The ethical values and behaviors are not only abstract terms, but they are refined and conceptualized byreal-life experiences. The societal context where the actions of humans can be analyzed by ethicaldecision-making is entirely relevant to deliberate on what is the right thing to do and what the m...oralagent should do, since the ethical values and principles response to the actual practices of life and to theneeds of humans in the society. This elaboration takes us to the realm of social ethics.This article reviews the definition and contextual meaning of social ethics at a broader level by givingspecial emphasis to the ethical theories and principles, focusing on the societal and public setting. Ethicswill be deliberated with social and community aspects. Based on the principle of justice and public healthethics, the concept of social ethics has been investigated concisely through the relationship between man,as a moral person, and the society in exemplification of the issues of healthcare ethics. It is argued that thetension between individualism and communitarian needs can be reconciled with the perspective of socialethics by respecting the individual autonomy without disregarding the common good and social justice.By promoting the values of social responsibility, solidarity, and social utility, social ethics has beenproposed as the basis of a rational, moral, egalitarian, pluralistic, democratic society rising on the pillars ofhuman rights and human dignity.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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The aims of these guidelines are to provide guidance to health-care providers (i.e. the end-users of these guidelines: physicians, nurses, pharmacists and caregivers) on the adequate relief of pain associated with cancer. They also assist policy-makers, programme managers and public health personnel... to create and facilitate appropriately balanced policies on opioids and prescribing regulations for effective and safe cancer pain management. Proper and effective stewardship of opioid analgesics in the cancer treatment setting is essential to ensure the safety of patients and to reduce the risk of diversion of medicine into society.
The goal of cancer pain management is to relieve pain to a level that allows for an acceptable quality of life.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Front Chem. 2021; 9: 622286.
Published online 2021 Mar 12. doi: 10.3389/fchem.2021.622286
Rapport sur les populations clès
Accessed November 2017
This publication makes the case for working with men and women, boys and girls, together in an intentional and mutually reinforcing way that challenges gender norms in the pursuit of improved health and gender equality. In addition to providing a definition for the new concept of gender synchronizat...ion, this document provides examples of synchronized approaches that have worked first with women and girls, or first with men and boys, and describes interventions that have worked with both sexes from the start. It also provides examples of new and emerging programs that should be watched in the coming years for the knowledge they may contribute to the implementation of gender synchronization.
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Orientaciones provisionales
9 de agosto de 2021
El presente documento tiene por objeto describir un conjunto mínimo de actividades de vigilancia recomendadas a nivel nacional para detectar y supervisar la prevalencia relativa de las variantes del SRAS-CoV-2 y esbozar un conjunto de actividades pa...ra la caracterización y evaluación del riesgo que plantean estas variantes. También se ofrece un conjunto de indicadores para normalizar la vigilancia y la notificación pública de la circulación de variantes.
El documento está dirigido principalmente a las autoridades de salud pública nacionales y subnacionales y a los socios que apoyan la aplicación de la vigilancia de las variantes del SRAS-CoV-2
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Recommendations on the management of diabetes mellitis during the COVID-19 pandemic
Orientations provisoires
9 août 2021
Le présent document vise à décrire un ensemble minimal d'activités de surveillance recommandées au niveau national pour détecter et surveiller la prévalence relative des variantes du SRAS-CoV-2 et à présenter un ensemble d'activités pour la caractér...isation et l'évaluation du risque que présentent ces variantes. k posés par ces variants. Un ensemble d'indicateurs est également fourni pour normaliser la surveillance et la déclaration publique de la circulation des variants.
Ce document est principalement destiné aux autorités de santé publique nationales et infranationales et aux partenaires qui soutiennent la mise en œuvre de la surveillance des variantes du SRAS-CoV-2.
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La OMS ha elaborado una definición de caso clínico de la afección posterior a la COVID-19 mediante la metodología Delphi que incluye 12 dominios, disponible para su uso en todos los entornos. Esta primera versión fue elaborada por pacientes, investigadores y otras personas, en representación d...e todas las regiones de la OMS, en el entendimiento de que la definición puede cambiar a medida que surjan nuevas pruebas y siga evolucionando nuestra comprensión de las consecuencias de la COVID-19.
La afección posterior a la COVID-19 se produce en personas con antecedentes de infección probable o confirmada por el CoV-2 del SRAS, normalmente a los 3 meses de la aparición de la COVID-19 con síntomas y que duran al menos 2 meses y no pueden explicarse por un diagnóstico alternativo. Los síntomas más comunes son la fatiga, la dificultad respiratoria y la disfunción cognitiva, pero también otros, y generalmente tienen un impacto en el funcionamiento diario. Los síntomas pueden ser de nueva aparición tras la recuperación inicial de un episodio agudo de COVID-19 o persistir desde la enfermedad inicial. Los síntomas también pueden fluctuar o recaer con el tiempo.
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Cadre pour la planification, l'ebaoration et la mise en oeuvre de solutions avec et pour les jeunes e
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.
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Целью этой главы является представление ключевых элементов, касающихся терапевтического использования психотропных лекарственных средств у детей и подростков, ... также знакомство
клиницистов с общими принципами фармакотерапии психиатрических расстройств в период развития. Для более детального ознакомления со специфическими медикаментами мы рекомендуем читателям обратиться к соответствующим главам, посвященным конкретным расстройствам.
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This study aimed to determine the drug resistance profile of Mycobacterium tuberculosis in Mozambique and concludes that M. tuberculosis resistance to antituberculosis drugs is high in Mozambique, especially in previously treated patients. The frequency of M. tuberculosis strains that were resistant... to isoniazid, rifampin, and streptomycin in combination was found to be high, particularly in samples from previously treated patients.
J Bras Pneumol. 2014;40(2):142-147
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