BMC Infectious Diseases 2012, 12:352/1471-2334/12/352
Known avoidable environmental risks to health cause at least 12.6 million deaths every year, and account for about one quarter of the global burden of disease (2016 data) (1). Air pollution alone causes about 7 million
deaths a year, placing it among the top global risks to health (2). Global envir...onmental challenges are on the rise, including climate change, rapid urbanization and increased resistance to drugs.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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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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Implementation guide for national, district and facility levels.
This implementation guide contains practical guidance for policy-makers,
programme managers, health practitioners and other actors working to
establish and implement quality of care (QoC) programmes for maternal,
newborn and child ...health (MNCH) at national, district and facility levels.
It is intended to help anyone, throughout the health system, who wants
to take action to improve the QoC for MNCH.
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Guidelines
June 2017
HIV strategic information for impact
Republic of The Gambia; Accessed on 31.01.2019
Le présent document expose des recommandations exhaustives de l’OMS sur les soins prénatals systématiques à l’intention des femmes enceintes et des adolescentes. Le but de ces recommandations est de compléter les directives de l’OMS existantes sur la prise en charge des complications spé...cifiques associées à la grossesse. Elles sont destinées à refléter et à répondre à la nature complexe des problèmes entourant la pratique et la délivrance des soins prénatals et à donner la priorité à la santé et au bien-être de la personne – et pas seulement à la prévention de la mortalité et de la morbidité – selon une démarche visant le respect des droits de l’homme.
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Children in every country are struggling with the impact of COVID-19. An entire generation has had its education disrupted, from nurseries and pre-primaries to universities and apprenticeships
Le présent Plan du SNU en RDC d’appui à la réponse socioéconomique au COVID-19 est adossé au Programme Multisectoriel d’Urgence d’Atténuation des effets de la COVID-19 en RDC, formulé par le Gouvernement, avec le soutien des partenaires au développement. Il est également aligné au Pl...an Cadre des Nations Unies de Coopération au Développement Durable (UNSDCF) et adossé aux cinq piliers du Programme cadre des NU pour la réponse socioéconomique immédiate au COVID-19, développé par UNDG, qui fait référence au rapport du SG des NU intitulé « Solidarité mondiale, responsabilité partagée : impacts socioéconomiques de la COVID-19 ».
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Défis et progrès. ce rapport présente l’information la plus à jour sur l’incidence de la grossesse non planifiée et de l’avortement à Kinshasa (République démocratique du Congo). La publication du Protocole de Maputo au Journal officiel de la nation en 2018 a formalisé l’obligation... du gouvernement d’élargir l’accès à l’avortement médicalisé dans les conditions énoncées au Protocole. Néanmoins, les obstacles à la mise en œuvre continuent de rendre les services d’avortement sécurisé largement inaccessibles. En conséquence, la majorité des femmes de Kinshasa qui choisissent d’interrompre leur grossesse le font-elles dans la clandestinité — souvent dans des conditions non médicalisées potentiellement dangereuses pour leur santé.
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Le Ministère de la Santé et de l’Action sociale a créé une Cellule de Santé Communautaire (CSC) rattachée à la Direction Générale de la Santé pour impulser, organiser et coordonner la santé communautaire. Un document de Politique de santé communautaire a également été élaboré pour... servir de cadre de référence et d’outil de régulation et d’orientation des initiatives communautaires. Un Plan Stratégique National de Santé Communautaire (PSNSC) opérationnalise la Politique de santé communautaire et fixe les priorités du secteur dans les cinq prochaines années (2014 – 2018).
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This report is produced by the UNDAC Team in Lima. It is developed in collaboration with the partners of the National Humanitarian Network (RHN). It covers the period from 27 to 30 March 2017. The next report will be issued around April 3, 2017