Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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In low- and middle-income middle-income countries, reliable and disaggregated disability data on prevalence, participation and barriers are often unavailable. This study aimed to estimate disability prevalence, determine associated socio-demographic factors and compare access in the community betwee...n people with and without disability in Dehradun district of Uttarakhand, India, using the Rapid Assessment of Disability survey.
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Disaster planning - organization and administration. 2.Emergency medical services - methods. 3.Emergency medical services - organization and administration. 4.Emergencies. 5.Health policy. 6.Health facilities.7.Guidelines.
ON LIFE SUPPORT3The Democratic Republic of Congo’s Ebola outbreak has been contained, but confl ict and under-development leave over three million children at risk from measles and other killer diseases. The country’s medical services – ill-equipped and under-resourced – are on life support ...and in no condition to protect children unless urgent measures are taken.
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Pakistan is on the verge of a public health disaster as a result of the massive monsoon rainfalls and unprecedented levels of flooding that are affecting 33 million people across the country.
The risk of disease outbreaks is extremely high and malnutrition rates are rising.
WHO requires US$ 81.5 m...illion to respond to this health crisis in flood-affected Pakistan, to ensure a coordinated delivery of essential health care services, efficient management of severe acute malnutrition, and stronger outbreak detection and control.
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Int. J. Environ. Res. Public Health 2020, 17(23), 8849; https://doi.org/10.3390/ijerph17238849
The aim of building climate resilient and environmentally sustainable health care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable... and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such health care facilities contribute to high quality of care and accessibility of services and, by helping reduce facility costs, also ensure better affordability. They are an important component of universal health coverage.
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South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South A...frica’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
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This report is not a country scorecard. Rather, its purpose is to act as a compass to guide progress towards health in the SDGs.
There has been a significant improvement in the state of health in the region with healthy life expectancy - time spent in full health - in the region increasing from 50....9 years to 53.8 between 2012 and 2015 - the most marked increase of any region in the world.
What is making Africans sick is changing. The top killers are still lower respiratory infections, HIV and diarrhoeal disease and countries have routinely focused on preventing and treating this trio, often through specialized programmes. The payoff has been significant declines in deaths due to these diseases. There has been a 50% reduction in the burden of disease caused by what have been the top 10 killers since 2000 and death rates have dropped from 87.7 to 51.1 deaths per 100,000 persons between 2000 and 2015...
Chronic diseases like heart disease and cancer are now claiming more lives with a person aged 30 to 70 in the region having a one in five chance of dying from a noncommunicable disease (NCDs).
Countries are specifically failing to provide essential services to two critical age groups – adolescents and the elderly...
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The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based service delivery in different countries.
Countries were selected for their geographic diversity, type o...f service delivery model, and programmatic scale-up.
This brief reviews Malawi’s community health model to inform future policy, program design, and implementation in other countries.
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The Department of Health is committed to providing the best quality care to patients and users of health services, in order to meet their expectations and needs, and to improve service delivery.
The main purpose of the National Core Standards is to:
• Develop a common definition of quality of ...care, which should be found in all health establishments in South Africa as a guide to the public and to managers and staff at all levels;
• Establish a benchmark against which health establishments can be assessed, gaps identified, strengths appraised; and
• Provide a national framework to certify health establishments as compliant with standards
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A... comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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For the Fiscal Year 2014-2015, the Health Sector continued to implement interventions and strategies meant to improve the availability, accessibility and utilization of quality healthcare services across public and private health facilities; and to ensure the reduction of the burden of communicable ...and non-communicable diseases in Rwanda. This annual report highlights key achievements registered by the health sector during the Fiscal Year 2014-2015. Achievements are highlighted under three big components: Health Programs, Health Systems Support and Budget Execution.
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Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arlington, VA: Management Sciences for Health. Submitted to the United Nations Children’s Fund by JSI, Arlington, VA: JSI Research & Training Institute, Inc....
This guide will assist program managers, service providers, and technical experts when conducting a quantification of commodity needs for the 13 reproductive, maternal, newborn, and child health commodities prioritized by the UN Commission on Life-Saving Commodities for Women and Children. This quantification supplement should be used with the main guide—Quantification of Health Commodities: A Guide to Forecasting and Supply Planning for Procurement. * This supplement describes the steps in forecasting consumption of these supplies when consumption and service data are not available; after which, to complete the quantification, the users should refer to the main quantification guide for the supply planning step.
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This European compendium was produced to provide operational examples of the new nursing and midwifery roles and new service delivery models currently being employed across the Region. The case studies directly relate to the priority areas in Health 2020 and exemplify the types of activities needed ...to fully implement the objectives within the Strategic Directions framework.
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Assessment and Guidance for Strengthening Integration of Mental Health into Primary Health Care and Community-Based Service Platforms in Ukraine
The Mental Health Atlas, released every three years, is a compilation of data provided by countries around the world on mental health policies, legislation, financing, human resources, availability and utilization of services and data collection systems. It serves as a guide for countries for the de...velopment and planning of mental health services. The Mental Health Atlas 2020 includes information and data on the progress made towards achieving mental health targets for 2020 set by the global health community and included in WHO’s Comprehensive Mental Health Action Plan. It includes data on newly-added indicators on service coverage, mental health integration into primary health care, preparedness for the provision of mental health and psychosocial support in emergencies and research on mental health. It also includes new targets for 2030.
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This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ...e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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The following is a breakdown of key considerations to guide planning and resource allocation for COVID-19 preparedness and response to support UNHCR regional and country operations in Public Health, WASH, Shelter and Settlements programmes. While some of the activities are more relevant in camps or ...settlements it is important to assess the availability of all services outlined. These are based on the Strategic preparedness and Response Plan for COVID 19 and UNHCR guidance for operations and, where relevant, operation or site level outbreak preparedness and response plans.
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