Dear all,
See the current version of the Kampala statement from the first international symposium on Community Health Workers held from 21st to 23rd February 2017 in Kampala, Uganda. [here]
Best wishes,
Dr. David Musoke
Department of Disease Control and Environmental Health
School of Public Health
Makerere University College of Health Sciences
P. O. Box 7072, Kampala, Uganda
Email: dmusoke@musph.ac.ug ; sokidavi@yahoo.com
Mobile: +256712987736 ; +256704814265
In the midst of helping victims of xenophobic attacks in KwaZulu-Natal, the South African Red Cross launched an app on 8 April, that they believe will change the lives of many people.
The official ‘First Aid’ app of The South African Red Cross Society gives you instant access to information that will assist you during the most common emergencies such as what to do when someone starts choking, how to treat snake and spider bites, Cardiopulmonary Resuscitation (CPR) and First Aid.
The app is tailored specifically for South Africans. It contains preloaded content that can be accessed instantly anytime and anywhere, even without airtime. Once the app is downloaded, it can operate without reception or internet connection.
The app is said to include videos and interactive quizzes that can help save a life and is free on iOS devices.
“This App is a life saving machanism. It can be used by anyone from the age of 10 to 60 years. And we will in the next months introduce Zulu and Afrikaans to the videos on the App,” said Red Cross SA marketing director Deshika Daya.
It contains simple step-by-step instructions to guide you through everyday first aid scenarios. It is fully integrated with 10177 ambulance services that you can call from the app at any time.
There are videos and animation, making learning first aid fun and easy. The videos include information on Tuberculosis, and HIV/AIDS among other diseases.
The app also includes safety tips for extreme weather conditions and disasters that will help you in effectively preparing for emergencies.
There is a crisis in our global health workforce. A looming shortage of 18 million skilled workers stands between us and the promise of universal health coverage—and the economies it could help stimulate. But how do we recruit more smart, capable workers to this field around the world? How do we make the most of the health workers we have? And how can countries build the fit-for-purpose workforces they need to foster healthy, productive populations, which are a must for economic growth? ….more
COHRED Africa aims to promote the growth of LMIC capacity in research and innovation that will definitely change the way collaborative contracts, partnerships and ethical review takes place. [ http://africa.cohred.org/ ] We are giving you an early update of our activities we hope will make impact in 2017! Today, we would like to introduce you to three of our key developments currently underway in Africa as we strive to optimize health, equity and development in research and innovation. We would be delighted to hear from you – there are many exciting ways and opportunities for partnering and hope you will join us in exciting ventures in Africa and globally. We are ALL about GLOBAL IMPACT
FAIR RESEARCH CONTRACTING (FRC)
The goal of FRC is to inform and educate research partners, particularly in developing countries, on building sustainable, equitable partnerships by bridging the gap where there is limited:
We can assist by translating legal knowledge, policy and practice into strategic research frameworks. Fair Research Contracting has designed a number of solutions to assist your research institution’s infrastructure by enhancing your competitive advantage and building effective, sustainable research partnerships.
We currently offer services in the form of :
RESEARCH FAIRNESS INDEX (RFI)
The aim of the RFI is to create a reporting system that encourages governments, business, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. We prioritize its application in global health because there are so many urgent health-related issues, but the RFI can be applied in any other setting as well.
In practice the RFI operates by providing a guide to high quality reporting on measures and conditions that promote fair research partnerships, the RFI encourages all stakeholders in research and innovation for health to describe what is done within their organisation to promote fair partnerships. Through our extensive global consultative process, we have identified 17 key areas of relevance to effective and lasting partnerships.
The RFI acknowledges that successful partnerships often start at personal level but are then continued at institutional or national levels. While mutual admiration, respect and friendship are essential to create the foundation of effective partnerships – it is the institutional and national dimensions of research collaboration that define how, ultimately, benefits are shared.
Learn more: http://rfi.cohred.org/
RHinnO Ethics
RHinnO ethics is a high quality, efficient and technology-driven software that enables the review of research protocols. This ensures that Research Ethics Committees (RECs) remain compliant to the demand of the 21st century “digital” researchers. RHInnO Ethics provides a one stop shop which enables administrators, researchers and reviewers to comprehensively manage the entire review cycle, including protocol submission, reviewing protocols, approval and follow-up through an online platform.
