Your search found 136 Results

  1. 1
    375711

    Managing complications in pregnancy and childbirth (MCPC): A guide for midwives and doctors. Highlights from the World Health Organization’s 2017 Second Edition.

    World Health Organization [WHO]. Department of Maternal, Newborn, Child and Adolescent Health; World Health Organization [WHO]. Department of Reproductive Health and Research; Maternal and Child Survival Program

    [Geneva, Switzerland], WHO, 2017 May. 8 p. (WHO/MCA/17.02; USAID Cooperative Agreement No. AID-OAA-A-14-00028)

    Since it was first published in 2000, the World Health Organization’s (WHO’s) Managing Complications in Pregnancy and Childbirth (MCPC) manual has been used widely around the world to guide the care of women and newborns who have complications during pregnancy, childbirth and the immediate postnatal period. The MCPC manual targets midwives and doctors working in district-level hospitals. Selected chapters from the first edition of the MCPC were revised in 2016 based on new WHO recommendations, and the second edition of the MCPC manual is now available. This brief reviews the revision process and summarizes updated clinical guidelines for a subset of revised chapters, including: emotional and psychological support; hypertensive disorders of pregnancy; bleeding in early pregnancy and after childbirth; and prevention and management of infection in pregnancy and childbirth. (Excerpt)
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  2. 2
    375642

    Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Second edition.

    World Health Organization [WHO]; United Nations Population Fund [UNFPA]; UNICEF

    Geneva, Switzerland, WHO, 2017. 492 p. (Integrated Management Of Pregnancy And Childbirth)

    Since the first edition was published in 2000, the Managing Complications in Pregnancy and Childbirth (MCPC) manual has been used widely around the world to guide the care of women and newborns who have complications during pregnancy, childbirth and the immediate postnatal period. The MCPC manual targets midwives and doctors working in district-level hospitals. Selected chapters from the first edition of the MCPC were revised in 2016 based on new World Health Organization recommendations, resulting in this second edition.
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  3. 3
    371987

    The effectiveness of the WHO training course on complementary feeding counseling in a primary care setting, Ismailia, Egypt.

    El-Sayed H; Martines J; Rakha M; Zekry O; Abdel-Hak M; Abbas H

    Journal of the Egyptian Public Health Association. 2014 Apr; 89(1):1-8.

    BACKGROUND: The adequacy and timing of complementary feeding of the breastfed child are critical for optimal child growth and development.Considerable efforts have been made to improve complementary feeding in the first 2 years of life. One of them was the WHO complementary feeding counseling course (CFC). OBJECTIVES: To evaluate the effectiveness of the WHO CFC on knowledge and counseling abilities of primary healthcare physicians; on caretaker's knowledge and adherence to physicians' recommendations and their feeding practices; and on children's growth. PARTICIPANTS AND INTERVENTIONS: A single-blinded randomized-controlled study was carried out in 40 primary healthcare centers divided into matched pairs according to their location, either in rural or urban areas, and training of the selected physicians on integrated management of childhood illness. One center from each pair was selected randomly for its physician to receive CFC training in nutrition counseling and the matched center was selected as a control. Forty primary healthcare center physicians and 480 mother-child (6-18 months) pairs were included in the study. The mother-child pairs recruited were visited at home within 2 weeks, 90, and 180 days after the initial consultation with trained health workers. Special questionnaires were used to collect information on healthcare providers' knowledge of nutrition counseling and practice (counseling skills); maternal knowledge of basic nutrition-counseling recommendations, maternal compliance with the recommended feeding practice; child dietary intake; and gains in weight and length. RESULTS: CFC-trained physicians were more likely to engage in nutrition counseling and to deliver more appropriate advice. This was reflected in improvements in maternal recall of complementary feeding messages, which were higher in the intervention group compared with the control group. Six months after the consultation, children in the intervention group had significantly greater weight gains compared with the control group (0.96 vs. 0.78 kg; P=0.038). Children in the intervention group, who were 12-18 months of age at the time of recruitment, had significantly less faltering in length gain compared with the control group (height/age Z-score; 0.23 vs. 0.04; P=0.004). CONCLUSION AND RECOMMENDATIONS: Nutrition counseling training improved counseling abilities of primary healthcare physicians and led to improvements in mothers' knowledge and practices of complementary feeding. In turn, this led to improved growth of children. We recommend wide and regular utilization of the CFC course to improve the knowledge and skills of health workers who provide counseling to mothers for complementary feeding.
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  4. 4
    346649
    Peer Reviewed

    The FIGO initiative for the prevention of unsafe abortion.

