This document describes a study that investigated the reasons for the frequent failure of national health systems based on primary health care to make effective use of community health workers. The report assesses different national experiences in order to pinpoint weaknesses, trace key mistakes, and define corrective actions. The report opens with a brief historical overview of problems that have arisen in the use of community health workers and reasons for these problems. Noting that governments frequently fail to decide what community health workers are expected to achieve, the second section proposes an explicit definition of the place, role, and functions of community health workers within the context of a national health system. The report then identifies and explores eight weaknesses, ranging from policy and organizational errors that have built failure into the system to problems of poor selection, insufficient training, inadequate motivation, and lack of reward. Strategies to overcome each problem are proposed. Specific recommendations drawn from national experiences are also included. The final sections condense the contents into a series of conclusions and recommendations intended to guide the reshaping of national programs. Eight references and a 59-item reading list conclude the document. (KC)
This facilitators' guide for training community health workers (CHWs) and community volunteers (CVs) is intended for training in tuberculosis (TB) and integration of TB prevention and care services into community-based activities. The training lasts 3 days. It includes a PowerPoint slide set which is an integral part of the guide. Together these allow the facilitator to progress carefully from one idea to the next. This document is not for use directly by CHWs or CVs. The training includes six training modules. It starts with introductions objectives and norms followed by a brief presentation of the ENGAGE-TB approach which will enable CHWs and CVs to integrate TB activities into their existing work. The third module allows substantial time for CHWs and CVs to understand the basics of TB: its signs and symptoms and how it can be prevented and treated. The fourth module deals with integration of community-based TB services into community work. This is followed by a field visit to a TB clinic so that CHWs understand how clinical and laboratory aspects are handled. Finally the CHWs and CVs reflect on what they have learnt and describe how they will integrate TB services into their work on their return home.
Life expectancy is increasing in many parts of the world and more are also being enabled to live with disabling conditions that once might have been fatal. People who are chronically ill, have serious disabilities, have HIV/AIDS, are mentally ill, or victims of accidents and disasters, or elderly - many will need continuing care and support and these numbers will grow. How best to meet these needs is getting more attention. Such care is not to just look after the sick but to enable those with long term illnesses or disabilities to live their lives as fully as possible. Institutionalization is often not the best way of care and the home where the patient lives with family members and friends nearby is often more appropriate. This report examines the options, highlighting the clear benefits of home-based care whilst being aware of the needs of the carers in the home. The report stresses it is time for health systems to take responsibility for providing caregivers in families and communities with the support they both need, and to bring greater benefit to the patient.
Although poverty and gender significantly influence health and socio-economic development, health professionals are not always adequately prepared to address such issues in their work. This publication, one of a set of modules intended for use in pre-service and in-service training of health professionals in the Western Pacific Region, focuses on the inter-relationship between poverty and health, including definitions of poverty and its multiple dimensions; indicators of poverty including methods of determining the prevalence of poverty and inequality within a community; how the health care system can address issues of poverty, with a special focus on low-income women and those from other marginalised or vulnerable groups.
Improvements in health cannot be achieved in isolation as they require an integrated, multisectorial development approach. The WHO's Regional Office for the Eastern Mediterranean has introduced the following community-based initiatives: basic development needs approach; healthy villages programme; healthy cities programme; women in health and development. These community-based initiatives have provided a stimulus for health and human development. This training manual provides material to help develop trainers; update the knowledge of field managers; and reinforce leadership and management skills.
Annotation. Despite considerable progress in malaria control over the last 10 years, malaria is still a serious problem, particularly in sub-Saharan Africa where about 90 per cent of clinical cases occur. Malaria, either alone or in combination with other diseases, is estimated to kill between 1.1 and 2.7 million people worldwide each year. This report analyses the effect of health sector reforms on malaria control programmes.
Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.
WHO's concern is that, despite national and global efforts to control malaria, the disease burden remains high, especially in tropical Africa. The situation is further compounded in emergency situations. It is therefore necessary to review the current vector control strategies and their effectiveness in various operational and eco-epidemiological settings and to identify the challenges for implementation in different health systems. These would serve as a basis for the development of a strategic framework for strengthening malaria vector control implementation. The Roll Back Malaria (RBM) Initiative was launched by the WHO Director-General in 1998 as a Cabinet Project to coordinate global actions against malaria. The RBM goal is to reduce the global malaria burden by half by 2010 as compared to 2000"--Publisher's statement
Data collected (and organized by world region, gender and age groups) on the incidence and prevalence, severity and course of rheumatoid arthritis, osteoarthritis, osteoporosis, major limb trauma and spinal disorders, and their economic impact.
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