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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
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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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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati
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ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma
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symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
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Pocket guide to show the positive impact that physical activity can have on your own mental wellbeing, including some tips and suggestions to help you get started.
There are many reasons why physical activity is good for your body having a healthy heart and improving your joints and bones are just
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two, but did you know that physical activity is also beneficial for your mental health and wellbeing
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Research globally has shown that metered dose inhaler (MDI) technique is poor,
with patient education and regular demonstration critical in maintaining correct use of
inhalers. Patient information containing pictorial aids improves understanding of medicine
usage; however, manufacturer leaflets i
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llustrating MDI use may not be easily understood by
low-literacy asthma patients.
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Globally, 85,000 women and girls were killed intentionally in 2023. 60 per cent of these homicides—51,000—were committed by an intimate partner or other family member. 140 women and girls die every day at the hands of their partner or a close relative, which means one woman or girl is killed eve
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ry 10 minutes.
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Early Identification and Early Intervention Services for Young Children with Developmental Delays and Disabilities in Namibia Republic of Namibia Namibia
Regional Consultations Report
Namibia has, for many years, had a strong legislative and policy framework for the protection of children. These policies and laws have been developed through the combined expertise of those working in the field of child protection who have ensured Namibia has a robust legal framework that is in li
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ne with international best practices.
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Tax capacity—the policy, institutional, and technical capabilities to collect tax revenue—is part of a deeper process of state building that is essential for achieving the sustainable development goals. This Staff Discussion Note shows that developing countries have made some progress in revenue
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mobilization during the past decades, but that much more is needed. It finds that a staggering 9 percentage-point increase in the tax-to-GDP ratio is feasible through a combination of tax system reform and institutional capacity building. Achieving this calls for a holistic and institution-based approach that focuses on improving policy, administration, and legal implementation of core taxes. The note offers practical lessons and guidance, based on IMF capacity-building experience in this area.
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The framework recommends expanded coverage of malaria diagnostic and treatment services, intensified vector control to drive down transmission, strengthened malaria surveillance, and increased transborder collaboration, especially in terms of efforts to control the sale and use of artemisinin monoth
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erapies. Since it is unlikely that national malaria control programs will be able to implement all the activities described in this framework simultaneously, a list of suggested priority activities has been included in the Annex.
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Exposure to air pollution has significant adverse health effects, leading to nearly 1 in every 8 deaths globally. Air pollution affects all age groups, from unborn children to older people, in both high- and low-income nations.
The 2022 report reviews the global malaria diagnostics market and technological landscape to support Unitaid’s 2023–2027 strategy for quality malaria case management. The report highlights the stalled progress of malaria control efforts, the gaps in access to diagnostics and the public health im
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plications of P. falciparum HRP2/3 gene deletions, which compromise the accuracy of the widely used HRP2-detecting rapid diagnostic tests (RDTs). The report analyses the malaria RDT market, noting supplier diversification, price trends and production shifts resulting from the pandemic. It also addresses the emerging point-of-care G6PD testing market, which is required to ensure the safe radical cure of P. vivax infections. It surveys technological innovation, including digital microscopy, hemozoin tests, nucleic acid detection and biosensors, while emphasising that RDTs and microscopy will remain the mainstay of case management in the near term. The report identifies market shortcomings, access barriers and opportunities to improve malaria case management and diagnostic coverage.
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Progress on the sustainable development goals.
Pathogens 2022, 11, 33. https://doi.org/10.3390/pathogens11010033
The International Federation of Red Cross and Red Crescent Societies (IFRC) is the world’s largest volunteer-based humanitarian network. With our 190 member National Red Cross and Red Crescent Societies worldwide, we are in every community reaching 160.7 million people annually through long-term s
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ervices and development programmes, as well as 110 million people through disaster response and early recovery programmes. We act before, during and after disasters and health emergencies to meet the needs and improve the lives of vulnerable people. We do so with impartiality as to nationality, race, gender, religious beliefs, class and political opinions.
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The text explains the concept of disaster preparedness and outlines how societies can better prepare for and respond to emergencies. It describes key components such as risk assessment, planning, resource management, warning systems, and training, emphasizing that effective preparedness requires coo
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rdination between institutions, communities, and individuals. The text also highlights the importance of early warning systems, showing that not only technical accuracy but also clear communication and community response are crucial. Overall, it argues that disaster preparedness is an ongoing process that combines planning, capacity building, and practical measures to reduce risks and improve emergency response.
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This issue brief aims to provide a comprehensive overview of key publications, guidelines, and practical materials on malaria prevention, diagnosis, and treatment. The selected documents reflect current evidence and field-based experiences, supporting healthcare professionals, researchers, and publ
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ic health authorities in their efforts to control and eliminate malaria.
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This document assembles these best practices and provides a resource for the proper management of equipment in the laboratory to ensure accurate, reliable and timely testing, and maintain a high level of laboratory performance. Improved equipment management also lowers repair costs, lengthens instru
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ment life, reduces interruption of services due to breakdowns and failures, and enables laboratory accreditation and the achievement of high-quality and accessible laboratory services at all levels of healthcare service delivery.
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It provides comprehensive guidance for logistics planners in humanitarian responses to pandemics, covering preparedness, response strategies, assessment methodologies, and operational planning.
This guidance document, titled 'Preparedness Enabler's Guide (PEG)', published in May 2023, aims to promote effective and sustainable localization in humanitarian preparedness through insights and practical tools derived from the Global Logistics Cluster's experience.