    Shaw D

    International Journal of Gynaecology and Obstetrics. 2010 Jul; 110 Suppl:S17-9.

    Unsafe abortion is a recognized public health problem that contributes significantly to maternal mortality. At least 13% of maternal mortality is caused by unsafe abortion, mostly in poor and marginalized women. The International Federation of Gynecology and Obstetrics (FIGO) launched an initiative in 2007 to prevent unsafe abortion and its consequences, building on its work on other major causes of maternal mortality. A Working Group was identified with collaborators from many international organizations and terms of reference provided direction from the FIGO Executive Board as to possible evidence-based interventions. A total of 54 member associations of FIGO, representing almost half its member societies, requested participation in the initiative, with 43 subsequently producing action plans that are country specific and involve the national government and multiple collaborators. Obstetrician/gynecologists have demonstrated the importance of the initiative by an unprecedented level of engagement in efforts to reduce maternal mortality and morbidity in country and by sharing experiences regionally. (c) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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  5. 5
    328537

    Procuring Single-Use Injection Equipment and Safety Boxes: A Practical Guide for Pharmacists, Physicians, Procurement Staff and Programme Managers

    World Health Organization [WHO]. Health Technology and Pharmaceuticals, Department of Blood Safety and Clinical Technology

    Geneva, Switzerland, World Health Organization [WHO], 2003 May 5. (WHO/BCT/03.04)

    The objective of this guide is to accompany pharmacists, physicians, procurement staff and programme managers through the process of procuring single-use injection equipment and safety boxes of assured quality, on a national or international market, at reasonable prices. International organizations have established standardized procurement procedures for medicines and medical devices. This guide describes how these procedures can be used to ensure the procurement of injection equipment and safety boxes. Institutions procuring injection equipment need to develop a list of manufacturers that are prequalified on the basis of certain criteria which include international quality standards. This guide provides steps and tools for procurement, including a pre-qualification procedure of injection equipment for purchase. Developing a monitoring system for supplier performance will improve and safeguard the quality of injection equipment selected and prevent or eliminate unreliable suppliers.
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  6. 6
    322363

    Ethical concerns in female genital cutting [editorial]

    Cook RJ

    African Journal of Reproductive Health. 2008 Apr; 12(1):7-11.

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  7. 7
    323576
    Peer Reviewed

    Audit of paediatric prescriptions for the common paediatric problems.

    Javed M

    Pakistan Journal of Medical Sciences. 2007 Oct-Dec; 23(6):932-935.

    The objectives were to compare the prevailing prescribing practices of paediatricians with minor and major diploma for common paediatric problems. It was a Cross sectional study in which 10 % of children visiting the outpatient department of paediatrics, Hamdard university hospital with gastroenteritis and Acute respiratory infections, diagnosed according to UNICEF/ WHO protocol were enrolled, their prescriptions checked and results were entered in specially designed Performa. Five hundred prescriptions were reviewed of which 308 were due to Gastro enteritis, 192 were due to respiratory tract infections1). Average numbers of drugs/ prescription were 3.33 +or- 1.2. Paediatricians with minor diploma prescribed 3.5 +or- 1.2 drugs/ prescription. Paediatricians with major diploma prescribed 2.8 +or-1.2 drugs/ prescription (p-valve 0.32) Antibiotic in diarrhoea and respiratory tract infections (upper and lower respiratory tract infections were written in 81.7% cases by paediatricians with lower diploma and 77.7 % cases by paediatricians with major diploma (p-valve 0.27). In respiratory tract infections antihistamines were prescribed in 79.7% of cases by paediatricians with minor diploma and 69.5 % cases by paediatricians with major diploma (p-valve0.11). Anti emetic in Gastroenteritis were written in 69.1% cases by paediatricians with minor diploma and 56.2% cases by Paediatricians with major diploma (p-valve 0.021). More drugs and more antibiotic were given by doctors, with major diploma. Antibiotics were totally different than recommended by the National ARI programme, which the Paediatricians teach in Medical Colleges. The antibiotics prescribed for common Paediatric Problems were totally different than recommended by the National ARI programme which the Paediatricians teach in Medical College. Active intervention is needed to improve the quality of medical education of physicians who treat children, while in depth measures are required for the training of paediatricians. (author's)
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  8. 8
    322951
    Peer Reviewed

    Meeting the health needs of Iraqi refugees in Jordan.

