Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources... and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction... of community-based provision of Family Planning through community health workers. In addition, the expansion of adolescent sexual and reproductive health programs is a pillar of this policy that will help attract and retain the next generation of Family Planning users. These efforts are anticipated to trigger a paradigm change in the way Family Planning services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all.
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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...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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4th edition 2022 of the Handbook includes new WHO recommendations that expand contraceptive choices. Also, guidance on starting ongoing contraception following emergency contraception is provided.
Drawing on lessons from recent outbreaks, this new edition details tangible me...asures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and the use of digital technologies by providers. It also expands guidance for women and young people at high risk of HIV.
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Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
The main goal of IPC in the cholera response is to
• To reduce transmission of health care-as...sociated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
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Reporting period: January 2014 – December 2014
The human immunodeficiency virus (HIV) epidemic in Myanmar is concentrated among men who have sex with men (MSM), people who inject drugs (PWID) and female sex workers (FSW). HIV prevalence in the adult population aged 15 years and older was esti...mated at 0.54% in 2014. But data from HIV Sentinel Sero-Surveillance (HSS) indicates higher prevalence in 2014 among key populations: FSW 6.3%, MSM 6.6% and PWID 23.1%. Compared to 2012 data, the prevalence has declined from 7.1% in FSW and 8.9% in MSM, but has increased from 18% in PWID.
Epidemiological modelling suggests that in 2014 there were around 212,000 people living with HIV (PLHIV) in Myanmar, 34% of whom were females. Nearly 11,000 people died of HIV-related illnesses, compared to approximately 15,000 in 2011. An estimated 9,000 new infections occurred in 2014.
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Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver integrated preventive and curative package of care of services to manage common childhood illness in h...ard-to-reach communities in Bondo Subcounty, Kenya
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The Practical Approach to Care Kit (PACK) is a health systems improvement programme designed to support the work of primary care health workers in underserved communities (like doctors, nurses, midwives, health officers, community health practitioners), strengthen the health services in which they w...ork and thereby achieve the best possible patient outcomes
You can register for free and get the PACK Global Adult Guide for free
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This clinical job aid addresses the importance of maternal health and antiretroviral therapy adherence, as well as care and testing for the HIV-exposed infant until the infant’s final HIV diagnosis after the end of breastfeeding.
Integrated community case management (ICCM) – an approach where community-based health workers are trained to identify, treat and refer children under-five with pneumonia, diarrhoea and malaria – is increasingly being used across sub-Saharan Africa to supplement the gaps in basic healthcare prov...ision. ICCM programmes have been endorsed by major international organisations and donors, and many African Ministries of Health as a key strategy for reducing child mortality.
This learning paper describes Malaria Consortium’s approach to and experience of engaging local communities in integrated community case management (ICCM) in Uganda, Zambia and Mozambique.
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2nd edition.
The book is aimed at general health workers in low- and middle-income country settings and has some chapters on perinatal mental health. That said, it has definite applicability in high-income country settings too! In the new edition, there has been a big expansion of the psychosocial ...interventions. Thanks to your advocacy for such a resource being open-access (as the first edition was not), the book is freely available for download: https://www.cambridge.org/core/books/where-there-is-no-psychiatrist/47578A845CAFC7E23A181749A4190B54
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The Infection Prevention and Control (IPC) Guidelines aim to support healthcare workers improve quality and safety health care. The Guidelines further aim to promote and facilitate the overall goal of IPC by providing evidence-based recommendations on the critical aspects of IPC, focusing on the fun...damental principles and priority action areas. All health service organizations should consider the risk of healthcare-associated infection(s) (HAI) and antimicrobial resistance (AMR) transmission to implement these recommendations. The IPC Guidelines also set national standards for the prevention and control of HAIs and to ensure compliance to the National Quality Standards.
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The training focuses on building the capacity of health care workers at the primary and secondary level to address and manage TB in children.
A Program To Improve The Care For Patients With Common Mental Disorders In Primary Health Care.
The essence of the MANAS model is to shift mental health care from mental health specialists to primarycare doctors and lay HCs (someone similar to other more widely available... health workers) working as aprimary care team to improve the coverage and efficiency in treating CMD. This manual has been prepared based on the experience gained through the MANAS program and incorporates feedback from doctors who were involved in the program implementation. It outlines the details of the MANAS model and provides information on treatments that are relevant to doctors working in Primary Health Clinics
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A manual for physicians and other senior health workers. This fourth revision of the manual reflects recent clinical experience and research findings in diarrhoea case management. Compared to earlier versions, it includes revised guidelines on the management of children with acute diarrhoea using th...e new reduced (low) osmolarity ORS formulation and using zinc supplements, which have been shown to reduce duration and severity of diarrhoeal episodes, and revised guidelines for the management of bloody diarrhoea. Guidelines in the manual are based on the revised WHO chart that are included at the end of this document.
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The Extending Service Delivery (ESD) project has developed Healthy Timing and Spacing of
Pregnancy: A Trainer’s Reference Guide as a resource for trainers in developing in-service training
for facility-based healthcare providers and community health workers (chws) who already have
some basic ex...perience with and understanding of FP/RH. This is not a training manual, but a
reference guide which can be used and adapted by trainers based on whether or not trainees are facilitybased
or community-based.
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2nd edition. Known as “Community Case Management of Sick Children” (CCM), this approach sends community-based health workers out to find, diagnose, and successfully treat sick children, in partnership with their families. Inspired by the classic “Immunization Essentials”, this guide methodic...ally documents what is known about CCM and how to make it work. First, health program managers are introduced to the basics. Then, CCM Essentials walks its readers through the process of designing and managing a high-quality CCM program. The ultimate result: lives of newborns, infants and children saved around the world
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Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthcare professionals in antimicrobial prescribing and ...stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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1st edition
This resource provides practical guidance for front line health workers responsible for the diagnosis, management and care of patients with these two diseases. Published in collaboration with the World Diabetes Foundation