Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric...a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
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Countries are making progress toward the global goal of 95% of people living with HIV knowing their status by 2025. However, considerable gaps remain in achieving these goals globally. Men in high HIV burden settings and men from key populations in all settings are consistently less likely to know t...heir HIV status than women. Globally, 78% of men ages 15 years and older who are living with HIV are aware of their HIV status, compared with 86% of women with HIV of these ages.
Offering HIV testing services, including HIV self-testing, at formal and informal workplaces has emerged as an effective, acceptable and feasible approach for reaching men. A 2018 World Health Organization (WHO) and International Labour Organization (ILO) policy brief provides key guiding principles for HIVST implementation at workplaces. Building on the 2018 policy brief, this brief captures early experience with HIVST implementation at workplaces and discusses emerging approaches of sustainable financing that can be adapted for HIV self-testing at workplaces.
The primary audiences for this policy brief are ministries of health and labour, national HIV programmes, employers’ organizations, workers’ organizations (labour unions), enterprises, implementing partners, including civil society organizations, and health insurance agencies.
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short information/patient handout on coronary heart disease, on this homepage available in:
arabic, english, german, french, russian, spanish & turkish
ext. Homepage, accessed 2018/04/16
Devant le nombre grandissant de personnes diagnostiquées d’un cancer et de décès qui y sont associés, les soins palliatifs gagnent en importance pour améliorer la qualité de vie et soutenir la personne et sa famille durant leurs expériences de santé. Dans ce contexte, l’intégration pré...coce des soins palliatifs aux soins oncologiques standards semble être une approche sous-utilisée et novatrice qui pourrait répondre aux besoins spécifiques de la clientèle oncologique palliative. Les infirmières en oncologie doivent assumer un rôle crucial en dispensant des soins tout au long de la trajectoire de la maladie, soins palliatifs compris. Le but de cette revue rapide est de synthétiser et présenter les avantages des interventions de soins palliatifs précoces et de décrire leurs caractéristiques. La recherche documentaire sur CINAHL et PubMed a fait ressortir cinq essais randomisés réalisés entre 2010 et 2018, qui ont été analysés. La majorité des études sélectionnées ont conclu que l’intégration précoce des soins palliatifs aux soins oncologiques standards, tels que la chimiothérapie et la radiothérapie, permettrait d’améliorer la qualité de vie, les symptômes anxiodépressifs et la survie globale. Mots-clés : soins palliatifs, soins palliatifs précoces, intervention, cancer, oncologie
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Debido a la actual crisis socio-económica, política y de derechos humanos en Venezuela, cerca de 4.5 millones de personas han salido de su país; convirtiéndose en la segunda peor crisis migratoria del mundo, después de Siria. Se estima que más del 20% de los refugiados y migrantes son niños y... adolescentes. Cerca del 57% de los venezolanos en el exterior se encuentran en Ecuador, Colombia y Perú, según Naciones Unidas.
En 2018, Plan International decidió implementar una estrategia regional en Colombia, Ecuador y Perú para mejorar las condiciones de vida de los refugiados y migrantes venezolanos, durante sus etapas de tránsito y asentamiento.
Durante los meses de junio y julio de 2019, el equipo de la oficina regional visitó más de siete ciudades entre Colombia, Ecuador y Perú para escuchar los testimonios de los refugiados y migrantes, así como para analizar sus necesidades en materia de mecanismos de protección, prevención de la violencia y salud sexual y reproductiva.
El presente documento refleja algunas de las situaciones de riesgo y violencia a las que millones de venezolanos se enfrentan cada día, desde los testimonios y experiencias de 17 refugiados y migrantes.
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In early 2015, the Americas region began to experience a surge in migration flows due in large part to the rise of people emigrating from Venezuela in response to the country’s faltering economy. This swell in migration continued in the years following, as the number of Venezuelans living in Latin... American countries rose from an estimated 700,000 in 2015 to over 3 million by late 2018.1 As of June 2019, an estimated 4.3 million Venezuelan’s have left the country since 2015
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In this paper they make estimates of the potential short-term economic impact of COVID-19 on global monetary poverty through contractions in per capita household income or consumption.
