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Found 55 results
  1. Content Article
    Prolonged length of stay (LOS) in emergency departments (ED) is a widespread problem in every hospital around the globe. Multiple factors cause it and can have a negative impact on the quality of care provided to the patients and the patient satisfaction rates. This project aimed to ensure that the average LOS of patients in a tertiary care cancer hospital stays below 3 hours. 
  2. Content Article
    In this article for The Lancet, Professor Gagandeep Kang from the Bill & Melinda Gates Foundation examines what the story of rotavirus vaccine development in India can tell us about the opportunities, the necessary enabling environment and the challenges of creating products to improve global health. He highlights that although multiple successful vaccines were developed during the Covid-19 pandemic—in quantities that were inconceivable at the start of the pandemic—vaccine nationalism trumped the efforts of WHO, which established a prioritisation framework for vaccination of clinically vulnerable populations. The COVAX scheme was not successful in its aim to ensure that vaccines could be financed and distributed equitably around the world. This experience of delayed and low access to vaccines has led to calls for reparative justice and for moving away from short-term fixes of product donations to support local or regional vaccine manufacturing. Sharing intellectual property and enhancing regional capacity are now framed as moral imperatives against colonialism, and the development of the rotavirus vaccine provides lessons on how this can be achieved.
  3. News Article
    Five million children worldwide died before their fifth birthday in 2021, with almost half (47%) dying during their first month, according to new UN figures. Most of the deaths could have been prevented with better healthcare, say campaigners, adding that deaths among newborn babies haven’t reduced significantly since 2017. Children born in sub-Saharan Africa are 15 times more likely to die in childhood than children in Europe and North America. UN figures also show that 1.9 million babies were stillborn during 2021, more than three-quarters (77%) in sub-Saharan Africa and in south Asia. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times greater than for women in Europe and North America. Read full story Source: The Guardian, 10 January 2022
  4. Content Article
    To overcome this preventable disease we need to invest in failing infrastructure and tackle humanitarian crises at cholera’s roots, says Petra Khoury in this BMJ article. Once thought to be close to eradication, cholera is back—dehydrating and killing people within hours and ravaging communities across six continents. Despite the alarming numbers of cases and deaths over the past year, decision makers are averting their eyes, leaving people to die from a preventable and treatable disease. The healthcare community should sound the alarm for immediate actions. A strong and global emergency response is urgently needed, but it is only a first step. More than ever the world must invest in water and sanitation systems and prepare communities before outbreaks occur.
  5. Content Article
    Globally, the under-five mortality rate (U5MR) fell to 38 deaths per 1,000 live births in 2021, while under-five deaths dropped to 5.0 million. Although this demonstrates a decrease, this immense, intolerable and mostly preventable loss of life was carried unequally around the world , and children continue to face widely differing chances of survival based on where they are born. In contrast to the global rate, children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world with a 2021 U5MR of 74 deaths per 1,000 live births – 15 times higher than the risk for children in Europe and Northern America and 19 times higher than in the region of Australia and New Zealand This report outlines and analyses figures from The United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME) to examine levels and trends in child mortality around the world during 2022.
  6. Content Article
    Port-au-Prince, the capital of Haiti, has seen waves of clashes between armed groups. The violence has driven a stark need for emergency trauma care and surgery, and cut people off from the everyday healthcare services they need. Nurse Amadeus von der Oelsnitz explains how the Médecins Sans Frontières / Doctors Without Borders (MSF) principles of neutrality, impartiality and independence help teams provide vital healthcare in a city torn apart by insecurity.
