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...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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La Guinée a été le point zéro de la flambée récente de la maladie à virus Ebola. Le taux de mortalité attribuée à Ebola en Guinée était de 66 %, nettement plus élevé que les taux des deux autres pays ouest-africains les plus affectés : la Sierra Leone (32 %) et le Liberia (45 %). Face... à la fermeture des cliniques, aux patients qui évitent les établissements sanitaires de peur de contracter Ebola et aux patients présentant des symptômes semblables à ceux d’Ebola qu’on renvoie chez eux, les experts en matière de santé s’inquiètent que d’autres maladies, telles que le paludisme, la pneumonie et la fièvre typhoïde, ne seront pas soignées, et que des soins de routine comme ceux qui favorisent la santé maternelle et infantile ne seront pas fournis.
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PLOS ONE | DOI:10.1371/journal.pone.0172392 February 16, 2017
Review
Drake AL et al. Journal of the International AIDS Society 2019, 22:e25271 http://onlinelibrary.wiley.com/doi/10.1002/jia2.25271/full | https://doi.org/10.1002/jia2.25271
Alternative Report to the UN Committee on the Rights of Persons with Disabilities in response to South Africa’s Baseline Country Report of March 2013 on the UN Convention on the Rights of Persons with Disabilities, with particular reference to the provisions of Article 24
Pulmonary tuberculosis predictors and rapid molecular diagnosis
Preditores de tuberculose pulmonar e experiência com o diagnóstico molecular rápido
El pediatra es el médico de cabecera de los niños pequeños y es el primero en ser consultado por las familias. Los padres esperan que el pediatra no solo sea un experto en atender al niño durante una enfermedad, sino que también lo sea en temas
vinculados al desarrollo. Las alteraciones del d...esarrollo son motivo frecuente de consulta en el ámbito pediátrico. La identificación temprana, el diagnóstico y el seguimiento de estos pacientes constituyen un verdadero desafío para los
médicos pediatras.Esta guía ofrece recomendaciones para la vigilancia del desarrollo, la pesquisa, la evaluación y el seguimiento de pacientes con
retrasos y discapacidades del desarrollo.
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BMJ Glob Health 2017;2:e000345. doi:10.1136/bmjgh-2017-000345. WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical expo...sure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.
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Misceláneo
Capítulo J.10
Edición: Matías Irarrázaval & Andres Martin
Traducción: Fernanda Prieto-Tagle
The World Heart Federation (WHF) has been advocating globally for stronger
legislation and policy regarding cardiovascular disease (CVD) for many years. Now, as focus shifts from global to national progress, we call on members and colleagues to advocate for greater action on CVD in your local setti...ngs. This ‘Road to 2018 Toolkit’ provides World Heart Federation members with information
and specific, practical tools to support national CVD advocacy, especially around the United Nations High-Level Meeting on NCDs in 2018.
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Sustainability Science (2019) 14:1343–1354
Reprinted from Australian Family Physician Vol. 39, No. 10, october 2010
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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Otros trastornos
Capítulo H.4
Editores: Laura Borredá Belda, Matías Irarrázaval & Andres Martin
Traductores: Sara Diego Castaño, Laura Álvarez Bravos, Rebeca Santonja & Beatriz Ortega
Autres troubles
Chapitre H.4
The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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