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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
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These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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This editorial will consider the often heralded and sometimes belittled Surgical Safety Checklist (SSCL) for its general benefits, potential utility, and range of evidence attesting to its value in quality and safety improvement.
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and
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burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Anywhere But Syria: How 10 Years of Conflict Left Syria’s Displaced Children Without a Sense of Home
After ten years of war, the vast majority of Syria’s children cannot imagine a future in their country, according to a new report by Save the Children. On average, 86% of Syrian refugee children surveyed in Jordan, Lebanon, Turkey and the Netherlands said they would not want to return to their cou
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ntry of origin. Of children displaced inside Syria, one in three would rather be living in another country. Children who fled their homes are struggling to feel safe where they are now, as around two in five children of those surveyed by Save the Children said they face discrimination and a lack of education. Many feel they have no say over their future.
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The Mtoto Mwerevu Stunting Reduction Toolkit is a resource for government and organisations involved in addressing stunting and broader nutrition issues in Tanzania. The toolkit was developed in conjunction with the Government of Tanzania (GoT) with funding from UK Aid as part of the Addressing Stun
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ting in Tanzania Early (ASTUTE) programme. Its goal is to provide government, donors, non-governmental organisations, and civil society organisations (CSOs) with programming recommendations and tools to help implement successful multi-sectoral social and behaviour change (SBC) interventions aimed at preventing and reducing stunting.
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The goal of this best practice guideline is to strengthen collaborative practice among nurses, because effective collaborative practice is essential for working in health-care organizations.
In this guideline, we focus on collaborative practice amongst three types of nursing professionals – reg
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istered nurse (RN), registered practical nurse (RPN) and nurse practitioner (NP) – and explore what fosters healthy work environments for them, aware that collaboration must align with the needs of the patient or client.
This best practice guideline was developed to assist nurses, nursing leaders, other health professionals and senior managers to enhance positive outcomes for patients/clients individual/family/group/community), nurses, and the organization through intra-professional collaborative practice.
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Best practice guidelines are systematically developed statements designed to assist nurses working in partnership with persons and their families to make decisions about health care and services (Field & Lohr, 1990). This nursing Best Practice Guideline (BPG) is intended to replace the RNAO BPGs Scr
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eening for Delirium, Dementia and Depression in Older Adults (2010b) and Caregiving Strategies for Older Adults with Delirium, Dementia and Depression (2010a).
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The assistive technology capacity assessment (ATA-C) is a system-level tool to evaluate a country’s capacity to finance, regulate, procure and provide assistive technology. It can be used for awareness raising, policy and programme design, and ongoing monitoring and evaluation. This manual provide
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s guidance and practical information on the ATA-C implementation process. The ATA-C is intended to be implemented by an experienced team, in collaboration with relevant ministries and users’ organizations.
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Consolidating Earthquake Safety Assessment Efforts in India. This document provides succinct instructions on how to perform rapid visual screening (RVS), a quick method of earthquake assessment of buildings. It covers a brief description of RVS and its role as a simplified qualitative assessment in
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the wider methodology of earthquake assessment of buildings, and the recommended forms for pre-earthquake and post-earthquake Level 1 Assessments for seven building typologies. The method recommended by the primer is the BMTPC method which provides both Seismic Safety Index and Performance Rating to a particular building.
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Since the start of the pandemic, the region has been hit by multiple natural and biological disasters. At the same time, climate change has continued to warm the world, exacerbating the impacts of many of these disasters. The *Asia-Pacific Disaster Report 2021, *also launched today, shows that the p
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andemic, combined with the persistent reality of climate change, has reshaped and expanded the disaster “riskscape” in Asia and the Pacific.
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BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3026 (Published 11 August 2020)
The BMJ "practice pointer" inlcudes a one-page visual summary of assessment and initial management of patients with persistant symptoms following acute SARS-CoV-2 infection
16.7.2021
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
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a total of 222 suspected cases 19 confirmed cases and 76 deaths between 1 and 11 November 2020.
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These WHO interim recommendations for use of the BBV152 COVAXIN vaccine were developed on the basis of advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) and the evidence summary included in the background document and annexes referenced below.
This document has been
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updated: version 15 March 2022.
The vaccine is formulated from an inactivated SARS-CoV-2 antigen and is presented in single dose vials and multidose vials of 5, 10 and 20 doses.
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At a time when the world is reeling from the deepest global disruption and health crisis of a lifetime, this year’s Living Planet
report provides unequivocal and alarming evidence that nature is unraveling and that our planet is flashing red warning signs of
vital natural systems failure. The
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Living Planet Report 2020 clearly outlines how humanity’s increasing destruction of nature is having
catastrophic impacts not only on wildlife populations but also on human health and all aspects of our lives.
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This publication provides managers with guidance on how to create basic HIV prevention cascades as a starting point to enhance their ability to monitor and improve their programming and to facilitate comparisons of programme effectiveness across sites.
These WHO interim recommendations for use of the COVID-19 vaccine BIBP produced by Sinopharm were developed on the basis of advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) and the evidence summary included in the background document and annexes referenced below.
Th
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is document has been updated: version 15 March 2022.
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