Diarrhoea usually clears up without treatment after a few days, particularly if it’s caused by an infection. In children, diarrhoea usually passes within five to seven days and rarely lasts longer than two weeks. In adults, diarrhoea usually improves within two to four days, although some infections can last a week or more. While waiting for your diarrhoea to pass, you can ease your symptoms by following the advice outlined below.

Drink fluids

It’s important to drink plenty of fluids to avoid dehydration, particularly if you’re also vomiting. Take frequent small sips of water. Ideally, adults should drink a lot of liquids that contain water, salt and sugar. Examples are soup broth or water mixed with juice. If you’re drinking enough fluid, your urine will be light yellow or almost clear. It’s also very important for babies and small children not to become dehydrated. Give your child frequent sips of water, even if they’re vomiting. A small amount is better than none. Fruit juice or fizzy drinks should be avoided as they can make diarrhoea worse in children. If you’re breastfeeding or bottle feeding your baby and they have diarrhoea, you should continue to feed them as normal. Contact your GP immediately if you or your child develop any symptoms of dehydration…..more

Other resources

Dear All,

Attached please find invitation as well as the preliminary programme.

pain-symposium-invitation-january-2017

pain-symposium-program-january-2017

Regards

Doris Bosch

Administrative Assistant

Department of Family Medicine

University of Pretoria

Cell: 072 239 4463

        074 627 1396

Tel: 012 373 1096

Fax2email:  086 275 2955

doris.bosch@up.ac.za

Please take note of this short course on cancer care for the family practitioner that starts March 20th on-line.

Please advertise to any medical officers, general practitioners or family physicians that might be interested.

Best wishes

Bob

PROFESSOR BOB MASH

Head: Division of Family Medicine and Primary Care

icon-flyer-march-2017

If you have lower back pain, you are not alone. About 80 percent of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a leading contributor to missed work days. In a large survey, more than a quarter of adults reported experiencing low back pain during the past 3 months.

Men and women are equally affected by low back pain, which can range in intensity from a dull, constant ache to a sudden, sharp sensation that leaves the person incapacitated. Pain can begin abruptly as a result of an accident or by lifting something heavy, or it can develop over time due to age-related changes of the spine. Sedentary lifestyles also can set the stage for low back pain, especially when a weekday routine of getting too little exercise is punctuated by strenuous weekend workout.

Most low back pain is acute, or short term, and lasts a few days to a few weeks. It tends to resolve on its own with self-care and there is no residual loss of function. The majority of acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back (the spine, muscle, intervertebral discs, and nerves) fit together and move…..more

More in search

Gauteng Health MEC Qedani Mahlangu resigned, hours before the release of the Health Ombudsman‘s report, while the head of Gauteng Health and other senior officials implicated the deaths of 94 psychiatric patients, will face disciplinary action,

Business Day reports that Gauteng Premier David Makhura said: “I have instructed the director-general in the office of the premier to urgently institute appropriate action to deal with the recommendations for the Ombudsman,” Makhura said. “There can be no passing of the buck.”

The premier is quoted in the report as saying he would urgently implement all recommendations made by the ombudsman. In the meantime, all patients currently placed at NGOs would be transferred back to public healthcare facilities and state-owned institutions so that their specialised needs were catered for. This would happen in the next seven days and be concluded in 45 days.

The report said Health MEC Qedani Mahlangu resigned on Tuesday night ahead of the official release of the report. Makhura said he had accepted her resignation….more

Medical graduates with one or two years of practical experience are holding South Africa’s public healthcare system together – but are falling apart themselves, says a Sunday Times report.

With workloads estimated to have tripled over the past few years, interns are often left running entire hospital units. They are supervised by seniors – equally burdened registrars with three to five years’ experience – while consultants are available for off-site telephone consultation….more

At the start of 2017, our team has taken some time to reflect on the bigger picture –  how our objectives align with global movements and initiatives of different kinds and how best a small group like ours can have the impact we aspire to.

We have been especially interested in looking at the Every Woman Every Child (EWEC) movement and seek to understand how best we could engage with it so that we can track its progress, learn from it and think about how we could contribute our experience too.

In 2016, EWEC published The Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030. The strategy describes adolescents as “central to everything we want to achieve, and to the overall success of the 2030 Agenda.”

The three overarching objectives of the updated Global Strategy are Survive, Thrive and Transform. The vision is to – end preventable death – that no woman, child or adolescent should face a greater risk of preventable death because of where they live or who they are and to realize their rights to the highest attainable standards of health and well-being…

The strategy document includes nine action areas and three of these (in highlights) are very pertinent to the work of Children for Health (although most overlap).

Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030: Nine Action Areas:

• Country leadership
• Financing for health
• Health system resilience
• Individual potential
• Community engagement
• Multi-sector action
• Humanitarian and fragile settings
• Research and innovation
• Accountability for results, resources and rights

The section on ‘individual potential’ begins with this statement:

Women, children and adolescents are potentially the most powerful agents for improving their own health and achieving prosperous and sustainable societies.

This sentiment is what we know at Children for Health – it’s the fuel in our tank, the engine that drives us. We seek to advocate for the role of children in this mix. In our experience however, although some people hold this idea in their minds, it is rare to find it in their actions or hearts. After all, the ‘Participation Principle’ was a cornerstone of the United Nations Convention on the Rights of the Child – ratified by most governments in 1989?but its still rare re to find evidence of ‘good participation’ on the ground where women and children truly are agents of their own destiny.

We would love to find out from others who are conducting practical work to bring the EWEC strategy to life and in particular how young adolescents (10-14 year olds) are contributing and benefiting from work being done in this area. Its really important that strategy documents like this have a practical impact and we’d like to find out more how its ‘translating’ into policy and practice.

To read the full text of our article on EWEC and its relevance to our work at Children for Health in the other two areas too, please click this link http://www.childrenforhealth.org/impact/children-for-health-and-the-every-woman-every-child-global-strategy-report-2016-2030-by-clare-hanbury-ceo-children-for-health/

Thanks! and Happy New Year!  

Clare

AIDSFree is proud to announce the release of “Training of Trainers”: Peer Education Program for Inmates and Staff to Reduce Tuberculosis and HIV Risk in Tanzania Prisons.

AIDSFree held two training of trainers (TOT) in Dodoma to train 55 prison officers from 26 prison facilities to train prison staff and inmates on the new peer education program. This report presents the findings from these evaluations, suggests some recommendations for future TOTs of this kind, and summarizes the sessions delivered.

Learn more here: http://bit.ly/2iOYUEO

—

ALEX PENLER   COMMUNICATIONS OFFICER | AIDSFREE

PHONE: 703.310.5232 | WWW.JSI.COM FB Twitter

TWITTER: @APenler   SKYPE: alex.penler

HIFA profile: Alex Penler is Communications Officer at JSI in the USA. Professional interests: Gender, Global Health, HIV/AIDS.  alexandra_penler AT jsi.com

__________

The WHO Global Learning Laboratory (GLL) for Quality Universal Health Coverage aims to gather people from across the globe, representing various disciplines within a safe space to share knowledge, experiences and ideas; challenge those ideas; and spark new ways of doing, all to strengthen approaches towards achieving quality care for all, placing people at its centre. The GLL is organized around three areas. First, national quality policy and strategy (NQPS). Second, specific technical areas – for example WASH and maternal & child health – that need to be considered carefully in achieving quality UHC. Third is the heart of the GLL, the role of compassion in quality UHC, acknowledging the human spirit that drives quality.

For a 2-minute video, click here: Global Learning Laboratory informational video

https://drive.google.com/file/d/0B3cOiNRekmn7YTU1Wk1LNzN2c1E/view

To hear more, join us on a live webinar on 1 February  at 15.00 (Geneva)

Webinar Objectives:

The first webinar of the Global Learning Laboratory on Quality Universal Health Coverage aims to:

·         Explain the rationale for the GLL4QUHC

·         Describe the architecture of the GLL4QUHC.

·         Orient participants on the functionality of the WHO Global Learning Laboratory for Quality Universal Health Coverage.

·         Answer any pressing questions from participants on the Global Learning Laboratory for Quality Universal Health Coverage.

Date: Wednesday, 1 February 2017

Time:

·         Geneva, Switzerland:15:00 CET   

·         Washington DC, USA: 09:00 EST

·         Tokyo, Japan: 23:00 JST

·         London, United Kingdom: 14:00 GMT

·         New Delhi, India: 19:30 IST

·         Lagos, Nigeria: 15:00 WAT

·         Cairo, Egypt:16:00 EET  

To register, please visit: https://www.eventbrite.com/e/gll-webinar-101-the-who-global-learning-laboratory-for-quality-universal-health-coverage-registration-30581326571

               ALL THOSE REGISTERED WILL RECEIVE A WEBINAR LINK 48 HOURS BEFORE THE EVENT.

