BMJ Open2018;8:e020423. doi:10.1136/bmjopen-2017-02042
EC has been increasingly used in the evaluation of maternal and child health programmes.12–15 For instance, Nesbitt et al compared crude coverage and EC of pregnant women with facility-based obstetric services in Ghana and estimated that alth...ough 68% of the women studied had service access only 18% received high-quality care provided by a skilled birth attendant.16 Similarly, by comparing EC of young children receiving Strengths and limitation of this study. Using multiple data sources (direct observation, vignettes, facility inventories) this study comprehensively assessed under 5-year-old child service
performance of first-line health facilities. We conducted this study in around 500 primary-level health facilities and within 7000 households
across six regions in Burkina Faso.
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Asia is home to more than half of the world’s 1.1 billion girls. Gender inequality in many parts of the region means that girls are often systematically disadvantaged and oppressed by poverty, violence, exclusion and discrimination. Girls’ development is hampered by child, early and forced marri...age and high adolescent pregnancy rates. Across the region, genderbased violence against girls and women constitutes a serious and widespread rights violation, particularly with regard to domestic violence, marital rape, and trafficking in women and girls.
Emerging data shows that since the outbreak of COVID-19, violence against girls and women, particularly domestic violence, has intensified
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A treatment literacy guide for pregnant women and mothers living with HIV
Positive Health, Dignity and Prevention for Women and their Babies is intended for use by networks of women living with HIV, women’s groups, peer educators and others wishing to help guide women living with HIV t...hrough the decisions they will need to take before, during and after their pregnancy. It is not intended as a substitute for going to a health facility and seeking information from a healthcare worker.
The facilitator’s manual and flipchart are intended to be used by leaders of support groups, peer educators or lay counsellors to facilitate small groups or community sessions with women living with HIV. Together, they provide accurate and comprehensive information to enable pregnant women and mothers living with HIV to know their rights and make informed decisions about their health, and the health of their baby.
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After introducing Ethiopia's WASH sector challenges and trends, the plan describes IRC Ethiopia's vision and strategy which draws from IRC and Water For People's joint framework - Destination 2030. It then details the organisational changes and business development needed to implement the strategic ...plan. Detailed targets are provided in the annexes.
At IRC, we believe that turning on a working tap should not be a surprise or cause for celebration. We believe in a world where water, sanitation and hygiene services are fundamental utilities that everyone is able to take for granted. For good.
We face a complex challenge. Every year, thousands of projects within and beyond the WASH sector fail – the result of short-term targets and interventions, at the cost of longterm service solutions.
This leaves around a third of the world’s poorest people without access to the most basic of human rights, and leads directly to economic, social and health problems on a global scale. IRC exists to continually challenge and shape the established practices of the WASH sector.
Through collaboration and the active application of our expertise, we work with governments, service providers and international organisations to deliver systems and services that are truly built to last.
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Policy Brief, Updated in March 2017
Key messages
• Meaningful involvement of sex workers in the HIV response through peer-based education and outreach and consultation in policy making and programme planning is vital to reduce their vulnerability to HIV and other sexually transmitted inf...ections (STIs) and ensure that the challenges they face are addressed adequately.
• Sex workers (female, transgender and male) have the right to protect their health through accessing comprehensive and evidence-informed HIV and sexual and reproductive health (SRH) interventions.
• Innovative HIV prevention strategies and creative use of combination interventions are needed to reach mobile and ”hard to reach” sex workers.
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The "National Guideline for Cholera Surveillance and Outbreak Response" by the Ethiopian Public Health Institute (EPHI) provides a comprehensive approach to combating cholera outbreaks in Ethiopia. It emphasizes the importance of a multisectoral approach, including case management, WASH measures, an...d the use of cholera vaccines. A key component is the establishment of Cholera Treatment Centers (CTCs) that provide 24/7 care. Additionally, the guideline stresses water quality monitoring and hygiene practices to prevent the spread of cholera and protect public health.
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The occurrence of a case of wild polio in a previously polio free area as presently in Syria, whether through importation, laboratory accident, or mutation of vaccine virus (VDPV), should be considered a public health emergency, that requires a rapid and high quality response as utmost priority
Antimicrobial Resistance Surveillance and Research Network | This manual describes well accepted methods to carry out drug susceptibility testing on important gram positive and gram negative clinically relevant bacteria. Methods of specimen collection, transport, culture, anti-microbial drug suscept...ibility testing (common, special phenotypic and
molecular techniques) as well as quality control and quality assurance have been described in a concise manner.
