The public health workforce is a key component of public health system.To articulate the scope of public health workforce,we reviewed the relevant World Health Organization(wHO)guidance and peer-reviewed journal artic...The public health workforce is a key component of public health system.To articulate the scope of public health workforce,we reviewed the relevant World Health Organization(wHO)guidance and peer-reviewed journal articles on this subject.Specifically,we assessed and compared the relevant publications produced by WHO Headquarters and Regional Offices along with other literature on this issue.Our focus was on the“occupation,workplace setting,and employer of public health workforce”.It is noteworthy that WHO has adopted a conceptual framework with an inclusive scope of the public health workforce,while setting out a 5-year vision to strengthen capacity across all WHO Member States for a multidisciplinary workforce to deliver the essential public health functions,including emergency preparedness and response.The importance of public health workforce in global and national responses to the coronavirus disease 2019(COVID-19)pandemic is recognized.We also observed that there were diverse understandings of the scope of public health workforce worldwide,including macro-,meso-and micro-level perspectives.In the post-COVID-19 era,we suggest that policy-makers and practitioners at the national,regional and global level adopt a coordinated approach to expand and strengthen the national workforce as guided by the WHO towards the health-related targets of United Nations Sustainable Development Goals such as health security and Universal Health Coverage.展开更多
Agricultural workers are among the most vulnerable groups facing occupational health risks,yet their protection remains insufficient globally.Despite employing nearly one-third of the global workforce,agriculture is o...Agricultural workers are among the most vulnerable groups facing occupational health risks,yet their protection remains insufficient globally.Despite employing nearly one-third of the global workforce,agriculture is one of the most hazardous sectors,with risks intensified by climate change and limited regulatory coverage.This commentary examines emerging challenges,research gaps,and policy directions,with a focus on international frameworks and China's recent experiences.While initiatives like Healthy China 2030 and pilot projects using international tools have advanced rural occupational health,major barriers persist,especially for precarious and informal agricultural workers.Strengthening national actions and international coordination is urgently needed.Reviving the Joint ILO/WHO Committee on Occupational Health would help bridge the gap between global commitments and local implementation.Protecting agricultural workers is essential for promoting human rights,advancing public health resilience,and achieving sustainable development goals related to health,labor,and food security.展开更多
The Belt and Road Initiative provides a unique opportunity to improve health outcomes in vast regions of the world. Launched in 2013, the Initiative has been conceived as a platform for collaboration that is forward-l...The Belt and Road Initiative provides a unique opportunity to improve health outcomes in vast regions of the world. Launched in 2013, the Initiative has been conceived as a platform for collaboration that is forward-looking and mutually benefi cial. It is being built on shared values and a vision of a common destiny. As the Chinese President Xi Jinping said in September 2018, China hopes to create “a road of peace, prosperity, openness, green development and innovation and a road that brings together different civilizations.”[1]展开更多
Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 re...Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.展开更多
Objective:To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.Methods:This study was a retrospective evaluation of the quality of malaria case management at...Objective:To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.Methods:This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage.The review period was from January to December 2008.The sample included twelve lower level health facilities from four districts.The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities,more than 80%of the patients had a temperature taken to establish their fever status.About 67%(CI_(95)66.1-68.7)were tested for parasitemia by either rapid diagnostic test or microscopy,whereas the remaining22.5%(CI_(95)213.1-23.7)were not subjected to any malaria test.Of the 2247 malaria cases reported(complicated and uncomplicated),71%were parasitologicaily confirmed while 29%were clinically diagnosed(unconfirmed).About 56%.(CI_(95)53.9-58.1)of the malaria cases reported were treated with artemether-lumefantrine(AL),35%(CI_(95)33.1-37.0)with sulphadoxine-pyrimethamine,8%(CI_(95)6.9-9.2)with quinine and 1%did not receive any anti-malarial.Approximately 30%of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial,contrary to the guidelines.There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used,and in the choice of anti-malarials for the treatment of malaria confirmed cases.Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not.Gender,in service training on malaria,years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices.Conclusions:Malaria case management was characterised by poor adherence to treatment guidelines.The non-adherence was mainly in leans of:inconsistent use of confirmatory tests(rapid diagnostic test or microscopy)for malaria;prescribing anti-malarials which are not recommended(e.g.sulphadoxine-pyrimethamine)and prescribing anti-malarials to cases testing negative.Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.展开更多
Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With j...Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With just 11 years to achieve its goal of universal health coverage by the year 2030, significant efforts will be needed to quantify the scale of the burden facing decision-makers about health system strengthening and redevelopment. Convergence of the health systems will be an additional challenge in Myanmar. Methods: Results from a WHO study in 2009 and 2014, combined with data from the 2016 Global Burden of Disease Study, were compiled and analysed for Myanmar to assess the levels and trends of selected NCDs and NCD risk factors. Results: The prevalence of major NCDs in Myanmar are in general higher than global and regional averages, with a significant increase in diabetes mellitus and chronic obstructive pulmonary diseases in the last 25 years. Major NCD risk factors in Myanmar include smoking, use of smokeless tobacco, alcohol consumption among men, low level of fruit and vegetable consumption, hypertension, and emerging of overweight and obesity, especially among women. Tobacco use increased in both sexes between 2009 and 2014, but only significantly in men. Rates of hypertension increased for both men and women, including those currently on medications—suggesting a need for better treatment regimens. Overweight and obesity rates increased in both men and women, although the increase in obesity for men was not significant. Alcohol consumption results were mixed—with lower levels of high level drinking in men, but generally increased consumption by women. Intake of fruit and vegetables increased slightly between 2009 and 2014 and rates of high levels of physical activity also increased. Diabetes prevalence rates increased significantly in women (X2 = 11.3;p = 0.01) and men (X2 = 9.6;p = 0.02) between 2009 and 2014. Conclusions: Improved awareness of risk factors, coupled with early diagnosis and effective treatment of conditions and risks, is paramount to keeping the population healthy and economically active, and maintaining health care costs. Proven cost-effective interventions to prevent and control NCD-related risk factors, notably increasing tobacco taxes, should be endorsed and implemented in the population. Inaction could hamper the country’s effort to achieve universal health coverage by the year 2030.展开更多
<strong>Background:</strong> Main purpose of this article is to offer information, criteria and conceptual proposals that could clarify the extent or scope of environmental health, and systematize the appr...<strong>Background:</strong> Main purpose of this article is to offer information, criteria and conceptual proposals that could clarify the extent or scope of environmental health, and systematize the approaches for its institutional stewardship by environmental health services. Hopefully, it will be useful to managers, professionals, technicians and academics involved in the management, implementation, teaching or research of this multidisciplinary field. <strong>Methods:</strong> The notion of “environment” is examined, a definition is proposed, and a look is taken at the “green” and “blue” sides of environmental problems. A number of understandings in various countries for “environmental health” are put forth and lists of basic areas for environmental health are analyzed. <strong>Results:</strong> One finding is that all lists are, in reality, unsystematic groupings of three different constituents: determinants, processes and functions. Consideration of these groupings leads to a homogeneous list of 18 areas and 77 sub-areas. Sets or series are provided for each type of constituent (64 determinants, 18 processes and 25 functions), and their aggregation forms the enormous universe of environmental health activities. On the other hand, certain rules of operation are proposed which make it possible, through a form of algebra, to construct expressions based on the provided sets of constituents. And it becomes possible to employ a common symbolic language for describing or assigning activities in the environmental health services. <strong>Conclusions:</strong> The article analyses the contemporaneous extent of environmental health.展开更多
There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in fo...There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in formulating appropriate policies aimed at improving people’s lives due to lack of evidence-based research findings. We describe the potential of a Health and Demographic Surveillance System (HDSS) in informing appropriate health interventions towards reducing the high maternal and child deaths in rural communities of north western Nigeria through the Verbal Autopsy (VA) data collection. VA data collection involves the use of VA questionnaires—set of open ended and closed ended questions adapted from the World Health Organization (WHO) module— administered to the caregivers, parents or family members of a deceased person to elicit information on signs and symptoms and their durations, and other pertinent information about the deceased in the period before death. VA interviews were conducted by trained VA enumerators on all 2100 deaths reported during the update round 4 of routine data collection (July-December, 2012) and returned forms were checked for consistencies and completeness by a trained research officer. The forms were later coded by trained medical doctors for possible cause of death using the WHO International Classification of Diseases (ICD 10) codes. Fifty cases of neonatal deaths, 1650 cases of infant and child deaths, and 400 cases of adult deaths were reported during the update round 4 data collection. Neonatal sepsis was reported as the leading cause of neonatal deaths (58%) while malaria and intestinal infectious diseases were reported as the leading cause of infant and child deaths and adult deaths respectively (45% and 17%, respectively). The study provides documented evidence of high neonatal deaths due to neonatal sepsis in an area with low hygiene and high home delivery rates. The findings from the VA data collection at Nahuche HDSS inform the intervention study on home distribution of chlorhexidine to pregnant women. The findings from this study call on government and other stakeholders to strengthen research capacity to generate timely data and findings returned to policy makers within the shortest period of time for decision making.展开更多
