Experts Consultation on Family Practice in Eastern Mediterranean Region 12-13 December 2017 Cairo – Egypt

Background

Resolution WHA69.24 “Strengthening integrated, people-centred health services [IPCHS]” was endorsed by the 69th session of WHA held in May 2016. The IPCHS resolution urged Member States to implement, as appropriate, the framework of action and make health care systems more responsive to people’s needs. In the Eastern Mediterranean Region Office [EMRO] this strategy is operationalized through scaling up service delivery through the Family Practice [FP] program.

Resolution EM/RC63/R.31, October 2016, was endorsed by the Regional Committee following the technical discussion paper “Scaling up Family Practice: progressing towards universal health coverage2”. The resolution, among other actions, requested the Regional Director to establish a group of experts for technical support of FP scaling-up in the region.

To raise policymakers’ awareness and provide evidence-based information on family practice situation in the region, WHO EMRO has accomplished several assessments, training of trainers workshops have been conducted at regional level and in the countries, and a number of resource materials have been developed including training manuals and operational guides, FP country profiles and advocacy videos. See attached list of publications.

Objectives

The overall objective of the Expert Consultation is to provide strategic advice on scaling-up of family practice to help countries accelerate progress towards the achievement of universal health coverage. The specific objectives of the experts’ consultation are:

 To advise on strategic directions for scaling up of family physicians in EMR in the context of the technical paper presented on the subject in the 63rd RC;

 Provide high level technical guidance on the WHO online training of general practitioners in Family Medicine;

 Share global and regional perspectives on best practices related to family practice and recommend how these can be adapted to the region;

 Advise on developing and strengthening partnerships with institutions within and outside the region, and in resource mobilization for scaling-up of family practice;

Expected outcomes:

 Identify practical steps to implement WHO/EMRO resolutions on scaling up family practice.

 Agree on the framework of action for scale up family practice implementation in the EMR.

 Identify actions to overcome gap in family physicians productions.

Target Participants

Limited group of regional and international experts in family practice/primary health care from Bahrain, Brazil, Iran, Ireland, Lebanon, Jordan, Morocco, Pakistan, United Kingdom, South Africa, WHO EMRO and HQ.

WHO EMRO 2014 Approach to Family Practice

WHO EMRO 2016 Resolutions re Family Practice

WHO EMRO 2016 Technical Paper re Family Practice

 

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WONCA E-Update Friday 8th December 2017

WONCA E-Update
Friday 8th December 2017

WONCA News – November 2017
The latest WONCA News (November 2017) is still accessible via the WONCA website, with lots of WONCA news, views and events. As ever, many articles also appear in Spanish and French. December’s WONCA News will appear over the weekend of 15/16 December.

WONCA Working Party on the Environment: Planetary Health in South America

In August’s WONCA News we included a report from Ralph Guggenheim about using WONCA conferences to promote the issue of planetary health, and he reported on his experiences at WONCA Europe in Prague. Now Paola Rava Dellepiane, WONCA Working Party on the Environment member, writes more on this issue, and describes her experiences at the WONCA Iberoamericana-CIMF Conference, in Lima, Perú, from 17th to 20th  August, 2017. The article also refers to WONCA’s Policy Statement on Planetary Health, which was endorsed by WONCA Executive at its April 2017 meeting.

WONCA and One Health
Remaining on an environmental theme, a reminder that WONCA is a partner with the One Health Initiative. One Health is the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, plants and our environment. We’re proud to be one of a long and prestigious list of supporters, and encourage anyone with an interest in health and the environment to access their website for further information.

“Between animal and human medicine there are no dividing lines–nor should there be. The object is different but the experience obtained constitutes the basis of all medicine.”
Rudolf Virchow, MD (the father of cellular pathology)

Education for Primary Care (EPC) – free access article on health promotion in medical education
Professor Val Wass, Chair of WONCA’s Working Party on Education and Editor of EPC, has informed us that this month there is free access to an important article in EPC on “Health promotion in medical education: lessons from a major undergraduate curriculum implementation” by Ann Wylie and Kathleen Leedham-Green. The article can be freely accessed at http://www.tandfonline.com/doi/full/10.1080/14739879.2017.1311776

WONCA Rural Health Conference April 2018 – Abstract deadline 31st December
A further reminder that the 15th WONCA Rural Health conference will take place in New Delhi, India, from 26th to 29th April 2018. Registration and abstract submission are both now open, but please note that the last date for abstract submission is 31st December. We especially encourage young doctors and medical students to join this event, which is also open to NGOs, nurses and other health professionals.

