Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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The emergence and transmission of zoonotic diseases are driven by complex interactions
between health, environmental, and socio-political systems. Human movement is considered
a significant and increasing factor in these processes, yet forced migration remains an
understudied area of zoonotic res...earch–due in part to the complexity of conducting interdisciplinary
research in these settings.
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A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists working on this disease, the manual details the exac...t procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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Case Manangement Training Modules
These guidelines are designed for settings with limited resources to provide inexpensive and effective control strategies for prevention of TB transmission in health care workers (HCW).
Safe water, sanitation and hygiene (collectively known as WASH) are crucial for human health and well-being. Yet, millions of people globally lack adequate WASH services and consequently suffer from or are exposed to a multitude of preventable illnesses.
A series of information sheets to help empower communities and strengthen health systems
This series of information sheets introduces health literacy, its
relevance to public policy, and the ways it can be used to inform
the promotion of good health, the prevention and management
of communicab...le and noncommunicable diseases, and the
reduction of health inequities. It provides information and links
to further resources to assist organizations and governments
to incorporate health literacy responses into practice, service
delivery systems, and policy.
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DHS Working Papers No. 108 | Zimbabwe Working Papers
No. 9
Submitted to the US Agency for International Development by the
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program.
This manual provides a framework to identify problems and design interventions to improve access to and use of medicines for children. It is a resource for ...both health policy makers and health system managers and presents a structured approach to the steps introduced in the framework in the context of child health.
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This guide focuses on the evaluation of psychosocial programs that are aligned with two main goals: - To promote psychosocial wellbeing by promoting an environment that provides appropriate care, opportunities for development and protects children from exposure to situations that are harmful to thei...r psychosocial wellbeing, and - To respond to psychosocial problems by strengthening social and psychological supports for children who have been exposed to situations that affect their psychological development.
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The WHO Mental Health Gap Action Programme (mhGAP) aims at scaling up mental health services in non-specialized health settings to achieve universal health coverage. The mhGAP operations manual is an integral component of the mhGAP package and supports district health managers and others responsible... for integrating mental and physical health services. The manual offers practical guidance and necessary tools for planning, preparing, implementing, monitoring and evaluating mhGAP
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within n...ational quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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A job aid for non-specialist health professionals