Immunization is one of the most cost-effective public health interventions to date, saving an estimated 2 to 3 million lives each year. As a direct result of immunization, the world is closer than ever to eradicating polio, and deaths from measles – a major child killer – have declined by 73 per... cent worldwide between 2000 and 2018, saving an estimated 23.2 million children’s lives. The emergence of COVID-19, however, threatens to reverse this progress by severely limiting access to life-saving vaccines.
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This study has two broad objectives. Thefirst objective was to assess the financialsustainability of CBHI schemes, focusing on schemes that have been operational for more than twoyears. The first componentprovidesquantitative descriptions of enrollment, utilization, and financial solvency of CBHI sc...hemes over time.The second objective ofthe assessment was to provide in-depth descriptions of institutional structures, human resource capacity, engagement and commitment of key stakeholders, and community and member engagement byCBHI schemesthat drive or constrain sustainability of CBHI schemes.
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin...g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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Ce document fournit des conseils provisoires sur la prévention, l'identification et la gestion de l'infection des travailleurs de la santé dans le contexte de COVID-19. Il s'adresse aux services de santé au travail, aux services ou points focaux de prévention et de contrôle des infections, aux ...administrateurs des établissements de santé et aux autorités de santé publique, tant au niveau national qu'au niveau des établissements.
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The Nigeria Centre for Disease Control (NCDC) declared a Yellow Fever (YF) outbreak and activated a multi-sectoral Emergency Operations Centre for coordination of Yellow Fever response on 12 November 2020. The outbreak, which mainly affected three states of Delta, Enugu and Bauchi, already recorded ...a total of 222 suspected cases 19 confirmed cases and 76 deaths between 1 and 11 November 2020.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W...e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find t...hat patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
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The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this paper explores the impact of this current macro-fisc...al outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
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The COVID-19 pandemic led to school closures around the world, affecting almost 1.6 billion students. The effects of even short disruptions in a child’s schooling on their learning and well-being have been shown to be acute and long lasting. The capacities of education systems to respond to the cr...isis by delivering remote learning and support to children and families have been diverse yet uneven.
This report reviews the emerging evidence on remote learning throughout the global school closures during the COVID-19 pandemic to help guide decision-makers to build more effective, sustainable, and resilient education systems for current and future crises.
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Joule 5, 2687–2714 October 20, 2021 Cell Press
This report aims to outline the current available knowledge on the health and wellbeing of older persons in the Region of the Americas during the United Nations Decade of Healthy Ageing (2021-2030). It also seeks to guide political actions towards ensuring the human rights of older persons, and desc...ribes the negotiation and drafting process behind the Inter-American Convention on Protecting the Human Rights of Older Persons. It reports on the doctrinal and legal developments that led the Region of the Americas to draft the Convention and describes its action areas and guaranteed rights, as well as the obligations assumed by the States Parties. The Convention is an essential tool to advance the strategies of the Decade of Healthy Ageing. This publication reflects on the importance of having a major legal instrument for this purpose at the international level. The demographic transition in Latin America and the Caribbean will continue to shape the ability of countries and health systems to respond to the needs of the population. Given this reality, international instruments will be needed to guarantee the full enjoyment of the human rights of older persons. In order to design inclusive and sustainable systems, accurate, updated, and effective information is required. The Decade of Healthy Ageing––the initiative that constitutes the framework for this document––is a strategic period in which to focus on data generation and monitoring.
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Die vorliegende Studie HLS-MIG liefert erstmals für Deutschland detaillierte Daten zur Gesundheitskompetenz von Menschen mit Migrationshintergrund. Sie konzentriert sich auf die beiden großen Einwanderungsgruppen: Menschen mit ex-sowjetischem und türkischem Migrationshintergrund. Die Studie schli...eßt inhaltlich und methodisch an die zweite Studie zur Gesundheitskompetenz der Bevölkerung in Deutschland an (HLS-GER 2; Schaeffer et al. 2021) und ist um relevante migrationsspezifische Aspekte
ergänzt worden. Neben der allgemeinen Gesundheitskompetenz wurden auch die digitale und die navigationale Gesundheitskompetenz untersucht.
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special education, culture, psychology, education, policy
Estima-se que 17,8 milhões de mulheres em todo o mundo com 18 anos ou mais viviam com o VIH em 2015, o equivalente a 51% dos adultos que viviam com o VIH. As raparigas adolescentes e as mulheres jovens são particularmente afectadas; em 2015 representavam 60 por cento dos indivíduos com idades com...preendidas entre os 15-24 anos que viviam com o VIH, e 58 por cento das infecções por VIH recentemente adquiridas entre a população jovem deste grupo etário. Em muitos países, as mulheres que vivem com o VIH não têm acesso equitativo a serviços de saúde de boa qualidade e enfrentam muitas formas de estigma e discriminação entrecruzadas. Além disso, estas mulheres são desproporcionadamente vulneráveis à violência, incluindo as violações dos seus direitos sexuais e reprodutivos.
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Claims for refugee status related to situations of armed conflict and violence under Article 1A(2) of the 1951 Convention and/or 1967 Protocol relating to the Status of Refugees and the regional refugee definitions
UNHCR issues these Guidelines on International Protection pursuant to its mandate,... as contained in, inter alia, the Statute of the Office of the United Nations High Commissioner for Refugees, namely paragraph 8(a), in conjunction with Article 35 of the 1951 Convention relating to the Status of Refugees, Article II of its 1967 Protocol, Article VIII(1) of the 1969 OAU Convention Governing the Specific Aspects of Refugee Problems in Africa, and Commitment II(e) of the 1984 Cartagena Declaration on Refugees.
These Guidelines clarify paragraph 164 of the UNHCR Handbook on Procedures and Criteria for Determining Refugee Status under the 1951 Convention and otherwise complement the Handbook. They are to be read in conjunction with UNHCR’s other Guidelines on International Protection.
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The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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