Best regards

Etienne Guillard – PharmD, MSc

Health Systems & Services Strengthening Director

Solthis

www.solthis.org

Have you ever felt like you had a cold that wouldn’t go away?  If it hangs around for more than 10 days, or gets worse after it starts getting better, there’s a good chance you have sinusitis, a condition where infection or inflammation affects the sinuses.

WHAT ARE THE SINUSES?

Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows air from the nose to enter the sinuses and mucus made in the sinuses to drain into the nose.

WHAT IS SINUSITIS?

Sinusitis, also called rhinosinusitis, affects about 1 in 8 adults annually and generally occurs when viruses or bacteria infect the sinuses (often during a cold) and begin to multiply. Part of the body’s reaction to the infection causes the sinus lining to swell, blocking the channels that drain the sinuses. This causes mucus and pus to fill up the nose and sinus cavities….more

More search results

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Either way there’s only one surefire way to recreate this feeling for an audience and although there are many well-written and descriptive articles out there which have worked as call to actions, no form of media in the contemporary world can now challenge the power of video. ….more

Wiysonge CS, Bradley HA, Volmink J, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev. 2017 Jan 20;1:CD002003. doi: 10.1002/14651858.CD002003.pub5. (Review) PMID: 28107561

BACKGROUND: Beta-blockers refer to a mixed group of drugs with diverse pharmacodynamic and pharmacokinetic properties. They have shown long-term beneficial effects on mortality and cardiovascular disease (CVD) when used in people with heart failure or acute myocardial infarction. Beta-blockers were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, the benefit of beta-blockers as first-line therapy for hypertension without compelling indications is controversial. This review is an update of a Cochrane Review initially published in 2007 and updated in 2012.

OBJECTIVES: To assess the effects of beta-blockers on morbidity and mortality endpoints in adults with hypertension.

SEARCH METHODS: The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to June 2016: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 6), MEDLINE (from 1946), Embase (from 1974), and ClinicalTrials.gov. We checked reference lists of relevant reviews, and reference lists of studies potentially eligible for inclusion in this review, and also searched the the World Health Organization International Clinical Trials Registry Platform on 06 July 2015.

SELECTION CRITERIA: Randomised controlled trials (RCTs) of at least one year of duration, which assessed the effects of beta-blockers compared to placebo or other drugs, as first-line therapy for hypertension, on mortality and morbidity in adults.

DATA COLLECTION AND ANALYSIS: We selected studies and extracted data in duplicate, resolving discrepancies by consensus. We expressed study results as risk ratios (RR) with 95% confidence intervals (CI) and conducted fixed-effect or random-effects meta-analyses, as appropriate. We also used GRADE to assess the certainty of the evidence. GRADE classifies the certainty of evidence as high (if we are confident that the true effect lies close to that of the estimate of effect), moderate (if the true effect is likely to be close to the estimate of effect), low (if the true effect may be substantially different from the estimate of effect), and very low (if we are very uncertain about the estimate of effect).

MAIN RESULTS: Thirteen RCTs met inclusion criteria. They compared beta-blockers to placebo (4 RCTs, 23,613 participants), diuretics (5 RCTs, 18,241 participants), calcium-channel blockers (CCBs: 4 RCTs, 44,825 participants), and renin-angiotensin system (RAS) inhibitors (3 RCTs, 10,828 participants). These RCTs were conducted between the 1970s and 2000s and most of them had a high risk of bias resulting from limitations in study design, conduct, and data analysis. There were 40,245 participants taking beta-blockers, three-quarters of them taking atenolol. We found no outcome trials involving the newer vasodilating beta-blockers (e.g. nebivolol).There was no difference in all-cause mortality between beta-blockers and placebo (RR 0.99, 95% CI 0.88 to 1.11), diuretics or RAS inhibitors, but it was higher for beta-blockers compared to CCBs (RR 1.07, 95% CI 1.00 to 1.14). The evidence on mortality was of moderate-certainty for all comparisons.Total CVD was lower for beta-blockers compared to placebo (RR 0.88, 95% CI 0.79 to 0.97; low-certainty evidence), a reflection of the decrease in stroke (RR 0.80, 95% CI 0.66 to 0.96; low-certainty evidence) since there was no difference in coronary heart disease (CHD: RR 0.93, 95% CI 0.81 to 1.07; moderate-certainty evidence). The effect of beta-blockers on CVD was worse than that of CCBs (RR 1.18, 95% CI 1.08 to 1.29; moderate-certainty evidence), but was not different from that of diuretics (moderate-certainty) or RAS inhibitors (low-certainty). In addition, there was an increase in stroke in beta-blockers compared to CCBs (RR 1.24, 95% CI 1.11 to 1.40; moderate-certainty evidence) and RAS inhibitors (RR 1.30, 95% CI 1.11 to 1.53; moderate-certainty evidence). However, there was little or no difference in CHD between beta-blockers and diuretics (low-certainty evidence), CCBs (moderate-certainty evidence) or RAS inhibitors (low-certainty evidence). In the single trial involving participants aged 65 years and older, atenolol was associated with an increased CHD incidence compared to diuretics (RR 1.63, 95% CI 1.15 to 2.32). Participants taking beta-blockers were more likely to discontinue treatment due to adverse events than participants taking RAS inhibitors (RR 1.41, 95% CI 1.29 to 1.54; moderate-certainty evidence), but there was little or no difference with placebo, diuretics or CCBs (low-certainty evidence).

