Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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The WHO guidelines provide recommended steps for safe phlebotomy and reiterate accepted principles for drawing, collecting blood and transporting blood to laboratories/blood banks.
A handbook for district and health facility staff
These guidelines are designed for settings with limited resources to provide inexpensive and effective control strategies for prevention of TB transmission in health care workers (HCW).
Safe water, sanitation and hygiene (collectively known as WASH) are crucial for human health and well-being. Yet, millions of people globally lack adequate WASH services and consequently suffer from or are exposed to a multitude of preventable illnesses.
The Minimum Standards for Age and Disability Inclusion in Humanitarian Action inform the design, implementation, monitoring and evaluation of humanitarian programmes across all sectors and phases of response, and in all emergency contexts, ensuring older people and people with disabilities are not e...xcluded.
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Systematic screening for active tuberculosis: an operational guide.
Program Report for Collaborative Agreement: DFD-A-00-08-00309-00 September 30, 2008 -December 31, 2015
CBM’s Child Safeguarding Policy is based on the UN Convention on the Rights of the Child, 1989 (and its optional protocols); the national child protection legislation of Germany as well as that of the CBM program
countries and the Keeping Children Safe Standards. This policy has been created beca...use respecting the dignity of all children and keeping them safe is a foundational principle of CBM’s work. For the purpose of this policy a child is anyone under the age of 18 years. CBM is committed to ensuring a safe environment for children through investing the necessary resources needed to apply the procedures contained in this policy.
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Submitted to the US Agency for International Development by the
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program.
This manual provides a framework to identify problems and design interventions to improve access to and use of medicines for children. It is a resource for ...both health policy makers and health system managers and presents a structured approach to the steps introduced in the framework in the context of child health.
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The WHO Mental Health Gap Action Programme (mhGAP) aims at scaling up mental health services in non-specialized health settings to achieve universal health coverage. The mhGAP operations manual is an integral component of the mhGAP package and supports district health managers and others responsible... for integrating mental and physical health services. The manual offers practical guidance and necessary tools for planning, preparing, implementing, monitoring and evaluating mhGAP
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