RHInno has the following advantages for 3 important stakeholders :
For Researchers, RHInnO Ethics can:
For Ethics Reviewers, RHInnO Ethics can:
For Administrators, RHInnO Ethics can:
Learn more: http://www.rhinnolabs.com/
Please feel free to contact us if you have any questions, comments or suggestions. For a detailed discussion on how FRC, RFI and RHInnO can help you organization, please contact us COHRED Africa
Jacintha Toohey Executive DirectorBusiness Manager +27 33 260 5770 toohey@cohred.org
Ms Nivedhna Singh+27 33 260 6165 nivedhna@cohred.org
STAY CONNECTED http://www.cohred.org http://africa.cohred.org
Council on Health Research for Development, Africa (COHRED Africa), Suite 281, Private Bag X6,, Cascades, Pietermaritzburg, 3202 South Africa
New research has just been published on what differentiates authors who publish in low- and high-impact journals
Some interesting findings in a new study by authors in Brazil show that significant linguistic and financial inequalities still exist for researchers worldwide. The authors, Carlos Eduardo Paiva et al, collected responses from 269 participants who had published in 30 medical journals which they grouped according to low and high impact factor.
The main indicator for the increased likelihood of publishing in a higher impact factor journal was living in a country where English is the official language, which was associated with an almost threefold greater chance of publication.
The level of English language was more relevant than being located in a wealthy country. However, living in a country with a higher per capita gross domestic product was still associated with a greater chance of being published in a high-impact journal.
HIFA profile: Katie Foxall is Head of Publishing at eCancer, Bristol, UK. katie AT ecancer.org
It’s good to see the collaboration between Cochrane and Wikipedia going from strength to strength:
‘Cochrane has partnered with Wikipedia to improve the evidence base of Wikipedia health articles…’
http://www.cochrane.org/news/cochrane-and-wikipedia-working-together-improve-access-health-evidence
Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
Below are extracts fro a WHO news release. Full text here:
http://www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/en/
27 February 2017 – WHO’s list of antibiotic-resistant “priority pathogens” include bacteria that pose the greatest threat to human health. The list is intended to guide and promote research and development of new antibiotics in an effort to address growing global resistance to antimicrobial medicines.
‘Dr Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation. “Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”…
‘The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia.
‘These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria.
‘While more R&D is vital, alone, it cannot solve the problem. To address resistance, there must also be better prevention of infections and appropriate use of existing antibiotics in humans and animals, as well as rational use of any new antibiotics that are developed in future.’
Cochrane review: Support for health professionals reduces unnecessary use of antibiotics in hospitals
‘An updated Cochrane Review published 9 February has identified effective and safe ways to reduce unnecessary use of antibiotics in hospitals. Guidelines and policies that promote better targeting of antibiotics in patients who need them have the greatest impact when they are supported by the most effective ways to change doctors’ behaviour…
‘The researchers found 221 studies from the US, Europe, Asia, South America, and Australia. The interventions were aimed at healthcare professionals who prescribe antibiotics to hospital in-patients receiving acute care, and those undergoing planned surgery. The interventions broadly fell into two categories. ‘Restrictive’ techniques applied rules to make physicians prescribe properly, whilst ‘enabling’ techniques provide advice or feedback to help physicians make more informed prescribing decisions…
‘Interventions that included enabling or restrictive techniques were consistently more effective than interventions that relied on simple education alone (e.g. meetings or distribution of guidelines)…’
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Comment (Neil PW): This is a useful review but it appears the vast majority of the 221 studies were conducted in high-income countries where prescribers have good access to reliable information on medicines. Globally, and especially in low and middle income countries, we know that ‘most prescribers receive most of their prescribing information from the pharmaceutical industry and in many countries this is the only information they receive.’ World Medicines Report, WHO, 2011. Also, the review looks at hospital prescribing, where access to reliable, update information is generally better than in primary health care.
It is common sense that access to reliable and approapriate information on medicines is a sine qua non for rational prescribing. Yes, there are many porescribers who have aberrant prescribing habits despite good access to information, and this is what this systematic review seems to be largely about (not the majority of prescribers, particularly in primary care in LMICs, who practise with inadequate access to information).
As other HIFA members have said frequently, ‘Context is everything’.
Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
Full text: http://www.who.int/hepatitis/news-events/hepatitis-testing-guidelines-news/en/
‘The World Health Organization (WHO) issued its first-ever global guidance on testing for chronic viral hepatitis B and C on 16 February 2017. Viral hepatitis causes an estimated 1.4 million deaths worldwide each year. The guidelines were released in a special session at the 26th Conference of the Asian Pacific Association for the Study of the Liver (APASL), held in Shanghai, China.
‘WHO estimates that more than 300 million people are chronically infected with hepatitis B or C worldwide. However, less than 5% of these people have been tested or are aware of their diagnosis.