The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Man...The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Many local hospitals have reported a surge of cases, with most cases presenting with severe respiratory complications. We aim to present a comprehensive surge filter protocol for outpatient programs to mitigate the surge of cases admitted in the emergency rooms and intensive care units (ICUs) of local hospitals in our community. Our surge filter protocol was developed based on a detailed review of how South Korea and Spain mounted their outpatient surge responses. Our preliminary findings revealed that our Four-Ts approach (<em>i.e.</em>, Test, Treat, Track, and Teach) has resulted in none of our patients reaching a clinical requirement for inpatient care.展开更多
This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthc...This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthcare delivery model including philosophies/values,structure,process and outcome were used to conduct a quality assessment of the integrated health system in Ghana.Each element clearly showed that Ghana is currently not running a coordinated health practice model,thus making it a tolerant,rather than an inclusive,health system.Therefore,the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana.The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics.As such,governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings.Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings.This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.展开更多
Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal ...Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.展开更多
Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and espec...Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.展开更多
An emerging healthcare delivery model is enabling a new era of clinical care based on well-informed decision-making processes.Current healthcare information systems(HISs)fall short of adopting this model due to a conf...An emerging healthcare delivery model is enabling a new era of clinical care based on well-informed decision-making processes.Current healthcare information systems(HISs)fall short of adopting this model due to a conflict between information security needed to implement the new model and those already enforced locally to support traditional care models.Meanwhile,in recent times,the healthcare sector has shown a substantial interest in the potential of using blockchain technology for providing quality care to patients.No blockchain solution proposed so far has fully addressed emerging cross-organization information-sharing needs in healthcare.In this paper,we aim to study the use of blockchain in equipping struggling HISs to cope with the demands of the new healthcare delivery model,by proposing HealthyBlockchain as a granular patient-centered ledger that digitally tracks a patient’s medical transactions all along the treatment pathway to support the care teams.The patient-centered ledger is a neutral tamper-proof trail timestamp block sequence that governs distributed patient information across the decentralized discrete HISs.HealthyBlockchain connects patients,clinicians,and healthcare providers to facilitate a transparent,trustworthy,and secure supporting platform.展开更多
Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. W...Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.展开更多
</span><b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></b></span><b> </b><span style=&...</span><b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></b></span><b> </b><span style="font-family:Verdana;">The coronavirus disease 2019 (COVID-19) incidence continues to rise in many parts of the world with increasing fatality. At the same time, tuberculosis (TB) has been identified as the leading cause of death amongst all infectious diseases globally. Routine screening of clients visiting health facilities can help to prevent the spread of these diseases. <b></span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"></b></span><b> </b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">assess the </span><span style="font-family:Verdana;">relationship between the practice of facility-based routine tuberculosis</span><span style="font-family:Verdana;"> screening and routine screening for COVID-19. <b></span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"></b> Using a Snowball technique, a cross-sectional online survey was carried out during the national lockdown from 5 July to 5 August 2020. The target population for this survey was health care workers from the different health facilities across Nigeria. </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">An </span><span style="font-family:Verdana;">online semi-structured questionnaire was used to interview healthcare workers to identify their </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">knowledge, attitudes, and practices (KAP) towards</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> COVID-19 and the practice of routine TB screening. Descriptive analysis, analysis of variance (ANOVA), and Pearson’s Chi-square test was used for statistical comparative analysis. <b></span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></b> This shows that 53.9% of healthcare workers did not practice routine TB screening while 46.9% did not practice routine COVID-19 screening. Respondents who practiced routine TB screening were found to