Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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The COVID-19 pandemic has exacerbated and added yet another layer of vulnerability to an already dire web of vulnerabilities of girls in the African continent, which constitute about 49% of the total child population. Critically, gender equality and girls’ multidimensional vulnerability have been ...accentuated to an unprecedented level. The pandemic has triggered major concerns about the potential reversal of the strides achieved over the years towards gender equality and human development in Africa.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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Unchecked inequality and failure to protect the rights of poorest women could undermine peace and world’s development goals, new UNFPA report warns:
- Only about half of the world’s women hold paid jobs
- Globally, women earn 77 per cent of what men get
- Three in five women worldwide lack m...aternity leave, many pay "motherhood penalty"
The report is also available in French: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_FR_swop_Etat_de_la_population_mondiale.pdf; in Spanish: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_ES_SWOP_Estado_de_la_Poblacion_Mundial.pdf; in Russian: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_RU_SWOP_NARODONASELENIE_MIRA_V_2017_GODU.pdf and in Arabic: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_AR_SWOP_Hl_skn_llm_.pdf
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This report serves the specific purpose of collating legally relevant information on conditions in countries of origin pertinent to the assessment of claims for asylum. It is not intended to be a general report on human rights conditions. The report is prepared within a specified time frame on the b...asis of publicly available documents as well as information provided by experts. All sources are cited and fully referenced.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur...ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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Report on the nutrition and health situation of Nigeria
Data collection – 13th July to 13th September 2015
A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal health system evaluations continue to identify major gaps in capacity ... to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
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Science of The Total Environment Volume 764, 10 April 2021, 142919
Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi...scal cutbacks in many developed countries, total assistance remained steady, reaching an all-time high of $31.3 billion in 2013. While annual increases have leveled off since 2010, continued international funding is a sign of the international development community’s enduring support for global health.
The report also shows shifts in sources of financing. As funding from many bilateral donors and development banks has declined, growth in funding from the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, non-governmental organizations, and the UK government is counteracting these cuts. Development assistance for different health issues is tracked up to 2011, revealing that the greatest increase in funding was for maternal, newborn, and child health.
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