How to Write Easy-to-Read Health Materials

Medical concepts and language can be complex. People need easily understandable health information regardless of age, background or reading level. MedlinePlus offers guidelines and resources to help you create easy-to-read health materials.

What are easy-to-read (ETR) materials?

ETR materials are written for audiences who have difficulty reading or understanding information. These materials can also benefit people who prefer reading easy-to-read information.

How do you create easy-to-read materials?

Writing ETR materials involves several important steps:

Step 1: Plan and Research….more


Diagnosis and management of dementia in LMICs

CITATION: Ferri CP, Jacob KS (2017) Dementia in low-income and middle-income countries: Different realities mandate tailored solutions. PLoS Med 14(3): e1002271. doi:10.1371/journal.pmed.1002271

‘The ageing of populations is the most significant social transformation of the 21st century [1] and has highlighted the importance of age-related conditions such as dementia, which has been recognised across regions, countries, and cultures. The number of people living with dementia has been increasing and is estimated to reach 75 million worldwide by 2030, with the majority of these individuals living in low-income and middle-income countries (LMICs) [2]. The assessment, recognition, and care of people living with dementia in LMICs are complex issues. Dementia is often seen as part of the ageing process, and even when recognized, there still remain problems related to stigma, lack of resources for the adequate care of people with dementia (PWD), variations in the way the condition is assessed and perceived, and how it is addressed in noncommunicable disease (NCD) policies and prevention strategies…

‘Dementia is under-recognised, underdisclosed, undertreated, and undermanaged, particularly in LMICs…

‘A strategy of employing community health workers to identify mental illnesses in general and dementia in particular in resource-poor settings has been recommended [9]; however, it has been found that this strategy leads to a very high false positive rate. The reasons for this rate include the fact that disorders with low prevalence at the community level cannot be diagnosed accurately unless a referral system is in place…’

Best wishes, Neil

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MedBox: Free Resources

Screen Shot 2017-03-30 at 7.11.08 AMMEDBOX collates the increasing number of professional guidelines, textbooks and practical documents on health action available online today and brings these into the hands of humanitarian aid workers: when they need it, where they need it. MEDBOX is constantly updated. We are keen to receiving more documents, training materials and presentations relevant to improve the quality of health action!  MEDBOX is an independent platform providing information free of charge. ….more


Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). You are more likely to get one of these viruses if you cut or damage your skin in some way.

Wart viruses are contagious. Warts can spread by contact with the wart or something that touched the wart.

Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth. ….more

Jobs in Malawi

The College of Medicine, a constituent College of the University of Malawi, has academic staff vacancies in the departments under the School of Public Health and Family Medicine; and the faculty of Medicine. Applications are invited from suitably qualified candidates to fill the positions indicated below: See attached here advert University of Malawi

PATIENT EDUCATION: Understanding Varicose Veins — the Basics

What Are Varicose Veins?

Varicose veins usually announce themselves as bulging, bluish cords running just beneath the surface of your skin. They almost always affect legs and feet. Visible swollen and twisted veins — sometimes surrounded by patches of flooded capillaries known as spider veins — are considered superficial varicose veins. Although they can be painful and disfiguring, they are usually harmless. When inflamed, they become tender to the touch and can hinder circulation to the point of causing swollen ankles, itchy skin, and aching in the affected limb.

Besides a surface network of veins, your legs have an interior, or deep, venous network. On rare occasions, an interior leg vein becomes varicose. Such deep varicose veins are usually not visible, but they can cause swelling or aching throughout the leg and may be sites where blood clots can form.

Varicose veins are a relatively common condition, and for many people they are a family trait. Women are at least twice as likely as men to develop them. In the U.S. alone, they affect about 23% of all Americans.

What Causes Varicose Veins?…more

Knowledge and practice regarding Dengue and Chikungunya in Tanzania

‘There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers.’ This is the conclusion of a new paper from tanzania. Unfortunately, the paper is restricted-access, so many of us will never learn more than the abstract below.

