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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Compreh
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ensive primary health care reduces morbidity, disability and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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This resource presents a comprehensive framework designed to enhance and streamline telemedicine services within health-care systems. It addresses the critical need for accessible and effective telemedicine solutions, especially in the face of globa
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l health challenges and the evolving demands on health-care infrastructures. It outlines a multidimensional strategy that includes an assessment of the current health-care ecosystem, strategic visioning for telemedicine integration, organizational change management, development of telemedicine services, and continuous monitoring, evaluation, and optimization. It emphasizes the importance of considering the unique needs of diverse populations and ensuring equitable access to telemedicine technologies. By leveraging global best practices and empirical evidence, the document aims to guide stakeholders through the lifecycle of telemedicine service implementation—from conceptualization to maturity. Intended for health-care decision-makers, policy-makers, and telemedicine practitioners, the framework supports the development of high-quality telemedicine services at various levels of the health system. It facilitates a collaborative approach, encouraging alignment and coordination among different stakeholders to achieve a common goal: building a resilient, patient-centred, and technologically advanced health-care system.
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An Indicator-based Approach - This manual presents an indicator-based approach for rapidly assessing pharmaceutical management systems and programs. The manual contains a set of 46 indicators of performance, grouped under eight topics of pharmaceutical management, with each topic being covered by a
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subset of indicators. Thirty-four of the indicators are quantitative, that is, expressed as numbers. Twelve are qualitative, in that they describe the presence or absence of a policy or management system, and in some cases, the degree of implementation.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
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e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities.
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As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.
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Cholera Surveillance: Detecting and Reporting Cases
Johns Hopkins Bloomberg School of Public Health
(2015)
C1
The intention of this document is to clarify and outline the steps to effective cholera surveillance. It discusses when,
where and why surveillance for cholera is needed and how to establish a useful and cost-effective surveillance
system for ch
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olera. To make comments, corrections and additions, please contact the authors at stopchol@jhsph.
edu or jhsph.stopchol@jhu.edu.
Check also: DOVE Project www.stopcholera.org
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This manual is a good example of the successful outcomes of the productive mutual cooperation between the United States Agency for International Development (USAID) through the Basic Education Support and Training (BEST – Yemen) Project; funded by the USAID, and the Government of Yemen (GY) throug
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h its Ministry of Education (MoE). The BEST Project and the MoE have worked collaboratively to ensure sustainable development where local resources are used wisely and sufficiently by the different Yemeni generations while at the same time building healthy school and community environment. ECOSAN was one area that the project introduced to the MoE as one significant system to reach sustainable environmental development. The Project facilitated a highly quality extensive training on ECOSAN at the Stockholm Environmental Institute – SEI in Stockholm, Sweden.
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The key areas covered are diagnosis, imaging, pathology, surgery, rehabilitation, palliative care and survivorship. It emphasizes a multi-disciplinary team approach which is paramount for quality cancer care. The specific cancers covered are breast, central nervous
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system, gastrointestinal, gynecological, head and neck, hematological, Kaposi’s sarcoma, lung, prostate and pediatric cancers. They also complement the National Guidelines for Cancer Management in Kenya released in 2013.
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Lancet Planet Health 2022;6: e760–68
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden
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. But emerging pandemic threats are just one dimension of the complex relationship between agriculture and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. This changing relationship is examined through four current disease issues.
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Outbreak Investigation, Response and Control – Module 8. Integrated Disease Surveillance Project: Training Manual for State & District Surveillance Officers
Integrated Disease Surveillance Project (IDSP)
Ministry of Health and Family Welfare, Government of India
(2005)
C2
The document “Outbreak Investigation, Response and Control – Module 8” is a training module from the Integrated Disease Surveillance Project (IDSP) designed to guide health officials in investigating and managing disease outbreaks. It explains
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the basic principles and steps of outbreak investigation, including detecting unusual increases in disease cases, confirming diagnoses, collecting and analyzing epidemiological data, and identifying the source and mode of transmission. The module also describes appropriate control and prevention measures, emphasizes timely reporting and coordination within the surveillance system, and aims to strengthen the capacity of public health workers to effectively respond to infectious disease outbreaks at the district and state levels.
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Providing differentiated delivery to children and adolescents
A. Grimsrud; D.Walker; W. Ameyan; S. Brusamento
Unicef; World Health Organization; Pata Pata Pata; IAS
(2019)
C_WHO
Differentiated service delivery is a client-centered approach, simplifying and adapting services to better meet the needs of people living with HIV and reducing unnecessary burdens on the health care syste
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m. Differentiated ART delivery for clinically stable children and adolescents is supported by global agencies, and a growing body of evidence highlights how differentiated ART provides a significant opportunity to improve treatment adherence among children and adolescents living with HIV.
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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
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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.
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There is a crucial need to initiate and sustain fistula programs that increase access and strengthen the capacity of the health care system to provide high quality services for repair and care of wo
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men living with female genital fistula. Therefore, it is important to pay particular attention to the quality of training, and to proactively determine how this training fits into the health care system. Furthermore, the quality of training is improved by committing adequate resources to ensure competent trainers, able to train and follow-up their trainees. Women with genital fistulae, their families and the community need to have confidence in the health care system. It is therefore necessary to have pro-active discussions about the quality of training with relevant stakeholders. These fistula training guidelines and standards go towards harmonizing the training approach and to improving the quality of training and hence, service delivery.
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These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population groups. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminis
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hes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources
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and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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This booklet avises on how to deal with unexpected emotions; changes in family routines and the relationship with the patient; Offers helpful tips on how to advocate for the patient within the health sy
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stem and the community; Helps caregivers know what to expect when the end of life is near; Gives tips on how to ask others for help; self-care.
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The purpose of this interim guidance is to provide information and insight to assist public policy and
health system leaders in preparing for and responding to an MCE caused by terrorist use of exp
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losives
(TUE). This document provides practical information to promote comprehensive mass casualty care
in the event of a TUE event and focuses on two areas:
1. leadership in preparing for and responding to a TUE event, and
2. effective care of patients in the prehospital and hospital environments during a TUE event.
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Differentiated Service Delivery
recommended
Differentiated service delivery (DSD), previously referred to as differentiated care, is a client-centred approach that simplifies and adapts HIV services across the cascade to reflect the preferences, expectations and needs of people living with and affected by HIV, while reducing unnecessary burde
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ns on the health system
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"Explosions can produce unique patterns of injury seldom seen outside combat.
When they do occur, they have the potential to inflict multi-system life-threatening injuries
on many persons simultaneously. The injury patterns following such events a
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re a product of
the composition and amount of the materials involved, the surrounding environment,
delivery method (if a bomb), the distance between the victim and the blast, and any
intervening protective barriers or environmental hazards. Because explosions are relatively
infrequent, blast-related injuries can present unique triage, diagnostic, and management
challenges to providers of emergency care. "
accessed 2018/03/29
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National Tuberculosis Programme and Senior Paediatricians
This guideline was first developed in 2007 but further updated in 2012 and 2016 to ensure the use of the latest evidence-based international recommendations on childhood TB. The guidelines will fill the gaps in a systematic approach to T ... B in children and will help to achieve an internationally recommended standard of care at all levels of the health system in Myanmar. more
This guideline was first developed in 2007 but further updated in 2012 and 2016 to ensure the use of the latest evidence-based international recommendations on childhood TB. The guidelines will fill the gaps in a systematic approach to T ... B in children and will help to achieve an internationally recommended standard of care at all levels of the health system in Myanmar. more