be more likely to practice routine COVID-19 screening (p</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.001). Healthcare workers in primary healthcare centers were more likely to carry out routine screening for both diseases (p</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">0.001) and among these, Com</span><span style="font-family:Verdana;">munity Healthcare Workers were more likely to carry out routine screening for both diseases than other cadres (p</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.001). </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"><b></span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sion/Recommendation:</span></b><span style="font-family:Verdana;"></b> Routine screening for infectious diseases is still not institutionalized in the Nigerian health system, making the control of these diseases difficult. Continued sensitization on the need for routine screening for infectious diseases like TB and COVID-19 should be done for healthcare workers at the different levels in the health care system.展开更多
The aim of this study was to ascertain performance of Healthcare Facilities on safe healthcare waste management practices. To achieve this, a national assessment was conducted country wide to assess performance of var...The aim of this study was to ascertain performance of Healthcare Facilities on safe healthcare waste management practices. To achieve this, a national assessment was conducted country wide to assess performance of various healthcare practices related to waste materials management, WASH, and Hygiene practices as linked to infection prevention and control. The assessment of healthcare waste management in the facilities was conducted in all the 26 regions of Tanzania Mainland for one month. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that most of permanent staff (88%) in the Healthcare facilities had knowledge on hand hygiene, but the gap was observed to the waste handlers (12%) who were not equipped with the hand hygiene knowledge. About 89% of the hand washing stations were available at mortuary units, followed by 75% at main entrance and the lowest was 3% at waste zone areas of the healthcare facilities. Hand washing materials like soap were mainly found at theaters (64%) followed by mortuary (60%) and last at waste zones. It was concluded that handling of HCW is not properly practiced to the expectations, necessitating strengthens of supervision. The findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.展开更多
The aim of this study was to assess Readiness of Healthcare facilities to Implement onsite Healthcare Waste Management Protocols and Incineration Guidelines in Tanzania. To address this, a national assessment was cond...The aim of this study was to assess Readiness of Healthcare facilities to Implement onsite Healthcare Waste Management Protocols and Incineration Guidelines in Tanzania. To address this, a national assessment was conducted country wide to assess readiness of Healthcare Facilities (HCFs) to undertake various Healthcare Waste Management (HCWM) initiatives with particular focus to adherence to HCWM protocols and incineration guidelines. The assessment of healthcare waste management was conducted in facilities in the 26 regions of Tanzania mainland for one month. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that 46.2%, 33.3% and 25% of the health centres, district hospitals and regional hospitals did not have appointed supervisors, which makes it difficult for the HCFs to perform better in managing healthcare waste in their respective facilities. It was further revealed that healthcare facilities have made remarkable improvement in the overall healthcare waste management with evidence of ongoing common activity on purchasing injection safety boxes (69.2%) and purchasing of waste bins (53.8%) at all levels. On average, about 70% of the HCFs have plans and budget though inadequate to support HCWM activities. In a conclusion Healthcare Facilities must designate a better system to compressively address healthcare waste management issues. Again the findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.展开更多
Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) ...Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.展开更多
Context/objectives: The COVID-19 pandemic has disrupted all programs, potentially impacting access to health services for children under 5 years old. The Far North of Cameroon is one of the northern regions with a pre...Context/objectives: The COVID-19 pandemic has disrupted all programs, potentially impacting access to health services for children under 5 years old. The Far North of Cameroon is one of the northern regions with a prevalence of malnourished children ranging from 5% to 10%. Due to the barrier measures implemented to combat the pandemic, many parents are reluctant to take their children to healthcare facilities. Some of these children were benefiting from the Ambulatory Care Center (ACC) program prior to the COVID-19 outbreak. The main objective of this research is to assess the impact of COVID-19 on access to health services for children under 5 in the Mayo Tsanaga (MT) and Logone & Chari (LC) departments. The implementation of barrier measures could significantly increase the risk of malnutrition among children under 5 years old. Method: A cross-sectional analytical study was conducted in the MT and LC departments, employing both retrospective and prospective approaches. Data was collected through questionnaire, interview guide and a review of existing data prior to the pandemic (DHIS 2). Kobo Collect software was used for data collection, and R software was used for analysis. Results: Children who benefitted from the ACC program during the COVID-19 period were found to have a lower prevalence of malnutrition compared to those who did not benefit (OR: 0.09, CI {0.0 - 0.44}). Conclusion: COVID-19 has led to a decrease in the utilization of health facilities in both departments of the study, resulting in an increase in health issues such as malnutrition among children under 5 years old. Various policies have been implemented to improve attendance at health facilities.展开更多
