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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from
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Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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The World Health Organization (WHO)6, the Civil Society Action Committee and the Lancet Migration global collaboration are amongst many organisations that have advised governments against returning irregular migrants during the Coronavirus disease 2019 (COVID-19) pandemic. The expulsion of i
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rregular migrants to under-prepared countries puts migrants and communities at risk, and is against the principles of solidarity and public health that should inspire action during these challenging times. It also puts at risk the staff who implement these policies. Detention, overcrowded conditions and lack of hygiene all render irregular migrants more vulnerable to the impact of COVID-19. Irregular laborers, agricultura land food workers, cleaners and caregivers are all essential in the response to the pandemic, there fore the temporary or longer term regularisation of migrants to facilitate their access to health, social services and employment should be considered as a humane, practical and self-interested alternative to forcible return.
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This document was designed to inform educators, amongst others, about enhancing the pre-service curriculum with mental health Gap Action Programme Intervention Guide (mhGAP-IG) materials, which can provide future professionals with the theoretical and clin
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ical knowledge they need to provide mental health in non-specialized health care settings.
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Noncommunicable diseases (NCDs) such as cancer, cardiovascular disease, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Kazakhstan. This report provides evidence through three analyses that NCDs reduce economic output and
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discusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs (direct and indirect costs) comprise 2.3 trillion tenge, equivalent to 4.5% of gross domestic product in 2017. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment. For example, the salt policy package achieved a benefit-to-cost ratio of 118.4 over 15 years, a return of more than 118 tenge for every 1 tenge invested.
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The manual has been designed in a comprehensive manner, the aim being to provide a holistic approach to the short-term development of human resources, with a focus on primary care physicians. This is a reference manual meant for primary care physicians who will provide care to older people in primar
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y health care facilities. The information on old age care is meant to be incorporated into the everyday clinical practice of primary care physicians. This manual will help to enhance the knowledge and skills of physicians. It is expected that the use of the manual will improve the approach to issues of old age and promote holistic care of older people, which will ultimately improve their quality of life.
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The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Health Sector Transformation Plan (HSTP). The EHSTG, which is consistent with the national focu
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s on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
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The training is based on ensuring that the competencies to care for newborn are acquired.
A range of adult learning methods are used, these include reading and self-study,
discussion, and case based learning in written exercises and group discussions, visual presentations and extensive
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clinical practice.
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21 January 2022
The overall threat posed by Omicron largely depends on four key questions: (i) how transmissible the variant is; (ii) how well vaccines and prior infection protect against infection, transmission, clinical disease and death; (iii) h
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ow virulent the variant is compared to other variants; and (iv) how populations understand these dynamics, perceive risk and follow control measures, including public health and social measures (PHSM).
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Understanding and building resilience to early life trauma in Belarus and Ukraine
Marais, J.F.; Ol. Kazakova, D. Krupchanka, et al.
World Health Organization WHO, Regional Office of Europe
(2019)
C_WHO
In 2018 and early 2019, the WHO Regional Office for Europe’s cultural contexts of health and well-being project worked alongside the University of Exeter’s WHO Collaborating Centre on Culture and Health, the Minsk Regional Centre for Psychiatry and Addiction, and the Institute of Mental Health o
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f the Ukrainian Catholic University to engage researchers, practitioners, health-care workers and other relevant stakeholders in a series of workshops on the cultural contexts of early life trauma in Belarus and Ukraine.
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The primary audience for these recommendations includes health professionals who are responsible for developing national and local health-care guidelines and protocols and health workers involved in the provision of care to women and their newborns
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during pregnancy, labour and childbirth; this includes midwives, nurses, general medical practitioners and obstetricians. The primary audience also includes managers of maternal and child health programmes, and relevant staff in ministries of health and educational and training institutions, in all settings.
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The primary audience for these recommendations includes health professionals who are responsible for developing national and local health-care guidelines and protocols and health workers involved in the provision of care to women and their newborns
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during pregnancy, labour and childbirth; this includes midwives, nurses, general medical practitioners and obstetricians. The primary audience also includes managers of maternal and child health programmes, and relevant staff in ministries of health and educational and training institutions, in all settings.
more
The primary audience for these recommendations includes health professionals who are responsible for developing national and local health-care guidelines and protocols and health workers involved in the provision of care to women and their newborns
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during pregnancy, labour and childbirth; this includes midwives, nurses, general medical practitioners and obstetricians. The primary audience also includes managers of maternal and child health programmes, and relevant staff in ministries of health and educational and training institutions, in all settings.
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The recommendations cover the level of blood pressure to start medication, what type of medicine or combination of medicines to use, the target blood pressure level, and how often to have follow-up checks on blood pressure. In addition, the guideline provides the basis for how physicians and other h
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ealth workers can contribute to improving hypertension detection and management.
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Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve universal health coverage and the Sustainable Development Goals, t
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he beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
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Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in failure to provide adequate, accessible and quality m
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aternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
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The document is a comprehensive practical guide for managing cholera epidemics. It includes detailed instructions on outbreak investigation, control measures, case management, and the organization of treatment facilities. It emphasizes strategies such as rehydration therapy, water sanitation, hygien
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e promotion, and vaccination to prevent the spread of cholera. The guide serves as a resource for healthcare professionals, logisticians, and public health officials to respond effectively to cholera outbreaks.
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The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease, the associated risk factors, and the increasing burden on
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healthcare systems, particularly in low- and middle-income countries. The report discusses strategies for preventing Type 2 diabetes, managing diabetes effectively, and reducing complications through integrated healthcare approaches. It emphasizes the need for global action, national policies, and collaboration across sectors to address diabetes and improve health outcomes worldwide.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue
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s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clini
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cal) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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