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The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries. It comprises six modules and an implementation guide. This package supports Ministries of Health to strengthen CVD management in primary health care settings. The practical, step-by step modul
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es are supported by an overarching technical document that provides a rationale and framework for this integrated approach to the management of NCDs.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
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terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
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echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh
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ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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Guide technique pour la prise en charge des maladies cardiovasculaires dans le cadre des soins de santé primaires
A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
AHA/ASA Guideline
DOI: 10.1161/STR.0000000000000158
Реализация комплексных программ по профилактике ВИЧ/ИППП среди секс-работников: ПРактИЧескИе Подходы на осноВе соВместных меРоПРИятИй
Всемирная организация здравоохранения (World Health Organization); UNFPA; UNAIDS; et al.
Всемирная организация здравоохранения (World Health Organization); UNFPA; UNAIDS; et al.
(2015)
C_WHO
Данный инструмент предназначен для использования должностными лицами в сфере общественного здравоохранения и руководителями программ по ВИЧ и ИППП; НПО, включая
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общественные и гражданские организации; а также медицинскими работниками. Он также может представлять интерес для международных финансирующих организаций, лиц, ответственных за формирование политики в сфере здравоохранения, и правозащитников.
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The report is geared towards mayors, local government officials and city policy planners.It highlights key areas where city leaders can tackle the drivers of NCDs, including tobacco use, air pollution, poor diets and lack of exercise, and improve road safety.
From anti-tobacco actions in Beijing a
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nd Bogor, to road safety initiatives in Accra and Bangkok, a bike sharing scheme in Fortaleza, and actions to create walkable streets for seniors that have reduced elderly pedestrian deaths by 16% in New York City, the report aims to share knowledge between urban policy planners.
Of the 19 case studies cited, 15 are from developing countries, where 85% of premature adult deaths through NCDs take place, and over 90% of road traffic fatalities are recorded. You can download the case studieson the website https://www.who.int/ncds/publications/tackling-ncds-in-cities/en/.
Over 90% of future urban population growth will be in low or middle-income countries, and seven of the world’s 10 largest cities are in developing countries.
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Policy Brief
Technical Brief
As a new chapter in the response to the world drug problem begins, UNAIDS calls on countries to adopt the recommendations contained within this report, and to rapidly transform those commitments into laws, policies, services and support that allow people who use drugs to live healthy and dignified l
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ives.
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he Guidelines are an example of the support that UNDP provides to practically integrate international human rights commitments into national, regional and global policy and programmes.
Practical Guidance for collaborative interventions
WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i
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n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
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WHO working group on HIV incidence assays meeting report
10–11 December 2015
Glion, Switzerland
UNAIDS/WHO working group on global HIV/AIDS and STI surveillance
WHO/HIV/2017.03
UNAIDS 2018 / Guidance
Guidance for policy-makers, and people living with, at risk of or affected by HIV
Charting the Course of Education and HIV
UNESCO Publishing (United Nations Educational, Scientific and Cultural Organization)
(2014)
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Education on the move
Condoms - The prevention of HIV, other sexually transmitted infections and unintended pregnancies
UNAIDS (Joint United Nations Programme on HIVAIDS)
(2016)
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UNAIDS 2016 / Meeting Report
l’IMC et le gain de poids gestationnel sont des facteurs déterminants des risques de
résultats de grossesse, de la santé de la mère et de l’enfant. Cette étude analyse l’incidence de la
nutrition chez les femmes enceintes sur la santé néonatale au Bénin. Les résultats d’estimation
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par les
équations simultanées montrent que le gain de poids gestationnel insuffisant ou excessif a des effets
néfastes aussi bien sur la santé de la mère que sur celui de l’enfant. L’étude montre que la majorité des
femmes béninoises étudiées, avec un IMC faible ou normal n’atteignent pas le gain de poids
gestationnel recommandé en fin de grossesse. La plupart des nouveau-nés de petits poids de naissance
sont nés de femme dont l’IMC est normal, ce qui renforce la théorie bien connue que l’IMC n’est pas un
bon indicateur de la malnutrition chez la femme enceinte.
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