scholarly journals Epidemiology and Health Planning

2021 ◽  
pp. 178-198
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury

This chapter focuses on how local health teams can use epidemiology to help plan for health priorities and identify high-risk groups and to tackle inequalities. Using a systems approach epidemiology can help to strengthen primary health care and improve the delivery of district health services and programmes. These need to be delivered so people have high levels of access to high-quality services and programmes that also achieve high levels of population coverage.

2021 ◽  
pp. 1-19
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury

This chapter introduces the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) and the central role of epidemiological concepts, knowledge, and skills in planning, management, and evaluation of district health systems in support of primary health care. It focuses on interventions to improve the health status of whole populations and shows how epidemiology is essential to support local decision-making for improvements in the population’s health. Health planning is outlined using a systems approach for high-priority health services and public health programmes delivered by district health services and programmes. The differences between interventions for clinical medicine and public health are explained. The systems approach to district planning are also explained.


2021 ◽  
pp. 213-221
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury

Ethical practice is important for all health workers in public, non-government, and private health services that aim to strengthen primary health care. Four general principles are important: respect for the right of individuals to practice informed choices (autonomy), a fair distribution of benefits and risks (justice), benefits that should far outweigh risks (beneficence), and do no harm or injury (non-maleficence). Local health teams should use these principles together with national guidelines to organise a fair and just approach to district health planning, data collection, and local research studies.


2020 ◽  
Author(s):  
Naqibullah Hamdard ◽  
Alim Atarud ◽  
Khalid Seddiq ◽  
Anwar Hanif

Abstract BackgroundTuberculosis (TB) remains a global public health threat. World Health Organization (WHO) End TB strategy recommends that effective TB control relies on general health systems, especially, on integrated and well-functioning PHC facilities. Despite, integration in Basic Package of Health Services (BPHS), evidence demonstrates that a large number of TB cases are not captured. 25000 TB cases are missed every year (Aloudal, 2015). 49% of individuals, recorded at health facilities as presumptive to have TB have not been screened (HMIS, 2016). This study intended to evaluate different dimensions of TB surveillance system and the Primary Health Care (PHC) facilities' role in TB active case finding. MethodsWe conducted a cross-sectional study. The study was implemented in eleven provinces of Afghanistan in from August to November 2016. The geographic and demographic representativeness determined the choice of provinces. All primary health care facilities in studied provinces equated to 870, therefore, considering a 95 % confidence interval, a sample size of 161 facilities established the sample frame. A stratified sampling strategy facilitated the selection of sampled facilities within different categories from an inclusive list of all facilities.ResultsThe study found that the overall sensitivity of TB surveillance systems in-country is 56.30 %. This means that 43.70 % of 171 TB cases had remained undetected. 43.81 % of studies facilities used at least one accepted active case finding strategy while 56.20 % implemented none. In studied areas, 83.33 % of 11 studied DHs and 69.57 % of 35 studied CHCs had a referral system for MDR-TB patients.ConclusionTo enhance sensitivity and boost case findings, it is essential to implement case-finding strategies targeted at high-risk groups in specific areas. The high-risk groups include IDPs, returnees, slum residents, prisoners, and addicts. Additionally, it is necessary to train private pharmacists and traditional healers to identify and refer individuals with TB symptoms for follow up and further evaluation at the PHC level.


