Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A...Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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This Guide contains information, guidelines, diagrams and other materials addressed to medical practitioners who are engaged in the treatment of casualties of chemical weapons. It is made available to the public for information purposes, but is not intended to be used by the public. All decisions re...garding patient care must be made with a healthcare provider and consider the unique characteristics of each patient.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi...ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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The extensive use of antimicrobials in human and veterinary medicine in recent years has accelerated the emergence and spread of resistant microorganisms. This situation has been worsened by the lack of investment in developing new effective antibiotics. The severity of the consequences is clear to ...see: it is estimated that each year, drug-resistant infections result in at least 25 000 patient deaths and cost the EU EUR 1,5 billion in healthcare costs and through loss of productivity
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Covid-19 Social Policy Response Series / No.14
This report examines Ecuador’s social policy response to mitigate the Covid-19 pandemic’s effects and protect
vulnerable populations. It chronologically traces containment, closure policies, social policies and programmes
put in place following t...he announcement of Covid-19 as a global pandemic. A combination of external con-
straints and domestic structures, i.e. informality and weak coordination, led to truncated efforts in the healthcare
response, while persistent inequalities in access to technology and high levels of informality led to fragmented
education, labour policies and social protection responses. The report zooms into the Family Protection Grant
(Bono de Protección Familiar or BPF), a new social protection programme that covers informal workers, which
captures the difficulties in reaching unregistered populations amid lockdown and containment measures.
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The compendium provides guidance on low-cost handwashing facilities that can be widely used in low and middle-income countries. We hope that this can be shared extensively as governments and agencies tackle the crisis in low and middle-income countries where handwashing facilities are urgently neede...d in households, communities, schools and healthcare facilities.
The compendium includes information and further reading on: handwashing facilities – including facilities that are accessible for all, environmental cues to reinforce handwashing behaviours, physical distancing hygiene promotion.
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Previous crises, such as the Ebola virus disease (EVD) in West Africa in 2014, indicate the direct impact movement restrictions and disease containment efforts have on food availability, access, utilization and violence – particularly gender-based violence (GBV). The importance of maintaining and ...upscaling food security interventions for the most vulnerable populations, alongside the health sector’s efforts to avert disease spread, is therefore undeniable. The COVID-19 outbreak in South Sudan threatens to paralyze an already fragile food system and negatively impact more than 6.5 million people in South Sudan who remain vulnerable. At the same time, the core national capacities for prevention, preparedness and response for public health events is limited, and the healthcare system has been weakened by years of conflict, poor governance and low investments.
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These Guidelines are intended to provide knowledge to the treating ophthalmologists, pediatricians, ocular oncologists, pediatric oncologists, and general physicians to arrive at an early diagnosis of retinoblastoma in the settings of district hospital, in private clinics and hospitals. The guidelin...es will enable the contact health personnel to refer at the right
time to the tertiary care hospital for management of retinoblastoma.
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Handbook of COVID-19 Prevention and Treatment, expecting to share their invaluable practical advice and references with medical staff around the world. This handbook compared and analyzed the experience of other experts in China, and provides good reference to key departments such as hospital infect...ion management, nursing, and outpatient clinics. This handbook provides comprehensive guidelines and best practices by China's top experts for coping with COVID-19.
This handbook, provided by the First Affiliated Hospital of Zhejiang University, describes how organizations can minimize the cost while maximizing the effect of measures to manage and control the coronavirus outbreak. The handbook also discusses why hospitals and other healthcare institutions should have command centers when encountering a large-scale emergency in the context of COVID-19. This handbook also includes the following:
- Technical strategies for addressing issues during emergencies.
- Treatment methods to treat the critically ill.
- Efficient clinical decision-making support.
- Best practices for key departments like inflection management and outpatient clinics.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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This case study examines the humanitarian response to the conflict-related crisis in the North-East of Nigeria, focusing primarily on the period from 2015 to the end of 2016. The aim is test the central hypotheses of the Emergency Gap project: that the current structure, conceptual underpinning and... prevalent mindset of the international humanitarian system limits its capacity to be effective in response to conflict-related emergencies.
As with many conflict-related crises, the emergency in north-east Nigeria has deep and complex roots in the history of the region. The conflict began in 2009 and quickly developed beyond the control of the authorities. It unfolded in the midst of pre-existing political, social and economic tensions, making an effective humanitarian response exceedingly difficult. Despite this complexity, what is clear is that the crisis has resulted in a sprawling humanitarian disaster that has killed over 25,000 people as a direct result of the violence, and continues to devastate many more lives through hunger, psychological trauma and lack of access to healthcare.
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This curriculum can be used freely in order to stimulate means of ethical analysis, reflection and decision-making.
SUI supporting material
• Person stories
• Role plays
• Multiple choice questions
• Video link
En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niveles de hace veinte años. Estas cifras no solo imp...lican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
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En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niveles de hace veinte años. Estas cifras no solo imp...lican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
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