WONCA Featured Doctor – Dr Anwar AlNajjar (Kuwait)

This month one of WONCA’s Featured Doctors is Dr Anwar AlNajjar of Kuwait, who is President of the WONCA Eastern Mediterranean Region (EMR) conference to be held in Kuwait from 1st to 3rd March 2018. She is a Family Medicine Consultant working in a Primary Health Center (PHC) and is also the Director of the General Practitioner Training Program which is newly established in Kuwait to be parallel to Family Medicine Residency Program (FMRP). This program is ensuring higher standards of general practitioners working in PHC and to promote the services provided by them.

She is a trainer and examiner in the Family Medicine Residency Program (FMRP) that is part of Faculty of Primary Care and is also assistant exam convener of the simulated surgery exam in the program. Read more of her story at: http://www.globalfamilydoctor.com/member/WoncaPeople/ALNAJJARDrAnwar.aspx

Even with easy access to ARVs, only one in three HIV-positive people will seek them

SA’s policy to reduce HIV infections is to do what the UN recommends‚ which is to get 90% of people tested‚ 90% of HIV-positive people taking antiretrovirals and 90% of those on treatment taking it properly so they are not infectious. This will ultimately decrease the rate of new infections.

But a study of 27‚000 people in Hlabisa in rural KwaZulu-Natal shows that even if you make it easy for people to test for HIV and to gain access to treatment‚ most people will not make use of those facilities‚ especially men……moremore

South Africans with HIV miss out on the benefits of early treatment due to a fear of stigma

Antiretrovirals—the drugs used to keep HIV in check—don’t only prevent people from getting AIDS; they also keep virus levels low, making those taking them less likely to pass the infection to others.

This phenomenon has opened a new avenue for the fight against HIV: Treatment as Prevention.

Since 2015 the World Health Organization has been urging countries to offer ARTs immediately to people who test positive, instead of waiting for their immune systems to deteriorate beyond a set point. In this ‘test and treat’ scenario, the theory goes, more people will have suppressed viral loads, which means there will be less transmission, ultimately leading to less HIV all round. ….more

Health workforce and governance: the crisis in Nigeria

Abstract

Background

In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria.

Methods

We conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria. A critical analysis, with extended commentary, on recent health workforce crises (2010–2016) and the health system in Nigeria was conducted.

Results

The Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months’ salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population.

Conclusions

An encompassing stakeholders’ forum in the Nigerian health sector remain essential. The national health system needs a solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. It is hoped that this paper may prompt relevant reforms in health workforce and governance in Nigeria toward better health service delivery in the country.

Keywords

Health workforceHealth crisisHealth governanceHealth systemNigeria

Open access article publishing charges for researchers based in EIFL network countries

If you are based in one of the EIFL network countries listed below the following article publishing charge discounts or waivers can be used by you to publish in many of our pure open access (OA) journals. Check the complete list of participating OA journals and find out more about our EIFL OA agreement on Taylor & Francis’ Author Services website. https://www.cogentoa.com/

Country APC Armenia $250 Azerbaijan $250 Belarus $250 Bosnia and Herzegovina $250 Botswana $250 Cambodia Full waiver Congo (Democratic Republic) $250 Estonia $250 Ethiopia Full waiver Fiji $250 Georgia $250 Ghana Full waiver Kenya Full waiver Kosovo $250 Kyrgyzstan Full waiver Laos Full waiver Latvia $250 Lesotho Full waiver Lithuania $250 Macedonia $250 Malawi Full waiver Maldives $250 Moldova $250 Myanmar Full waiver Namibia Full waiver Nepal Full waiver Palestine $250 Senegal Full waiver Serbia $250 Tanzania Full waiver Thailand $250 Uganda Full waiver Ukraine $250 Uzbekistan Full waiver Zambia Full waiver Zimbabwe Full waiver

WONCA E-Update Friday 1st December 2017

WONCA E-Update
Friday 1st December 2017

WONCA News – November 2017
The latest WONCA News (November 2017) is still accessible via the WONCA website, with lots of WONCA news, views and events. As ever, many articles also appear in Spanish and French. December’s WONCA News will appear over the weekend of 15/16 December.

Policy Bite: Rural priorities and progress in Australia
This month’s Policy Bite looks at the work of WONCA’s Working Party on Rural Practice, and in particular some recent developments in Australia.

