Guidance | Preparedness - Response and early recovery - Recovery and reconstruction
Cureus. 2015 Nov; 7(11): e372.
Published online 2015 Nov 3. doi: 10.7759/cureus.372
PMCID: PMC4671837
PMID: 26677422
Revision for Field Review
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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This recommendation is an update of one of the 49 recommendations that were published in the WHO recommendations on antenatal care for a positive pregnancy experience. The recommendation was developed initially using the standardized operating procedures described in the WHO handbook for guideline d...evelopment.
In summary, the process included: (i) identification of priority question and outcomes; (ii) retrieval of evidence; (iii) assessment and synthesis of the evidence; (iv) formulation of recommendation; and (v) planning for the implementation, dissemination, impact evaluation and updating of the recommendation. This recommendation was identified by the Executive Guideline Steering Group (GSG) as a high priority for updating in response to new evidence on this question.
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Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se...verely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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DHS Working Papers No. 119
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 countries 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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Safe sanitation is essential for health, from preventing infections to improving and maintaining mental and social
well-being. Lack of adequate sanitation contributes to diarrhoeal diseases, parasitic infections, and undernutrition, as
well as posing significant risks and causing anxiety, especial...ly for women and girls. Achieving universal access to safe
sanitation, which protects health, privacy, and dignity, is a global development goal and a recognized basic human right.
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This paper focuses on the Sustainable Development Goals related to poverty, economic growth, inequality, health, food production and the environment. It presents concrete examples of the underlying and complex aspects of antibiotic resistance and its impacts across different Sustainable Development ...Goals. The aim of this paper is to inform and stimulate discussions on how to further advance the implementation of 2030 Agenda for Sustainable Development, the Global Action Plan on Antimicrobial Resistance, National Action plans on Antimicrobial Resistance, as well as work within all sectors that affect and are affected by antibiotic resistance
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The Manifesto was launched at a High Level Event in London on the 31st July 2019, where Emergency response mechanisms to address the Climate and Environmental Crisis are being explored. The Manifesto has been developed in response to the increasing international and United Nations evidence and under...standing of the severity of our global climate and environmental crisis. This builds upon collaborative action to advance the InterAction Council's Dublin Charter, endorsed at its Plenary Session in 2017. The overall aim is to secure a healthy planet for the wellbeing of future generations for all, by placing the health of the planet at the heart of decision making and establishing emergency response mechanisms at global, national and community levels.
Now more than ever, we need courageous leadership to take crucial decisions and actions to secure a healthy planet for all, including the very existence of human civilization. The InterAction Council is encouraged by the boldness and energy of our younger generations, as well as the commitment expressed by the 30 organisations endorsing the Manifesto. The establishment of the Digital Platform for Planet, Place and People, a Hub of the Commonwealth Centre for Digital Health, will act as a collaborative mechanism to promote innovation and rapid responses as a common good. Going forward, we welcome everyone to become a Guardian to Secure a Healthy Planet for All, and to support this initiative in scaling up the ambitions laid out in the Manifesto.
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This publication is a compendium of 49 country examples highlighting efforts in improving refugees’ and migrants’ health following the adoption of the WHO Global Action Plan on Promoting the health of refugees and migrants at the seventy-second World Health Assembly, in May 2019.