For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Female Genital Schistosomiasis (FGS) is a gynaecological disease caused by Schistosoma haematobium, a parasitic worm that is acquired by skin contact with freshwater contaminated by schistosome cerceriae. Communities in which the infection is most endemic have limited access to clean water and healt...hcare services. Up to 150 million adolescent girls and women are estimated to be at risk of FGS and about 16–56 milion womens are living with FGS, with the majority of these in sub-Saharan Africa. The variability of these estimates points to the fact that this neglected tropical disease is not well studied and frequently not prioritized by local, regional, and global health policy makers.
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A year ago, the second Special Session of the World Health Assembly (WHASS) unanimously agreed to start a diplomatic process for a new binding instrument aimed at ensuring the international community is better prepared for the next health emergencies. The establishment of an Intergovernmental Negoti...ating Body (INB) at the WHO paved the terrain for a proper negotiation, which has started to unfold. The INB will be releasing the “conceptual zero draft” of the treaty text in early December 2022.
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The purpose of the handbook is to provide those involved in nutrition coordination with relevant tools, guidance, information and resources to support their roles in facilitating predictable, coordinated and effective preparation for, and responses to, nutrition needs in humanitarian emergencies. Ra...ther than being prescriptive, the handbook aims to raises key issues encountered to date.
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COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targete...d actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550
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Bain LE, et al. BMJ Glob Health 2017;2:e000227. doi:10.1136/bmjgh-2016-000227
This research report provides results from the study of living conditions
among people with disabilities in Lesotho. Comparisons are made
between disabled and non-disabled in household level and individual
level. Disability was defined as limitation to perform certain activities that
was measure...d according to the Washington City Group questions.
Results obtained in Lesotho are also compared to those obtained in
earlier studies carried out in Mozambique, Zambia, Namibia, Zimbabwe
and Malawi. The Lesotho study was undertaken in 2009-2010.
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A guide for developing a hygiene promotion program to increase handwashing with soap
The Government of India is embarking on a mammoth task to prevent COVID-19 spread among communities. The Rapid Evidence Synthesis team received a request to support the planning and development of resources for ensuring preparedness of FLHWs for COVID-19 . The rapid evidence synthesis was conducted ...in a period of three days.
The findings highlight what we can learn from recent pandemics such that we are prepared for potential scenarios and challenges due to COVID-19. Key issues which decision-makers need to consider, based on available evidence
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BMJ Global Health Vol.4 (2019 no.4
The Drug Resistance Index (DRI) is proposed as measure of antibiotic effectiveness in a given country, by combining, in a single metric the use of various antibiotic groups and the resistance proportions of several pathogens.It is a complicated measure that gives ...results that cannot be understood by common knowledge and logic. The DRI conveys a wrong message.
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Ending the epidemics of HIV, tuberculosis and malaria by 2030 is within reach, but not yet fully in our grasp.
With only 11 years left, we have no time to waste. We must step up the fight now.
THE SYRIAN ARAB REPUBLIC, IRAQ, JORDAN, LEBANON, TURKEY, WEST BANK AND GAZA STRIP, EGYPT
Over the 20 years that followed, this unique partnership has invested more than US$53 billion, saving 44 million lives and reducing the combined death rate from the three diseases by more than half in the countries in which the Global Fund invests.
Insufficient funding is hindering the achievement of malaria elimination targets in Africa, despite the pressing need for increased investment in malaria control. While Western donors attribute their inaction to financial constraints, the global health community has limited knowledge of China’s ex...panding role in malaria prevention. This knowledge gap arises from the fact that China does not consistently report its foreign development assistance activities to established aid transparency initiatives. Our work focuses on identifying Chinese-funded malaria control projects throughout Africa and linking them to official data on malaria prevalence. By doing so, we aim to shed light on China’s contributions to malaria control efforts, analysing their investments and assessing their impact. This would provide valuable insights into the development of effective financing mechanisms for future malaria control in Africa.
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Strengthening global health security to protect the world against future epidemics and pandemics requires well-tested and decentralized capacities for the local detection and rapid containment of outbreaks of infectious disease. For such capacities to translate into effective response actions, ind...ividuals and teams must be well connected and coordinated, despite differences in the size, geography, technical focus or constituency of their parent institution.
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Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to t...he trauma to which many were exposed. Several interventions were carried out with aims to integrate mental health into primary health care services. The interplay between socio-cultural beliefs and health (both mental and physical) in Haiti has been widely commented upon by both foreign aid and local caregivers. Observations frequently highlight barriers to the willingness of patients to seek care and to their acceptance of biomedicine over traditional Vodou beliefs. The perception of Haitian beliefs as barriers to the availability and acceptance of mental health care has intensified the difficulty in providing effective recommendations and interventions both before and after the earthquake. Argued in this review is the importance of considering the interactions between socio-cultural beliefs and mental health when developing models for the prevention, screening, classification and management of mental illness in Haiti. These interactions, especially relevant in mental health care and post-disaster contexts, need to be acknowledged in any healthcare setting. The successes and failures of Haiti’s situation provide an example for global consideration.
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Disaster Recovery Toolkit