The estimates are based on three scenarios: low, medium, and high global contractions of 5, 10, and 20 per cent;... we calculate the impact of each of these scenarios on the poverty headcount using the international poverty lines of US$1.90, US$3.20 and US$5.50 per day.
The estimates show that COVID poses a real challenge to the UN Sustainable Development Goal of ending poverty by 2030 because global poverty could increase for the first time since 1990 and, depending on the poverty line, such increase could represent a reversal of approximately a decade in the world’s progress in reducing poverty.
In some regions the adverse impacts could result in poverty levels similar to those recorded 30 years ago. Under the most extreme scenario of a 20 per cent income or consumption contraction, the number of people living in poverty could increase by 420–580 million, relative to the latest official recorded figures for 2018.
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EU Policies Contribute to Abuse of Migrants in Libya
This report documents severe overcrowding, unsanitary conditions, malnutrition, and lack of adequate health care. Human Rights Watch found violent abuse by guards in four official detention centers in western Libya, including beatings and whippin...gs. Human Rights Watch witnessed large numbers of children, including newborns, detained in grossly unsuitable conditions in three out of the four detention centers. Almost 20 percent of those who reached Europe by sea from Libya in 2018 were children.
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A Estrutura de Vigilância Baseada em Eventos deve ser usada por autoridades e agências responsáveis
pela vigilância e resposta. Essa estrutura serve como um esboço para orientar as partes interessadas
em implementar a vigilância baseada em eventos (EBS) usando uma abordagem multissetorial ...de One
Health. Para esse fim, o documento é organizado em capítulos e anexos interligados que podem ser
modificados e adaptados, conforme necessário, pelos usuários.
Esta é uma versão revisada da “Estrutura para Vigilância Baseada em Eventos” original, publicada em
2018. Essa estrutura não substitui nenhum outro material disponível do EBS, mas se baseia em
documentos relevantes ou relacionados existentes e serve como um guia prático para a
implementação do EBS na África. Essa estrutura está alinhada com a terceira edição da Avaliação
Externa Conjunta da OMS para os seguintes indicadores: sistemas de vigilância de alerta precoce
fortalecidos que são capazes de detectar eventos importantes para a saúde pública e a segurança da
saúde (Indicador D2.1); melhor comunicação e colaboração entre os setores e entre os níveis de
autoridade de resposta à saúde pública nacional, intermediário e local em relação à vigilância de
eventos importantes para a saúde pública (Indicador D2.2); e melhor capacidade nacional e
intermediária de analisar dados ( Indicador D2.3). À medida que os países começarem a implementar
e demonstrar a funcionalidade do EBS, eles garantirão um aumento nas pontuações do JEE e
progredirão no cumprimento dos requisitos descritos no IHR 3F.
.
Além disso, nos Estados Membros da União Africana que adotaram a estratégia Integrada de
Vigilância e Resposta a Doenças (IDSR), este documento é um complemento e pode aprimorar a
implementação do IDSR, especialmente para a 3ª edição (2019), que inclui componentes
relacionados ao EBS.
