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Publication Years
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INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require substantial resources but little consideration has bee
...
n given to which treatments are appropriate for less advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (no
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n-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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The text explains the concept of disaster preparedness and outlines how societies can better prepare for and respond to emergencies. It describes key components such as risk assessment, planning, resource
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management, warning systems, and training, emphasizing that effective preparedness requires coordination between institutions, communities, and individuals. The text also highlights the importance of early warning systems, showing that not only technical accuracy but also clear communication and community response are crucial. Overall, it argues that disaster preparedness is an ongoing process that combines planning, capacity building, and practical measures to reduce risks and improve emergency response.
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Vol. 2: Clinicians' Guide
Clinicians’ Guide is designed to assist busy medical practitioners in the field with patient management by providing current, essential, practical guidance and background, packaged into a single ... resource more
Clinicians’ Guide is designed to assist busy medical practitioners in the field with patient management by providing current, essential, practical guidance and background, packaged into a single ... resource more
The clinical guidelines and protocols for the practice of emergency medicine presented in this document are designed to be a useful resource not only for those wishing to become emergency medicine specialists, but also for general practitioners and
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other healthcare providers tasked with caring for patients in hospital emergency departments. Healthcare providers using this Emergency Medicine Clinical Guideline (EMCG) are provided with fundamental concepts and principles essential to emergency medicine and the management of patients with undifferentiated emergency conditions.
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Version 1.1. The WHO protocol has been adapted to resource-limited settings and builds on existing methodologies from the European Centre for Disease Prevention and Control (ECDC), the Global PPS project from University of Antwerp, the US Centers fo
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r Disease Control and Prevention (CDC), and the Medicines Utilisation Research in Africa (MURIA).
Point Prevalence Surveys collects information on prescribing practices of antibiotics and other information relevant to treatment and management of infectious diseases in hospitalized patients, and complements surveillance of antimicrobial consumption.
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Accessed on 03.03.2020
The country recognizes the importance of family planning as they focus on achieving a demographic dividend. In order to improve the service delivery and supply chain, Senegal is strengthening its data management and reporting
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. Domestic resource mobilization for family planning remains a key challenges for Senegal.
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This page describes ten immediate water, sanitation and hygiene (WASH) actions that low-resource healthcare facilities can undertake with limited budget in the near-term (0-3 months) to prepare for and address COVID-19. On the second page, WHO and U
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NICEF have provided input on how to best adapt their Eight Practical Steps in the midst of COVID-19. Finally, we have compiled resources for action. While some activities may be temporary stopgaps, the goal is to provide incremental improvements that can be sustained and built upon after the outbreak subsides. In particular, the proper management of WASH will be critical to protect healthcare workers and prevent infections.
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The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate manageme
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nt of diabetes into primary health care. It will serve as basis for development of simple algorithms for use by health care staff in primary care in low-resource settings, to reduce the risk of acute and chronic complications of diabetes. The guideline was developed by a group of external and WHO experts, following the WHO process of guideline development. GRADE methodology was used to assess the quality of evidence and decide the strength of the recommendations.
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The document, titled "Prevention and Control of Noncommunicable Diseases: Guidelines for Primary Health Care in Low-Resource Settings," provides the World Health Organization's (WHO) recommendations for managing noncommunicable diseases (NCDs) such
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as cancer, heart disease, diabetes, and chronic respiratory illnesses in low-resource healthcare settings. It outlines cost-effective interventions for early diagnosis, treatment, and prevention within primary healthcare, focusing on accessible methods for diabetes management, blood pressure control, dietary and lifestyle guidance, and essential medication use. The guidelines aim to support healthcare professionals in delivering effective NCD care where resources are limited, ultimately improving health outcomes and reducing NCD complications.
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The document, titled "Prevention and Control of Noncommunicable Diseases: Guidelines for Primary Health Care in Low-Resource Settings," provides the World Health Organization's (WHO) recommendations for managing noncommunicable diseases (NCDs) such
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as cancer, heart disease, diabetes, and chronic respiratory illnesses in low-resource healthcare settings. It outlines cost-effective interventions for early diagnosis, treatment, and prevention within primary healthcare, focusing on accessible methods for diabetes management, blood pressure control, dietary and lifestyle guidance, and essential medication use. The guidelines aim to support healthcare professionals in delivering effective NCD care where resources are limited, ultimately improving health outcomes and reducing NCD complications.
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The document “Hospital Preparedness for Epidemics” published by the World Health Organization (WHO) provides guidance on how hospitals and healthcare facilities can prepare for and respond effectively to infectious disease outbreaks. It outlines key components of epidemic preparedness, including
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planning and management structures, infection prevention and control, communication systems, human resource management, logistics, laboratory capacity, and the continuity of essential health services. The guide emphasizes the importance of coordination within hospitals and with public health authorities, as well as training staff and ensuring adequate supplies and infrastructure. Overall, the document serves as a practical framework to help hospitals strengthen their readiness, maintain critical healthcare services, and respond efficiently during epidemics or other health emergencies.
