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Covid-19 pandemic impact on maternal and child health services access in Nampula, Mozambique: a mixed methods research

das Neves Martins Pires P.H. , Macaringue C. , Abdirazak A. et al. BMC Health Services (2021) CC

The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community. METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites. RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%. CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique. more

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Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso

Ouedraogo Y., Furlane G., Fruhauf T. et al. Global Health: Science and Practice (2018) CC

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...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. more

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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... more

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Особенности психоэмоциональных расстройств у больных рассеянным склерозом в разных клинико-демографических группах

Лукина Е. В., Чернышева О. А., Елисеева В. А. Саратовский научно-медицинский журнал (2018) C1

Цель: проведение анализа психоэмоциональных расстройств у пациентов с рассеянным склерозом, не по-лучающих никакого лечения по поводу этих нарушений. Материал и м... more

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Guidance on mainstreaming biodiversity for nutrition and health

World Health Organization WHO (2020) C_WHO

This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to: Consider... more

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Prevention, Screening and Control of Common Non-Communicable Diseases: Hypertension, Diabetes an Common Cancers (Oral, Breast, Cervix)

National Health Mission (2016) CC

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 Comprehensive primary health care reduces morbidity, disab... more

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Clinical Management of Yellow Fever in the Region of the Americas. Experiences and Recommendations for Health Services

Pan American Health Organisation PAHO (2023) CC

The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog... more

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Support tool to strengthen telemedicine: resource for assessment, strategy development, and strengthening of telemedicine services

World Health Organisation (WHO) (2024) C_WHO

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 global health challenges and the evolving demands on hea... more

Oxfam Water Distribution Manual

Oxfam (2006) CC

Oxfam Water Supply Scheme for Emergencies. This manual is part of a series of guides devised by the Oxfam Public Health Engineering Team to help provide a reliable water supply for populations affected by conflict or natural disaster. Wherever possible, water supplies in emergency conditions should ... more

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Оценка уровня тревожности и депрессии у больных рассеянным склерозом

Лукина Е.В. ,Кузнецова Д.Е. Саратовский научно-медицинский журнал. (2012) C1

Цель: анализ уровня тревожности и тяжести депрессии у больных рассеянным склерозом. Материал и методы. Чтобы определить уровень депрессии и тревожности у больных �...�С в зависимости от пола, возраста, течения, длительности заболевания, была отобрана группа пациентов с достоверным диагнозом Рассеянный склероз по критериям Ч.Позера, состоящая из 79 человек с длительностью заболевания более двух лет. Ис-пользовалась специально разработанная анкета, которая включала в себя таблицы для оценки жалоб, данных анамнеза, неврологического статуса больного и стандартные опросники (тест на тревожность Тейлора, шкала депрессии НИИ психоневрологии им.Бехтерева, индекс общего психологического благополучия). Результа-ты. Такие аффективные расстройства, как тревожность, депрессия, достаточно часто встречаются у больных рассеянным склерозом, однако выражены они в группах больных, получающих и неполучающих ПИТРС, по-разному. Заключение. Следует рекомендовать практическим неврологам при лечении больных рассеянным склерозом обращать внимание на наличие или отсутствие у них определенного спектра психических наруше-ний, в первую очередь тревожно-депрессивного синдрома, который нуждается в персонифицированной меди-каментозной и немедикаментозной коррекции. http://www.ssmj.ru/system/files/201202_484-488.pdf more

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Childhood Asthma: Low and Middle-Income Countries Perspective

Soto-Martínez, M.E.; Soto-Quiros, M.E.; Custovic, A. Acta Medica Academica (2020) CC

Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poo... more

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HEARTS. Technical package for cardiovascular disease management in primary health care. Systems of Monitoring

World Health Organization WHO, et al. (2018) C_WHO

Monitoring is a crucial element in any successful programme. It is important to know if health care facilities – and ultimately countries – are meeting the agreed goals and objectives for preventing and managing cardiovascular diseases (CVD). Monitoring is the on-going collection, management ...and use of information to assess whether an activity or programme is proceeding according to plan and/ or achieving defined targets. Not all outcomes of interest can be monitored. Clear outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met. To allow progress to be monitored, this module provides a set of indicators on CVD management. Agreeing on a set of indicators allows countries to compare progress in CVD management and treatment across different districts or subnational jurisdictions, as well as at a facility level, identify where performance can be improved, and track trends in implementation over time. Monitoring these indicators also helps identify problems that may be encountered so that implementation efforts can be redirected. This module starts from the collection of data at facility level, which is then “transferred up” the system: facility-level data are aggregated at subnational level to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys. Implementing a monitoring system requires action at many levels. At national and subnational levels, staff can determine how best to integrate data elements into existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS). In the facility setting, personnel must be aware of what data are needed. Sample data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools more

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Estimates of aid for reproductive, maternal, newborn, and child health: findings from application of the Muskoka2 method, 2002–17

Dingle, A.; Schäferhoff, M.; Borghi, J. et al. The Lancet (2020) CC

Background Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017. Methods Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators. Findings After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million). Interpretation Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention. Funding Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health. more

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National spending on health by source for 184 countries between 2013 and 2040

Dieleman, J.; Templin, T.; Sadat, N. et al. (2016) CC

A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at simi...lar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. Methods We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Findings Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending. Interpretation Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action. Funding Bill & Melinda Gates Foundation. more

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Plan Stratégique du Secteur de la Santé pour la Réforme

Ministère de la Santé Publique et de la Population, Haiti (2008) CC

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Improving the quality of health services: tools and resources

World Health Organization WHO (2019) C_WHO

This compendium collates current tools and resources on quality improvement developed by the WHO Service Delivery and Safety Department and provides examples of how the tools and resources have been applied in country settings. The target audience for this document are ministries of health, facility... more