Attitude counts: engaging with rice farmers in West Africa
In: Development in practice, Band 21, Heft 6, S. 806-821
ISSN: 1364-9213
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In: Development in practice, Band 21, Heft 6, S. 806-821
ISSN: 1364-9213
In: Development in practice, Band 21, Heft 6
ISSN: 0961-4524
In: Journal of Health and Medical Sciences, Vol.3 No.3 (2020)
SSRN
BACKGROUND: The World Health Organization's Global Strategy on Human Resources for Health (HRH) emphasizes the importance of dynamic and effective health worker regulation for achieving the health-related Sustainable Development Goals, with the establishment of education standards and quality assurance of education programs being critical. Governments in West Africa have struggled to address the problems within their higher education systems for health professionals, and it is now generally acknowledged that private institutions can play a crucial role in revitalizing the region's outdated universities. However, the rapid expansion of private schools raises concerns about the quality of education and adequacy of regulatory mechanisms. The USAID-funded Mali HRH Strengthening Activity, led by IntraHealth International, assisted Mali's Ministry of Health and Social Development to deliver targeted HRH interventions to improve the quality of education in private universities, better manage available health workers, and initiate a decentralized strategy for health worker recruitment and motivation. CASE PRESENTATION: In 2018, the HRH activity leveraged the West African Health Organization (WAHO)'s accreditation system to support 10 private nursing schools to introduce WAHO's regionally accepted, competency-based curriculum in reproductive, maternal, newborn, and child health. The project undertook a 10-step process to work alongside private nursing and midwifery schools to assess their current status against WAHO regional standards, implement action plans to address identified gaps, and support the institutions toward accreditation. As a result, eight schools in Mali are now accredited compared to only three at project inception. CONCLUSIONS: This case study underscores the importance of private school accreditation in Mali to improve the quality of health worker training through a standardized local curriculum. By supporting existing regulatory bodies that oversee accreditation, local capacity for initial ...
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In: World policy journal: WPJ, Band 32, Heft 3, S. 3-8
ISSN: 1936-0924
In: World policy journal: WPJ ; a publication of the World Policy Institute, Band 32, Heft 3, S. 3-8
ISSN: 0740-2775
In: Advances in Applied Sociology: AASoci, Band 12, Heft 5, S. 138-144
ISSN: 2165-4336
In: Working Paper, 82
This study's aim is to document and analyse the recent evolution of Mali's natural environment. It considers the explanatory causes and the responsibility of structural adjustment for the observed effects, and makes recommendations on how policies should be reformed if sustainable development is to be achieved. (DÜI-Hff)
World Affairs Online
Les cellulites nécrosantes descendantes d'origine dentaire sont graves et de prise en charge difficile. Leur diffusion se fait classiquement vers le médiastin, les cavités pleurales, voir le cerveau. La diffusion spécifique à la glande mammaire est atypique, rare et peu décrite. Nous rapportons 2 cas colligés en 15 ans de pratique de chirurgie thoracique. Il s'agissait de deux patientes, l'une âgée de 32 ans et l'autre de 25 ans toutes vivaient en milieu rural. Leurs itinéraires diagnostiques et thérapeutiques, les facteurs de risque, les moyens thérapeutiques utilisés et leurs pronostics ont été discutés. Le but de ce travail était de mettre l'accent sur la gravité de cette pathologie et inciter à la mise en œuvre d'une politique de prévention à l'échelle nationale. Mots clés : cellulite, glande mammaire, dentaire.
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In: PNAS nexus, Band 1, Heft 3
ISSN: 2752-6542
Abstract
Little is known about the temporal patterns of infection and transmission of Lassa virus (LASV) within its natural reservoir (Mastomys natalensis). Here, we characterize infection dynamics and transmissibility of a LASV isolate (Soromba-R) in adult lab-reared M. natalensis originating from Mali. The lab-reared M. natalenesis proved to be highly susceptible to LASV isolates from geographically distinct regions of West Africa via multiple routes of exposure, with 50% infectious doses of < 1 TCID50. Postinoculation, LASV Soromba-R established a systemic infection with no signs of clinical disease. Viral RNA was detected in all nine tissues examined with peak concentrations detected between days 7 and 14 postinfection within most organs. There was an overall trend toward clearance of virus within 40 days of infection in most organs. The exception is lung specimens, which retained positivity throughout the course of the 85-day study. Direct (contact) and indirect (fomite) transmission experiments demonstrated 40% of experimentally infected M. natalensis were capable of transmitting LASV to naïve animals, with peak transmissibility occurring between 28 and 42 days post-inoculation. No differences in patterns of infection or transmission were noted between male and female experimentally infected rodents. Adult lab-reared M. natalensis are highly susceptible to genetically distinct LASV strains developing a temporary asymptomatic infection associated with virus shedding resulting in contact and fomite transmission within a cohort.