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Chinese Medicine, (2016) 11:37
Medicinal plants are globally valuable sources of herbal products, and they are disappearing at a high speed. This article reviews global trends, developments and prospects for the strategies and methodologies concerning the conservation and sustainable use of me ... dicinal plant resources to provide a reliable reference for the conservation and sustainable use of medicinal plants. We emphasized that both conservation strategies (e.g. in situ and ex situ conservation and cultivation practices) and resource management (e.g. good agricultural practices and sustainable use solutions) should be adequately taken into account for the sustainable use of medicinal plant resources. We recommend that biotechnical approaches (e.g. tissue culture, micropropagation, synthetic seed technology, and molecular marker-based approaches) should be applied to improve yield and modify the potency of medicinal plants.
https://doi.org/10.1186/s13020-016-0108-7 more
Medicinal plants are globally valuable sources of herbal products, and they are disappearing at a high speed. This article reviews global trends, developments and prospects for the strategies and methodologies concerning the conservation and sustainable use of me ... dicinal plant resources to provide a reliable reference for the conservation and sustainable use of medicinal plants. We emphasized that both conservation strategies (e.g. in situ and ex situ conservation and cultivation practices) and resource management (e.g. good agricultural practices and sustainable use solutions) should be adequately taken into account for the sustainable use of medicinal plant resources. We recommend that biotechnical approaches (e.g. tissue culture, micropropagation, synthetic seed technology, and molecular marker-based approaches) should be applied to improve yield and modify the potency of medicinal plants.
https://doi.org/10.1186/s13020-016-0108-7 more
The paper “Artificial Intelligence for Public Health Surveillance in Africa: Applications and Opportunities” examines how artificial intelligence (AI) can improve public health systems across Africa, particularly in low-resource settings. It exp
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lores how machine learning and other AI techniques are being used for disease detection, outbreak prediction, real-time surveillance, and health resource management.
The authors focus on major public health challenges such as HIV, cholera, Ebola, measles, tuberculosis, malaria, COVID-19, and mental health. Through numerous case studies, the paper shows that AI can enhance the accuracy and speed of disease detection, predict outbreaks more effectively than traditional methods, support vaccination strategies, and optimize healthcare resource allocation. At the same time, it discusses important barriers to implementation, including limited data quality, infrastructure constraints, ethical concerns, and shortages of technical expertise.
Overall, the paper highlights AI’s strong potential to strengthen disease surveillance and health outcomes in Africa while emphasizing the need for careful integration, improved data systems, and supportive policy frameworks.
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R4D conducted a thorough desk review and qualitative fiscal space analysis, 19 interviews about financing for the three diseases and the extent of alignment between public financial management systems and health policy objectives, and a validation w
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orkshop with government officials.
Tanzania’s disease response faces a triple transition challenge: replacing donor funding, closing the resource gap that would exist even with donor funding, and more efficiently delivering on disease response objectives. more
Tanzania’s disease response faces a triple transition challenge: replacing donor funding, closing the resource gap that would exist even with donor funding, and more efficiently delivering on disease response objectives. more
Infectious disease outbreaks and epidemics are increasing in frequency, scale and impact. Health care facilities can amplify the transmission of emerging infectious diseases or multidrug-resistant organisms (MDRO) within their settings and communities. Therefore, evidence-based infection prevention
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and control (IPC) measures in health care facilities are critical for preventing and containing outbreaks, while still delivering safe, effective and quality health care. This toolkit is intended to support IPC improvements for outbreak management in all such facilities, both public and private throughout the health system. Specifically, this document systematically describes a framework of overarching principles to approach the preparedness, readiness and response outbreak management phases. The document also provides a toolkit of resource links to guide specific actions for each infectious disease and/or MDRO outbreak management phase at any health facility. This document is specifically tailored to an audience of stakeholders who establish and monitor health care facility-level IPC programs including: IPC focal points, epidemiologists, public health experts, outbreak response incident managers, facility-level IPC committee(s), safety and quality leads and managers, and other facility level IPC stakeholders.
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The document is a comprehensive practical guide for managing cholera epidemics. It includes detailed instructions on outbreak investigation, control measures, case management, and the organization of treatment facilities. It emphasizes strategies su
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ch as rehydration therapy, water sanitation, hygiene promotion, and vaccination to prevent the spread of cholera. The guide serves as a resource for healthcare professionals, logisticians, and public health officials to respond effectively to cholera outbreaks.
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Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in fa
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ilure to provide adequate, accessible and quality maternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
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UNFPA supports the Youth Health Line (YHL), launched in 2012, as a nationwide, youth friendly health service to provide information and counseling for adolescents and youth on issues related to their health and reproductive health. The YHL is providing a vital service to young people around the coun
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try who are dialing the toll-free number ‘120’ from any phone to speak to a professionally trained youth health counselor. These conversations are confidential, free of judgment, and do not require parental consent. The average reach of the YHL per year is 120,000 adolescents and youth served by full-time male and female counselors.
This Standard Operating Procedure for YHL provides a critical resource for the administration and day-to-day management. The SOP is designed to provide direction to all staff responsible for carrying out the administrative and managerial functions of the YHL. The SOP is intended to guide UNFPA Implementing Partners in running the YHL with a consistent approach to ensure improved access and quality of services provided to adolescents and youth in Afghanistan.
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Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to phar
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macopeia unopened insulin vials must be stored in a refrigerator (2–8°C), while storage at ambient temperature (25–30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2–8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four–week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
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