Refugee children and adolescents exhibit resilience despite a history of trauma. However, trauma can affect a refugee
child’s emotional and behavioral development. Mental health providers should consider how the refugee experience (e.g.,
exposure to hunger, thirst, and lack of shelter; injury an...d illness; being a witness, victim, or perpetrator of violence; fleeing
your home and country; separating from family; living in a refugee camp; resettling in a new country; and navigating
between the new culture and the culture of origin) may contribute to a child or adolescent’s emotional or behavioral presentation
in a clinic, school, or community setting.
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Maintaining proper storage conditions for health commodities is vital to ensuring their quality. Product expiration dates are based on ideal storage conditions and protecting product quality until their expiration date is important for serving customers and conserving resources. Guidelines for the S...torage of Essential Medicines and Other Health Commodities is a practical reference for those managing or involved in setting up a storeroom or warehouse. The guide contains written directions and clear illustrations on receiving and arranging commodities; special storage conditions; tracking commodities; maintaining the quality of the products; constructing and designing a medical store; waste management; and resources. It was written to meet the needs of district-level facilities; however, the guidelines and information it contains apply to any storage facility, of any size, in any type of environment.
Available in English, French, Spanish and Russian
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Accessed July 4, 2019
Around one in four adults has at least one mental health need at any time, and in the next 20 years the number of British people expected to suffer from dementia will grow by 40 per cent. Even though you might not be working in a setting specifically caring for people with men...tal health conditions, dementia and learning disabilities, it is still important to have some awareness of the signs and symptoms. This will help you to show compassion and care when you observe any behaviour that seems unusual or difficult to understand, and to be aware of the need to consult more experienced staff about behaviours if necessary.
Chapter 5: Introducing practical healthcare
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ecancer, Cardiff University and the African Palliative Care Association have developed an online course in palliative care contextualised for African healthcare professionals. The course has been created through the IAEA Programme of Action for Cancer Therapy, Virtual University of Cancer Control a...nd is available for free through ecancer as well as the VUCCnet online.
Filming and development of the modules took place in the UK and South Africa and involved input from 37 of Africa’s leading palliative care experts as well as Cardiff University’s team. Dr Fiona Rawlinson, who is a consultant in palliative medicine at the Princess of Wales Hospital, UK and the leader of Cardiff University’s team, worked closely with the African Palliative Care Association to ensure the content of the course was appropriate for the sub-Saharan cancer profile and resource setting
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Background: Traumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term
violence. In South Afri...ca, the lifetime prevalence for PTSD in the general population is estimated at 2.3%.
Aim: To examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a community sample of adolescents.
Setting: Low-socioeconomic communities in KwaZulu-Natal.
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The ethical values and behaviors are not only abstract terms, but they are refined and conceptualized byreal-life experiences. The societal context where the actions of humans can be analyzed by ethicaldecision-making is entirely relevant to deliberate on what is the right thing to do and what the m...oralagent should do, since the ethical values and principles response to the actual practices of life and to theneeds of humans in the society. This elaboration takes us to the realm of social ethics.This article reviews the definition and contextual meaning of social ethics at a broader level by givingspecial emphasis to the ethical theories and principles, focusing on the societal and public setting. Ethicswill be deliberated with social and community aspects. Based on the principle of justice and public healthethics, the concept of social ethics has been investigated concisely through the relationship between man,as a moral person, and the society in exemplification of the issues of healthcare ethics. It is argued that thetension between individualism and communitarian needs can be reconciled with the perspective of socialethics by respecting the individual autonomy without disregarding the common good and social justice.By promoting the values of social responsibility, solidarity, and social utility, social ethics has beenproposed as the basis of a rational, moral, egalitarian, pluralistic, democratic society rising on the pillars ofhuman rights and human dignity.
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The RehApp is specifically designed for fieldworkers in low-and middle-income countries and aims to enhance their capacity to work with people with disabilities within the community: assess their abilities and inabilities, design rehabilitation interventions, provide care and support and refer appro...priately. It consists of different chapters – covering various types of impairments – organised according to the International Classification of Functioning, Disability and Health, commonly known as the ICF.
The RehApp is available for free, and once downloaded, it can be used in any setting without internet access. It is currently available in English, French, Nepali, and Portuguese. Several chapters area also available in Amharic, Burmese, Khmer, Spanish, Tajik and Vietnamese. The App is available for Apple and for Android.
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The procurement of essential medicines and other health products is a critical function in support of the effective discharge of WHO’s mandate, and WHO values the importance of the quality of essential medicines and health products that are supplied to countries. The first World Health Assembly in... 1948 recognized the need to establish a procurement service at WHO, and recommended setting up an office “to give advice on the procurement of essential drugs, biological products and other medical supplies”.
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Over the last decade, there have been numerous disasters and major emergencies that have profoundly impacted the lives of millions of people worldwide. To support these crises, national and international emergency medical teams (EMTs) are often deployed to assist disaster affected populations. EMTs ...are teams of healthcare professionals composed most frequently of doctors, nurses, psychologists and others to provide direct clinical care to people affected by disasters and conflicts and to support local health systems. In agreement with the World Health Organization’s (WHO) Global Health Emergency Health Workforce programme, any health professional coming from another country to practice health care in a disaster setting must be part of a team that is qualified, trained, equipped, resourced, and meets minimum acceptable standards to practice.
