BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r...eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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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
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This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities. ...As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.
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The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio...ns such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
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Using the WHO model list of essential medicines to update a national essential medicines list
Since 1977, WHO has been working with countries to design the package of essential medicines as an integral component of treatment within the continuum of care, developing and disseminating the Model List ...of Essential Medicines (Model List). WHO is committed to supporting Member States in sharing best practices in selecting
essential medicines, and in developing processes for the selection of medicines for national essential medicines lists (national EMLs, or NEMLs) consistent with the evidence-based methods used for updating the WHO Model List.
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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around t...he hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644
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These guidelines provide specific recommendations and expert suggestions — for national policy-makers and programme managers and their partners and stakeholders— on prioritizing, planning and providing HIV testing, counselling, treatment and care services for adolescents
Estimating the size of key affected populations (KAP) provides important data for planning and implementing an effective response to the HIV epidemic. In the Philippines, these KAP include males who have sex with males (MSM), female sex workers (FSW), and injecting drug users (IDU). Given the diffic...ulty in reaching these populations, as well as their high mobility, the process consequently entailed a specific methodology to directly estimate the size of KAP.
The national estimate of MSM was 531,500 or 2.2% (1.8%-3.2%) of males aged 15-49. Within this MSM estimate, figures for transgender women (TGW) and male transactional sex workers (MSW) were determined. The national estimate for TGW was 122,800 or about 0.50% (0.40%-0.75%) of males aged 15-49, and 23% of the MSM population. Meanwhile, MSW comprised 0.35% (0.29%-0.53%) of the male population aged 15-49 and 16% of the MSM population, giving a best estimate of 86,600.
The estimate of combined RFSW and FFSW was 66,100 or 0.28% (0.19%-0.40%) of females aged 15-49. Meanwhile, there are approximately 10,000 to 21,700 IDU or 0.04%-0.09% of males aged 15-49.
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This report reviews and analyses the Affordable Medicines Programme, which was introduced in Ukraine in April 2017 to provide patients with improved access to 23 outpatient medicines for the treatment of chronic noncommunicable diseases. The evaluation combines both quantitative and qualitative anal...ysis. The findings confirm that the Programme has contributed to a significant increase in access to needed outpatient medicines in Ukraine. Further, while implementation was successful overall, uptake across regions was uneven. The report concludes by listing a number of policy options to support the sustainability and expansion of the Affordable Medicines Programme.
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The document “Malaria Elimination Programme Review, India 2022”, published by the WHO Country Office for India, provides an in-depth assessment of India’s progress toward malaria elimination. It evaluates the structure, implementation, and effectiveness of national and subnational malaria prog...rams, focusing on surveillance, diagnosis, treatment, vector control, and community engagement. The review identifies strengths, challenges, and areas for improvement, offering evidence-based recommendations to accelerate India's efforts to eliminate malaria by 2030.
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The document titled "Checklist for Assessing Management of Severe Malaria" is part of the MalariaCare Toolkit. It provides a structured tool for supervisors conducting outreach training and supportive supervision (OTSS) visits in healthcare facilities. The checklist is designed to evaluate and guide... the clinical management of severe malaria cases, including diagnostics, treatment planning, complication management, patient monitoring, and the administration of injectable artesunate. It also includes sections for direct observation of clinical procedures and supervisor feedback to help improve healthcare worker performance and adherence to national treatment guidelines.
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Blended Learning Modulef or the Health Extension Programme
In this study session, you will learn about the general features of faeco-oraldiseases: the main types commonly found in Ethiopia, their general symptomsand signs, how to treat mild cases and when to refer patients with severeconditions for... specialised treatment, or laboratory tests to confirm thediagnosis. You will also learn about the importance of giving effective healtheducation to your community on ways to prevent and control faeco-oraldiseases.
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The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Designed ...for implementation in primary healthcare settings, especially in low-resource environments, the package includes protocols for screening, diagnosis, treatment, and management of these diseases. The document emphasizes an integrated approach, supporting universal health coverage by empowering healthcare workers with practical tools to improve NCD care. It aims to reduce premature mortality from NCDs and enhance global health equity.
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A healthcare worker manual. 2nd edition
The development of this National Manual for the Management of HIV-related Opportunistic Infections and Conditions for use by health care workers at the frontline of our fight against HIV/AIDS is intended to improve their understanding of the causes, preventio...n and appropriate management of opportunistic infections and conditions in adults and adolescents (OIs in children is covered effectively in the Integrated Management of Childhood Illnesses – IMCI – materials). It is also intended to be a practical guide at the clinic level, so as to improve quality of life, treatment outcomes and survival of PLHA. Crucially, this manual uses a “symptom-based” approach to support health care workers at the most basic primary level to be able to effectively initiate the care of PLHA with OIs and refer patients as appropriate (effective triage of patients at the primary care level). The result of this will be to move the management of OIs closer to the patient while ensuring that referral links with higher-level facilities and care is cultivated.
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All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement measures to achieve malaria elimination and prevent it...s reestablishment by increasing the intensity and quality of interventions, reorienting initiatives, reducing delays that favor transmission, and ensuring adequate monitoring to adjust interventions. In this regard, the first suggested step is to stratify the territory - so that interventions and population groups can be planned and prioritized - and then implement diagnosis, treatment, investigation and response (DTI-R) actions as a key strategy aimed at effectively eliminating the disease and preventing its reestablishment in all strata. In addition, the document seeks to operationalize the concept of "surveillance as an intervention" promoted by the World Health Organization through the Global Technical Strategy for Malaria 2016-2030 and highlights the importance of communities having access to early diagnosis and treatment. Finally, the manual also includes management and monitoring aspects that must be taken into account to eliminate the foci with transmission.
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The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la...test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
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Health Policy and Planning, Volume 35, Issue 1, February 2020, Pages 47–57, https://doi.org/10.1093/heapol/czz122
Colombia has an underreporting of 30% of the total cases, according to World Health Organization (WHO) estimations. In 2016, successful tuberculosis (TB) treatment rate was 70%, and t...he mortality rate ranged between 3.5% and 10%. In 2015, Colombia adopted and adapted the End TB strategy and set a target of 50% reduction in incidence and mortality by 2035 compared with 2015.
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This publication represents a key step forward in translating Control of the leishmaniases (WHO Technical Report Series, No. 949) into a more practical tool for health personnel directly involved in the case management of cutaneous leishmaniasis. With this manual, countries will have, for the first ...time, standardized diagnosis and treatment protocols, case definitions and indicators to enable them to easily track progress on cutaneous leishmaniasis case management across the Region. It will provide support to professionals in charge of cutaneous leishmaniasis, in order to alleviate the suffering of affected populations from this appalling disfiguring and stigmatizing neglected tropical disease.
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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...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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