Community case management: IRC’s experience and considerations for scale up
Yolanda Barbera & Amina Issa Mohamud, International Rescue Committee
CORE Group Spring Meeting, April 28, 2010
De wereld is vol van verandering. En de consument verandert, niet in de laatste plaats vanwege technologische ontwikkelingen, in een grillig tempo mee. Waar staan we? Waar gaan we naartoe? Welke ontwikkelingen kunnen we nog verwachten? Als spreker tijdens een bijeenkomst van het Installatie Marketing Platform ging ik in op het thema 'Online Marketing anno 2016'.
Ben je zelf op zoek naar een spreker voor jouw event?
Neem dan contact met me op via wieger@xpertmarketing.nl of kijk voor meer info op http://wie.gr/spreekt/
Mobile Marketing - mobiele ontwikkelingen en oplossingenWieger Waardenburg
Op NextMarketing 2013 was er aandacht voor het thema mobiele marketing. Ter inleiding daarop een aantal cijfers / trends over de indrukwekkende manier waarop het mobiele landschap zicht ontwikkelt.
Vervolgens gaat het om mobiele toepassingen en een basis stukje mobiele marketing. Het begin daarvan is natuurlijk een mobiele website of liever een responsive website. Vanuit het 'bedienen' van mobiele bezoekers kan gestart worden met mobiele marketing.
De wereld is vol van verandering. En de consument verandert, niet in de laatste plaats vanwege technologische ontwikkelingen, in een grillig tempo mee. Waar staan we? Waar gaan we naartoe? Welke ontwikkelingen kunnen we nog verwachten? Als spreker tijdens een bijeenkomst van het Installatie Marketing Platform ging ik in op het thema 'Online Marketing anno 2016'.
Ben je zelf op zoek naar een spreker voor jouw event?
Neem dan contact met me op via wieger@xpertmarketing.nl of kijk voor meer info op http://wie.gr/spreekt/
Mobile Marketing - mobiele ontwikkelingen en oplossingenWieger Waardenburg
Op NextMarketing 2013 was er aandacht voor het thema mobiele marketing. Ter inleiding daarop een aantal cijfers / trends over de indrukwekkende manier waarop het mobiele landschap zicht ontwikkelt.
Vervolgens gaat het om mobiele toepassingen en een basis stukje mobiele marketing. Het begin daarvan is natuurlijk een mobiele website of liever een responsive website. Vanuit het 'bedienen' van mobiele bezoekers kan gestart worden met mobiele marketing.
Success beyond numbers: The Salud Mesoamerica Initiative’s results-based fin...RBFHealth
The Salud Mesoamérica Initiative (SMI) is a public-private partnership between the Bill & Melinda Gates Foundation (BMGF), the Carlos Slim Foundation, the Government of Spain, the Inter-American Development Bank (IDB), the countries of Central America and the State of Chiapas in Mexico. SMI works to reduce maternal and health inequalities through a results-based financing model, aligned with priorities established by the governments of the region. Among the poor in Mesoamerica, only 5 out of every 10 pregnant women are attended during childbirth by skilled birth personnel and the mortality rate among children in poverty is twice that of the national average.
Success beyond numbers: The Salud Mesoamerica Initiative’s results-based fin...RBFHealth
The Salud Mesoamérica Initiative (SMI) is a public-private partnership between the Bill & Melinda Gates Foundation (BMGF), the Carlos Slim Foundation, the Government of Spain, the Inter-American Development Bank (IDB), the countries of Central America and the State of Chiapas in Mexico. SMI works to reduce maternal and health inequalities through a results-based financing model, aligned with priorities established by the governments of the region. Among the poor in Mesoamerica, only 5 out of every 10 pregnant women are attended during childbirth by skilled birth personnel and the mortality rate among children in poverty is twice that of the national average.
YoungMinds: A charity PMO perspective of the pandemic
Wednesday 28 September 2022
APM PMO Specific Interest Group
Presented by:
Patrick Scott
The link to the write up page and resources of this webinar:
https://www.apm.org.uk/news/youngminds-a-charity-pmo-perspective-of-the-pandemic-webinar/
Content description:
The covid-19 pandemic provided a significant challenge to the charity sector, but also in facing that challenge, opportunities to grow and strengthen practice. This webinar presented on Wednesday 28 September provides a perspective on what charities have been doing and can do now to prepare for the future.
Over 60% of charities have dipped into their reserves since the covid-19 pandemic started. The YoungMinds PMO has risen to the challenge, building a broader, strategic programme management office that is able to deliver significant value to the organisation and offer a broad range of services.
YoungMinds is the UK’s leading charity fighting for children and young people's mental health.
They strive towards a world where no young person feels alone with their mental health, and all young people get the mental health support they need, when they need it, no matter what.
Watch the Webinar Here: https://compliatric.com/overview-of-carf-accreditation/
CARF accreditation is a process that helps health and human service providers improve the quality of their services and meet internationally recognized standards. CARF accredits programs in a variety of settings, including hospitals, rehabilitation centers, substance abuse treatment centers, and home health agencies.
CARF accreditation is a valuable asset for health and human service providers. It signals to consumers, payers, and regulators that a provider is committed to quality and continuous improvement. CARF accreditation can also help providers attract and retain top talent, and it can give them a competitive edge in the marketplace.
In this webinar, Michael Johnson, Senior Managing Director of Behavioral Health will provide an overview of accreditation and the value for organizations.
Directors Meeting - Sept. 17, 2019
UofSC Division of Student Affairs and Academic Support
Featuring:
Jarod Holt, Fraternity and Sorority Life
Vicki Hamby, Career Center
Debbie Beck, Student Health Services
Alicia Bervine, Student Affairs and Academic Support
Dennis Pruitt, VP for Student Affairs
OSCR’s survey of 4,827 charities across Scotland was conducted from 5th–15th May 2020. It examines the impact of COVID-19 and the subsequent lockdown measures on charities.