Knowledge and Practice Regarding Dengue and Chikungunya: a cross sectional study among Healthcare Workers and Community in Northern Tanzania

Debora C. Kajeguka, Rachelle E. Desrochers, Rose Mwangi, Maseke R. Mgabo, Michael Alifrangis, Reginald A. Kavishe, Franklin W. Mosha and Manisha A. Kulkarni

DOI: 10.1111/tmi.12863


Objective: To investigate knowledge and prevention practices regarding dengue and chikungunya amongst community members, as well as knowledge, treatment and diagnostic practices among healthcare workers.

Method: We conducted a cross-sectional survey with 125 community members and 125 healthcare workers from 13 health facilities in six villages in the Hai district of Tanzania. A knowledge score was generated based on participant responses to a structured questionnaire, with a score of 40 or higher (out of 80 and 50 total scores for community members and healthcare workers, respectively) indicating good knowledge. We conducted qualitative survey (n=40) to further assess knowledge and practice regarding dengue and chikungunya fever.

Results: 15.2% (n=19) of community members had good knowledge regarding dengue, whereas 53.6%, (n=67) of healthcare workers did. 20.3% (n=16) of participants from lowland areas and 6.5% (n=3) from highland areas had good knowledge of dengue (?2 = 4.25, p=0.03). Only 2.4% (n=3) of all participants had a good knowledge score for chikungunya. In the qualitative study, community members expressed uncertainty about dengue and chikungunya. Some healthcare workers thought that they were new diseases.

Conclusion: There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers. Health promotion activities on these diseases based on Ecological Health Mode components to increase knowledge and improve preventive practices should be developed.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare information – Join HIFA:  

“Medspeak” can shut down effective communication with patients

‘The 56-year-old inpatient is scared and worried. His physician has told him the swelling in his right calf that brought him to the hospital may be caused by an “agent” or “pathogen,” but he is confused. An “agent” sounds like a person, and a “pathogen” sounds like “psychopath.” When the physician returns with the diagnosis, cellulitis, and says it is an “inflammation of the skin and subcutaneous tissues,” the patient is further confused and flummoxed about deciding whether to stay in the hospital for antibiotic treatment or receive a prescription and rest at home…’

‘Only 12 percent of U.S. adults are highly proficient when it comes to health literacy, which is the capacity to understand and act on medical information…

‘Killian and Coletti [] argue that physicians should make use of the Health Literacy Universal Precautions Toolkit, published by the Agency for Healthcare Research and Quality (AHRQ), to protect patients’ dignity and autonomy, manage the legal risks of misunderstandings, comply with accrediting bodies’ regulations, and improve patient safety and health care outcomes…

‘AHRQ also advises that to communicate clearly, physicians should:

  • Greet patients warmly. Receive everyone with a welcoming smile, and maintain a friendly attitude throughout the visit.
  • Make eye contact. Make appropriate eye contact throughout the interaction.
  • Listen carefully. Try not to interrupt patients when they are talking. Pay attention, and be responsive to the issues they raise and questions they ask.
  • Use plain, nonmedical language. Don’t use medical words. Use common words that you would use to explain medical information to your friends or family, such as stomach or belly instead of abdomen
  • Use the patient’s words. Take note of what words the patient uses to describe his or her illness and use them in your conversation.
  • Slow down. Speak clearly and at a moderate pace.
  • Limit and repeat content. Prioritize what needs to be discussed, and limit information to three to five key points and repeat them
  • Be specific and concrete. Don’t use vague and subjective terms that can be interpreted in different ways.
  • Show graphics. Draw pictures, use illustrations, or demonstrate with 3-D models. All pictures and models should be simple, designed to demonstrate only the important concepts, without detailed anatomy.
  • Demonstrate how it’s done. Whether doing exercises or taking medicine, a demonstration of how to do something may be clearer than a verbal explanation.
  • Invite patient participation. Encourage patients to ask questions and be involved in the conversation during visits and to be proactive in their health care…’

The full article is freely available here:

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare information – Join HIFA:  

