INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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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.
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In the light of the transmissibility of coronaviruses, and the global experience with MERS-CoV (ongoing) and SARS in 2003 which were also caused by coronaviruses, South African authorities have compiled this guideline document to support surveillance, case finding, diagnosis, management and public h...ealth responses to cases under investigation.
*Please note*
The interim guidelines are based on what is currently known about the Coronavirus Disease 2019 (COVID-19). The National Department of Health (NDOH) and National Institute for Communicable Diseases will update these interim guidelines as needed and as additional information becomes available.
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Tis first edition describes the standard operating procedures for health products for NTDs amenable to preventive chemotherapy and the medicines donated to treat them. These include albendazole for lymphatic filariasis and soil-transmitted helminthiases; azithromycin for trachoma and yaws; diethylca...rbamazine citrate for lymphatic filariasis; ivermectin for onchocerciasis and lymphatic filariasis; mebendazole for soil-transmitted helminthiases; praziquantel for schistosomiasis; and triclabendazole for foodborne trematodiases. Standard operating procedures for diseases amenable to case management will be covered in subsequent editions, including the application process for requesting medicines (Chapter 1). In the meantime, the procedures described in the rest of the document apply for both case management and preventive chemotherapy NTD health products.
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It is too early to know the full impact of COVID-19 on Africa. To date the experience has been varied. There are causes for concern, but also reasons for hope. Early estimates were pessimistic regarding the pandemic’s impact on the continent. But the relatively low numbers of COVID-19 cases report...ed thus far have raised hopes that African countries may be spared the worst of the pandemic. While the virus is present in all African countries, most countries have recorded fewer than 1,000 cases. The African Union acted swiftly, endorsing a joint continental strategy in February, and complementing efforts by Member States and Regional Economic Communities by providing a public health platform.
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The Policy Guidelines and Service Standards for National Sexual and Reproductive Health Programme document outlines the steps on how to offer and deliver services. Improving quality of care is critical to improving clients' health status as well as increasing access to, and utilization of Sexual and... Reproductive Health services. Service Standards and Guidelines are intended to be used by programme managers, implementers, trainers, surpervisors, and service providers as a tool for delivering quality care measures.
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Цель настоящего доклада — повысить осведомленность о деменции как
одной из приоритетных проблем общественного здравоохранения, сформу-
лировать подход к этой п...облеме с точки зрения общественного здравоох-
ранения и призвать к принятию надлежащих мер на международном
и национальном уровнях на основе принципов вовлечения, интеграции,
справедливости и доказательности.
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Recommendations for a public health approach
HIV/AIDS Programme
Available in: English, French, Chinese, Spanish, Russian, Arabic, Thai, Korean, Tajik, Vietnamese, Uzbek
http://www.who.int/disabilities/cbr/guidelines/en/
The handbook is the first comprehensive collection of practical tips for journalists on how to report on GBV in the context of Syria crisis, building upon internationally recognised ethical principles. It gives an overview of techniques to guarantee the safety, confidentiality and dignity of survivo...rs, their families and communities. It includes terms, ethical questions and practical concerns associated with covering GBV, as well as an overview of some of the organisations involved in both combatting GBV and providing support services for survivors.
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The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa...l health planning and the first point of reference for all actors working in the health sector. The overall aim of this policy is to ensure universal accessibility (in geographical and financial terms) of equitable and affordable quality health services (preventative, curative, rehabilitative and promotional services) for all Rwandans. It sets the health sector’s objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. A companion Health Sector Strategic Plan (HSSP) elaborates the strategic directions defined in the Health Sector Policy in order to support and achieve the implementation of the policy, and more detailed annual operational plans describe the activities under each strategy.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Lancet Glob Health 2019Published OnlineOctober 22, 2019 https://doi.org/10.1016/S2214-109X(19)30425-5