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Esta publicación presenta la Agenda para las Américas sobre salud, medioambiente y cambio climático 2021-2030. Esta agenda es un llamamiento al sector de la salud para que lidere la labor a fin de abordar los determinantes ambientales de la salud en la Región de las Américas. La Organización P...anamericana de la Salud (OPS) colaborará con sus Estados Miembros para alcanzar el propósito y el objetivo de esta agenda de promover el bienestar de todos a todas las edades, utilizando un enfoque sostenible y equitativo en el que se otorgue prioridad a la reducción de las inequidades en la salud. La agenda se ha elaborado bajo la égida de la Estrategia mundial de la OMS sobre salud, medio ambiente y cambio climático, y se basa en los compromisos establecidos en la Agenda de Salud Sostenible para las Américas 2018-2030 y el Plan Estratégico de la OPS 2020-2025. La agenda se elaboró en consulta con el grupo técnico asesor y mediante un proceso de toma de decisiones basado en el consenso con los Estados Miembros durante el período 2019-2020. Con la finalidad de alcanzar el Objetivo de Desarrollo Sostenible 3, la agenda se centra en: mejorar el desempeño de los programas e instituciones de salud pública ambiental; fomentar sistemas de salud sostenibles y resilientes desde el punto de vista medioambiental; y promover ciudades y comunidades saludables y resilientes desde el punto de vista medioambiental. Su aplicación será específica para cada contexto y se basará en las necesidades y realidades de los diversos países. Beneficiará a los países y territorios al promover prácticas de buena gobernanza, fortalecer el liderazgo y la coordinación en el sector de la salud, fomentar la acción intersectorial, centrarse en la prevención primaria, y mejorar la evidencia disponible y la comunicación. Facilitará el acceso a los recursos humanos, técnicos y financieros necesarios para abordar los determinantes ambientales de la salud y garantizará que la Región se involucre plenamente en los procesos y acuerdos mundiales sobre salud, medioambiente y cambio climático.
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Terceira Edição. A terceira edição do manual sobre intervenção de rotação tarsal bilamelar para o tratamento do entrópio devido à triquíase tracomatosa, publicado pela Organização Mundial da Saúde (OMS), apresenta várias atualizações e melhorias. Desde sua primeira edição em 1993... e a segunda em 2015, esta nova versão amplia o conteúdo inicial, incorpora avanços acordados na quarta Reunião Científica Mundial sobre Tracoma em 2018 e melhora significativamente a estrutura e apresentação do manual. Descrições detalhadas sobre o exame do entrópio foram adicionadas, listas de instrumentos cirúrgicos necessários foram otimizadas e orientações sobre cuidados pós-operatórios foram aprimoradas
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This publication describes the history of malaria in Uzbekistan. It evaluates the policies and strategies applied after the re-establishment of local transmission to contain malaria outbreaks in the 1990s and early 2000s, and highlights the interventions subsequently used to eliminate malaria in the... country. Uzbekistan was officially certified by WHO as a malaria-free country in 2018. Lessons for countries embarking upon elimination are distilled. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
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La enfermedad de Chagas, también llamada tripanosomiasis americana, sigue siendo endémica en 21 países de América Latina. Sin embargo, como consecuencia de las migraciones, la urbanización, la intensificación del turismo, la modificación de las estrategias agrícolas y el cambio climático, l...a enfermedad ha traspasado el marco rural y el ámbito latinoamericano que le dieron identidad durante decenios, y ha logrado instalarse en la periferia de las ciudades del área endémica y en países de América del Norte, Europa, Asia y Oceanía y transformarse en un problema de salud pública global. Teniendo en cuenta que el Chagas afecta a poblaciones en situación de pobreza en las que produce graves consecuencias para la salud y la economía de las personas infectadas, y que los recursos orientados a fomentar el desarrollo de proyectos de investigación, estrategias de control y planes de atención médica a los pacientes detectados son escasos, la Organización Mundial de la Salud (OMS) incorporó esta enfermedad al grupo de enfermedades infecciosas desatendidas (EID) en el año 2005. Se reconoce actualmente la naturaleza multidimensional de la enfermedad de Chagas, cuya caracterización contempla una intrincada trama de aspectos socioculturales, políticos, biológicos, ambientales y sanitarios. Parte sustancial de todo ello radica en el carácter zoonótico de la endemia y la consiguiente imposibilidad de su erradicación. Por ende, resulta muy complicada la construcción de la ruta crítica para enfrentar esta enfermedad, con la aspiración o el objetivo de su eliminación como problema de salud pública. El propósito de esta guía es ofrecer a los Estados Miembros un instrumento que permita actualizar y estandarizar los procesos de evaluación del control, verificación de la interrupción de la transmisión, y validación de la eliminación de la enfermedad de Chagas como problema de salud pública, en consonancia con: a) la Estrategia y plan de acción para la prevención, el control y la atención de la enfermedad de Chagas; b) el Plan de acción para la eliminación de las enfermedades infecciosas desatendidas y las medidas posteriores a la eliminación 2016-2022; c) el Plan de acción sobre entomología y control de vectores 2018-2023; d) guías o procedimientos operativos estandarizados existentes para la verificación o validación de la eliminación de otras enfermedades infecciosas desatendidas (EID) como la oncocercosis, la filariasis linfática y el tracoma, y e) Enfermedades tropicales desatendidas. Prevención, control, eliminación, erradicación.
