Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytolo...gy, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a ‘screen-and-treat’ approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. This guideline provides recommendations for strategies for a screen-and-treat programme
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Successful detonation of an improvised nuclear device (IND) would be a catastrophic event, causing an unprecedented number of injuries and lives lost, as well as economic, political, and social disruption. However, an effective medical response and an infrastructure prepared to protect itself from f...allout could save tens of thousands of lives. Since 2001, all levels of government, academic institutions, and professional organizations have done significant work to enhance our ability to prepare for and respond to a nuclear detonation. The following manual is intended to simplify and translate the necessary protective actions and medical response modalities in order to make them more accessible and easier to translate into practice. The approach of this manual is to provide a common baseline application for various allied response disciplines (to include senior operational responders, emergency managers, public health advisors, and municipal, State, and Federal executives and elected officials). This manual will enhance mutual understanding of the basics of nuclear response.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub...erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society a...pproach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
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For IST to be effective there is need for utilization of multiple techniques that will lead to transfer of competences (Bluestone et al. 2013). Learning settings should be selected to support relevant and realistic practice so as to increase the efficiency of IST. Alternatives to hotels such as trai...ning institutions and hospitals are viable options for reducing costs of IST as well as being appropriate venues (MOH 2012). There is documented evidence of involvement of academic institutions in providing health leadership capacity building through IST in other countries; for example, in Uganda, IST in leadership for doctors and nurses was done through a blended approach that included didactic and online sessions (Nakanjako et al. 2015). Adapting these concepts, FUNZOKenya piloted eight regional hubs, each serving a cluster of counties, which would train health workers for five years (2012-2016) on priority service delivery topics
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The community based programme aims to address the psychosocial needs of children and youth through helping to rebuild peaceful child- and youth-friendly communities through the use of cultural, creative, recreational, sportive and social activities. Within War Child, the community-based approach is ...relatively new and Sierra Leone was the first self-implementing War Child Programme Area (WPA) applying this approach.
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Guidance module.
The QualityRights training and orientation modules have been developed to enhance the knowledge, skills and understanding of key stakeholders on how to promote the rights of people with psychosocial, intellectual or cognitive disabilities, improve the quality of services and suppo...rt provided in the field of mental health and related areas, in line with international human rights standards, in particular the UN Convention on the Rights of Persons with Disabilities and the recovery approach.
mental health and related fields, in accordance with international human rights standards, in particular the UN Convention on the Rights of Persons with Disabilities and the recovery approach.
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The purpose of this handbook is to bring together in summarized form the issues, recommended strategies and political measures involved in addressing each of the components of the STOP TB Strategy. It outlines the range of activities to be addressed by national TB control programmes and the recommen...ded approaches to implementation of the Strategy. An adequate strategy for the control of TB globally requires a comprehensive approach to address all the main constraints to control the disease, including emerging challenges, in addition to the main factors influencing the TB incidence such as socioeconomic and environmental factors.
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Training Manual
Building on earlier EngenderHealth work in counseling, Counseling for Effective Use of Family Planning responds to an identified gap in existing materials and fills the needs expressed by those in the field. The intended audiences for this curriculum are health care providers, their... supervisors, and the managers of the programs in which they work. The counseling skills addressed here are expected to be relevant to the provision of both preventive and curative health services through the workshop participants’ national health systems. Finally, the curriculum’s participatory approach to defining terms and to generating profiles of potential clients is designed to assist trainees in addressing the realities and exploring the reproductive health priorities of their communities in a culturally appropriate manner.
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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This Practice Parameter reviews the evidence from research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder since the previous Parameter was published in 1998. It highlights the importance of early identification of posttrau...matic stress disorder, the importance of gathering information from parents and children, and the assessment and treatment of comorbid disorders. It presents evidence to support trauma-focused psychotherapy, medications, and a combination of interventions in a multimodal approach.