The Working Party’s vision is “health for all rural people around the world”, and, as for WONCA as a whole, one of the key aims of their advocacy is to ensure governments recognise the importance of family medicine and its rural and remote workforce. It is therefore a source of celebration that Prof Paul Worley, a member of the WONCA Rural Working Party, has been appointed as the first Rural Health Commissioner of Australia.

You can read much more on Paul, and his new role, on the WONCA website, and can also view a YouTube video of his inspiring inaugural speech: http://www.globalfamilydoctor.com/News/PolicyBiteRuralprioritiesandprogressAustralia.aspx

WONCA Working Party on Education at APR Conference
In this month’s WONCA News, Prof Val Wass, Chair of the WONCA Working Party on Education reports on the groups’ activities at the recent WONCA Asia Pacific Region conference.  She led a series of workshops at the Pattaya conference, in collaboration with a number of colleagues including Professor Nobutaro Ban (Japan) and Drs Eva Irene Maglonzo (Philippines), Victor Ng (Canada), Hashmet Parveen (Brunei) and Chandramani Thuraisingham (Malaysia).  Topics of the workshops included: The Undergraduate (UG) Curriculum; Continuous Professional Development (CPD); and Formative Assessment.  You can read more of the report at: http://www.globalfamilydoctor.com/News/EducationWPattheAsiaPacificconference.aspx

PCI GP Update Global Programme 2018 
WONCA has an association with Primary Care International (PCI) which is the only organisation accredited by the Royal Society of Medicine (RSM) to deliver primary care updates specifically developed for family doctors practising internationally. PCI’s GP Update Global Programme 2018, to be held at the Wellcome Trust in London from 16-20 April, has been awarded 30 CPD credits by RSM in accordance with its current guidelines. Further details, including how to book early bird tickets (deadline 15th December), are at https://www.gp-update.co.uk/gp-update-5-day-2018

The course is a unique opportunity open to GPs/family doctors practising outside of the UK to network with colleagues from around the world. It will bring delegates up to speed on all the latest evidence-based updates in primary care – and offers 30 hours of consecutive learning (30 CPD credits).

Feedback from the last course was incredibly positive: 100% of delegates said that they would come again and would recommend it to colleagues.

WONCA E-Update Friday 24th November 2017

WONCA E-Update
Friday 24th November 2017

WONCA News – November 2017
The latest WONCA News (November 2017) is accessible via the WONCA website, with lots of WONCA news, views and events. As ever, many articles also appear in Spanish and French.

CEO reports on latest Executive meeting
In his column this month, Dr Garth Manning, WONCA’s CEO, reports on the recent Executive meeting held in Bangkok on 29th and 30th October. The meeting, which was also Professor Michael Kidd’s last on the WONCA Executive, considered new membership applications, reports from WONCA’s Working Parties and Special Interest Groups and much more.

WONCA Featured Doctor – Dr Karen Flegg
One of this month’s WONCA Featured Doctors will be very well known to many of you. Karen Flegg has been WONCA Editor for 7 years, and so far has managed to avoid being featured, but she has now bowed to pressure and “…do as I do to others… and tell more about myself!”. She has had a fascinating and varied career so far, including time as CEO of the Royal New Zealand College of GPs and has been increasingly involved with WONCA since her first conference in Dublin in 1998.

WONCA SIG on Family Violence
Our colleagues in the WONCA Special Interest Group on Family Violence have notified us of a meeting in Brussels on 1st and 2nd December. In partnership with Europrev and others, this is an excellent opportunity to network, collaborate and workshop ideas in the prevention of family violence within the health sector. Day 1 will look at “How to start a family justice center” whilst Day 2 looks at “Family justice centers and the health sector”.

WONCA Europe conference 2018 – Krakow
The WONCA Europe conference for 2018 will take place in Krakow, Poland, from 24th to 27th May. The theme of the conference is “Family Medicine: quality; efficiency; equity”. Members are advised that the deadline for abstract submission is 30th November 2017, whilst Early Bird registration finishes on 31st December.

WONCA E-Update 17th November 2017

WONCA E-Update
Friday 17th November 2017

WONCA News – November 2017
The latest WONCA News (November 2017) is accessible via the WONCA website, with lots of WONCA news, views and events. As ever, many articles also appear in Spanish and French.