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A technical guide for sputum smear microscopy, initiated by the International Union against Tuberculosis, is designed to be an easy to use reference standard for the collection, storage and transport of sputum specimens and for the examination of sputum smears by direct microscopy. This edition incl...udes updates addressing bio-safety and quality assurance aspects of sputum smear microscopy.
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The key areas covered are diagnosis, imaging, pathology, surgery, rehabilitation, palliative care and survivorship. It emphasizes a multi-disciplinary team approach which is paramount for quality cancer care. The specific cancers covered are breast, central nervous system, gastroint...estinal, gynecological, head and neck, hematological, Kaposi’s sarcoma, lung, prostate and pediatric cancers. They also complement the National Guidelines for Cancer Management in Kenya released in 2013.
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This guide is strongly practice -oriented and intended as an open resource when replicating similar methods of psychosocial care in other projects. It describes the steps in the development of our pilot project
"Low threshold psychosocial support for refugees and asylum seekers’ in... Germany ", from the initial idea of the project to its practical implementation. It is to be understood as apractical report for transferring the working methods of MSF from project countries to the German context. A particular focus is the training and working methods of psychosocial peer counsellors. They are at the heart of our approach to low-
threshold psychosocial care
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this publication serves as a practical guide and useful resource for practitioners, farmers, scientists, and technicians to better understand the initiative undertaken by GGGI. In this compendium, GGGI provides the latest knowledge and capacity building materials on these topics and offers informati...on on the most relevant topics on technologies related to climate-smart agriculture and solar irrigation – both of which can be used as training materials.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable diseases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over... the world – and thereby also the need for dialysis. Unfortunately, the prevalence increases most rapidly in lowand middle-income countries. Globally, there are great inequities in access and quality of management of kidney failure. Many low- and middle-income countries cannot meet the increased need for dialysis. If the patients receive dialysis, it might only be for a limited period due to the out-of-pocket expenses. There are global disparities in CKD mortality reflecting the disparities in access to care. Lack of access to dialysis is an important cause of the increased CKD mortality in low- and middle-income countries.
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Nosocomial or health-facility-acquired infections are a serious issue, representing one of the most significant causes of morbidity and mortality in healthcare systems and consuming many scarce resources, especially in developing countries. Although much has been done, particularly in the hospital s...etting, to reduce the risk of these infections, the problem persists and demands innovative and cost-efficient solutions.
Although the care provided in most primary health care facilities is predominantly ambulatory with few or no inpatient beds, infection prevention is still important to minimize or eliminate the risks of facility-acquired infections and assure quality patient care.
Health facilities and hospitals should have written infection control procedures and guidelines in place and should also be monitoring that these procedures are adhered to in both inpatient and ambulatory care settings.
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For the purpose of this document, Interprofessional is defined as: Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communication, sharing of knowledge and coordination of services to provide... services to patients/clients and their care-giving systems. This best practice guideline, Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes is intended to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/clients, providers, teams, the organization and the system. This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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The Rwanda Malaria Strategic Plan 2020–2024 outlines Rwanda’s national strategy to reduce malaria morbidity and mortality by at least 50% compared to 2019 levels. The vision is a malaria-free Rwanda contributing to socioeconomic development.
The plan includes strengthening prevention through lo...ng-lasting insecticide-treated nets, indoor residual spraying, and larval source management; ensuring universal access to testing and treatment; improving surveillance and data use; and enhancing program management, coordination, and financing. It also emphasizes community engagement and behavior change to ensure at least 85% of the at-risk population adopts protective practices.
The strategy builds on past lessons, involves multi-sectoral collaboration, and aligns with global malaria goals. It highlights equity, quality services, and evidence-based interventions as guiding principles, aiming to mobilize national and international resources for sustained impact.
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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a...nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
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Severe cases of COVID-19 are associated with rehabilitation needs related to the consequences of ventilatory support, and prolonged immobilization and bed rest. These may include: − Impaired lung function; − Physical deconditioning and muscle weakness; − Delirium and other cognitive impairment...s; − Impaired swallow and communication; and − Mental health disorders and psychosocial support needs. − Rehabilitation needs may be amplified by underlying health conditions and decrements in health associated with ageing, − Rehabilitation professionals play an important role in facilitating early discharge, which is especially critical in the context of hospital bed shortages. − Rehabilitation needs of people with severe COVID-19 exist during the acute, sub-acute and long-term phases of care; rehabilitation professionals should be positioned in ICUs, hospital wards, stepdown facilities and in the community. − Particularly in the acute phase, rehabilitation interventions for patients with severe COVID-19 requiring ventilatory support generally require a particular skill-set acquired through specialist training.
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