    Devi S

    Lancet. 2007 Dec 1; 370(9602):1815-1816.

    Over 2 million Iraqis have fled from violence in Iraq to neighbouring countries such as Jordan and Syria. But, unable to cope with the influx of refugees and their health and humanitarian needs, these countries are making entry more restrictive. 7-year-old Mohammad sat up in his hospital bed in Amman, Jordan, half his face concealed by thick, white bandages, as his father Salman recounted their tale. In October last year, the family was receiving condolences at a traditional mourning tent outside their Baghdad home for Salman's father, who was killed in sectarian violence because of his past job as an army officer under Saddam Hussein. As the mourners congregated, a car bomb exploded at the nearby market, prompting the panicked family to flee in all directions. Salman's experience as a policeman made him shout out warnings to people nearby but to no avail as a second bomb detonated soon afterwards. (excerpt)
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  9. 9
    321302
    Peer Reviewed

    Management of acute diarrhoea in primary care in Bahrain: Self-reported practices of doctors.

    Ismaeel AY; Al Khaja KA; Damanhori AH; Sequeira RP; Botta GA

    Journal of Health, Population and Nutrition. 2007 Jun; 25(2):205-211.

    This nationwide study was conducted to assess the extent of adherence of primary-care physicians to the World Health Organization (WHO)-recommended guidelines on the use of oral rehydration therapy (ORT), antimicrobials, and prescribing of other drugs used in treating symptoms of acute diarrhoea in Bahrain. A questionnaire-based, cross-sectional survey was carried out in primary-care health centres. During a six-week survey period (15 August-30 September 2003), 328 (25.2%) completed questionnaires were returned from 17 of 20 health centres. In a sample of 300 patients, oral rehydration salts (ORS) solution was prescribed to 89.3% (n=268) patients; 12.3% received ORS alone, whereas 77% received ORS in combination with symptomatic drugs. Antimicrobials were prescribed to 2% of the patients. In 11.4% of the cases, rehydration fluids and other drugs were given parenterally. The mean number of drugs was 2.2+0.87 per prescription. In approximately one-third of the patients, three or more drugs were used. Primary-care physicians almost always adhered to the WHO guidelines with respect to ORT and antimicrobials. However, in several instances, ORT was prescribed along with polypharmacy, including irrational use of drugs for symptomatic relief. Effective health policies are needed to reduce the unnecessary burden on the healthcare system. (author's)
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  10. 10
    320315

    Traditional health practitioner and the scientist: Bridging the gap in contemporary health research in Tanzania.

    Mbwambo ZH; Mahunnah RL; Kayombo EJ

    Tanzania Health Research Bulletin. 2007 May; 9(2):115-120.

    Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania. (author's)
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  11. 11
    318925
    Peer Reviewed

    Michel Kazatchkine: The Global Fund’s new Executive Director.

    McCarthy M

    Lancet. 2007 Jul 28; 370(9584):311.

    In 1983, Michel Kazatchkine was a clinical immunologist at the Hôpital Broussais in Paris, France, when he was called to see a French couple with unexplained fever and severe immune deficiency who had been airlifted home from Africa. This man and woman were the first of many AIDS patients that Kazatchkine would take care of in the coming decades. There were no effective antiretroviral treatments available, and the couple lived only a few months on the ward before dying. "Those were difficult years with patients dying every day on the wards", Kazatchkine recalls. Much of his time, he says, was spent providing end-of-life care, consoling patients, "and holding their hands when they were dying". This year, after more than two decades of working in AIDS clinical care, research, and international programmes, Kazatchkine takes over the helm of the second largest funder of AIDS care: the Global Fund to Fight AIDS, Tuberculosis & Malaria. Anthony Fauci, Director of the US National Institute of Allergy andInfectious Disease, who says he has worked "up close and personal" with Kazatchkine since the early days of the epidemic, calls him "the perfect kind of person for the position". He's a scientist who understands the science; a clinician who understands clinical care; and an expert in AIDS who understands the epidemic, Fauci says. "He's also a fine 'people person': the kind of person who can build consensus, but also the kind of person who can take the lead." (excerpt)
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  12. 12
    315687

    Medical organizations support condom use.