WHO: Monitoring and evaluating digital health interventions A practical guide to conducting research and assessment

digital-hThis WHO resource on Monitoring and Evaluating Digital Health Interventions provides step-wise guidance to improve the quality and value of monitoring and evaluation (M&E) efforts in the context of digital health interventions, also commonly referred to as mHealth or eHealth interventions. This Guide is intended for implementers and researchers of digital health activities, as well as policy-makers seeking to understand the various stages and opportunities for systematically monitoring implementation fidelity and for evaluating the impact of digital health interventions. …more

‘Gauteng as a village of 100 people’

‘Gauteng as a village of 100 people’, GCRO’s latest Urban Data Gallery application, is an interactive animation that presents Gauteng as if it only had 100 residents. Who are these people? What are their life circumstances? What are their beliefs and opinions on key issues?

The urban setting in our animation is reminiscent of Gauteng. The square is surrounded by buildings and scenes from around the Gauteng City-Region. The figures in the square suggest the gender and racial diversity of Gauteng in a non-‘representative’ manner. In this interactive realm, the 100 animated ‘villagers’ roam around and each represent 1% of the 30 000 respondents in GCRO’s Quality of Life IV (2015/16) survey. In this fun and informative visualisation, users can explore the answers to a series of questions from the 2015/16 survey through five interactive scenarios. Each scenario has five variables that a user can select. You can discover where people in Gauteng would prefer to live; how worried or happy they are; or even whether they think South Africa is a failed state or not. Click these or a host of other questions and your selection changes the way in which the 100 villagers cluster and interact with one another, reflecting the results from the Quality of Life survey. In other words, the villagers are proxies for the survey data, where you, the user, can choose what results are shown from a set of themes and questions….here

New loo is water-wise and flush with praise

While more than 10.3-million households in South Africa, or 60.6%, have access to a flush toilet, more than 4.3 million households still rely on pit latrines. And at least 409,881 households have no sanitation whatsoever, according to Stats SA .

But a KwaZulu-Natal company, Sanitation Solutions, with branches in other provinces, has come up with a water-saving ceramic flushing toilet that could be the answer to sanitation problems in rural and peri-urban areas.

The Lali Loo derives its name from the Xhosa word ilali ,which means a village. The loo can be used where there is no sewerage infrastructure. ….more

‘Grain of sand’ cameras born out of chance and creative freedom

A set of 3D-printed lenses that are smaller than a grain of sand but can mimic eagle-eye vision came about thanks to a chance discussion with a colleague and the freedom to pursue scientific creativity, according to its inventor.

Optics was always one of Professor Harald Giessen’s favourite scientific fields, a fact he attributes to the ability to create visual wonders. ‘It is always nice when you can see what you are doing with lasers and light, it’s just beautiful. Seeing the light beams and working with mirrors and lenses is something very hands-on and practical. The visual aspect is very pleasing.’

Prof. Giessen, a specialist in nano optics at the University of Stuttgart, Germany, hit the scientific headlines in February when, together with colleagues, he revealed a set of incredibly tiny 3D-printed camera lenses that mimic how an eagle sees the world. Companies eager to exploit the ability to capture detailed images from a distance are lining up at his door, from firms working on robots and automation to medical tech businesses.

But, as Prof. Giessen well knows, scientists can’t always control how their work is used. ‘Of course it gives the spies incredible abilities to spy even more on us,’ he said. ‘In the end it will probably end up in the hands of the bad guys. This is what I fear, but I think it will make a real difference in medical technology.’

What they’re all interested in is a 2 millimetre by 3 millimetre chip that contains four lenses, each of which is 100 micrometres wide, or about the size of a speck of dust. Combining the data from these lenses produces a picture that is high-resolution in the centre and less focused towards the edges, known as a foveated image…..more

PATIENT EDUCATION: What causes mouth ulcers? 25 possible conditions

Mouth ulcers — also known as canker sores — are normally small, painful lesions that develop in your mouth or at the base of your gums. They can make eating, drinking, and talking uncomfortable. Women, adolescents, and people with a family history of mouth ulcers are at higher risk for developing mouth ulcers.

