For many years, Community Health Care Workers (CHWs) in Tanzania and Africa in general have played significant role in community health promotion. Their specific roles have been changing from time to time. However, their key roles have over time included giving health education and dissemination of ...health information to communities, invariably moving on to include other services such as offering curative services and conducting community surveys. Deployment of CHWs has mainly been a response to the severe shortage of the human resource for health in most African countries due to brain drain for various reasons that include unattractive terms and conditions of employment. On the other hand the human resources for health (HRH) is a result of positive growing demand for health services, a situation confronted by inadequate supply of trained health personnel from training institutions to meet the demand.
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The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis in health systems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed ...in light of the increasing evidence of climate change and its associated health risks (1); global, regional and national policy mandates to protect population health (2); and a rapidly emerging body of practical experience in building health resilience to climate change (3).
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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Antimicrobials are precious agents for combating infectious diseases and had saved millions of lives throughout the world. However, the current trend of increasing antimicrobial resistance (AMR) has become a global health problem with increased morbidity and mortality in infectious diseases. Sri La...nka is not an exemption and face many health related issues with multidrug resistant (MDR) organisms. Currently there is a global effort in combating antimicrobial resistance. WHO extends its fullest support and plays a major role in motivating the countries to combat antimicrobial resistance with national action plans in place. Sri Lanka has initiated combating AMR with multisectoral collaboration, under one health concept. The development of the National Strategic Plan (NSP) 2017-2022 provides the roadmap to combat AMR.
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La presente publicación describe la evidencia científica disponible sobre la efectividad del uso de mascarillas o respiradores en la prevención y control de infecciones respiratorias virales incluido COVID-19 a nivel comunitario y hospitalario. Se identificaron 778 estudios publicados hasta abril... de 2020 como parte de la búsqueda sistemática de evidencias (320 población general y 452 personal de salud). Siete estudios fueron seleccionados para responder a las preguntas de investigación de los cuales cinco fueron ensayos clínicos respecto al subgrupo de población general y una revisión sistemática y un ensayo clínico respecto al subgrupo de personal de salud.
Esta publicación pertenece al compendio Publicaciones Minsa sobre COVID-19
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New and updated information.
Adverse health effects of hot weather and heat-waves are largely preventable. Prevention requires a portfolio of actions at different levels:from health system preparedness, coordinated with meteorological early warning systems, to timely public ... and medical advice andimprovements to housing and urban planning. This publication offers detailed information for various target audiences, and on medicaladvice and treatment practices
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities. ...As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.
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Children in every country, every culture and at every social level face various forms of abuse,
neglect, exploitation and violence1. The abuse takes place at home, in school, in institutions,
at work, in the community, in armed conflict and natural disasters. Much violence against
children, such ...as corporal punishment and sexual abuse, remains legal and socially approved
in many countries. Growing up with violence and abuse seriously affects a child’s development,
dignity, and physical and psychological integrity. Save the Children works to prevent
abuse and neglect from happening, ensure the victims of violence are supported and that
justice is ensured.
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Sexual abuse perpetrated against children is one of the most significant crises of our time. Child sexual abuse is a significant risk factor for children, in common with other forms of child maltreatment. Sexual abuse can have severe short- and long-term consequences on the physical, mental, social,... emotional and economic well-being of children, families and communities. In emergencies, the threat of all forms of child abuse and gender-based violence (GBV), including child sexual abuse, is acute and widespread.
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Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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Tax capacity—the policy, institutional, and technical capabilities to collect tax revenue—is part of a deeper process of state building that is essential for achieving the sustainable development goals. This Staff Discussion Note shows that developing countries have made some progress in revenue... mobilization during the past decades, but that much more is needed. It finds that a staggering 9 percentage-point increase in the tax-to-GDP ratio is feasible through a combination of tax system reform and institutional capacity building. Achieving this calls for a holistic and institution-based approach that focuses on improving policy, administration, and legal implementation of core taxes. The note offers practical lessons and guidance, based on IMF capacity-building experience in this area.
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Climate change and variability is affecting maize (Zea mays L.) production in eastern Ethiopia but how farmers perceive the challenge and respond to it is not well documented. A study was conducted to analyze smallholder maize farmers’ perception of climate change/variability and identify their ad...aptation approaches and barriers for adaptation in the eastern highlands of
Ethiopia.
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This threat assessment addresses the implications of the ongoing Marburg virus disease (MVD) outbreak in
Rwanda for the European Union/European Economic Area (EU/EEA). MVD is a severe disease in humans and,
although uncommon, it has the potential to cause epidemics with significant case fatality. ...All recorded MVD
outbreaks to date have originated in Africa. MVD is not an airborne disease and is considered not to be
contagious before symptoms appear. Direct contact with the blood and other body fluids of infected people
and animals or indirect contact with contaminated surfaces and materials like clothing, bedding and medical
equipment is required for transmission. The risk of infection is minimised when proper infection prevention and
control precautions are strictly followed. There is no approved treatment or vaccine for MVD; however, several
pharmaceuticals and candidate MVD vaccines are under investigation.
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Le suivi évaluation des interventions en santé passe par une meilleure lisibilité de l’analyse situationnelle. Une capitalisation du niveau d’atteintes des indicateurs est nécessaire pour traduire la situation sanitaire. Le présent tableau de bord de santé décrit cette situation à traver...s une appréciation objective des performances du système de santé en rapport avec la mise en œuvre des différentes stratégies et politiques telles le Plan national de développement sanitaire (PNDS), la Stratégie de croissance accéléré de développement durable (SCADD), les Objectifs du millénaire pour le développement (OMD) etc.
Son élaboration a requis un processus participatif avec la participation des acteurs du
système de santé notamment les structures centrales, les projets et programmes, les
acteurs du niveau intermédiaire, périphérique avec l’appui technique des partenaires. Audelà du caractère descriptif de la situation sanitaire, il apparait comme un outil de plaidoyer et interpelle sur les efforts à consentir pour une amélioration de l’état de santé des populations. Il comporte six sections que sont (i) les données générales, (ii) les ressources en santé, (iii) la santé de la mère et de l’enfant, (iv) les maladies à potentiel épidémique, (v) les maladies d’intérêt spécial, (vi) l’utilisation des services de santé.
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This paper is Oxfam’s essential guide for WASH staff and partners. It describes the processes and standards that Oxfam WASH programmes should follow if they are to be carried out effectively, consistently and in a way which treats affected communities with respect.
All WASH staff members are expe...cted to understand and follow these Minimum Requirements. However, it is recognised that in acute emergencies it is preferable to start work on the basics immediately, and build up a comprehensive, quality programme in the following days and weeks. There will, therefore, be some programmes in which certain individual requirements are not appropriate or relevant; in such cases staff members responsible should be able to justify why she/he did things differently, or how the minimum requirement was achieved over time.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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La presente guía tiene además como objetivo, ser un respaldo y no una camisa de fuerza para los médicos, pues pretendemos con ella proveer evidencia sólida respecto a los riesgos, beneficios o consecuencias que puede generar la toma de una decisión en pacientes con tuberculosis. Como lo propone... el Ministerio Nacional de Salud en sus normas técnicas, se busca un manejo integral del niño con tuberculosis pulmonar, asegurando la oportunidad, la eficiencia y la calidad de la atención.
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Mental health is critical to personal well-being, interpersonal relationships, and successful contributions to society. Mental health conditions consequently impose a high burden not only on individuals, families and society, but also on economies. In Jamaica, mental health conditions are highly pre...valent and major contributors to morbidity, disability, and premature mortality.
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