Quality, Innovation, Productivity and Prevention in Primary CareNHSScotlandEvent
What do the Quality Ambitions mean for Primary Care? This session describes the ongoing innovative local improvements and national work with NHS
Boards and Primary Care contractors to improve quality, efficiency and outcomes as well as the future plans for Primary Care.
Similar to Community case management: IRC’s experience and considerations for scale up (20)
Preliminary results from a survey on the use of metrics and evaluation strate...jehill3
Preliminary results from a survey on the use of metrics and evaluation strategies among mHealth projects
Patricia Mechael, Nadi Kaonga
Center for Global Health and Economic Development at the Earth Institute, Columbia University
CORE Group Spring Meeting, April 30, 2010
Working with the “institutional” health system: HAI’s model of health systems...jehill3
Working with the “institutional” health system: HAI’s model of health systems strengthening
Emily deRiel, Health Alliance International
CORE Group Spring Meeting, April 30, 2010
Boosting Nutrition Impact via Integrated Program Strategiesjehill3
Boosting Nutrition Impact via Integrated Program Strategies
Heather Danton and Paige Harrigan, Save the Children
CORE Group Spring Meeting, April 30, 2010
Retention, attrition and motivation of voluntary workers in community-based p...jehill3
Retention, attrition and motivation of voluntary workers in community-based programs
Peter Winch and Anne Palaia, Johns Hopkins Bloomberg School of Public Health
CORE Group Spring Meeting, April 29, 2010
Community Directed Interventions to Improve Malaria in Pregnancy Control Serv...jehill3
Community Directed Interventions to Improve Malaria in Pregnancy Control Services in Nigeria
William R Brieger, Bright Orji, Joseph Okeibunor, Emmanuel Otolorin, Gbenga Ishola, Barbara Rawlins
JHPIEGO
Safe Motherhood and Reproductive Health Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
HBLSS: Improving on Innovation
American College of Nurse Midwives
Safe Motherhood and Reproductive Health Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Meeting the Water, Sanitation and Hygiene Needs of People Living with HIV/AID...jehill3
Meeting the Water, Sanitation and Hygiene Needs of People Living with HIV/AIDS and their Families
Elizabeth Younger, USAID
SBC Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Barrier Analysis Survey: Working Group Participationjehill3
Barrier Analysis Survey: Working Group Participation
Mitzi Hanold, Food for the Hungry
SBC Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
21. Region 1,000,000 people Cost USD per year Initial training (3,333 CBDs) 133,333 Refresher training/6 months 186,666 Refresher training/1 year 93,333 Supervision costs (20 USD/month/supervisor) 40,000
Strategy to deliver life-saving curative interventions at community level for the conditions that cause the most child deaths
IRC is actually implementing CCM in six different countries: Sierra Leone, Ivory Coast, South Sudan, Ethiopia, Uganda and Rwanda.
This graph shows how the population covered with community case management increases over time in IRC program. We started in October 2004 and at the moment almost 2,5 million people live in a village where a community health worker is treating fever, diarrhea and ARI among children under five. As we can see, the country that is contributing the most to the scale up is Rwanda.
This graph shows the number of treatments delivered over time. The fluctuations are mainly due to seasonality, stock out of drugs, policy change for malaria treatment. When we look at the single contribution of each condition to the total of treatments we can see that the gross of the treatments is represented by treatment of fever, although we see how the treatment mix is becoming more balanced over time.
Data entry. Validation included in entry
Reporting module. Can generate standard reports, run independent reports, and generate charts
GIS module. Can look at indicators over time and space. This map is the coverage of all of the health facilities in sierra leone by primary symptom.
Avoid shortcuts in CBD selection. Scale up is the art of increasing coverage without sacrificing quality. In CBD selection, rapid scale up often implies district-level selection of CBDs, use of the existing volunteer network and literacy as a pre-condition. Example of Uganda.
Don’t overstretch CHVs. Here the art is balancing the task shifting trend with the need to ensure technical performance, retention levels and the training costs. Example of workload in Rwanda and Uganda.
Better to start off integrated. In this graph we see the proportion of the treatments that are for fever, diarrhea or ARI by country. When we started in Rwanda the National Malaria Control Program was implementing home based treatment of fever. Rwanda introduced diarrhea and pneumonia later on. For Sierra Leone and Southern Sudan, IRC was able to start off integrated. The Rwanda program still suffers from the sequential introduction of the three conditions, and has an unbalanced treatment mix, that is not likely to reflect the proportional morbidity of each condition. IRC introduced the three conditions simultaneously in Sierra Leone and Southern Sudan, and the treatment mix is more balanced.
No NGO can scale up alone. A consortium called Kabeho Mwana, or “the living child” was formed between CONCERN, World Relief and IRC and is actually covering 20% of the country’s population. The consortium has given us credibility as key government partners in child survival, has allowed us to optimize manpower, to achieve geographical overage and cross-institutional learning. In this sense, IRC is trying to partner with other implementing agencies in other countries, we have partnered with CARE in Sierra Leone and would be willing to do the same anywhere where we work. But the other main lesson learned is that nobody can scale like the government can and the Rwanda case is a clear example. That opens the ground to what donors could do ; in order to apply for a USAID child survival grant in Rwanda we had to create the consortium, so instead of funding isolated experiences in different countries donors could consolidate government and NGOs’ efforts, sit at the same table per country and come up with a plan to achieve scale. It seems that Canadian CIDA is oriented to do so in a place like Uganda through UNICEF and NGOs with presence and experience in community health like Malaria Consortium and IRC.