    Alford S

    Washington, D.C., Advocates for Youth, 2005. [2] p. (Issues at a Glance)

    Clinical considerations for the pediatrician: Help ensure that all adolescents have knowledge of and access to contraception, including barrier methods and emergency contraception supplies. Pediatricians should actively support and encourage the use of reliable contraception and condoms by adolescents who are sexually active or contemplating sexual activity. In the interest of public health, restrictions and barriers to condom availability should be removed. Schools are an appropriate site for the availability of condoms in a community program because they contain large adolescent populations. Health professionals have an obligation to provide the best possible care to respond to the needs of their adolescent patients. This care should, at a minimum, include comprehensive reproductive health services, such as sexuality education, counseling...[and] access to contraceptives. (excerpt)
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  13. 13
    310953
    Peer Reviewed

    Health in an unequal world.

    Marmot M

    Lancet. 2006 Dec 9; 368(9552):2081-2094.

    William Harvey was born in Folkestone on April 1, 1578. He was educated at the King's School, Canterbury, Gonville, and Caius College, Cambridge, and the University of Padua, graduating as doctor of arts and medicine in 1602. He became a Fellow of the Royal College of Physicians in 1607 and was appointed to the Lumleian lectureship in 1615. In the cycles of his Lumleian lectures over the next 13 years, Harvey developed and refined his ideas about the circulation of the blood. He published his conclusions in 1628 in Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, which marks the beginning of clinical science. In it, Harvey considered the structure of the heart, arteries, and veins with their valves. By carefully devised experiments and supported by the demonstration of the unidirectional flow of the blood in the superficial veins of his own forearm, he established that the blood circulated, and did not ebb and flow as had been believed for more than 1000 years. (excerpt)
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  14. 14
    303230

    A WHO study of treatment schedules for early syphilis in use throughout the world.

    Willcox RR

    Bulletin of the World Health Organization. 1954; 10:579-617.

    Ten years have elapsed since penicillin was introduced in the treatment of syphilis. In order to appraise recent trends in syphilo-therapy in the world, WHO carried out a detailed study of treatment practices in early syphilis. A questionnaire was circulated to leading venereologists and clinics in the world, and 277 replies were received from 55 countries giving particulars of 294 schedules. A total of 65.3% of the participants used penicillin alone and 28.9% used it in combination with other drugs. In North America all clinics relied solely on penicillin as against 52.2% in Europe; and procaine penicillin G in oil with aluminium monostearate (PAM) was used in 91% of clinics in the Americas and Asia and in 60.6% of European clinics. The most common dosage of penicillin in all stages of early syphilis was 4.8- 6.0 million units; but appreciably larger doses were used in Europe than elsewhere, some 39.4% of schedules using 10.8 million units or more. There were single instances of 36 million units being given. Consolidation treatment was given in none of the North American clinics; seldom in Asia; by about one-third of the participants in Central and South America; and, for secondary syphilis, in 59% of European schedules. This study shows that with intensive treatment with PAM the saving in drug cost to clinics over the classical courses of arsenic and bismuth may be as much as £4 per case, but the overhead expenses are, of course, not reduced. (excerpt)
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  15. 15
    294423
    Peer Reviewed

    Primary health care in complex humanitarian emergencies: Rwanda and Kosovo experiences and their implications for public health training. [Soins de santé primaire dans le cadre d'urgences humanitaires complexes : les expériences du Rwanda et du Kosovo, et leurs implications dans le domaine de la formation en santé publique]

    Gardemann J

    Croatian Medical Journal. 2002; 43(2):148-155.