From the President – November 2017
This month Professor Amanda Howe reports on her visit to Lebanon, where she attended the national meeting of the Lebanese Society of Family Medicine. She also reports on her visit to Tahaddi clinic, which is next to one of the main Palestinian refugee camps, and provides health services to a population who live mostly in shanty housing. Over 65% of these patients are Syrian refugees, while the remaining 35% are Lebanese residents of the area. She met one GP (Dr Dany Daham) who has been there 14 years, and he and his colleagues were, clearly, both highly committed and passionate about the importance of their work. You can read more about the work on the Tahaddi Clinic by logging on to the WONCA website at the link below, and an additional document resource is available to download at the end of the article.

She also reflects on the big recurring ‘discourse’ about how to measure primary health care performance. She has attended two meetings recently – one in Paris (Organisation for Economic Cooperation and Development) and one in Washington DC (the third ‘Starfield Summit’ run by the Robert Graham Center) – but remains troubled that more energy seems to be going into measuring than establishing primary health care in many countries. Read more of Amanda’s reflections at: http://www.globalfamilydoctor.com/News/FromthePresident-November2017.aspx

Mental Health Matters – November Update
In this month’s WONCA News, Professor Chris Dowrick, Chair of the Working Party on Mental Health (WWPMH), highlights the many activities of the working party in the various WONCA regions. In particular he highlights Weng Chin, from the Asia Pacific Region, who has successful launched the new guidance on Non-drug interventions for common mental health problems during the recent Pattaya conference. It’s an excellent document, which WONCA Executive was delighted to endorse at its recent meeting, and we commend it to you. Please download it, use it with your own patients, and share it with your partners and colleagues.

AAFP Helps Colleagues in Puerto Rico after the devastating hurricanes

Kim Yu MD from the USA, is one amazing colleague. Just after the recent hurricane devastated Puerto Rico, Kim took to Facebook and drove a fundraising effort to help her colleagues in Puerto Rico, raising over $62,000 from all the chapters of the American Academy of Family Physicians in just over one week. With these funds she bought 50 generators and has helped collect relief from private planes and distribute aid to over 95 locations, shelters, hospitals, clinics, nursing homes, convents, foster homes and more! Kim is currently living in Orange County, California, USA although she grew up and trained in the UK. Read the story of this fantastic effort (and how to donate) on the WONCA website at: http://www.globalfamilydoctor.com/News/AAFPPuertoRico.aspx

Welcome Message from Seoul 2018

In this month’s WONCA News you’ll find a welcome message from Professor Jong Sik Kim, Chair of the Host Organizing Committee for Seoul 2018. Professor Kim reminds us of a couple of deadlines:

  • Deadline for abstract submission is 28th February 2018
  • Deadline for Early Bird registration is 31st March 2018

However another important deadline is that submissions for workshops at Seoul should be received no later than 31st December 2017. More details, as ever, from the WONCA website: http://www.globalfamilydoctor.com/News/Worldconference2018Seoul-welcome.aspx

Wonca | Global Family Doctor Newsletter
WONCA News November 2017
This month do read the inspiring story from the USA tells how family doctors led by Kim Yu are helping Puerto Rico colleagues devasted by natural disasters.

News from our Working Parties and Special Interest Groups, includes the latest clinical tool from the WP on Mental Health: GP/FP Role in non drug interventions. There are also new resources from the WHO for their global campaign: Medication Without Harm.

I find myself in the odd position of being a featured doctor this month (after seven years of avoidance). Also featured is the president of the coming WONCA EMR conference in Kuwait, Dr Anwar Alnajjar.

Finally, don’t forget next year’s conferences will soon be here – it’s time to submit abstracts and consider registering for at least one of them.
Dr Karen Flegg. WONCA Editor.

Featured Stories

From the President – November 2017

WONCA President Amanda Howe visits Lebanon: Tahaddi clinic is next to one of the main Palestinian refugee camps, and provides health services to a population who live mostly in shanty housing. Over 65% of these patients are Syrian refugees, while the remaining 35% are Lebanese residents of the area.

From the CEO’s Desk: WONCA Executive meets

Greetings again from Bangkok. This month I’ll report on the meeting of the 2016-18 Executive, which took place in Bangkok on 29th and 30th October 2017 – this was the second full meeting of the 2016-18 WONCA Executive and the last meeting for Prof Michael Kidd.

