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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The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio...ns such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
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-Covid-19 и беременность
-Особенности применения методов диагностики у беременных
-Особенности лечения covid-19 при беременности
-Акушерская тактика при covid-19
-Маршрути...ация беременных и их новорожденных
-Организация работы родовспомогательных учреждений в период пандемии covid-19
medical care for pregnant women, women in labour, newborns and newborns in case a COVID-19 coronavirus infection
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Le Plan de réponse humanitaire (PRH) 2020 a été révisé et publié en mai 2020 afin d’intégrer l’impact de l’épidémie de COVID-19 sur les besoins humanitaires existants et sur les activités des partenaires humanitaires.
Dans le contexte de l’épidémie de COVID-19, la portée de l...analyse du PRH 2020 a été mise à jour afin d’intégrer les nouveaux besoins et activités liées à la réponse humanitaire au COVID-19 et d’ajuster les priorités humanitaires en prenant en compte l’évolution du contexte opérationnel.
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It's time to deliver differently.
Accessed: 13.11.2019
In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising region...al and national referral hospitals [Figure 3].
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Die Zahl der unbegleiteten und von ihren Eltern getrennten Kinder in Migration und auf der Flucht nimmt auf der Balkanroute ständig zu. Diese Kinder sind in höchstem Masse gefährdet, Opfer von Kinderhandel und Ausbeutung zu werden. terre des hommes und ECPAT Deutschland e. V. haben ihre Lage in D...eutschland und entlang der Route untersucht, um Schutzloesungen für sie zu finden. Im Bericht finden sich Fallbeispiele aus Deutschland und Forderungen an die deutschen Behörden.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Operational Guidelines for Planning and Implementation in District Hospitals