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Heart failure (HF) is a leading global public health problem with >64 million prevalent cases globally. Patients with HF with reduced ejection fraction (HFrEF) from low- and middle-income countries experience a 22% to 58% higher 1-year mortality rate than those in high-income countries.1 Guideline-d...irected medical therapy (GDMT) consisting of ACE (angiotensin-converting enzyme) inhibitors or ARB (angiotensin receptor blockers) or ARNI (angiotensin receptor-neprilysin inhibitors), β-blockers, MRA (mineralocorticoid receptor antagonists), and SGLT2 (sodium-glucose cotransporter 2) inhibitors substantially reduces mortality among patients with HFrEF. These medicines are among the most cost-effective interventions and are thus included as the highest priority health system interventions recommended by the Disease Control Priorities Project.2 Despite this high-quality evidence, GDMT remains widely underutilized in low- and middle-income countries resulting in widespread undertreatment of patients with HFrEF due to health system-, provider-, and patient-level barriers.1 National essential medicines lists (EMLs) promoted by the World Health Organization (WHO) guide countries on which medications to purchase in the setting of limited resources and have resulted in higher procurement and availability of essential medicines in the public sector.3 We provide a cross-sectional analysis of national EMLs in 53 low- and middle-income countries, and availability, price, and affordability of GDMT in select countries to identify potential barriers to access to these essential medicines for patients with HFrEF.
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Diabetic foot ulcers are a complication affecting approximately 15% of the total population with diabetes mellitus. There are three and half million diabetic patients in Saudi Arabia alone. Aim: to determine capacity building for nurses’ knowledge and practice regarding prevention of diabetic foot... complications. Research Questions: 1. Does the nurse’s knowledge prevent diabetic foot ulcer and other foot complications? 2. Does the high practice of the nurses during foot screening can prevent diabetic foot ulcer in primary health care centers in Saudi Arabia? Design: Descriptive, research designs have been utilized. Setting: Chronic disease clinic in primary health care centers in Jeddah city. Subjects: a purposive sample of 30 nurses and convenience sample of 30 patients. Tools: A. Diabetic foot ulcer Structured interview questionnaire to assess nurse’s knowledge regarding diabetes mellitus and diabetic foot. B. Health status assessment questionnaire to assess health history status of diabetic client. C. An observational checklist to assess the nurse practice once during diabetic foot screening. Results: Significant increase in nurse's knowledge had been observed, while the majority of them had poor practice in relation to foot screening. Whereas complicated diabetic patients represent 35.7% of diabetic patients have neuropathy. Moreover, only 7.1% have neuropathy and diabetic ketoacidosis. Also there was a significant moderate positive correlation between the overall score of nurse’s knowledge and the overall score of the practice regarding diabetic foot complications. Conclusions: Proper foot care, early recognition and management of risk factors prevent foot ulcer. Recommendations: Developing a structured training educational program for nurses dealing patients with diabetic foot disorders.
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Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The
Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and
communicating) to allow collection of co...mparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi.
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Many people have questions about the new coronavirus disease 2019 (COVID-19) vaccines. As vaccine recipients’ most-trusted source of information on vaccines, you play a critical role in helping them understand the importance of COVID-19 vaccination, as well as if and when it is likely to be recomm...ended for them.
The materials include proven communication strategies and tips for effectively setting expectations and addressing questions from COVID-19 vaccine recipients.
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S Afr Med J 2018;108(7):546-550. DOI:10.7196/SAMJ.2018.v108i7.13149
Antimicrobial stewardship programmes have been introduced worldwide in response to the rise in antimicrobial resistance. The World Health Organization has mandated each Member State to produce a plan to address this problem. We rep...ort on the organic development of an antibiotic stewardship programme in a rural regional hospital in a resource-limited setting in South Africa. This has resulted in organisational change with increased awareness, participation, monitoring and education in antibiotic stewardship throughout the hospital
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Learn the ETAT+ guidelines on how to resuscitate a newborn baby who is born not breathing in this exciting 3D simulation training app. Navigate around a virtual reality hospital, find the equipment you need and quiz yourself with interactive quizzes, multiple-choice questions (MCQs) and perform simu...lated procedures.
In this simulated scenario, you are faced with a baby who is born not breathing and have to use your clinical skills to follow the ETAT + guidelines and save the baby's life. You are working against the clock and must select the correct medical equipment and carry out the key life-saving steps needed.
ETAT + guidelines for the management of paediatric emergencies are currently used for training healthcare professionals in Kenya, Uganda, Rwanda, Zimbabwe, Zambia, Malawi, Tanzania, Sierra Leone and Myanmar and are supported by the UK's Royal College of Paediatrics and Child Health.
LIFE (Life-saving Instruction for Emergencies) is a new smartphone and virtual reality (VR) medical simulation training platform for teaching healthcare workers in Africa and low-resource settings how to save lives using a fun and challenging 3D game. LIFE allows nurses, doctors, medical students, trainees and healthcare workers who want to learn key resus skills on their own smartphones, to enter a realistic 3D hospital environment using the latest game-engine technology to try out their skills on simulated patients.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over... 134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. Good control of blood sugar blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India
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Despite the increasing population of refugees stuck in protracted situations and our awareness of the vulnerability of children and adolescents growing in up these contexts, relatively little is known about community based child protection mechanisms (CBCPMs) in refugee communities. CBCPMs, defined ...broadly, include all groups or networks that respond to and prevent problems of child protection and vulnerable children. These mechanisms may include family supports, peer group supports, and community groups such as primary and secondary schools, non-formal education and vocational training structures, women’s groups, religious groups, and youth groups, as well as traditional community processes, government mechanisms, and mechanisms initiated by international or domestic non-governmental organisations (NGOs). In diverse contexts, CBCPMs represent front-line, day-to-day efforts to protect children from exploitation, abuse, violence, and neglect and to promote children’s well being. This study, together with a parallel study conducted among the urban refugee population in Uganda, is the first study of CBCPMs undertaken in refugee settings.
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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant ...asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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