‘”Many people, especially those in low- and middle-income countries, don’t know they are infected, so they cannot access the right treatment,” said Dr Marc Bulterys, Team Lead of WHO’s Global Hepatitis Programme. “Improving access to hepatitis testing is critical to increasing access to life-saving treatments.”…’
Guidelines: http://www.who.int/hepatitis/publications/guidelines-hepatitis-c-b-testing/en/
Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
‘Successful disease control requires deep and meaningful engagement with local communities.’ This is the conclusion of a systematic review looking at the role of nurses and community health workers in confronting neglected tropical diseases in sub-Saharan Africa.
In our recent thematic discussion on CHWs we noted the wider issue of investment in CHWs versus investment in other primary health workers (including nurses). This is perhaps beyond the remit of this systematic review, but if anyone knows any research in this area, please let us know.
The authors also note (in the full text): ‘A lack of education of community members and CHWs was a major theme of the literature, and the importance of community education done by community nurses and CHWs is difficult to overemphasize.’
PLoS Negl Trop Dis. 2016 Sep 15;10(9):e0004914. doi: 10.1371/journal.pntd.0004914. eCollection 2016.
The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review.
Corley AG1, Thornton CP2, Glass NE1.
https://www.ncbi.nlm.nih.gov/pubmed/27631980
Corresponding author: acorley3@jhu.edu
ABSTRACT
INTRODUCTION:
Neglected tropical diseases produce an enormous burden on many of the poorest and most disenfranchised populations in sub-Saharan Africa. Similar to other developing areas throughout the world, this region’s dearth of skilled health providers renders Western-style primary care efforts to address such diseases unrealistic. Consequently, many countries rely on their corps of nurses and community health workers to engage with underserved and hard-to-reach populations in order provide interventions against these maladies. This article attempts to cull together recent literature on the impact that nurses and community health workers have had on neglected tropical diseases.
METHODS:
A review of the literature was conducted to assess the role nurses and community health workers play in the primary, secondary, and tertiary prevention of neglected tropical diseases in sub-Saharan Africa. Articles published between January 2005 and December 2015 were reviewed in order to capture the full scope of nurses’ and community health workers’ responsibilities for neglected tropical disease control within their respective countries’ health systems.
RESULTS:
A total of 59 articles were identified that fit all inclusion criteria.
CONCLUSIONS:
Successful disease control requires deep and meaningful engagement with local communities. Expanding the role of nurses and community health workers will be required if sub-Saharan African countries are to meet neglected tropical disease treatment goals and eliminate the possibility future disease transmission. Horizontal or multidisease control programs can create complimentary interactions between their different control activities as well as reduce costs through improved program efficiencies-benefits that vertical programs are not able to attain.
KEY MESSAGES
Workforce considerations
Treating urban and mobile pastoralist populations
Intervention integration and horizontal program planning
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Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
‘Many people with depression and other mental health problems can be treated successfully by community health workers, but so far no country has scaled up this approach. Vikram Patel talks to Fiona Fleck…’
Full text (WHO Bulletin, March 2017): http://www.who.int/bulletin/volumes/95/3/17-030317.pdf
Selected quote: ‘The idea is to train millions of community health workers and people in communities worldwide to deliver evidence-based psychosocial interventions.’
Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
Editorial: Strengthening health systems to provide rehabilitation services
Etienne Krug & Alarcos Cieza, Bull World Health Organ 2017;95:167 Published online: March 2017
Abstract / Resumen:
The world faces new challenges in light of health and demographic trends: populations are ageing, and the number of people living with noncommunicable diseases and the consequences of injuries is increasing.1–3 The health, social and economic consequences of these trends should serve as a call to policy-makers to invest not only in health services that reduce mortality and morbidity, but also in those that improve functioning and consequently well-being. These latter outcomes are at the core of rehabilitation, yet rehabilitation services are often underdeveloped, underresourced and undervalued….
Keep reading this editorial / Siga leyendo el editorial: click here.
http://www.who.int/bulletin/volumes/95/3/17-191809.pdf?ua=1
Visit the Portal/Blog of the PAHO/WHO Equity List & Knowledge network : http://equity.bvsalud.org
Below are extracts from a blog on the Maternal Health Task Force.
‘For decades, the medical and global health communities have viewed magnesium sulphate (MgSO4) as the gold standard for PE/E prevention and treatment [*see note below]. We know it works faster and better than other anticonvulsants like diazepam, but in many settings diazepam is still administered instead of MgSO4. So, why then, are the women who need it unable to get it? The reasons are many, but one is the lack of capacity among the existing health workforce. If more health providers – those based at primary and secondary health facilities – could administer MgSO4, more women and babies would survive PE/E…
‘To minimize this gap and improve maternal and newborn health outcomes, including those related to PE/E, the WHO recommends task shifting…
‘We have seen this be successful in many aspects of sexual and reproductive health. Skilled and traditional birth attendants in Madagascar and Mozambique were able to prevent death from hemorrhage when guidelines were changed to allow them to administer misoprostol. Unintended pregnancies are reduced when midwives can insert contraceptive implants and intrauterine devices (IUD) and when pharmacists can provide contraceptive injections. If frontline health workers such as nurses and midwives can provide these clinical services, then surely they can administer a loading dose of MgSO4 and refer PE/E patients to secondary facilities for further management.’