Mouth ulcers aren’t contagious and usually go away within one to two weeks. However, if you get a canker sore that is large or extremely painful or if it lasts for a long time without healing, you should seek the advice of a doctor.

What triggers mouth ulcers?

There is no definite cause behind mouth ulcers. However, certain factors and triggers have been identified. These include:… Read more

Community Health Worker Programmes in the WHO African Region: evidence and options – policy brief

CITATION: Community Health Worker Programmes in the WHO African Region: evidence and options – policy brief

by Nana Twum Danso, Uta Lehmann, Jennifer Nyoni et al.

World Health Organization, Regional Office for Africa, 2017

23 pp. 1.0 MB

‘The purpose of this policy brief is to inform discussions and decisions in the World Health Organization (WHO) African Region on policies, strategies and programmes to increase access to primary health care (PHC) services and make progress towards universal health coverage (UHC) by expanding the implementation of scaled-up Community Health Worker (CHW) programmes. This brief summarizes the existing evidence on CHW programmes with a focus on sub-Saharan Africa and offers a number of context-linked policy options for countries seeking to scale up and improve the effectiveness of their CHW programmes, particularly with regard to needs such as those of Guinea, Liberia and Sierra Leone, the three countries that were the most affected by the 2014–2015 Ebola Virus Disease outbreak.’


There is unanimity in the literature that CHW cadres and programmes have enormous potential in strengthening health and community systems at the interface that is now increasingly identified as community health systems. The key foundational elements of successful CHW large scale programmes are:

(a) Embeddedness, connectivity and integration with the larger system of health care service delivery, the health workforce and community governance, as opposed to functioning as stand-alone or short-term interventions;

(b) Cadre differentiation and role clarity in order for the scope of work and accountability responsibilities to be clear, to minimize confusion, and to manage the expectations of the formal health system and community members;

(c) Sound design, based on local contextual factors and effective people management. Specifically, evidence confirms that CHW programmes will fail unless CHWs are provided:

– initial and continuing training commensurate with their roles;

– regular, skilled and supportive supervision;

– adequate and appropriate incentives and compensation, whether monetary or other types;

– prospects for career development and progression.

(d) Ongoing monitoring, learning and adapting, based on accurate and timely local data to ensure heir optimal fit to the local context, since one size does not fit all.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA:  

PATIENT EDUCATION: 10 Ways to Manage Low Back Pain at Home

Perhaps you bent the wrong way while lifting something heavy. Or you’re dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they’ve had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.

Sometimes, it’s clearly serious: You were injured, or you feel numbness, weakness, or tingling in the legs. Call the doctor, of course. But for routine and mild low back pain, here are a few simple tips to try at home…..more

37-yr-old doctor entrepreneur brings private care to townships

Portia Lekgoto faced a dilemma: how to take her three-year-old daughter to a doctor without missing a day of work while waiting in line at one of only two public health clinics in the South African shantytown of Diepsloot.

She decided to take her daughter to Quali Health, a new private clinic that a friend had told her about. While she had to pay R250 for the visit, she finished the consultation by mid-morning.

“I am going to now drop my daughter off at her granny with the medication we have been given and then I will go into work,” Lekgoto, 34, said at the clinic. “This place, the staffs are friendly and it’s nice and clean. I’ll definitely come back.”…more

Understanding Diabetes

A condition that affects how your body uses energy in the form of glucose from food, diabetes can be successfully managed through proper self-monitoring, medication and lifestyle changes. People with diabetes have a high level of glucose in their blood, which can be caused by either too little insulin being produced by the pancreas or the body not accepting or using the insulin it produces, or a combination of both.

People with diabetes need to keep their blood sugar levels within a healthy range. Blood sugar levels are controlled through diet, physical activity and, for some people, a combination of medication and insulin injections.

Understanding Insulin

Insulin is a hormone your cells need to store and use energy from food, and it is responsible for getting glucose into your cells. If you have diabetes, insulin is not able to do its job. Meaning, glucose is unable to get into your cells, which causes it to build up in your blood. High levels of glucose then circulate through your body, damaging cells along the way.

Types of Diabetes….more