In: Ecology and society: E&S ; a journal of integrative science for resilience and sustainability, Band 15, Heft 4
ISSN: 1708-3087
The Sudano-Sahelian zone of West Africa has experienced recurrent droughts since the mid-1970s and today there is considerable concern for how this region will be able to adapt to future climate change. To develop well targeted adaptation strategies, the relative importance of climate factors as drivers of land use and livelihood change need to be better understood. Based on the perceptions of 1249 households in five countries across an annual rainfall gradient of 400-900 mm, we provide an estimate of the relative weight of climate factors as drivers of changes in rural households during the past 20 years. Climate factors, mainly inadequate rainfall, are perceived by 30-50% of households to be a cause of decreasing rainfed crop production, whereas a wide range of other factors explains the remaining 50-70%. Climate factors are much less important for decreasing livestock production and pasture areas. Increases in pasture are also observed and caused by improved tenure in the driest zone. Adaptation strategies to declining crop production include 'prayer' and migration in the 400-500 mm zone; reforestation, migration, and government support in the 500-700 mm zone; and soil improvement in the 700-900 mm zone. Declining livestock holdings are countered by improved fodder resources and veterinary services. It is concluded that although rainfed crop production is mainly constrained by climate factors, livestock and pasture are less climate sensitive in all rainfall zones. This needs to be reflected in national adaptation strategies in the region.
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In: Journal of the International AIDS Society, Band 17, Heft 1
ISSN: 1758-2652
ObjectiveWe aimed to describe the morbidity and mortality patterns in HIV‐positive adults hospitalized in West Africa.MethodWe conducted a six‐month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV‐positive patients were eligible. Baseline and follow‐up information until hospital discharge was recorded using standardized forms. Diagnoses were reviewed by a local event validation committee using reference definitions. Factors associated with in‐hospital mortality were studied with a logistic regression model.ResultsAmong 823 hospitalized HIV‐positive adults (median age 40 years, 58% women), 24% discovered their HIV infection during the hospitalization, median CD4 count was 75/mm3 (IQR: 25–177) and 48% had previously received antiretroviral treatment (ART). The underlying causes of hospitalization were AIDS‐defining conditions (54%), other infections (32%), other diseases (8%) and non‐specific illness (6%). The most frequent diseases diagnosed were: tuberculosis (29%), pneumonia (15%), malaria (10%) and cerebral toxoplasmosis (10%). Overall, 315 (38%) patients died during hospitalization and the underlying cause of death was AIDS (63%), non‐AIDS‐defining infections (26%), other diseases (7%) and non‐specific illness or unknown cause (4%). Among them, the most frequent fatal diseases were: tuberculosis (36%), cerebral toxoplasmosis (10%), cryptococcosis (9%) and sepsis (7%). Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS‐defining infectious diagnoses were associated with hospital fatality.ConclusionsAIDS‐defining conditions, primarily tuberculosis, and bacterial infections were the most frequent causes of hospitalization in HIV‐positive adults in West Africa and resulted in high in‐hospital fatality. Sustained efforts are needed to integrate care of these disease conditions and optimize earlier diagnosis of HIV infection and initiation of ART.
This book contains the abstracts of the papers/posters presented at the Tanzania Health Summit 2020 (THS-2020) Organized by the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS) held on 25–26 November 2020. The Tanzania Health Summit is the annual largest healthcare platform in Tanzania that attracts more than 1000 participants, national and international experts, from policymakers, health researchers, public health professionals, health insurers, medical doctors, nurses, pharmacists, private health investors, supply chain experts, and the civil society. During the three-day summit, stakeholders and decision-makers from every field in healthcare work together to find solutions to the country's and regional health challenges and set the agenda for a healthier future. Summit Title: Tanzania Health SummitSummit Acronym: THS-2020Summit Date: 25–26 November 2020Summit Location: St. Gasper Hotel and Conference Centre in Dodoma, TanzaniaSummit Organizers: Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS).
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Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
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