indicators and health co-benefits. It provides guidance on the economic valuation of health co-benefits of climate action, for inclusion in sector-specific cost–benefit analysis (CBA), including the spatial allocation of such costs and benefits.
The framework developed and presented in this study is comprehensive, and provides various entry points for different audiences, including decision-makers in the public and private sectors, researchers and scientists, working in the health sector as well as in other thematic areas and related sectors affected by climate action.
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his publication provides an overview of social inequalities in several indicators related to the health of women, children, and adolescents in a region deemed as one with high levels of inequality: Latin America and the Caribbean (LAC). In order for it to serve as a baseline for the 2030 Agenda, emp
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hasis is placed on examining these inequalities around the year 2014. The analysis suggests that reducing within-country disparities is a priority, as widespread social inequalities in health are identified among LAC countries.
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The 2022 Financing for Sustainable Development Report identifies a “great finance divide” as a main driver of the divergent recovery. Developed countries were able to borrow record sums at ultra-low interest rates to support their people and economies, but the pandemic response and investment in
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recovery of poor countries was limited by fiscal constraints. This joint report, by over 60 agencies of the United Nations system and partner international organizations, provides analysis and puts forward policy recommendations to overcome this “finance divide” and enhance developing countries’ access to financing for recovery and productive and sustainable investment.
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Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the
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world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approaches to improve mortality and the associated huge quality-adjusted life years lost to it once diagnose
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d. A possible venue to lower the incidence is to assess the safety and efficacy of various diabetes prevention strategies. Diet and exercise have a well-developed role in the prevention of weight gain and, ultimately, diabetes mellitus type II in high-risk individuals. However, high-risk individuals can also benefit from adjunct pharmacotherapy. In light of this information, we decided to conduct a systematic review of randomized controlled trials. This article summarizes the evidence in the literature on the pharmacological prevention of diabetes in high-risk individuals.
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance
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r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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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
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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 Country Cooperation Strategy is the World Health Organization (WHO)’s reference for country work guiding planning and resource allocation through alignment with national health priorities and harmonization with other development partners. It clarifies roles and functions of WHO in supporting t
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he national strategic plan for health through the Sector-Wide Approach and Malawi Growth and Development Strategy II. The Country Cooperation Strategy is based on a systematic assessment of the recent national achievements, emerging health needs,
challenges, government policies and expectations. An evaluation of the previous CCS was conducted and jointly discussed with the Ministry of Health as well as other key stakeholders. This process led to the identification of the, achievements, challenges and shortfalls of the previous CCS. Through this process the areas where WHO needed to focus on were also identified. The CCS development has also been done in parallel with the formulation of the new Health Sector Strategic Plan (HSSP) to ensure that there is a linkage between the two.
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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to
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sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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In the absence of a such a measure, and building on the success of developing the APCA African
Palliative Outcome Scale (POS) for adults, the African Palliative Care Association has developed the
APCA African Children’s POS. The tool has been validated across diseases, countries, settings and
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languages and used in both quality improvement and research studies. Moreover, feedback on the
tool from doctors and nurses who have used it has been very supportive, with providers perceiving
it as an easy-to-use instrument that helps them undertake holistic assessments that in part entail
discussing difficult issues.
This booklet is a practical guide intended to help users employ the APCA African POS correctly.
Following a discussion of the origins and background to the APCA African PPOS, the guide discusses
the measurement of outcomes, the development of the tool and its use (including the analysis of
collected data), before finishing with illustrative examples of the use of the questionnaire.
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