  7. News Article
    The World Health Organization has published its first ever list of lethal fungal infections that represent a threat to public health. Experts have noticed an increase in deadly fungal disease, with drug-resistant bacterial infections now responsible for roughly 1.27 million deaths every year. “Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment,” WHO said. The types of fungal infections listed often affect severely ill patients and those with significant underlying problems with their immune system, including people with cancer, HIV or AIDs, organ transplants, chronic respiratory disease or tuberculosis. “Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide,” said Dr Hanan Balkhy, WHO assistant director-general, antimicrobial resistance, said. In its new report, the WHO warns that there is only limited access to quality diagnostics and treatment for these developing fungal diseases. Medicines are often unavailable in low and middle income countries, leading to increased deaths among these populations. One deadly fungal pathogen, Candida auris, which is resistant to multiple drugs, is particularly difficult to eradicate from hospitals - even with intensive infection prevention measures, the WHO said. This means hospital wards often have to be shut down for prolonged periods of time when Candida auris is detected. Read full story Source: The Independent, 26 October 2022
  8. News Article
    Efforts by pharmaceutical companies to tackle global insulin inequity are “fragmented” and “falling short,” with many people with diabetes around the world still not having access to the drug. A report by the Access to Medicine Foundation examined access schemes run by the three main insulin manufacturers—Eli Lilly, Novo Nordisk, and Sanofi. It found that despite the programmes they run, access to the treatment is still severely limited or lacking in many low and middle income countries (LMICs). By 2030, the number of people with diabetes worldwide is expected to reach 643 million, with the numbers rising most rapidly in LMICs. The analysis reported that over the past decade pharmaceutical companies have carried out a “patchwork of approaches” that were often focused on a small number of countries or based around particular types of products or specific patient populations. It noted that most of the strategies had not guaranteed “sustained access for insulin dependent patients requiring ongoing, lifelong treatment” and most of the affordability schemes have been primarily focused on human insulins, with only a few for analogue products. Read full story (paywalled) Source: BMJ, 11 October 2022
  9. Content Article
    This report by the World Health Organization (WHO) identifies major global gaps in water, sanitation and hygiene (WASH) services. It outlines that: one third of health care facilities do not have what is needed to clean hands where care is provided one in four facilities have no water services 10% have no sanitation services. This means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater, with half of health care facilities lacking basic water services. In addition, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning. The report describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together. The report includes four recommendations to all countries and partners to accelerate investments and improvements in WASH services in health care facilities: Implement costed national roadmaps with appropriate financing. Monitor and regularly review progress in improving WASH services, practices and the enabling environment. Develop capacities of the health workforce to sustain WASH services and promote and practice good hygiene. Integrate WASH into regular health sector planning, budgeting and programming to deliver quality services, including Covid-19 response and recovery efforts.
  10. Content Article
    The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality rate twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. This aim of this study in The British Journal of Anaesthesia was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was developed using data from 8799 patients in 168 African hospitals. It includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The authors concluded that the ASOS Surgical Risk Calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance.
  11. Content Article
    The number of patients who die from post-surgical complications in low- and middle-income countries is shockingly high. In Africa alone, more than 600,000 people die each year after surgery, mostly from causes that are relatively easy to treat. This blog by Pierre Barker, Chief Scientific Officer at the Institute for Healthcare Improvement (IHI) looks at a method for reducing post-surgical death called the '5Rs for rescue': Risk stratification Recognise deterioration Respond Reassess Reflect/Redesign He describes how the IHI will test how to support the reliable implementation of the '5Rs for Rescue', which aims to reduce mortality by 25%.
  12. Content Article
    The Bulletin of the World Health Organization is a fully open-access monthly journal of public health with a special focus on low and middle-income countries.
  13. Content Article
    A large proportion of avoidable harm and adverse events occur in fragile, conflict-affected and vulnerable (FCV) settings. This article in the BMJ Open outlines the online Delphi study approach that will be taken to generate a consensus on the most relevant patient safety interventions for FCV settings. The results of this study will create a list of the most relevant patient safety interventions, based on the consensus reached among a range of experts including frontline clinicians and administrators, non-governmental organisations, policymakers and researchers. The study aims to increase awareness of the issues in this area, and identify priority interventions as well as areas for further evaluation and research.
  14. Content Article
    This article in the Journal of Global Health aimed to consider which patient safety interventions are the most effective and appropriate in fragile, conflict-affected, and vulnerable (FCV) settings. The authors examined available literature published between 2003 and 2020, using an evidence-scanning approach. They found that the existing literature is dominated by infection prevention and control interventions for multiple reasons, including strength of evidence, acceptability, feasibility and impact on patient and healthcare worker wellbeing. They identified an urgent need to further develop the evidence base, specialist knowledge and field guidance on a range of other patient safety interventions such as education and training, patient identification, subject specific safety actions and risk management.
  15. Content Article
    The article in the Journal of Global Health examines the unique patient safety risks that can arise in fragile, conflict-affected and vulnerable settings (FCV), including humanitarian crises, conflict, extreme adversity, services disruption and immediate or protracted emergencies. Recent estimates suggest a large proportion of the total number of preventable deaths take place in FCV settings, including 60% of preventable maternal deaths, 53% of deaths in children under five years, and 45% of neonatal deaths. The authors highlight a gap in knowledge and research about healthcare in FCV settings, which prevents researchers from being able to effectively assess interventions for quality, safety and sustainability. They suggest that more academic research is urgently needed in order to make policy and practice more effective in improving patient safety in these settings.
  16. Content Article
    This report by Save the Children's Global Medical Team (GMT) shares the results of independent audits conducted in 2021. The audits aimed to assess the safety and quality of clinical and pharmacy services delivered by the organisation across seven countries. The team strategically focused on higher-risk programmes where Save the Children staff deliver services directly, with an aim to ensure that services remain safe and fully assured.
