Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Mortality statistics are fundamental to public health decision making. Mortality varies by time and location, and its measurement is affected by well known biases that have been exacerbated during the COVID-19 pandemic. This paper aims to estimate excess mortality from ...the COVID-19 pandemic in 191 countries and territories, and 252 subnational units for selected countries, from Jan 1, 2020, to Dec 31, 2021.
The Lancet. 10 March 2022. doi: 10.1016/S0140-6736(21)02796-3.
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This quality standard covers prevention of falls and assessment after a fall in older people (aged 65 and over) who are living in the community or staying in hospital. It describes high-quality care in priority areas for improvement.
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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The 2nd edition is publised in 2017.
Specific Objectives
• To increase the knowledge and awareness of personnel on chemical management.
• To educate the personnel on the potential adverse health effects of chemical exposure.
• To educate the personnel on the existing laws pertaining to handling of hazardous
chemicals.
• To... promote safe and healthy work practices among personnel during chemical handling.
• To guide the personnel on transportation, storage and disposal of hazardous chemicals.
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Polymerase Chain Reaction (PCR) has significantly helped in early diagnosis and commencement of specific interventions for diseases control. It also plays a critical role in understanding the disease epidemiology and unraveling the transmission dynamics of the disease. This manual intends to p...rovide primary guidelines to assist health lab personnel in developing countries to establish a PCR diagnostic facility for efficient support to patient care as well as public health actions.
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Research Article
PLOS ONE | https://doi.org/10.1371/journal.pone.0189770 January 2, 2018
The purpose of this manual is to provide guidance in the design, implementation and evaluation of a course that aims to build and strengthen the capacity of health personnel to manage eye patients at primary-level health facilities in the African Region. The course falls within the remit of continuo...us professional development in its broadest sense. Its content focuses on simple evidence-based practice that can be easily carried out in primary-level health facilities all over Africa.
This manual is intended for use by course directors and facilitators. Its intended audience includes all persons who wish to commission, support or offer a course serving the above aims, including pre-service training. This manual sets out the requisite steps for the preparation and organization of such a course.
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World Humanitarian Data and Trends presents global- and country-level data-and-trend analysis about humanitarian
crises and assistance. Its purpose is to consolidate this information and present it in an accessible way, providing policymakers, researchers and humanitarian practitioners with an evid...ence base to support humanitarian policy decisions and provide context for operational decisions.
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Всемирный доклад о наркотиках 2016 года публикуется по завершении знаменательного события в истории глобальной политики в отношении наркотиков – специальной сесс...и Генеральной Ассамблеи по мировой проблеме наркотиков. В главе I представлен общий обзор ситуации с предложением опиатов, кокаина, каннабиса, стимуляторов амфетаминового ряда (САР) и новых психоактивных веществ (НПВ) и спросом на них, а также их воздействия на здоровье человека. В ней рассматриваются также научные данные о полинаркомании, обращаемости за лечением в связи с потреблением каннабиса и изменениях, произошедших после легализации потребления каннабиса в рекреационных целях в некоторых районах мира. Глава II сосредоточена на рассмотрении механизмов взаимодействия мировой проблемы наркотиков и всех аспектов устойчивого развития через призму целей в области устойчивого развития.
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