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The Western Pacific Region is the largest and most diverse region in the world, made up of 37 countries and territories in the Pacific, Oceania and parts of Asia, with a population of more than 1.9 billion people stretching over an area from China and Mongolia in the north to New Zealand in the sout...h. In 1999, 22 countries and territories in the Pacific joined together and launched the Pacific Programme to Eliminate Lymphatic Filariasis. Shortly after, the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000. In 2004, 12 countries in the Asia subregion of the Western Pacific Region and Southeast Asian Region joined and developed the Mekong-Plus Strategic Plan for Elimination of Lymphatic Filariasis. Since then, significant efforts have been made by all endemic countries, with annual mass drug administration (MDA) as a principal strategy, through strong partnership with the WHO and other donors and partners. As a result, by the end of 2019, 10 of 22 endemic countries in the region, including 8 of 16 countries in the Pacific and 2 countries in the Asia subregion, achieved WHO validation for elimination of lymphatic filariasis (LF) as a public health problem. All the other countries are either progressing with post-MDA surveillance or accelerating efforts by adoption of the new triple drug therapy strategy and enhancement of MDA campaigns to tackle persistent transmission. Some 85% of the originally endemic implementation units have stopped MDA and the number of people requiring MDA for LF in the Western Pacific Region was reduced by 72% from 2000 to 2018. This paper reviews the progress, key success factors and remaining challenges and indicates the way forward to achieve LF elimination in the Western Pacific Region.
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Mientras los países se esfuerzan por avanzar hacia los Objetivos de Desarrollo Sostenible (ODS) y lograr la cobertura sanitaria universal, las desigualdades sanitarias provocadas por la discriminación racial y los factores interrelacionados siguen estando omnipresentes. Las desigualdades que sufre...n los pueblos indígenas, los afrodescendientes, los romaníes y otras minorías étnicas son preocupantes a nivel mundial; son injustas, prevenibles y remediables
Los propios sistemas de salud son determinantes importantes de la salud y la equidad sanitaria. Pueden perpetuar las desigualdades sanitarias al reflejar el racismo estructural y las prácticas discriminatorias de la sociedad en general. En este sentido, el racismo sistémico (por ejemplo, relacionado con la ubicación de los servicios o los requisitos para acceder a ellos), los prejuicios implícitos, la práctica clínica mal informada o la discriminación por parte de los profesionales de la salud contribuyen a las desigualdades sanitarias. Ahora bien, los sistemas de salud también pueden convertirse en una de las principales fuerzas para combatir las desigualdades a las que se enfrentan las poblaciones que sufren discriminación racial.
La atención primaria de salud (APS) representa la estrategia esencial que permite reorientar los sistemas de salud y las sociedades para que sean más saludables, equitativos, eficaces y sostenibles. En 2018, al cumplirse el 40.º aniversario de la Declaración de Alma-Ata, la Organización Mundial de la Salud (OMS) y el Fondo de las Naciones Unidas para la Infancia (UNICEF) renovaron el énfasis en la atención primaria de salud con su estrategia sobre la atención primaria de salud en el siglo XXI.
La OMS ha señalado 14 mecanismos estratégicos y operacionales con los que los responsables políticos pueden reforzar la atención primaria de salud. Cada mecanismo dispone de múltiples puntos de partida posibles para emprender acciones específicas dirigidas a combatir la discriminación racial, fomentar la atención de salud intercultural y reducir las desigualdades sanitarias que sufren los pueblos indígenas, los afrodescendientes, los romaníes y otras minorías étnicas
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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge...s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to ...measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated.
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Le présent rapport présente les objectifs, la méthodologie utilisée, les résultats obtenus et les
principales recommandations / résolutions de cette retraite.