    In a complex humanitarian emergency, a catastrophic breakdown of political, economic, and social systems, often accompanied by violence, contributes to a long-lasting dependency of the affected communities on external service. Relief systems, such as the Emergency Response Units of the International Federation of Red Cross and Red Crescent Societies, have served as a sound foundation for fieldwork in humanitarian emergencies. The experience in emergencies gained in Rwanda in 1994 and Kosovo in 1999 clearly points to the need for individual adjustments of therapeutic standards to preexisting morbidity and health care levels within the affected population. In complex emergencies, public health activities have been shown to promote peace, prevent violence, and reconcile enemies. A truly democratic and multiprofessional approach in all public health training for domestic or foreign service serves as good pattern for fieldwork. Beyond the technical and scientific skills required in the profession, political, ethical, and communicative competencies are critical in humanitarian assistance. Because of the manifold imperatives of further public health education for emergency assistance, a humanitarian assistance competence training center should be established. Competence training centers focus on the core competencies required to meet future needs, are client-oriented, connect regional and international networks, rely on their own system of quality control, and maintain a cooperative management of knowledge. Public health focusing on complex humanitarian emergencies will have to act in prevention not only of diseases and impairments but also of political tension and hatred. (author's)
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  16. 16
    183924

    [HIV / AIDS: toward the year 2000] VIH / SIDA: hacia el ano 2000.

    Fuera del Closet. 1995 Nov; (7):4-8.

    Dr. Peter Piot, Associate Director of the WHO Global Programme on AIDS (GPA), is one of the many experts who believe that HIV/AIDS is no longer an epidemic disease like cholera, which follows a pattern with a predictable conclusion, but rather has become an endemic chronic infection like malaria. (excerpt)
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  17. 17
    279053

    Brief guide on tuberculosis control for primary health care providers for countries in the WHO European Region with a high and intermediate burden of tuberculosis.

    Ahamed N; Yurasova Y; Zaleskis R; Grzemska M; Reichman LB

    Copenhagen, Denmark, World Health Organization [WHO], Regional Office for Europe, 2004. [71] p.

    Tuberculosis is an increasingly serious problem in the WHO European region, particularly in the countries of eastern Europe, the Baltic States, and the Commonwealth of Independent States (CIS). Primary health care providers can play an important role in tuberculosis control through early detection of the disease, referral for treatment, and involvement in directly observed treatment. This guide has been written with the aim of developing the knowledge, awareness and skills of primary health care providers regarding tuberculosis and its prevention and control. The guide is not intended as a complete source of information on tuberculosis, but rather a summary of general principles regarding prevention, detection and treatment. The guide does not reflect specific national guidelines on TB control, and is intended to be used in conjunction with the appropriate national regulations. A reference card containing key information is included with this guide. (author's)
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  18. 18
    277663

    [The practice guideline 'Hormonal contraception' (second revision) from the Dutch College of General Practitioners; a response from the perspective of obstetrics and gynecology] De standaard 'Hormonale anticonceptie' (tweede herziening) van het Nederlands Huisartsen Genootschap; reactie vanuit de verloskunde-gynaecologie.

    Knuist M; Hamerlynck JV

    Nederlands Tijdschrift voor Geneeskunde. 2004 Jun 26; 148(26):1274-1275.

    The Dutch College of General Practitioners' (NHG) guideline on hormonal contraception does not follow the WHO criteria for the use of oral contraceptives in contrast to the guideline of the Dutch Society of Obstetrics and Gynaecology. Contrary to the WHO criteria, the NHG guideline considers a blood-pressure measurement before starting with an oral contraceptive to be unnecessary. It also considers no form of migraine to be contraindication for oral contraceptives. The NHG guideline further disclaims the (slightly) increased risk of developing breast cancer in women using oral contraceptives. It advises initiation of oral-contraceptive use two weeks postpartum in non-breast-feeding women and six weeks postpartum in breastfeeding women, instead of the three weeks and six months, respectively, indicated in the WHO guideline. Lastly, the NHG guideline is too optimistic as to the reliability of oral-contraceptive use, as no distinction is made between efficacy and effectiveness. Such discrepancies between two Dutch guidelines can be detrimental to women's health care. The WHO criteria for contraceptive use may be a valuable tool to overcome differences of opinion to as to achieve a badly needed full consensus. (author's)
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  19. 19
    276517
    Peer Reviewed

    Human resources and health outcomes: cross-country econometric study.