文摘The public health workforce is a key component of public health system.To articulate the scope of public health workforce,we reviewed the relevant World Health Organization(wHO)guidance and peer-reviewed journal articles on this subject.Specifically,we assessed and compared the relevant publications produced by WHO Headquarters and Regional Offices along with other literature on this issue.Our focus was on the“occupation,workplace setting,and employer of public health workforce”.It is noteworthy that WHO has adopted a conceptual framework with an inclusive scope of the public health workforce,while setting out a 5-year vision to strengthen capacity across all WHO Member States for a multidisciplinary workforce to deliver the essential public health functions,including emergency preparedness and response.The importance of public health workforce in global and national responses to the coronavirus disease 2019(COVID-19)pandemic is recognized.We also observed that there were diverse understandings of the scope of public health workforce worldwide,including macro-,meso-and micro-level perspectives.In the post-COVID-19 era,we suggest that policy-makers and practitioners at the national,regional and global level adopt a coordinated approach to expand and strengthen the national workforce as guided by the WHO towards the health-related targets of United Nations Sustainable Development Goals such as health security and Universal Health Coverage.
基金the Project to Carry Out International Expert Consultation and Promote the Alignment of China's Occupational Health with International High-Standard Technical Rules(2024-2025)which is funded by the Ministry of Human Resources and Social Security of the People's Republic of China(Grant No.H20240785).
文摘Agricultural workers are among the most vulnerable groups facing occupational health risks,yet their protection remains insufficient globally.Despite employing nearly one-third of the global workforce,agriculture is one of the most hazardous sectors,with risks intensified by climate change and limited regulatory coverage.This commentary examines emerging challenges,research gaps,and policy directions,with a focus on international frameworks and China's recent experiences.While initiatives like Healthy China 2030 and pilot projects using international tools have advanced rural occupational health,major barriers persist,especially for precarious and informal agricultural workers.Strengthening national actions and international coordination is urgently needed.Reviving the Joint ILO/WHO Committee on Occupational Health would help bridge the gap between global commitments and local implementation.Protecting agricultural workers is essential for promoting human rights,advancing public health resilience,and achieving sustainable development goals related to health,labor,and food security.
文摘The Belt and Road Initiative provides a unique opportunity to improve health outcomes in vast regions of the world. Launched in 2013, the Initiative has been conceived as a platform for collaboration that is forward-looking and mutually benefi cial. It is being built on shared values and a vision of a common destiny. As the Chinese President Xi Jinping said in September 2018, China hopes to create “a road of peace, prosperity, openness, green development and innovation and a road that brings together different civilizations.”[1]
基金supported by the Project of International Expert Consultation for the National Occupational Health System Innovation funded by the Ministry of Science and Technology of China in 2020-2022(Grant No.G20200001489).
文摘Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.
基金Supported by The Bill and Melinda Gates Foundation support to PATH for the Malaria Control Evaluation Partnership for Africa(MACEPA)project,Grant Number:OPP1013468
文摘Objective:To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.Methods:This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage.The review period was from January to December 2008.The sample included twelve lower level health facilities from four districts.The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities,more than 80%of the patients had a temperature taken to establish their fever status.About 67%(CI_(95)66.1-68.7)were tested for parasitemia by either rapid diagnostic test or microscopy,whereas the remaining22.5%(CI_(95)213.1-23.7)were not subjected to any malaria test.Of the 2247 malaria cases reported(complicated and uncomplicated),71%were parasitologicaily confirmed while 29%were clinically diagnosed(unconfirmed).About 56%.(CI_(95)53.9-58.1)of the malaria cases reported were treated with artemether-lumefantrine(AL),35%(CI_(95)33.1-37.0)with sulphadoxine-pyrimethamine,8%(CI_(95)6.9-9.2)with quinine and 1%did not receive any anti-malarial.Approximately 30%of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial,contrary to the guidelines.There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used,and in the choice of anti-malarials for the treatment of malaria confirmed cases.Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not.Gender,in service training on malaria,years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices.Conclusions:Malaria case management was characterised by poor adherence to treatment guidelines.The non-adherence was mainly in leans of:inconsistent use of confirmatory tests(rapid diagnostic test or microscopy)for malaria;prescribing anti-malarials which are not recommended(e.g.sulphadoxine-pyrimethamine)and prescribing anti-malarials to cases testing negative.Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.