It’s interesting that traditional birth attendants in Madagascar and Mozambique are trained to use misoprostol for complications of delivery, given that in other countries TBAs are banned altogether from attending deliveries (although in reality these latter countries may well simply be driving TBAs underground, leading to even worse results for individual TBA-assisted deliveries than countries where TBAs are more accepted and supported.)
*Note: I am not an expert, but I think this sentence needs qualification: my understanding is that MsSO4 is not used for the prevention of pre-eclampsia. Rather, it is used for prevention of eclampsia (in a patient who is already in pre-eclampsia) and treatment of eclampsia. I stand to be corrected…
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Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
Joint statements in support of WHO’s updated recommendations on standards of quality care for mothers and newborns
From the Healthy Newborn Network:
Health care professional associations at the launch of the Network for Improving Quality of Care for Maternal, Newborn and Child Health [http://www.who.int/maternal_child_adolescent/topics/quality-of-care/network/en/ ], have endorsed four joint statements calling all their member associations to assume a critical leadership role in advocating and implementing the actions outlined in the joint statements.
Joint Statement: Improving Quality of Maternal and Newborn Care in Low- and Middle-Income Countries
Below are extracts from the Commitment to Action:
At the Global and Regional Levels
At the National Level
Engage in advocacy…
The HIFA vision aligns strongly with the above and we look forward to the possibility of collaboration with the new Network for Improving Quality of Care as it evolves.
Best wishes, Neil
Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org
The government plans a National Health Insurance (NHI) fund this year that would start with maternal health services, improved psychiatric care and services for the elderly and disabled, and may be partially financed by a reduction in the tax subsidy currently given to medical scheme members, Finance Minister Pravin Gordhan announced.
Business Day reports that this is the first strong signal of progress on the NHI from Treasury since last year’s budget when Gordhan said it would soon issue a financing proposal for the policy, which promises sweeping reforms to South Africa’s healthcare system. That proposal has yet to materialise, partly because work is still under way to refine the NHI White Paper put out by Health Minister Aaron Motsoaledi in 2015. …more
Twice a week more than 50 elderly people from Ha-Mabila and surrounding villages, outside of Sibasa in Limpopo gather at a local sports ground to play football and perform traditional dances.
According to Violent Sirwali, who is their co-ordinator and coach, the football fun together with the dancing helps keep the village grannies healthy and fit.
The group gatherings were started in 2012 by a community-based organisation known as MAHE. They realised the need for a social gathering for senior citizens after finding that increasing numbers of them were drinking excessive amounts of traditional beer. …more
There has been a significant increase in deaths from diabetes, which is now South Africa’s second biggest killer.
Diabetes is the number one killer of women and people living in the Western Cape.
This is according to StatsSA, which yesterday (28 Feb) released a report on the causes of death in 2015.
Tuberculosis remains the country’s biggest single killer, claiming 7,2% of all deaths followed by diabetes, which was responsible for 5,4% of deaths.
In 2013, diabetes was the country’s fifth biggest killer and health experts say that poor diet and obesity is behind its meteoric rise.
“Excessive calorie consumption and sedentary lifestyles are the main contributors to the development of diabetes,” according to endocrinologist Dr Sundeep Ruder, who said 7% of South Africans aged 21 to 79 (3.85 million people) have diabetes. …more
Statistics South Africa says 460 236 deaths were recorded in 2015 which marks a 3% decline compared with the previous period.
Statistician-General Pali Lehohla released the latest report on mortality rates and causes of death in South Africa in Pretoria on Tuesday.
The report states that the three leading causes of death for 2015 in South Africa were tuberculosis, diabetes and cerebrovascular disease. …more
The planned sub-AltX retail market will help small entrepreneurs, such as spaza shops, raise capital. The JSE planned to launch a sub-AltX retail market to help small entrepreneurs, such as spaza shops, raise capital and to attract more retail investors, said CEO Nicky Newton-King.
The new market, Umnotho, had been in development for three years and was partly a response to Gauteng Premier David Makhura’s challenge to mobilise finance for township entrepreneurs, she said…..more
To use an MDI:
AfroPHC 