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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This manual describes some of the strategic, managerial, financial, technical and scientific aspects to be considered in establishing a national EQA programme for clinical laboratories and other testing services at all health care levels
The aim of the people-centred framework is to help countries to develop fully prioritized and budgeted NSPs based on a culture of making full use of the available data, which are aligned with national planning cycles and which provide the basis for a robust national response that can accelerate prog...ress towards the goal of ending TB. In addition, applying the framework for other possible applications according to the country’s planning and policy cycle encourages the culture of data utilization and evidence translation into decision making and planning.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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Compilation of country case studies and best practices. World Health Report (2010) Background Paper, 25
Как и руководство 2006 года, настоящий документ предназначен для специалистов,
занимающихся разработкой государственных программ по борьбе с туберкулезом, педиатр...ов и других работников здравоохранения в странах с низким и средним уровнем дохода. Эти рекомендации не подходят для стран с высоким уровнем дохода, где распространенность ТБ невысока. Особенно важно проводить это различие при выборе методов диагностики и обследовании контактных лиц.
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Информационный бюллетень, учет потребностей подростков. Подростки имеют особые потребности в области медицинских услуг, включая доступ к профилактической помощи..., лечению и уходу в связи со СПИДом, туберкулезом и малярией. Однако часто эти потребности не учитываются или не удовлетворяются в рамках национальных стратегий. Глобальный фонд предоставляет рекомендации в отношении того, как обеспечить охват населения, предоставляет информацию о том, какие виды услуг наиболее целесообразны и акцентирует внимание на возможностях привлечения подростков к разработке и оказанию услуг.
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Scaling Up Mental Health Care In Rural India
Each unit builds on the one prior, and they all combine to provide key information for developing an SBCC strategy. It is not essential, however, to work through the I-Kit from start to finish. Users can choose to focus on specific aspects for which they need support in their emergency communication... response. The nine units and corresponding worksheets are outlined in the I-Kit Site Navigator.
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This I-Kit provides essential information and tools for responding to an outbreak using an SBCC approach. It presents a series of nine units, each accompanied by exercise worksheets to help link the SBCC theory to practice.
The worksheets in each section are typically followed by a completed exam...ple. The completed examples will likely include information about an emergency that, during an actual event, might not be immediately available. This was done to illustrate the full range of information to inform a strategic communication response.
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Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine | The aim of this study was to explore the risk factors for stillbirth and neonatal death and change in perinatal outcomes after the introduction of helping Babies Breathe Quality Improvement Cycle in Nepal.
A growing body of evidence demonstrates that hospital based programs dedicated to improving antibiotic use, commonly referred to as “Antibiotic Stewardship Programs (ASPs),” can both optimize the treatment of infections and reduce adverse events associated with antibiotic use. This document summ...arizes core elements of successful hospital Antibiotic Stewardship Programs. It complements existing guidelines on ASPs from different American organizations.
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