    Anand S; Bämighausen T

    Lancet. 2004 Oct 30; 364:1603-1609.

    Only a few studies have investigated the link between human resources for health and health outcomes, and they arrive at different conclusions. We tested the strength and significance of density of human resources for health with improved methods and a new WHO dataset. We did cross-country multiple regression analyses with maternal mortality rate, infant mortality rate, and under-five mortality rate as dependent variables. Aggregate density of human resources for health was an independent variable in one set of regressions; doctor and nurse densities separately were used in another set. We controlled for the effects of income, female adult literacy, and absolute income poverty. Density of human resources for health is significant in accounting for maternal mortality rate, infant mortality rate, and under-five mortality rate (with elasticities ranging from –0.474 to –0.212, all p values = 0.0036). The elasticities of the three mortality rates with respect to doctor density ranged from –0.386 to –0.174 (all p values = 0.0029). Nurse density was not associated except in the maternal mortality rate regression without income poverty (p = 0.0443). In addition to other determinants, the density of human resources for health is important in accounting for the variation in rates of maternal mortality, infant mortality, and under-five mortality across countries. The effect of this density in reducing maternal mortality is greater than in reducing child mortality, possibly because qualified medical personnel can better address the illnesses that put mothers at risk. Investment in human resources for health must be considered as part of a strategy to achieve the Millennium Development Goals of improving maternal health and reducing child mortality. (author's)
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  20. 20
    274753

    Making pregnancy safer.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2003. 4 p. (WHO/RHR/01.30)

    Pregnancy, Childbirth, Postpartum and Newborn Care A Guide for Essential Practice: A guide for the essential routine and emergency care of women and newborns during pregnancy, childbirth, postpartum and postabortion periods, which should be available at all levels of the health service with particular focus on primary health care. Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors: A guide for midwives and doctors at the district hospital who are responsible for the care of women with complications in pregnancy, childbirth or the immediate postpartum period, as well as the immediate care of newborns with problems. (excerpt)
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  21. 21
    193980

    Tuberculosis in Pakistan: are we losing the battle? [editorial]

    Khan JA; Malik A

    Journal of the Pakistan Medical Association. 2003 Aug; 53(8):[2] p..

    How many private practitioners (PPs) listening to usual complaints of 'fever, cough and weakness for over two weeks' consider a diagnosis of active tuberculosis? In Pakistan, where TB is endemic and has assumed large proportions, the diagnosis would be considered and correctly treated by only a small percentage of PPs. A study recently conducted by the authors in Karachi showed that only 66% PPs ordered sputum microscopy as the preferred method for diagnosing TB. Only 50% thought themselves as capable enough to treat patients with pulmonary TB. Only 21% doctors prescribed a correct regimen in accordance with NTP or WHO guidelines. In such circumstances, if the PPs are treating 80% of patients presenting to them with tuberculosis1, one can imagine how worse the situation can get. Despite the fact that World Health Organization (WHO), in its effort to control TB, declared it a global emergency in 1993, TB still continues to account for the largest burden of mortality by any infectious agent worldwide. It is the second leading cause of adult death in impoverished communities of Karachi. Globally, Pakistan ranks 8th in terms of estimated number of cases by WHO, with an incidence of 175/100,000 persons. Pakistan alone accounts for 44% of total TB burden in the Eastern Mediterranean Region of the WHO comprising 23 countries. (excerpt)
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  22. 22
    192541

    WHO recommendations [letter]

    Mansour D

    Journal of Family Planning and Reproductive Health Care. 2004 Apr; 30(2):131.

