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2
Quality of care in fragile, conflict-affected and vulnerable settings: tools and resources compendium
recommended
This compendium represents a curated, pragmatic and non-prescriptive collection of tools and resources to support the implementation of interventions to improve quality of care in such contexts. Relevant tools and resources are listed under five are
...
as: Ensuring access and basic infrastructure for quality; shaping the system environment; reducing harm; improving clinical care; and engaging and empowering patients, families and communities.
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multi
...
ple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c
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ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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This package of materials is designed to provide the tools necessary to begin the implementation of respectful maternity care (RMC) in your area of work or influence. Using the tools in this toolkit, one can help to change and develop attitudes in o
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neself and among colleagues and other stakeholders in the care of women and their newborns.
The components of this toolkit can be used by clinicians who are providing maternity care, trainers or educators of clinicians who will be providing maternity care, supervisors of clinicians who provide maternity care, program managers who develop and manage programs with a maternity care component, and policymakers or other key stakeholders who want to promote RMC in the programs for which they are responsible.
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Burns are a global public health problem, accounting for close to 200,000 deaths annually. The majority of these occur in low- and middle-income countries, where a number of constraints complicate the public health task of addressing burns. While the primary prevention of burns in low- and middle-in
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come countries is a pressing need, the World Health Organization (WHO) also actively encourages further development of burn-care systems, including the training of health-care providers in the appropriate triage and management of people with burns.
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The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental health conditions. Meanwhile, those with pre-existing mental health conditions may experie
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nce a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
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Globally, approximately 56.8 million people are in need of palliative care
services; 78% of them living in low and middle-income country yet only
about 12% have their needs being met causing great suffering for many.
Nurses play a key role in the provision of primary health care (PHC) and the coordination and organization of medical care overall. Nurses are often the first point of contact with the health
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system and have an important role to play in leaving no one behind.
Large-scale reform of PHC in Ukraine started in 2018, and evolving and expanding practices have led to new challenges for both medical facilities and staff. It has become critically important to initiate new practices in the organization of the nursing profession, to adapt and increase their competencies, invest in skills development and create more nursing posts.
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Lancet Planet Health 2020; 4: e271–79
It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care providers to coordinate the continued
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care of children and adolescents with long-term conditions and diseases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
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The KMC implementation strategy targets a broad audience. These include policy-makers and programme managers at national, regional and local levels, government and nongovernmental organizations working in the area of maternal and newborn care, globa
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l and national professional associations, public and private hospital management at all levels of care, and facility- and community-based maternal and infant care providers.
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism
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for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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Guidelines for the Implementation of the SHA 2011 Framework for Accounting Health Care Financing
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
(2014)
CC
The accounting framework for health care financing is a key component of A System of Health Accounts 2011, published by OECD, Eurostat and WHO in October 2011.1 The framework makes health accounts more adaptable to rapidly evolving health financing
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systems, further enhances crosscountry comparability of health expenditures and financing data, and ultimately improves the information base for the analytical use of national health accounts (NHAs). It is hoped that SHA 2011 – including its financing framework – will make health accounts a more useful assessment and monitoring tool for health systems and health expenditure in the economy as a whole.
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Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries
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where the problem seems to be worsening. Globally, research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six Afri
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can countries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of
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the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capability for burns
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care from clinical, human resources and operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
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Mass population movements have accounted for the emergence of Chagas disease (CD) outside endemic regions,
including the European Union/European Economic Area (EU/EEA). The parasite responsible for causing CD,
Trypanosoma cruzi (T. cruzi), can be transmitted through substances of human origin (SoH
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O), such as blood
transfusions and organ transplantations [1], posing a risk to the recipients. This, together with congenital
transmission, is of increasing concern in non-endemic countries
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