Policy Bite: Rural priorities and progress – Australia

WONCA has had a Working Party on Rural Practice for many years. Their vision is “health for all rural people around the world”, and, as for WONCA as a whole, one of the key aims of their advocacy is to ensure governments recognise the importance of family medicine and its rural and remote workforce. It is therefore a source of celebration that Prof Paul Worley, a member of the WONCA Rural Working Party, has been appointed as the first Rural Health Commissioner of Australia

AAFP members help Puerto Rico colleagues

Kim Yu MD from the USA, is one amazing colleague. In just one week after the recent hurricane devastated Puerto Rico, Kim took to Facebook and drove a fundraising effort to help her collegues in Puerto Rico, raising over $62,000 from all the chapters of the American Academy of Family Physicians in just over one week,

Mental Health resource: GP/FP Role in non drug interventions

launched at the WONCA Asia Pacific Region Conference this week: “Family doctors’ role in providing non-drug interventions (NDIs) for common mental health disorders in primary care” is a new resource produced by the WONCA Working Party on Mental Health

World conference 2018 Seoul – welcome message

WONCA’s next world conference comes to Seoul, Korea from October 17 – 21, 2018. The theme of the conference is “Primary Care in the Future: Professional Excellence,” and will cover diverse disciplines of family medicine from the present to the future. For the vision of future family medicine, we plan to offer a dynamic and stimulating array of scientific and practical hands-on programs as well as special events. Find out more.

Español

De la Presidenta : Noviembre

Prioridades rurales y progresos – de Australia

français

De la Présidente : novembre

WHO Liaison

WHO new leadership team

Medication Without Harm

WONCA EMR at WHO

WONCA Asia Pacificat WHO

WONCA Groups

Rural Round-up: A Rural Health Commissioner

Mental Health MattersEducation WP- Asia Pacific

SIG Health Equity

Promoting Planetary Health

SIG Family Violence at VdGM

Featured Doctors

Karen FLEGG -Australia

Anwar ALNAJJAR -Kuwait

Notices

WONCA leaders awarded

Atai Omorutu Scholarship

CONFERENCES

World conference 2018 Seoul

World Rural Health 2018

Dragon News 5: Krakow

All conferences

IUDs may cut cervical cancer risk by a third — US systematic review

Considered a safe and highly effective contraception method, intrauterine devices (IUDs) may also be quietly offering protection against the third-most common cancer in women worldwide. A new study from the Keck School of Medicine of the University of Southern California has found that IUD use is associated with a dramatic decrease in the incidence of cervical cancer. …more

Climate change ‘will create world’s biggest refugee crisis’

Tens of millions of people will be forced from their homes by climate change in the next decade, creating the biggest refugee crisis the world has ever seen, according to a new report.

Senior US military and security experts have told the Environmental Justice Foundation (EJF) study that the number of climate refugees will dwarf those that have fled the Syrian conflict, bringing huge challenges to Europe.

“If Europe thinks they have a problem with migration today … wait 20 years,” said retired US military corps brigadier general Stephen Cheney. “See what happens when climate change drives people out of Africa – the Sahel [sub-Saharan area] especially – and we’re talking now not just one or two million, but 10 or 20 [million]. They are not going to south Africa, they are going across the Mediterranean.”

WHO QualityRights: transforming mental health services

Below are extracts from a new free-access article in The Lancet Psychiatry:
A movement to profoundly transform the way mental health care is delivered and to change attitudes towards people with psychosocial, intellectual, and cognitive disabilities is gaining momentum globally.

The Convention on the Rights of Persons with Disabilities (CRPD), which came into effect in 2008, clearly shows that changing attitudes towards — and practices — in mental health care is not only a necessity, but also an obligation under international human rights law…

Through [The QualityRights initiative] WHO is working to improve the quality of care provided by mental health services and promote the human rights of people with psychosocial, intellectual, and cognitive disabilities…

One of the most recent developments of the QualityRights initiative has been the publication of a set of 15 training and guidance modules. These modules help to build capacity among multiple stakeholders to change attitudes and practices in services and the community, and to create new services—including peer support—and strengthen civil society and advocacy efforts. These training modules have been developed in collaboration with more than 100 national and international actors including: disabled people’s organisations; non-governmental organisations; people with lived experience; family, care partners, and professionals working in mental health or related areas; human rights activists; lawyers; and others.