    May I congratulate the Journal and the Clinical Effectiveness Unit for continuing to produce excellent Guidance for those of us working in the field of reproductive health. The wide dissemination of these articles will ensure uniformity and quality in contraception provision in primary and secondary care. I have, however, one concern. This has been alluded to in a recent article describing the consensus process for adapting the World Health Organization (WHO) Selected Practice Recommendations for UK Use. As a result of the relaxation of some of the more cautious rules a very small number of women may become pregnant. An obvious example is giving Depo- Provera injections 2 weeks late (i.e. at 14 weeks) without any precautionary measures. The Selected Practice Recommendations for Contraceptive Use were developed to improve and extend contraceptive provision in developing countries. In developed countries, however, those becoming pregnant may take a more litigious view particularly when patient information leaflets and the Summaries of Product Characteristics (SPCs) state contrary and more cautious advice. In addition, new evidence regarding follicular development potential suggests that more, rather than less, caution may be advisable. Could the Faculty of Family Planning and Reproductive Health Care or the University of Aberdeen be sued? (excerpt)
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  23. 23
    186510
    Peer Reviewed

    FFPRHC Guidance (January 2004). The copper intrauterine device as long-term contraception.

    Royal College of Obstetricians and Gynaecologists. Faculty of Family Planning and Reproductive Health Care. Clinical Effectiveness Unit.

    Journal of Family Planning and Reproductive Health Care. 2004 Jan; 30(1):29-42.

    This Guidance provides information for clinicians providing women with copper-bearing intrauterine devices as long-term contraception. A key to the grades of recommendations, based on levels of evidence, is given at the end of this document. Details of the methods used by the Clinical Effectiveness Unit (CEU) in developing this Guidance and evidence tables summarising the research basis of the recommendations are available on the Faculty website (www.ffprhc.org.uk). Abbreviations (in alphabetical order) used include: acquired immune deficiency syndrome (AIDS); actinomyces-like organisms (ALOs); automated external defibrillator (AED); blood pressure (BP); British National Formulary (BNF); confidence interval (CI); copper-bearing intrauterine contraceptive device (IUD); emergency contraception (EC); Faculty Aid to Continuing Professional Development Topic (FACT); levonorgestrel-releasing intrauterine system (IUS); human immunodeficiency virus (HIV); Medicines and Healthcare products Regulatory Agency (MHRA); non-steroidal anti-inflammatory drugs (NSAIDs); odds ratio (OR); pelvic inflammatory disease (PID); relative risk (RR); Royal College of Obstetricians and Gynaecologists (RCOG); Scottish Intercollegiate Guidelines Network (SIGN); sexually transmitted infection (STI); termination of pregnancy (TOP); World Health Organization (WHO); WHO Medical Eligibility Criteria (WHOMEC); WHO Selected Practice Recommendations (WHOSPR). (author's)
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  24. 24
    190189
    Peer Reviewed

    WHO, the Global Fund, and medical malpractice in malaria treatment.

    Attaran A; Barnes KI; Curtis C; d'Alessandro U; Fanello CI

    Lancet. 2004 Jan 17; 363(9404):237-240.

    In 1998, WHO launched a new, high profile campaign to Roll Back Malaria, with the stated goal to halve malaria deaths worldwide by 2010. Achieving that goal requires preventive interventions (eg, insecticide-treated bednets, household insecticide spraying), but the main difference between life and death for malaria patients hinges on appropriate treatments. Simply, each malaria case must be promptly and accurately diagnosed, and treated with an effective malaria drug. However, with nearly half the time to the 2010 deadline now past, progress on effective treatment is so inadequate that Roll Back Malaria is failing to reach its targets. Far from being on track to halve malaria deaths, WHO acknowledges that “RBM [Roll Back Malaria] is acting against a background of increasing malaria burden”. (excerpt)
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  25. 25
    187531
    Peer Reviewed

    Gender and HIV / AIDS.

    Turmen T

    International Journal of Gynecology and Obstetrics. 2003 Sep; 82(3):411-418.

    The impact of gender on HIV/AIDS is an important dimension in understanding the evolution of the epidemic. How have gender inequality and discrimination against women affected the course of the HIV epidemic? This paper outlines the biological, social and cultural determinants that put women and adolescent girls at greater risk of HIV infection than men. Violence against women or the threat of violence often increases women’s vulnerability to HIV/AIDS. An analysis of the impact of gender on HIV/AIDS demonstrates the importance of integrating gender into HIV programming and finding ways to strengthen women by implementing policies and programs that increase their access to education and information. Women’s empowerment is vital to reversing the epidemic. (author's)
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