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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
...
sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr
...
ies, most mpox infections in humans result from a primary animal-to-human transmission. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or through close contact during and after birth.
more
The overall goal of the programme, to reduce the malaria morbidity and mortality by 75% (using 2012 as baseline) by the year 2020, continued to be pursued in 2014. The following areas were identified as some of the priorities for the year: Malaria Case Management under which we have Malaria in Pregn
...
ancy (MIP), Home Based Care and Diagnostics.
more
Antimicrobial resistance has become a serious public health threat for effective treatment of an ever increasing range of infections caused by bacteria, parasites, viruses and fungi. When infections can no longer be treated by first-line antibiotics
...
, other antibiotics must be used, which are both more expensive and more toxic. Treatment and hospitalization is prolonged, and patients undergoing operations and other medical procedures are more vulnerable to infections. All this imposes a huge burden on health care systems and on the economy of countries. This is a major challenge to the health system in Mauritius which provides health care free of user cost to the whole population.
more
The National Department of Health and Department of Agriculture, Forestry and Fisheries have collectively engaged to determine the key interventions that will form the basis for this strategy taking into account the recommendations from the WHO and
...
OIE.
The development and implementation of a National Antimicrobial Resistance Strategy Framework that complements international efforts is a major step towards containment of the growing threat of antimicrobial resistance in human and animal health. Global partnerships need to be strengthened because the responsibility for reducing resistance is a shared one. This responsibility is not only limited to the health care sector, but calls for collaborative action in all sectors - human, animal and agriculture.
The National Antimicrobial Resistance Strategy Framework will affect South Africa’s response to this looming threat. We already have the tools and expertise to make a difference, now all we need is to work together toward a better future.
more
For humanitarian organisations to respond effectively to complex crises, they require access to up-to-date evidence-based guidance. The COVID-19 crisis has highlighted the importance of updating global guidance to context-specific and evolving needs in humanitarian settings. Our study aimed to under
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stand the use of evidence-based guidance in humanitarian responses during COVID-19. Primary data collected during the rapidly evolving pandemic sheds new light on evidence-use processes in humanitarian response.
more
Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduc
...
e clinical variability and, in essence, improve health and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
more
The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health
...
care. Central to the WASH FIT methodology is training and incremental improvements.
Implementation of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
more
WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen
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t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
more
The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse
...
opioids to significantly improve their treatment and care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.
more
Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i
...
s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
more
This standard Operating procedure (SOP) for JDWNRH is intended to describe and
address various important areas like admission procedure, on call process of the
doctors, interdepartmental consultation, patient discharge process and verity of
other areas which was so far solely based on verbal i
...
nstruction in the workplace by
the seniors which very often led to mishaps and other associate problems. This SOP,
though not comprehensive, would serve as a guidebook for newly recruited health
staff as well as a reference book for existing health professionals in JDWNRH while
delivering health care services
more
As our world changes, so too does the burden of disease. Globalisation, evolving trade and consumption patterns, and increased access to life-saving medical care are just some of the factors that have transformed the global
...
health landscape.
more
The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Health Sector Transformation Plan (HSTP). Th
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e EHSTG, which is consistent with the national focus on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
more
These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population groups. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminis
...
hes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
more
The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the
...
health care settings. It aims to rationalize the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
more
The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa
...
l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
more
The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume series entitled Managing Hazardous Material Incidents. The series is designed to help emergency response and health
...
care professionals plan for and respond to hazardous material emergencies.
- Volume I Emergency Medical Services: A Planning Guide for the Management of Contaminated Patients
- Volume II Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients
- Volume III Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to hazardous materials.
more
There is a crucial need to initiate and sustain fistula programs that increase access and strengthen the capacity of the health care system to provide high quality services for repair and
...
care of women living with female genital fistula. Therefore, it is important to pay particular attention to the quality of training, and to proactively determine how this training fits into the health care system. Furthermore, the quality of training is improved by committing adequate resources to ensure competent trainers, able to train and follow-up their trainees. Women with genital fistulae, their families and the community need to have confidence in the health care system. It is therefore necessary to have pro-active discussions about the quality of training with relevant stakeholders. These fistula training guidelines and standards go towards harmonizing the training approach and to improving the quality of training and hence, service delivery.
more
National Tuberculosis Programme
The National Strategic Plan (NSP) for Tuberculosis (TB) 2016-2020 builds on the past experiences for the National Tuberculosis Programme and its partners. This NSP provides a roadmap for delivering quality TB prevention and ... care service to the entire population, as an integral part of the country's move toward Universal Health Coverage. Between 1990 and 2015, Myanmar reduced the prevalence of TB by 50%, meeting the targets set by the Millennium Development Goals. Going forward, the country aims to further accelerate the rate decline. more
The National Strategic Plan (NSP) for Tuberculosis (TB) 2016-2020 builds on the past experiences for the National Tuberculosis Programme and its partners. This NSP provides a roadmap for delivering quality TB prevention and ... care service to the entire population, as an integral part of the country's move toward Universal Health Coverage. Between 1990 and 2015, Myanmar reduced the prevalence of TB by 50%, meeting the targets set by the Millennium Development Goals. Going forward, the country aims to further accelerate the rate decline. more