文摘Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With just 11 years to achieve its goal of universal health coverage by the year 2030, significant efforts will be needed to quantify the scale of the burden facing decision-makers about health system strengthening and redevelopment. Convergence of the health systems will be an additional challenge in Myanmar. Methods: Results from a WHO study in 2009 and 2014, combined with data from the 2016 Global Burden of Disease Study, were compiled and analysed for Myanmar to assess the levels and trends of selected NCDs and NCD risk factors. Results: The prevalence of major NCDs in Myanmar are in general higher than global and regional averages, with a significant increase in diabetes mellitus and chronic obstructive pulmonary diseases in the last 25 years. Major NCD risk factors in Myanmar include smoking, use of smokeless tobacco, alcohol consumption among men, low level of fruit and vegetable consumption, hypertension, and emerging of overweight and obesity, especially among women. Tobacco use increased in both sexes between 2009 and 2014, but only significantly in men. Rates of hypertension increased for both men and women, including those currently on medications—suggesting a need for better treatment regimens. Overweight and obesity rates increased in both men and women, although the increase in obesity for men was not significant. Alcohol consumption results were mixed—with lower levels of high level drinking in men, but generally increased consumption by women. Intake of fruit and vegetables increased slightly between 2009 and 2014 and rates of high levels of physical activity also increased. Diabetes prevalence rates increased significantly in women (X2 = 11.3;p = 0.01) and men (X2 = 9.6;p = 0.02) between 2009 and 2014. Conclusions: Improved awareness of risk factors, coupled with early diagnosis and effective treatment of conditions and risks, is paramount to keeping the population healthy and economically active, and maintaining health care costs. Proven cost-effective interventions to prevent and control NCD-related risk factors, notably increasing tobacco taxes, should be endorsed and implemented in the population. Inaction could hamper the country’s effort to achieve universal health coverage by the year 2030.
文摘<strong>Background:</strong> Main purpose of this article is to offer information, criteria and conceptual proposals that could clarify the extent or scope of environmental health, and systematize the approaches for its institutional stewardship by environmental health services. Hopefully, it will be useful to managers, professionals, technicians and academics involved in the management, implementation, teaching or research of this multidisciplinary field. <strong>Methods:</strong> The notion of “environment” is examined, a definition is proposed, and a look is taken at the “green” and “blue” sides of environmental problems. A number of understandings in various countries for “environmental health” are put forth and lists of basic areas for environmental health are analyzed. <strong>Results:</strong> One finding is that all lists are, in reality, unsystematic groupings of three different constituents: determinants, processes and functions. Consideration of these groupings leads to a homogeneous list of 18 areas and 77 sub-areas. Sets or series are provided for each type of constituent (64 determinants, 18 processes and 25 functions), and their aggregation forms the enormous universe of environmental health activities. On the other hand, certain rules of operation are proposed which make it possible, through a form of algebra, to construct expressions based on the provided sets of constituents. And it becomes possible to employ a common symbolic language for describing or assigning activities in the environmental health services. <strong>Conclusions:</strong> The article analyses the contemporaneous extent of environmental health.
