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  1. 1
    375396

    Community health worker programmes in the WHO African Region: Evidence and options. Policy brief.

    World Health Organization [WHO]. Regional Office for Africa. Health Systems and Services Cluster

    Brazzaville, Republic of the Congo, WHO, Regional Office for Africa, 2017. 23 p. (Policy Brief)

    Community health worker (CHW) programmes have seen a renaissance in the last two decades and now many countries in Africa boast of such national or substantial sub-national programmes. The 2013 Third Global Forum on Human Resources for Health concluded that CHWs and other frontline primary health care workers “play a unique role and can be essential to accelerating MDGs and achieving UHC”, and called for their integration into national health systems. The Ebola virus disease (EVD) outbreak of 2014-2015 highlighted the imperative of ensuring the functioning of the health systems at the community level for both their day-to-day resilience and disaster preparedness. The purpose of this policy brief is to inform discussions and decisions in the World Health Organization (WHO) African Region on policies, strategies and programmes to increase access to primary health care (PHC) services and make progress towards universal health coverage (UHC) by expanding the implementation of scaled-up CHW programmes. This brief summarizes the existing evidence on CHW programmes with a focus on sub-Saharan Africa and offers a number of context-linked policy options for countries seeking to scale up and improve the effectiveness of their CHW programmes, particularly with regard to needs such as those of Guinea, Liberia and Sierra Leone, the three countries that were the most affected by the 2014-2015 EVD outbreak. For the purposes of this policy brief, a broad definition of CHW is used. CHWs are individuals “carrying out the functions related to health care delivery [who are] trained in some way in the context of the intervention [but have] no formal professional or paraprofessional certificated or degreed tertiary education [in a health-related field]”). WHO states that CHWs “should be members of the communities where they work, selected by the communities, answerable to the communities for their activities, and supported by the health system but not necessarily a part of its organization”. For the purposes of this brief, a working definition for a scaled-up CHW programme has been developed, where the term refers to a programme that is designed to be more than a pilot or demonstration project and has the intention of covering a substantial population size or geographic area, depending on the country’s context. (Excerpts)
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  2. 2
    340409

    Access to healthcare through community health workers in East and Southern Africa.

    Kumar M; Nefdt R; Ribaira E; Diallo K

    New York, New York, UNICEF, Program Division, Health Section, Knowledge Management and Implementation Research Unit, 2014 Jul. [70] p. (Maternal, Newborn and Child Health Working Paper)

    In addition to a comprehensive literature review, the study used a cross-sectional survey with close- and open-ended questions administered to UNICEF Country Offices and public sector key informants to investigate and map CHW characteristics and activities throughout the region. Responses were received from 20 of the 21 UNICEF Country Offices in the UNICEF East and Southern Africa region in May-June 20013. Data on 37 cadres from across the 20 countries made up of nearly 266,000 CHWs form the basis of this report. This report catalogues the types and characteristics of CHWs, their relationship to the broader health system, the health services they provide and geographic coverage of their work.
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  3. 3
    320992
    Peer Reviewed

    Surgical services in low-income and middle-income countries.

    Spiegel DA; Gosselin RA

    Lancet. 2007 Sep 22; 370(9592):1013-1015.

    Although substantial progress has been made in addressing the burden of communicable and vaccine-preventable diseases in low-income and middle-income countries, the burden of diseases that are surgically treatable is increasing and has been neglected. Both morbidity and mortality from surgically preventable (eg, elective hernia repair) or treatable (eg, strangulated hernia) disorders can be greatly decreased through simple surgical interventions. Why should a child die from appendicitis, or a mother and child succumb to obstructed labour, when simple surgical procedures can save their lives? Why should patients suffer permanent disability because of congenital abnormalities, fractures, burns, or the sequelae of acute infections such as septic arthritis or osteomyelitis? Many complications of HIV infection (eg, abscesses, fistulas, Kaposi sarcoma) are also amenable to simple surgical interventions. Available epidemiological information and experiential evidence lend support to the conclusion that basic surgical and anaesthetic services should be integrated into primary health-care packages. (excerpt)
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  4. 4
    313135

    HIV and AIDS and educator development, conduct, and support.

    Attawell K; Elder K

    Paris, France, UNESCO, 2006 Mar. 37 p. (Good Policy and Practice in HIV and AIDS and Education Booklet No. 3; ED-2006/WS/4; cld 26006)