To support the transformation of mental health services, WHO QualityRights is currently developing a best practice guide. This guide will identify, describe and provide evaluation data for good, promising, and emerging community-based mental health and related support and services that are responsive to people’s needs, promote recovery, and are in line with international human rights standards…

CITATION: WHO QualityRights: transforming mental health services
Michelle Funk, Natalie Drew
Lancet Psychiatry, Volume 4, No. 11, p826–827, November 2017
DOI: http://dx.doi.org/10.1016/S2215-0366(17)30271-7
http://thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30271-7/fulltext?dgcid=etoc-edschoice_email_Nov

Best wishes, Neil

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


Dear HIFA group

I would just like to share with you the September 2017 issue of the Movement for Global Mental Health (MGMH) newsletter: http://sh1.sendinblue.com/nbc011z94c.html?t=1507120945. The October 2017 issue will be sent out by 1 November 2017. Should you wish to subscribe to the newsletter, please click on this link and enter your email address: https://my.sendinblue.com/users/subscribe/js_id/2oshf/id/1/email/demo@email.com

The Movement for Global Mental Health (www.globalmentalhealth.org) and the SA Federation for Mental Health (www.safmh.org) will be hosting the 5th Global Mental Health Summit in Johannesburg, South Africa from 8-9 February 2018. There are still spaces available and you can register now: http://www.globalmentalhealth.org/5th-global-mental-health-summit-2018-1

The panels of the Summit will focus on these themes:
·         Persons with Lived Experience – the key partners in mental health and sustainable development
·         Value of research to advance the social movement – the role of persons with lived experience in research
·         Overcoming poverty through quality education and decent work and economic growth
·         Changing the culture around mental health, mental disorders and emotional wellbeing
·         Getting “creative and innovative” to achieve recovery and mental wellbeing
·         Infants, toddlers and young children – affording them mental health and wellbeing
·         Empowering the youth to play a role in achieving the SDGs
·         Not forgetting the vulnerable groups
·         Deinstitutionalisation and community integration – a human right
·         Civil society’s role in achieving the SDGs
·         Social movements giving a voice to persons with psychosocial and intellectual disabilities.

The information brochure and registration form is available at: http://www.globalmentalhealth.org/sites/default/files/5th%20Global%20Mental%20Health%20Summit%20INFO_1.pdf

Thank you
Kind regards,
Charlene Sunkel

Programme Manager: Advocacy & Development
SA Federation for Mental Health
T: +27 (0)11 781 1852
F: +27 (0) 86 558 6909
charlene@safmh.org
www.safmh.org
000-238 NPO / PBO 18/11/13/3099
Principal Coordinator: Movement for Global Mental Health

Apps to help the visually impaired access information: ‘Be My Eyes’

Dear Colleagues,

Today I came across this short video article from the BBC about a free app called ‘Be My Eyes’. Basically, it links a visually impaired person with a sighted volunteer in order by smartphone to help the former with a problem that they have.
http://www.bbc.co.uk/news/av/magazine-39056979/an-app-to-help-blind-people-to-see

A quick browse of the Be My Eyes website (http://bemyeyes.com/what-is-be-my-eyes/) and social media content gives some examples of the help that’s possible e.g.:
– read expiry dates on food
– read instructions
– help with a technical problem
– describe pictures/paintings

Immediately I thought of all sorts of health / health-information related issues that might be feasible,  especially for the developing world e.g.
– read expiry dates on medicines
– read instructions on how to take medicines
– help use a piece of medical equipment
– describe what a boil or rash looks like before going to a doctor

However, the site suggests the app is NOT used for the following (among other things):
– Anything that can put your health in danger
– Identifying or taking medicine
– Any health related issues

I understand their concern/caution; nevertheless it made me wonder if there are other similar aids out there, aside from readers,  for people with various disabilities? Meanwhile, there may be members who are aware of common problems faced by visually impaired caregivers and others? Maybe there are members who are developing aids?

Incidentally, I came across this link from the European Blind Union (EBU) on “Making information accessible for all” that may interest people producing (health) information that they want to be ‘accessible’:
http://www.euroblind.org/resources/guidelines/nr/88#How_do_blind_and_partially_sighted_people_read

Best wishes
Julie

HIFA profile: Julie N Reza is a writer, editor and consultant specialising in global healthcare and related fields (www.globalbiomedia.com). She predominantly works with NGOs and not-for-profit organisations. Previously she was the senior science editor at TDR, based at WHO in Geneva; prior to this she worked at the Wellcome Trust, UK, leading educational projects on international health topics including trypanosomiasis and trachoma. She has a PhD in immunology and a specialist degree in science communication. She also has several years research and postgraduate teaching experience. She is a member of the HIFA Steering Group and HIFA Social medica working group.
http://www.hifa.org/people/steering-group
http://www.hifa.org/people/social-media
http://www.hifa.org/support/members/julie
Email:   naimareza AT hotmail.com


Dear Julie,

Thank you so much for this valuable information.