AUTHORS’ CONCLUSIONS: Most outcome RCTs on beta-blockers as initial therapy for hypertension have high risk of bias. Atenolol was the beta-blocker most used. Current evidence suggests that initiating treatment of hypertension with beta-blockers leads to modest CVD reductions and little or no effects on mortality. These beta-blocker effects are inferior to those of other antihypertensive drugs. Further research should be of high quality and should explore whether there are differences between different subtypes of beta-blockers or whether beta-blockers have differential effects on younger and older people.

Do read our editorial from 14 papers on Community health workers in different contexts published in Human Resources for Health: “Close-to-community providers of health care: increasing evidence of how to bridge community and health systems” available at: https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0132-9

This outlines range of close to community providers including CTC providers are known by different names and titles in different contexts as well as synthesising findings on:

• – Strategies to support CTC providers’ interface role between communities and the health system
• – The role of the community in the selection and support of CTC providers
• – The need to move to supportive, structured relationships in CTC supervision
• – The critical role of programme design, motivation and incentives in responsive and people-centred health systems
• – Negotiating trusting relationships
• – Power relationships and gender roles shape CTC interactions at multiple levels.
• Many thanks

Sally

Prof. Sally Theobald

Professor in Social Science and International Health

Department of International Public Health

Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA

Visiting Fellow Institute of Development Studies, Sussex

Tel: +44 (0)151 7053197

Skype: sally.theobald

@sallytheobald

Proud hosts of HSG 2018

CITATION: Walsh A.; Brugha R.; Byrne E. “The way the country has been carved up by researchers”: ethics and power in north-south public health research. International Journal for Equity in Health. 15 (1) (pp 1-11), 2016.

https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0488-4

ABSTRACT

Background: Despite the recognition of power as being central to health research collaborations between high income countries and low and middle income countries, there has been insufficient detailed analysis of power within these partnerships. The politics of research in the global south is often considered outside of the remit of research ethics. This article reports on an analysis of power in north-south public health research, using Zambia as a case study. Methods: Primary data were collected in 2011/2012, through 53 in-depth interviews with: Zambian researchers (n = 20), Zambian national stakeholders (n = 8) and northern researchers who had been involved in public health research collaborations involving Zambia and the global north (n = 25). Thematic analysis, utilising a situated ethics perspective, was undertaken using Nvivo 10.

Results: Most interviewees perceived roles and relationships to be inequitable with power remaining with the north. Concepts from Bourdieu’s theory of Power and Practice highlight new aspects of research ethics: Northern and southern researchers perceive that different habituses exist, north and south – habituses of domination (northern) and subordination (Zambian) in relation to researcher relationships. Bourdieu’s hysteresis effect provides a possible explanation for why power differentials continue to exist. In some cases, new opportunities have arisen for Zambian researchers; however, they may not immediately recognise and grasp them. Bourdieu’s concept of Capitals offers an explanation of how diverse resources are used to explain these power imbalances, where northern researchers are often in possession of more economic, symbolic and social capital; while Zambian researchers possess more cultural capital.

Conclusions: Inequities and power imbalances need to be recognised and addressed in research partnerships. A situated ethics approach is central in understanding this relationship in north-south public health research.

—

Best wishes, Neil

Coordinator, HIFA Project on Health Partnerships

http://www.hifa.org/projects/health-partnerships-what-works-and-what-doesnt

CITATION: Shelley KD;  Belete YW;  Phiri SC;  Musonda M;  Kawesha EC;  Muleya EM; Chibawe CP;  van den Broek JW;  Vosburg KB. Implementation of the Community Health Assistant (CHA) Cadre in Zambia: A Process Evaluation to Guide Future Scale-Up Decisions. Journal of Community Health.  41(2):398-408, 2016 Apr.