    UNESCO recognizes the significant impact of HIV and AIDS on international development, and in particular on progress towards achieving Education For All (EFA). As the UN agency with a mandate in education and a co-sponsor of the Joint United Nations Programme on HIV and AIDS (UNAIDS), UNESCO takes a comprehensive approach to HIV and AIDS. It recognizes that education can play a critical role in preventing future HIV infections and that one of its primary roles is to help learners and educators in formal and non-formal education systems to avoid infection. It also recognizes its responsibility to address and respond to the impact of the epidemic on formal and non-formal education systems, and the need to expand efforts to address issues related to care, treatment and support of those infected and affected by HIV. UNESCO's global strategy for responding to HIV and AIDS is guided by four key principles, and focuses on five core tasks. The guiding principles that are the foundation of UNESCO's response to HIV and AIDS are: Work towards expanding educational opportunities and the quality of education for all; A multi-pronged approach that addresses both risk (individual awareness and behaviour) and vulnerability (contextual factors); Promotion and protection of human rights, promotion of gender equality, and elimination of violence (notably violence against women), stigma and discrimination; An approach to prevention based on providing information that is scientifically sound, culturally appropriate, and effectively communicated, and helping learners and educators to develop the skills they need to prevent HIV infection and to tackle HIV and AIDS-related discrimination. (excerpt)
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  5. 5
    312461

    Engaging all health care providers in TB control. Guidance on implementing public-private mix approaches.

    Uplekar M; Lonnroth K

    Geneva, Switzerland, World Health Organization [WHO], Stop TB Department, 2006. 52 p. (WHO/HTM/TB/2006.360)

    A great deal of progress has been made in global tuberculosis control in recent years through the large-scale implementation of DOTS. It has been acknowledged though that TB control efforts worldwide, although impressive, are not sufficient. The global TB targets -- detecting 70% of TB cases and successfully treating 85% of them, and halving the prevalence and mortality of the disease by 2015 as part of the Millennium Development Goals (MDGs) -- are likely to be met only if current efforts are intensified. Among the important interventions required to reach these goals would be a systematic involvement of all relevant health care providers in delivering effective TB services to all segments of the population. Therefore, engaging all health care providers in TB control is an essential component of WHO's new Stop TB strategy¹ and the Stop TB Partnership's Global Plan to Stop TB 2006-2015. (excerpt)
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  6. 6
    059776

    A simple cure for diarrhoea.

    Borra A

    WORLD HEALTH. 1989 Nov; 14-5.

    Diarrheal diseases continue to be the major causes of death for children in 4 Western Pacific Region nations: the Lao People's Democratic Republic, Papua New Guinea, the Philippines, and Viet Nam. They are also among the most frequent childhood illnesses in 18 of 35 countries and areas of the region. Many children die because physicians, health workers, and mothers do not know that oral rehydration therapy (ORT) is the single most effective treatment for diarrhea. All too often, older or hospital based physicians prescribe antidiarrheal drugs or antibiotics. ORT can successfully treat 90-95% of acute diarrheal cases. The oral rehydration salts (salt, glucose, sodium bicarbonate, and potassium chloride) are mixed with potable water so the child with diarrhea can drink it. The mixture replaces the water and salts removed from the body during diarrheal episodes. The 1st Diarrhoeal Training Unit (DTU) of the WHO Global Diarrhoeal Diseases Control programme in the region was found in Manila, the Philippines in December 1985. Its purpose continues to be the provision of hands-on training for health professionals in hospitals to convince them that ORT is effective. In 1988, 12 DTUs existed in such countries as China, the Lao People's Democratic Republic, Papua New Guinea, the Philippines, and Viet Nam. They will soon also operate out of medical, nursing, and midwifery schools. Even though 60% of the population in the Western Pacific Region has access to ORT packets, too many mothers still do no use them to treat their children with diarrhea. Further, they do not know that they should continue to feed them. In 1988 in the region, an estimated 50,000 children lived who would have died without ORT.
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  7. 7
    268447

    Report on the evaluation of the UNFPA-supported women, population and development projects in Indonesia (INS/79/P20 and INS/83/P02) and of the role of women in three other UNFPA-supported projects in Indonesia (INS/77/P03, INS/79/P04, and INS/79/P16).

    Concepcion MB; Thein TM; Simonen M

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Apr. vi, 52 p.

    The Evaluation Mission analyzes and assess the 2 United Nations Fund for Population Activities (UNFPA)-supported Women, Population and Development Projects and the role of women in 3 other UNFPA-assisted projects in Indonesia. The Mission concluded that the family planning and cooperative/income generation scheme as evolved in the 2 projects has contributed to increasing contraceptive acceptance and continuation and to a shift from the less reliable to the more reliable contraceptive methods. The projects have also assisted women and their families to expand their income generating activities, raise their incomes, and improve the family's standard of living. The Mission recommends that: 1) more diversified income producing activities be encouraged; 2) product outlets be identified and mapped and appropriate marketing strategies devised; 2) loan repayment schedules be carefully examined; 4) data collection, monitoring and evaluation be streamlined and strenghthened; and 5) the process of the entire rural cooperatives/income generation scheme be more comprehensively documented. In the 3 other projects, which are addressed to both men and women, the needs and concerns of women have not been adequately taken into account and/or the participation of women in all phases of the projects and their access to project benefits have not been equal to men. The Mission therefore recommends that special consideration be given to women's concerns in the design and formulation of all projects. The Mission ascertained that non-women specific projects tend to perpetuate existing discriminatory or unequal access to, and control of, resources by women unless specific consideration is accorded to them.
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