  17. Content Article
    This is part of our new series of Patient Safety Spotlight interviews, where we talk to people about their role and what motivates them to make health and social care safer. Roohil talks to us about the vital role of pharmacists in making sure medications help patients, rather than causing harm. She highlights the global threat of substandard and counterfeit medicines, the need to improve access to medicines and the importance of having pharmacists 'on the ground' to help patients understand how to take them.
  18. Content Article
    Nigeria is projected to become one of the most populous countries in the world, and is rightly taking its place on the world stage. The Lancet Nigeria Commission tells the story of the country through a health lens, and details recommendations that will enable the country and its people to fulfil their potential, and seize the opportunity ahead. It has been led by Nigerians for Nigerians. The Commissioners call for the creation of a new social contract that redefines the relationship between citizen and state. They argue that health has, to date, been neglected by successive governments and consequently the citizens of Nigeria, and must be recentred as a vital investment in the population – one that will reap political and economic benefits. Nigeria is poised to define the future of West Africa, the African continent, and the whole world. This Commission lays out how best to realise that ambition.
  19. Content Article
    This guide by the non-profit organisation US Pharmacopeia highlights the global challenge of substandard and falsified Covid-19 vaccines and the impact this has on individuals, the ability to control the pandemic, larger societal health, public trust and social justice. It outlines strategies to help prevent, detect and respond to substandard and falsified vaccines, in line with existing World Health Organization processes.
  20. Content Article
    Antibiotic resistance is a natural phenomenon that happens when bacteria develop the ability to defeat the drugs designed to kill them. This case study focuses on large outbreaks of antibiotic-resistant strains of cholera and typhoid in Zimbabwe. It describes the steps taken to tackle the outbreaks, including a mass typhoid Vi-conjugate vaccine (TCV) vaccination campaign from February to March 2019 in nine suburbs of Harare that were severely affected by the outbreak.
  21. Content Article
    In fragile, conflict-affected and vulnerable settings there is an urgent need for action on quality of healthcare, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
  22. Content Article
    Evidence on heterogeneity in outcomes of surgical quality interventions in low-income and middle-income countries is limited. Alidina et al. explored the factors driving performance in the Safe Surgery 2020 intervention in Tanzania’s Lake Zone to distil implementation lessons for low-resource settings. They found that performance experiences of higher and lower performers differed on the following themes: (1) preintervention context, (2) engagement with Safe Surgery 2020 interventions, (3) teamwork and communication orientation, (4) collective learning orientation, (5) role of leadership, and (6) perceived impact of Safe Surgery 2020 and beyond. Higher performers had a culture of teamwork which helped them capitalise on Safe Surgery 2020 to improve surgical ecosystems holistically on safety practices, teamwork and communication. Lower performers prioritised overhauling safety practices and began considering organisational cultural changes much later. Thus, while also improving, lower performers prioritised different goals and trailed higher performers on the change continuum. The authors conclude that future interventions should be tailored to facility context and invest in strengthening teamwork, communication and collective learning and facilitate leadership engagement to build a receptive climate for successful implementation of safe surgery interventions.
  23. Content Article
    There is widespread consensus that learning is crucial for the performance of health systems and the achievement of broader health goals. However, this consensus is not matched by shared knowledge and understanding of how health systems learn, or of how to improve health systems learning across different contexts.  The report is aimed at an audience of diverse stakeholders invested in strengthening health systems, and aims to achieve two things. First, to move towards a shared language and frameworks to discuss the problems and solutions of learning, as they apply to health systems. Second, the report seeks to advance action on learning – by providing stakeholders with clarity on steps that they can undertake to advance learning for health systems. This report is intended to be a starting point for gaining a shared understanding of learning health systems as an actionable agenda. The hope is that it will spur useful conversations and fuel the movement for better informed, more analytical and more self-reliant health systems – especially in the context of low- and middle-income countries. 
  24. Content Article
    The 17 September marks World Patient Safety Day, and this year the focus is on ‘Safe maternal and newborn care’. Recently there has been greater research attention on patient safety in low- and middle-income countries due to the global awareness of the need to improve safety standards for all patients, including in maternal care. In this blog, I highlight the scale of maternal and newborn death in low- and middle-income countries, the contributing factors to this, and the need to improve maternal health and safety.
  25. Content Article
    There are estimated 24 000–60 000 women who are pregnant and incarcerated worldwide and they often lack access to antenatal care at the same level as that available in their communities. Despite clear international standards that mandate equivalent care for people in prison, pregnant women in these settings face significant barriers to adequate antenatal care. The needs of pregnant women are often overlooked in prisons designed to house men . We must not forget this vulnerable and hidden cohort of women. Molly Skerker et al. explore the challenges for pregnant women in prisons worldwide.
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