ABSTRACT

Universal health coverage requires an adequate health workforce, including community health workers (CHWs) to reach rural communities. To improve healthcare access in rural areas, in 2010 the Government of Zambia implemented a national CHW strategy that introduced a new cadre of  healthcare workers called community health assistants (CHAs). After 1 year of training the pilot class of 307 CHAs deployed in September 2012. This paper presents findings from a process evaluation of the barriers and facilitators of implementation of the CHA pilot, along with how evidence was used to guide ongoing implementation and scale-up decisions.

Qualitative inquiry was used to assess implementation during the first 6 months of the program rollout, with 43 in-depth individual and 32 small group interviews across five respondent types: CHAs, supervisors, volunteer CHWs, community members, and district leadership. Potential ‘implementation moderators’ were explored using deductive coding and thematic analysis of participant perspectives on community acceptance of CHAs, supervision support mechanisms, and coordination with volunteer CHWs, and health system integration of a new cadre. Community acceptance of CHAs was generally high, but coordination between CHAs and existing volunteer CHWs presented some challenges. The supervision support system was found to be inconsistent, limiting assurance of consistent quality care delivered by CHAs. Underlying health system weaknesses regarding drug supply and salary payments furthermore hindered incorporation of a new cadre within the national health system. Recommendations for implementation and future scale based on the process evaluation findings are discussed.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org  

Cultural beliefs around health and illness are vitally important and HIFA includes many anthropologists and social scientists who can help us  understand and explore these beliefs, and to consider whether and how to challenge beliefs that may be harmful to health. One key area is around pregnancy and child birth. This open-access paper explores beliefs among pregnant women in Zambia.

CITATION: M’soka, N.C., Mabuza, L.H. & Pretorius, D., 2015, ‘Cultural and health beliefs of pregnant women in Zambia regarding pregnancy and child birth’, Curationis 38(1), Art. #1232, 7 pages. http://dx.doi.org/10.4102/curationis.v38i1.1232

http://www.curationis.org.za/index.php/curationis/article/view/1232/1605#27

ABSTRACT

BACKGROUND: Health beliefs related to pregnancy and childbirth exist in various cultures globally. Healthcare practitioners need to be aware of these beliefs so as to contextualise their practice in their communities.

OBJECTIVES: To explore the health beliefs regarding pregnancy and childbirth of women attending the antenatal clinic at Chawama Health Center in Lusaka Zambia.

METHOD: This was a descriptive, cross-sectional survey of women attending antenatal care(n = 294) who were selected by systematic sampling. A researcher-administered questionnaire was used for data collection.

RESULTS: Results indicated that women attending antenatal care at Chawama Clinic held certain beliefs relating to diet, behaviour and the use of medicinal herbs during pregnancy and post-delivery. The main beliefs on diet related to a balanced diet, eating of eggs, okra, bones, offal, sugar cane, alcohol consumption and salt intake. The main beliefs on behaviour related to commencement of antenatal care, daily activities, quarrels, bad rituals, infidelity and the use of condoms during pregnancy. The main beliefs on the use of medicinal herbs were on their use to expedite the delivery process, to assist in difficult deliveries and for body cleansing following a miscarriage.

CONCLUSION: Women attending antenatal care at the Chawama Clinic hold a  number of beliefs regarding pregnancy and childbirth. Those beliefs that are of benefit to the patients should be encouraged with scientific explanations, whilst those posing a health risk should be discouraged respectfully.

SELECTED EXTRACTS

‘Regarding the belief that eating eggs can cause a baby to be born without hair, it is of concern that almost a third of the women interviewed were of this opinion.’

‘Approximately one in three of the participants believed that ingesting okra during pregnancy caused excessive salivation of the child.’

‘Since almost three quarters of the respondents agreed with the belief that salt should be avoided during pregnancy, this needs to be addressed by healthcare practitioners. Salt is essential for the body to function normally’

‘The belief on the effect of using condoms during pregnancy was of great concern: about one in four respondents held the belief that using condoms during pregnancy could lead to a weak child, whilst only about half disagreed, and one in five were neutral on this belief.’

—

Working together for health in Zambia – Join HIFA-Zambia: http://www.hifa.org/forums/hifa-zambia

PDF version

Menopause is the time in a woman’s life when menstrual periods permanently stop. Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, weight gain, mood swings and urinary incontinence. Treatment of menopausal symptoms varies….more

Take a quiz and check yourself out http://www.medicinenet.com/menopause/quiz.htm