Parasitology ◽  
1989 ◽  
Vol 99 (S1) ◽  
pp. S81-S92 ◽  
Author(s):  
M. Tanner

SUMMARYDuring the last decade there has been a great increase in the number of countries that have endorsed the primary health care (PHC) policy at national level, set up national guidelines for it and launched its large-scale implementation. In addition, there have been many important developments with regard to appropriate, cost-effective technologies, training concepts and approaches to securing community participation. These achievements have produced numerous encouraging results. However, although the control of parasitic infections integrated into PHC systems has often been initially successful, these achievements could often not be sustained. Using case studies, mainly concerning schistosomiasis, as examples, control technologies and their applicability within PHC are discussed at three levels; the identification of public health priorities, the community-based implementation of control and the process of evaluation and monitoring. There is a great potential for the integration of a substantial part of control activities, particularly morbidity control, into PHC, provided that the aims and sequences of control activities are well matched with the felt needs of the communities concerned. This implies that the biomedical researcher, the epidemiologist and the health planner need to consider the indigenous health perspectives of the affected community. For example, recent progress in the laboratory in the development of vaccines against parasites needs to be complemented by field studies that continuously validate, standardize and assess the applicability of the proposed measures. This kind of interplay will form the basis for participatory approaches in health planning and make it possible for control activities to be integrated into existing PHC structures and to respond to the needs of the communities concerned.


Curationis ◽  
1978 ◽  
Vol 1 (3) ◽  
Author(s):  
J.V. Larsen

It has recently been demonstrated that about 56 percent of patients delivering in a rural obstetric unit had significant risk factors, and that 85 percent of these could have been detected by meticulous antenatal screening before the onset of labour. These figures show that the average rural obstetric unit in South Africa is dealing with a large percentage of high risk patients. In this work, it is hampered by: 1. Communications problems: i.e. bad roads, long distances. and unpredictable telephones. 2. A serious shortage of medical staff resulting in primary obstetric care being delivered by midwives with minimal medical supervision.


2013 ◽  
Vol 12 (4) ◽  
pp. 243 ◽  
Author(s):  
DanjumaAyotunde Bello ◽  
ZuwairaIbrahim Hassan ◽  
TolulopeOlumide Afolaranmi ◽  
YetundeOlubusayo Tagurum ◽  
OluwabunmiOluwayemisi Chirdan ◽  
...  

2021 ◽  
Vol 9 ◽  
Author(s):  
Babar S. Hasan ◽  
Muneera A. Rasheed ◽  
Asra Wahid ◽  
Raman Krishna Kumar ◽  
Liesl Zuhlke

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low and Middle-Income Countries (LMICs). If diagnosed and managed in a timely manner, as in high-income countries (HICs), most children lead a healthy life and achieve adulthood. However, children with CHD in LMICs have limited care available with subsequent impact on survival. The large disparity in global health research focus on this complex disease makes it a solid paradigm to shape the debate. Despite many challenges, an essential aspect of improving research in LMICs is the realization and ownership of the problem around paucity of local evidence by patients, health care providers, academic centers, and governments in these countries. We have created a theory of change model to address these challenges at a micro- (individual patient or physician or institutions delivering health care) and a macro- (government and health ministries) level, presenting suggested solutions for these complex problems. All stakeholders in the society, from government bodies, health ministries, and systems, to frontline healthcare workers and patients, need to be invested in addressing the local health problems and significantly increase data to define and improve the gaps in care in LMICs. Moreover, interventions can be designed for a more collaborative and effective HIC-LMIC and LMIC-LMIC partnership to increase resources, capacity building, and representation for long-term productivity.


Medicina ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 89-99
Author(s):  
S. T. Agliullina ◽  
◽  
L. M. Mukharyamova ◽  
G. R. Khasanova ◽  
L. A. Sitdikova ◽  
...  

The aim of the study was to analyze the attitude of the population to HIV testing and counseling and the frequency of testing-related counseling in a sample of the population of Kazan. Materials. An anonymous survey of various groups of the population permanently residing in the city of Kazan (n=301) was conducted using a questionnaire developed by us. The study involved 58.1% of women (175/301), 41.9% of men (126/301). Results. Most of the respondents had experience of undergoing HIV testing (95%, 286/301). Only 92 people out of 286 (32.2%) were examined on their own initiative. HIV testing was mainly carried out in the polyclinic at the place of residence/stay (66.8%, 191/286), while counseling, according to respondents, was carried out only in 16.20% of respondents (31/191). Conclusions. It is important to conduct a high-quality procedure of pre-and post-test counseling in the conditions of primary health care. It is necessary to train the medical staff of the polyclinic level in the skills of counseling on epidemiology and prevention of HIV infection.


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