I am a Tanzanian, became blind at the age of 50 years, and I am currently making use of screen readers to access information.

We from developing countries still need much assistance from developed world, we face a lot of challenges such as financial constraints, technical know how etc.

I have been very much impressed by the way this app (Be My Eyes) works and by this e-mail I would like to welcome anybody or organization to work with our organization in Tanzania so as to enable the visually impaired Tanzanians manages their daily living independently.

I’m a chairman of Computers For The Blind (CFTBT), a no-government organization registered in Tanzania and it is also a non-profit organization being run by people with blindness and visual impairment.

The main objective of our organization is to train blind and partial sighted persons to access information through computer application.

Welcome all,

Clement Y.Ndahani: CFTBT Chairman
E-mail: clement.ndahani@out.ac.tz

HIFA profile: Clement Yoramu Ndahani is a Technologist at The Open University of Tanzania.  Professional interests: Social work.  clement.ndahani AT out.ac.tz


Dear Clement,

Yours is exactly the type of response I was hoping to see.

I would imagine that there are many app developers – in high, medium and low-income countries – who would like to build apps that will help people with disabilities. But they may be unaware of the particular issues that you face in Tanzania and similar countries. I hope that through HIFA these messages find the right people and that some useful collaborations develop.

Incidentally, here in the UK, and I believe in many other countries, there are ‘hackathons’, in which developers/scientists come up with innovative solutions to a variety of problems. I notice that in Tanzania you have just had one such event http://daressalaam.sciencehackday.org/about-dar/ (Science Hack Day Dar es Salaam). I wonder if one approach would be to take part in or even host such an event?

On a slightly different note, the ‘Be My Eyes’ app also made me wonder if it would be adaptable for use by (a) groups with low literacy (a kind of ‘Be My Reader’) and (b) people with different languages/dialects (a kind of ‘Be My Translator’).

I wish you well with your endeavours.

Best wishes
Julie

HIFA profile: Julie N Reza is is a writer, editor and consultant specialising in global healthcare and related fields (www.globalbiomedia.com). She predominantly works with NGOs and not-for-profit organisations. Previously she was the senior science editor at TDR, based at WHO in Geneva; prior to this she worked at the Wellcome Trust, UK, leading educational projects on international health topics including trypanosomiasis and trachoma. She has a PhD in immunology and a specialist degree in science communication. She also has several years research and postgraduate teaching experience. She is a member of the HIFA Steering Group and HIFA Social medica working group.
http://www.hifa.org/people/steering-group
http://www.hifa.org/people/social-media
http://www.hifa.org/support/members/julie
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Dear Julie

I am a Nigerian and a Librarian. How do I get access to the app. [*see note below] I work with students with special needs and there are about One hundred and twenty-three visual challenged students among them.

HIFA profile: Ngozi Eunice Osadebe is a librarian at the University of Nigeria, Nsukka. Professional interests: Enhancing access to higher education for people with disability, Technology Assisted Learning. She is a member of the HIFA working group on Library and Information Services.
http://www.hifa.org/projects/library-and-information-services
http://www.hifa.org/support/members/ngozi-eunice
ngozi.osadebe AT unn.edu.ng

[*Note from HIFA moderator (Neil PW): Please see the Be My Eyes website http://bemyeyes.com/what-is-be-my-eyes/ ]

Lancet Global Health: Promoting rational use of antibiotics in China

CITATION: Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial
Prof Xiaolin Wei, Zhitong Zhang, Prof John D Walley, Joseph P Hicks, Jun Zeng, Simin Deng, Yu Zhou, Jia Yin, Prof James N Newell, Prof Qiang Sun, Guanyang Zou, Prof Yan Guo, Prof Ross E G Upshur, Dr Mei Lin,
Published: 25 October 2017
DOI: http://dx.doi.org/10.1016/S2214-109X(17)30383-2

Summary

Background: Inappropriate antibiotic prescribing contributes to the generation of drug resistance worldwide, and is particularly common in China. We assessed the effectiveness of an antimicrobial stewardship programme aiming to reduce inappropriate antibiotic prescribing in paediatric outpatients by targeting providers and caregivers in primary care hospitals in rural China.