文摘There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in formulating appropriate policies aimed at improving people’s lives due to lack of evidence-based research findings. We describe the potential of a Health and Demographic Surveillance System (HDSS) in informing appropriate health interventions towards reducing the high maternal and child deaths in rural communities of north western Nigeria through the Verbal Autopsy (VA) data collection. VA data collection involves the use of VA questionnaires—set of open ended and closed ended questions adapted from the World Health Organization (WHO) module— administered to the caregivers, parents or family members of a deceased person to elicit information on signs and symptoms and their durations, and other pertinent information about the deceased in the period before death. VA interviews were conducted by trained VA enumerators on all 2100 deaths reported during the update round 4 of routine data collection (July-December, 2012) and returned forms were checked for consistencies and completeness by a trained research officer. The forms were later coded by trained medical doctors for possible cause of death using the WHO International Classification of Diseases (ICD 10) codes. Fifty cases of neonatal deaths, 1650 cases of infant and child deaths, and 400 cases of adult deaths were reported during the update round 4 data collection. Neonatal sepsis was reported as the leading cause of neonatal deaths (58%) while malaria and intestinal infectious diseases were reported as the leading cause of infant and child deaths and adult deaths respectively (45% and 17%, respectively). The study provides documented evidence of high neonatal deaths due to neonatal sepsis in an area with low hygiene and high home delivery rates. The findings from the VA data collection at Nahuche HDSS inform the intervention study on home distribution of chlorhexidine to pregnant women. The findings from this study call on government and other stakeholders to strengthen research capacity to generate timely data and findings returned to policy makers within the shortest period of time for decision making.
文摘The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Many local hospitals have reported a surge of cases, with most cases presenting with severe respiratory complications. We aim to present a comprehensive surge filter protocol for outpatient programs to mitigate the surge of cases admitted in the emergency rooms and intensive care units (ICUs) of local hospitals in our community. Our surge filter protocol was developed based on a detailed review of how South Korea and Spain mounted their outpatient surge responses. Our preliminary findings revealed that our Four-Ts approach (<em>i.e.</em>, Test, Treat, Track, and Teach) has resulted in none of our patients reaching a clinical requirement for inpatient care.
文摘This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthcare delivery model including philosophies/values,structure,process and outcome were used to conduct a quality assessment of the integrated health system in Ghana.Each element clearly showed that Ghana is currently not running a coordinated health practice model,thus making it a tolerant,rather than an inclusive,health system.Therefore,the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana.The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics.As such,governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings.Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings.This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.
文摘Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.
文摘Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.
基金funding from Ibn Khaldun Fellowship for Saudi Women in partnership with the Center for Clean Water and Clean Energy at MITthe Deanship of Scientific Research at King Saud University through research Group No.RG-1438-002。
文摘An emerging healthcare delivery model is enabling a new era of clinical care based on well-informed decision-making processes.Current healthcare information systems(HISs)fall short of adopting this model due to a conflict between information security needed to implement the new model and those already enforced locally to support traditional care models.Meanwhile,in recent times,the healthcare sector has shown a substantial interest in the potential of using blockchain technology for providing quality care to patients.No blockchain solution proposed so far has fully addressed emerging cross-organization information-sharing needs in healthcare.In this paper,we aim to study the use of blockchain in equipping struggling HISs to cope with the demands of the new healthcare delivery model,by proposing HealthyBlockchain as a granular patient-centered ledger that digitally tracks a patient’s medical transactions all along the treatment pathway to support the care teams.The patient-centered ledger is a neutral tamper-proof trail timestamp block sequence that governs distributed patient information across the decentralized discrete HISs.HealthyBlockchain connects patients,clinicians,and healthcare providers to facilitate a transparent,trustworthy,and secure supporting platform.
文摘Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.
文摘</span><b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></b></span><b> </b><span style="font-family:Verdana;">The coronavirus disease 2019 (COVID-19) incidence continues to rise in many parts of the world with increasing fatality. At the same time, tuberculosis (TB) has been identified as the leading cause of death amongst all infectious diseases globally. Routine screening of clients visiting health facilities can help to prevent the spread of these diseases. <b></span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"></b></span><b> </b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">assess the </span><span style="font-family:Verdana;">relationship between the practice of facility-based routine tuberculosis</span><span style="font-family:Verdana;"> screening and routine screening for COVID-19. <b></span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"></b> Using a Snowball technique, a cross-sectional online survey was carried out during the national lockdown from 5 July to 5 August 2020. The target population for this survey was health care workers from the different health facilities across Nigeria. </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">An </span><span style="font-family:Verdana;">online semi-structured questionnaire was used to interview healthcare workers to identify their </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">knowledge, attitudes, and practices (KAP) towards</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> COVID-19 and the practice of routine TB screening. Descriptive analysis, analysis of variance (ANOVA), and Pearson’s Chi-square test was used for statistical comparative analysis. <b></span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></b> This shows that 53.9% of healthcare workers did not practice routine TB screening while 46.9% did not practice routine COVID-19 screening. Respondents who practiced routine TB screening were found to be more likely to practice routine COVID-19 screening (p</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.001). Healthcare workers in primary healthcare centers were more likely to carry out routine screening for both diseases (p</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">0.001) and among these, Com</span><span style="font-family:Verdana;">munity Healthcare Workers were more likely to carry out routine screening for both diseases than other cadres (p</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.001). </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"><b></span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sion/Recommendation:</span></b><span style="font-family:Verdana;"></b> Routine screening for infectious diseases is still not institutionalized in the Nigerian health system, making the control of these diseases difficult. Continued sensitization on the need for routine screening for infectious diseases like TB and COVID-19 should be done for healthcare workers at the different levels in the health care system.
