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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.more
Today there are Community-based Rehabilitation (CBR) programmes in a large number of countries. In many countries, the CBR approach is a part of the national rehabilitation services. However, there is a lack of reliable data about persons with disabilities who benefit from CBR and the kind of benefi...ts they receive. This article reviews the disability data collection systems and presents some case studies to understand the influence of operational factors on data collection in the CBR programmes. The review shows that most CBR programmes use a variable number of broad functional categories to collect information about persons with disabilities, combined occasionally with more specific diagnostic categories. This categorisation is influenced by local contexts and operational factors, including the limitations of human and material resources available for its implementation, making it difficult to have comparable CBR data. Therefore, any strategies to strengthen the data collection in CBR programmes must take these operational factors into account.more
Environmental Research Letters
Microplastic debris floating at the ocean surface can harm marine life. Understanding the severity of this harm requires knowledge of plastic abundance and distributions. Dozens of expeditions measuring microplastics have been carried out since the 1970s, but they ha...ve primarily focused on the North Atlantic and North Pacific accumulation zones, with much sparser coverage elsewhere. Here, we use the largest dataset of microplastic measurements assembled to date to assess the confidence we can have in global estimates of microplastic abundance and mass. We use a rigorous statistical framework to standardize a global dataset of plastic marine debris measured using surface-trawling plankton nets and coupled this with three different ocean circulation models to spatially interpolate the observations. Our estimates show that the accumulated number of microplastic particles in 2014 ranges from 15 to 51 trillion particles, weighing between 93 and 236 thousand metric tons, which is only approximately 1% of global plastic waste estimated to enter the ocean in the year 2010. These estimates are larger than previous global estimates, but vary widely because the scarcity of data in most of the world ocean, differences in model formulations, and fundamental knowledge gaps in the sources, transformations and fates of microplastics in the ocean.more
The global impact of COVID-19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. Here we present the results of epidemiological modelling which has informed policymaking in the UK and other countries i...n recent weeks.more
Le présent manuel fournit les directives actualisées à l'intention des médecins, infirmiers et laborantins confrontés à la tuberculose multirésistante (TB-MR). Il remplace la version élaborée en 2007 et s’est enrichi de l’expérience pratique de six années. Il s’appuie sur les recomm...andations de l’OMS de 2011.more
Catalogage à la source : Bibliothèque de l’OMS Rapport mondial sur le vieillissement et la santé.
1.Vieillissement. 2.Espérance de vie. 3.Sujet âgé. 4.Services de santé pour personnes âgées. 5.Santé mondiale. 6.Dynamique des populations. 7.Prestations des soins de santé. I.Organisation... mondiale de la Santé.
ISBN 978 92 4 256504 1 (Classification NLM : WT 104) ISBN 978 92 4 069482 8 (ePub)
ISBN 978 92 4 069483 5 (Daisy)
ISBN 978 92 4 069484 2 (PDF)more
Ce guide sur la tuberculose résistante est un outil pratique destiné à aider les agents de santé à prendre en charge le malade du point de vue clinique et opérationnel en mettant l’accent sur la décision thérapeutique, la mise en œuvre et le suivi du régime court de 9 mois pour le traite...ment de la tuberculose multirésistante. L’Union Internationale Contre la Tuberculose et les Maladies Respiratoires (L’Union) est en première ligne pour la lutte contre la tuberculose depuis près de 100 ans et s’engage dans les aspects les plus innovants du diagnostic et de la prise en charge de la tuberculose.more
Le Ministère de la Santé (MS), dans le cadre de la démarche qualité au niveau du secteur, s’est engagé depuis quelques années dans la normalisation des activités par l’élaboration et la mise en place de documents normatifs. C’est le cas du présent document de politique, normes et proc...édures en matière de prise en charge des Personnes Vivant avec le VIH (PVVIH).
L’impact socio-économique et sanitaire du VIH/Sida fait désormais de cette affection, tant un problème de santé publique qu’un problème de développement. C’est donc pour ne pas laisser les personnes infectées en marge du développement de notre pays, que leur prise en charge a été identifiée comme domaine de prestation de service avec des directives nationales de prise en charge des PVVIH diffusées.more
Ce manuel est destiné aux prestataires de soins chargés de la prise en charge des cas de paludisme simple et grave au niveau des structures de santé. C’est un document de référence facile d’utilisation, fournissant des connaissances et des compétences utiles aux agents de santé prenant e...n charge les cas de paludisme.more
Au cours de la dernière décennie, les données de séquençage génétique des agents pathogènes ont gagné en importance et contribuent désormais de façon déterminante à la détection et à la maîtrise des flambées de maladies infectieuses, en facilitant la mise au point de ...produits de diagnostic, de médicaments et de vaccins et en guidant lesactivités de riposte aux flambées(1-11). L’émergence du nouveau coronavirus, par la suite désigné « coronavirus 2 du syndrome respiratoire aigu sévère » (SARS-CoV-2), a encore accentué l’importance des données de séquençage génétique.more
This Urban Flood Risk Handbook: Assessing Risk and Identifying Interventions is a roadmap for conducting an urban flood risk assessment in any city in the world. It includes practical guidance for a flood risk assessment project, covering the key hazard and risk modeling stages as well as the evalua...tion of different flood-mitigating infrastructure intervention options and management of the project. The Handbook has been developed based on lessons learned from implementing urban flood risk assessments around the world in a diversity of contexts. It is intended for a wide variety of practitioners: project managers, city officials, and anyone else interested in conducting a strategic study of a city's flood risk and developing potential solutions for it. We expect this Handbook tocontribute to the understanding of urban flood risk, make this specialized knowledge more accessible to a wider public, and support the process of building cities that are not only capable of withstanding floods but also provide safe, inclusive, and sustainable environments for all their residents.more
The CERC manual provides an evidence-based framework and recommended practices for anyone who communicates on behalf of an organization responding to major emergencies such as natural disasters.