Methods: We did a pragmatic, cluster-randomised controlled trial with a 6-month intervention period…

Findings: We recruited all 25 eligible township hospitals in the two counties (14 hospitals in Rong county and 11 in Liujiang county), and randomly allocated 12 to the intervention group and 13 to the control group. We implemented the intervention in three internal pilot clusters between July 1, 2015, and Dec 31, 2015, and in the remaining nine intervention clusters between Oct 1, 2016 and March 31, 2016. Between baseline (the 3 months before implementation of the intervention) and endline (the final 3 months of the 6-month intervention period) the antibiotic prescription rate at the individual level decreased from 82% (1936/2349) to 40% (943/2351) in the intervention group, and from 75% (1922/2548) to 70% (1782/2552) in the control group. After adjusting for the baseline antibiotic prescription rate, stratum (county), and potentially confounding patient and prescribing doctor covariates, this endline difference between the groups represented an intervention effect (absolute risk reduction in antibiotic prescribing) of -29% (95% CI -42 to -16; p=0·0002).

Interpretation: In China’s primary care setting, pragmatic interventions on antimicrobial stewardship targeting providers and caregivers substantially reduced prescribing of antibiotics for childhood upper respiratory tract infections.

Best wishes, Neil

Member, HIFA Project on Information for Prescribers and Users of Medicines
http://www.hifa.org/projects/prescribers-and-users-medicines

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


Further to my message a few minutes ago I just saw there is an excellent linked Comment on the study. Thanks to The Lancet Global Health’s OA policy I am able to reproduce it at length below.

CITATION: Reducing antibiotic prescriptions for childhood upper respiratory tract infections
Gary W K WongEmail the author Gary W K Wong
Published: 25 October 2017
DOI: http://dx.doi.org/10.1016/S2214-109X(17)30423-0

Reducing antibiotic prescriptions for childhood upper respiratory tract infections

Resistance to antibiotics has become a major health threat worldwide, and one of the most important contributing factors is the widespread overuse of antimicrobials. This problem is most severe in low-income and middle-income countries (LMICs), where physicians have few resources for investigations and diagnosis, along with inherent concerns about missing an underlying bacterial infection… Poor knowledge and awareness among caregivers of children also results in inappropriate demand for antibiotic prescriptions for their children…

The study by Xiaolin Wei and colleagues in The Lancet Global Health9 provides important evidence regarding effective interventions in reducing unnecessary antibiotic prescriptions in rural China. The investigators did a cluster-randomised controlled trial, stratified by county, comparing the effectiveness of an intervention programme to reduce antibiotic prescribing with usual care in 25 township hospitals in rural Guangxi province, a low-income area in the southwest of China. The authors aimed to reduce antibiotic prescriptions in children older than 2 years of age with a diagnosis of an upper respiratory tract infection. Their intervention has two important components: first, they set up a comprehensive educational programme for participating doctors, including an interactive training session to improve their knowledge of appropriate use of antibiotics and monthly peer-review meetings to provide feedback. Second, they developed leaflets and an educational video that was played on a loop in the waiting area to educate the caregivers of the children. For children visiting these township hospitals with a diagnosis of upper respiratory tract infection, baseline antibiotic prescription rates were shockingly high at 82% and 75% in the intervention group and control group, respectively. The total duration of the trial including the initial pilot period and the full intervention period was 9 months. The results showed that the antibiotic prescription rate decreased from 82% to 40% in the intervention group and from 75% to 70% in the control group. The difference in the reduction between the two groups was highly significant, with an absolute reduction in antibiotic prescribing rate in the intervention group versus the control group of 29% (95% CI -42 to -16; p=0·0002).

Since antibiotic-prescribing behaviour and physicians’ concerns about treating upper respiratory tract infections are very similar across the world, it is highly likely that such an intervention would also be effective in other settings with a similar health care reimbursement system. One important remaining question is the sustainability of such prescribing behaviour once the intervention is stopped. Some form of re-enforcement or maintenance education is probably needed in order to sustain such a change in behaviour. Given the problems of antibiotic resistance and the cost of inappropriate antibiotic prescriptions, the benefits of these programmes will probably far exceed the costs needed to run them. In the emergency departments of large hospitals in Chinese cities like Beijing or Shanghai, children are often seen to be connected to an intravenous line receiving antibiotics, despite a diagnosis of relatively mild febrile respiratory illness. Further studies are needed to test whether or not such an educational programme is effective in changing the prescribing behaviour of physicians in these large hospitals, since the remuneration system and the parental expectations differ to those in the rural areas of China. Replication studies are needed to confirm if such programme is effective in other LMICs that may have different remuneration systems and expectations.

Best wishes, Neil

Member, HIFA Project on Information for Prescribers and Users of Medicines
http://www.hifa.org/projects/prescribers-and-users-medicines

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