文摘The aim of this study was to ascertain performance of Healthcare Facilities on safe healthcare waste management practices. To achieve this, a national assessment was conducted country wide to assess performance of various healthcare practices related to waste materials management, WASH, and Hygiene practices as linked to infection prevention and control. The assessment of healthcare waste management in the facilities was conducted in all the 26 regions of Tanzania Mainland for one month. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that most of permanent staff (88%) in the Healthcare facilities had knowledge on hand hygiene, but the gap was observed to the waste handlers (12%) who were not equipped with the hand hygiene knowledge. About 89% of the hand washing stations were available at mortuary units, followed by 75% at main entrance and the lowest was 3% at waste zone areas of the healthcare facilities. Hand washing materials like soap were mainly found at theaters (64%) followed by mortuary (60%) and last at waste zones. It was concluded that handling of HCW is not properly practiced to the expectations, necessitating strengthens of supervision. The findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.
文摘The aim of this study was to assess Readiness of Healthcare facilities to Implement onsite Healthcare Waste Management Protocols and Incineration Guidelines in Tanzania. To address this, a national assessment was conducted country wide to assess readiness of Healthcare Facilities (HCFs) to undertake various Healthcare Waste Management (HCWM) initiatives with particular focus to adherence to HCWM protocols and incineration guidelines. The assessment of healthcare waste management was conducted in facilities in the 26 regions of Tanzania mainland for one month. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that 46.2%, 33.3% and 25% of the health centres, district hospitals and regional hospitals did not have appointed supervisors, which makes it difficult for the HCFs to perform better in managing healthcare waste in their respective facilities. It was further revealed that healthcare facilities have made remarkable improvement in the overall healthcare waste management with evidence of ongoing common activity on purchasing injection safety boxes (69.2%) and purchasing of waste bins (53.8%) at all levels. On average, about 70% of the HCFs have plans and budget though inadequate to support HCWM activities. In a conclusion Healthcare Facilities must designate a better system to compressively address healthcare waste management issues. Again the findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.
文摘Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
文摘Context/objectives: The COVID-19 pandemic has disrupted all programs, potentially impacting access to health services for children under 5 years old. The Far North of Cameroon is one of the northern regions with a prevalence of malnourished children ranging from 5% to 10%. Due to the barrier measures implemented to combat the pandemic, many parents are reluctant to take their children to healthcare facilities. Some of these children were benefiting from the Ambulatory Care Center (ACC) program prior to the COVID-19 outbreak. The main objective of this research is to assess the impact of COVID-19 on access to health services for children under 5 in the Mayo Tsanaga (MT) and Logone & Chari (LC) departments. The implementation of barrier measures could significantly increase the risk of malnutrition among children under 5 years old. Method: A cross-sectional analytical study was conducted in the MT and LC departments, employing both retrospective and prospective approaches. Data was collected through questionnaire, interview guide and a review of existing data prior to the pandemic (DHIS 2). Kobo Collect software was used for data collection, and R software was used for analysis. Results: Children who benefitted from the ACC program during the COVID-19 period were found to have a lower prevalence of malnutrition compared to those who did not benefit (OR: 0.09, CI {0.0 - 0.44}). Conclusion: COVID-19 has led to a decrease in the utilization of health facilities in both departments of the study, resulting in an increase in health issues such as malnutrition among children under 5 years old. Various policies have been implemented to improve attendance at health facilities.