Journal of the American Academy of Children & Adolescents Psychiatry, Vol. 49 No. 4 APRIL 2010 pp.414-430
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The Comprehensive Rural Health Project, Jamkhed (CRHP), has been working among the rural poor and marginalized for the past 45 years. Founded in 1970 by Drs. Raj and Mabelle Arole to bring healthcare to the poorest of the poor, CRHP has become an organization that empowers people and communities to ...eliminate injustices through integrated efforts in health and development. CRHP works by mobilizing and building the capacity of communities to achieve access to comprehensive development and freedom from stigma, poverty, and disease. Pioneering a comprehensive approach to community-based primary healthcare (also known as the Jamkhed Model), CRHP has been a leader in public health and development in rural communities in India and around the world. At the core of this comprehensive community-based approach is its embrace of equity for all, utilizing healthcare as a means to break the cycle of poverty. The work of CRHP has been recognized by the WHO and UNICEF, and has been introduced to communities around the world.
accessed 23.07.2021
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The study on single-dose cholera vaccine in Zambia evaluates the effectiveness of using a single dose of the oral cholera vaccine (OCV) during a 2016 outbreak in Lusaka. Due to limited vaccine supply, authorities opted for a one-dose emergency campaign instead of the usual two-dose regimen. A matche...d case-control study was conducted to assess vaccine effectiveness, showing 88.9% short-term protection against cholera. The findings suggest that a single-dose approach can be an effective strategy in outbreak settings, especially when vaccine supplies are constrained. However, further research is needed to determine long-term immunity and effectiveness in young children.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im...munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
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Les modules de formation et d’orientation QualityRights ont été élaborés pour renforcer les connaissances, les compétences et la compréhension des principales parties prenantes sur la manière de promouvoir les droits des personnes en situation de handicap psychosocial, intellectuel ou cogni...tif, d'améliorer la qualité des services et des aides fournis dans le domaine de
la santé mentale et dans les domaines connexes, conformément aux normes internationales en matière de droits de l'homme, et en particulier la Convention des Nations unies relative aux droits des personnes handicapées et l'approche du rétablissement.
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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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Recovery partnership preparation package: Building capacity to reactivate safe essential health services and sustain health service resilience.
In the aftermath of an emergency, the recovery partnership preparation package supports the establishment and implementation of institutional health partne...rships, or ‘twinning partnerships’. These partnerships focus on shared learning and improvement in the services that are being delivered. The Twinning Partnerships for Improvement (TPI) approach supports capacity-building, the re-establishment of safe essential health services and encourages joint long term efforts on service delivery strengthening
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The Global Sexual and Reproductive Health Service Package for Men and Adolescent Boys has been developed to support providers of sexual and reproductive health (SRH) services to increase the range and quality of services to meet the specific and diverse needs of men and adolescent boys. This package... focuses specifically on the provision of such services integrated
within clinical and non-clinical contexts and follows a gender-transformative approach. It covers men and adolescent boys in all their diversity and takes a positive approach to SRH, seeing this not just as the absence of disease, but the positive expression of one’s gender, sex and sexuality. In doing so, this service package contributes to efforts to ensure universal access to sexual and reproductive health and rights (SRHR) as prioritized in the Sustainable Development Goals. This package is in no way intended to detract from the sexual and reproductive health and rights of women and adolescent girls, nor to divert resources, funding or attention from much-needed SRH services and programmes for women and adolescent girls.
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BMJ Global Health2020;5:e002914. doi:10.1136/bmjgh-2020-002914
The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and in...fluenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider lessons for COVID-19. We show how models detach from their implementation contexts through their connections with global narratives of pandemic response, and how sociological and anthropological research can help to locate models differently. This potentiates multiple models of pandemic response attuned to their emerging situations in an iterative and adaptive science. We propose a more open approach to the modelling of pandemics which envisages the model as an intervention of deliberation in situations of evolving uncertainty. This challenges the ‘business-as-usual’ of evidence-based approaches in global health by accentuating all science, within and beyond pandemics, as ‘emergent’ and ‘adaptive’.
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Antimicrobial resistance (AMR) is a threat to global health and development and it contributes to millions of deaths worldwide each year. Inappropriate use and overuse of antibiotics are driving an increase in AMR and have a detrimental impact on the effectiveness of these critical medicines. Throug...h the Global Action Plan on AMR, WHO is working to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
There is a recognized need for high-quality resources to improve antibiotic prescribing globally. To address this need, a pragmatic approach was taken by WHO to develop actionable guidance for empiric antibiotic use.
The WHO AWaRe (Access, Watch, Reserve) antibiotic book provides concise, evidence-based guidance on the choice of antibiotic, dose, route of administration, and duration of treatment for more than 30 of the most common clinical infections in children and adults in both primary health care and hospital settings. The information included in the book supports the recommendations for antibiotics listed on the WHO Model Lists of Essential Medicines and Essential Medicines Children and the WHO AWaRe classification of antibiotics.
The WHO AWaRe antibiotic book is accompanied by summary infographics for each infection for both adults and children that provide a quick-reference guide for health care workers at the point of care.
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