Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
Men are underrepresented in HIV testing services throughout sub-Saharan Africa. HIV testing is critical to achieve the UNAIDS 95-95-95 goals, as it is the first entry point to HIV care. In Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiag...nosed. Improved HIV testing among men is key to reaching UNAIDS goals, and to curbing HIV epidemics in the region.
more
Testing men for HIV during their partner’s pregnancy can guide couples-based HIV prevention and treatment, but testing rates remain low. We investigated a combination approach, using evidence-based strategies, to increase HIV testing in male partners of HIV-positive and HIV-negative ...pregnant women.
more
The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa.
The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment
and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts.
The recommendations in these guidelines are:
1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5%
(conditional recommendation: moderate-quality evidence).
2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence).
3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence).
4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence).
Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities.
more
The Government of Kenya, through the Ministry of Health, has the
constitutional obligation to provide the highest level of health care for its
citizens. The Ministry of Health’s review of the 2015 Policy document
on infection prevention and control (IPC) is in line with that goal.
Posters & Infographics on different topics, i.e: vaccination, people with high risk of severe Covid-19, for families, work, school, hand hygiene, care at home, public transport
A technical and environmental comparative overview of common shelter typologies found in settlements across UNHCR operations
Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
more
Updated May 2021. Manual 2. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in the community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for p...eople seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
Updated May 2021. Manual 3. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in the community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for p...eople seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
Updated May 2021. Manual 4. The Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in the community –PACK Adult, PACK Adolescent, PACK Child and PACK Community.PACK Home is designed for p...eople seeking more information about how to care for their own health and the health of their family at home.Collect and read all the PACK Home volumes in English, Afrikaans, isiXhosa, isiZulu or Sesotho
Download the different languages: https://knowledgetranslation.co.za/pack/pack-home/
more
Nutrition Care for Cancer patients - SOP
The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a foetus can grow). The cervix leads from the uterus to the vagina (birth canal) below.
Cervical cancer is the 2nd most common cancer among South African women, but the cancer women die of most in our country. ...Women in South Africa have a 1 in 42 lifetime risk of cervical cancer (NCR 2019).
more
Drug registration in Kenya started in 1982; the process mainly involves an evaluation committee at the Kenya Pharmacy and Poisons Board (PPB) that aims to approve products based on quality, safety and efficacy.