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Closing the stroke care gap: a collaborative, self-sustainable telemedicine enabled model from rural Nepal.

BACKGROUND: Stroke is a challenging global public health concern, disproportionately affecting people in rural communities. Stroke care is challenging in low and middle-income countries as it requires a coordinated multidisciplinary approach integrating pre-hospital recognition; acute stroke care, and long-term rehabilitation. Multiple barriers exist in LMICs: lack of community awareness; geographical and financial barriers; poor health systems; absence of standardized care pathways; and inadequate training among primary health care workers. Based on this background, this descriptive implement

Models of Integration for Mental Health and HIV/AIDS Among Adolescents and Young People in Low- and Middle-Income Countries: A Scoping Review.

Adolescents and young people (AYP) experience a disproportionate burden of both mental health conditions and HIV, particularly in low- and middle-income countries (LMICs)-nations classified by the World Bank as having lower or middle economies. Mental health problems such as depression, anxiety, and substance use increase HIV (Human Immunodeficiency Virus that attacks the human immune system and leads to various illnesses when untreated) risk, and negatively affect treatment adherence and outcomes. However, mental health remains insufficiently integrated into HIV research and programming. Evid

Factors influencing implementation of point-of-care tests for maternal and newborn screening and diagnosis in low-resource settings: a systematic review.

BACKGROUND: Despite the potential of point-of-care (POC) tests to improve maternal and newborn health, implementation in low- and middle-income countries remains inconsistent. POC testing enables rapid, decentralized screening, but barriers across health system, facility, and individual levels may undermine uptake. This review synthesizes evidence on factors influencing the adoption, implementation, and sustainability of POC tests within maternal-child health programmes in low-resourced settings. METHODS: A comprehensive search was performed across major bibliographic databases and grey liter

Potentials, barriers, and strategies for integrating tuberculosis, diabetes mellitus, and hypertension case management: A scoping review.

BACKGROUND: The coexistence of tuberculosis (TB) with other chronic diseases, such as diabetes mellitus (DM) and hypertension, presents a growing challenge for efforts to end TB due to the complex interactions of coordinated care among relevant care providers and increased risk of adverse outcomes. The comorbidities between TB and DM underscore the necessity of integrated care approaches that span screening, diagnosis, and treatment. Although integrated care models have the potential to improve patient outcomes by supporting people to complete treatment, improving retention in care, and stream

Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial.

Migrant populations - including labour migrants, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move - are exposed to a variety of stressors that affect their mental health. We designed and tested the effectiveness of a stepped-care programme consisting of two scalable psychological interventions developed by the World Health Organization (WHO) and locally adapted for migrant populations. A parallel-group randomized controlled trial was conducted in Italy. We recruited migrant adults (≥18 years) with psychological distress (scor

From Learning to Policy: Adapting National Cancer Control Plans and Implementation to Africa's Cancer Control Realities.

BACKGROUND: The Africa Cancer Research and Control ECHO (Africa Cancer ECHO) convenes cancer researchers, advocates, clinicians, policymaker … c areas. A key enabler and catalyst for change that was most often discussed during the sessions is task shifting, a strategy that involves redistributing tasks among healthcare providers to maximize efficiency and improve access to care. CONCLUSION: The content analysis of the 2020-2021 Africa Cancer ECHO series served as a useful evaluative tool to map the t …

Feasibility of community-based hypertension screening and referral by village health teams in eastern Uganda: A quasi-experimental study.

BACKGROUND: Uganda has a high prevalence of hypertension (HTN) and low diagnosis rates due to healthcare system deficiencies, like scarce diagnostic resources and a shortage of health workers. Task-shifting roles to community health workers (CHWs) could potentially fill gaps in the control of HTN, but this is still underexplored. This study determined the feasibility of leveraging CHWs, called Village Health Teams (VHTs), for HTN screening and referral in Eastern Uganda. METHODS: We conducted a quasi-experimental study from June to November 2023 in Bugembe town council, Jinja City, Eastern Ug

A descriptive summary of the WHO availability assessments of medical abortion medicines in eight African countries.

BACKGROUND: The use of medical abortion using either a combination of mifepristone and misoprostol, or misoprostol alone has contributed to increased safety and decreased mortality and morbidity. The availability of quality medical abortion medicines is an essential component in the provision of quality abortion care. Understanding the factors that influence the availability of medical abortion medicines is important to help in-country policymakers, program planners, and providers improve availability and use of medical abortion. METHODS: Using a national assessment protocol and an availabili

Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ Approach of Curamericas: 6. Management of pregnancy complications at Community Birthing Centers (Casas Maternas Rurales).

BACKGROUND: In Guatemala, Indigenous women have a maternal mortality ratio over twice that of non-Indigenous women. Long-standing marginalization of Indigenous groups and three decades of civil war have resulted in persistent linguistic, economic, cultural, and physical barriers to maternity care. Curamericas/Guatemala facilitated the development of three community-built, -owned, and -operated birthing centers, Casas Maternas Rurales (referred to here as Community Birthing Centers), where auxiliary nurses provided physically accessible and culturally acceptable clinical care. The objective of

Characterising support and care assistants in formal hospital settings: a scoping review.

BACKGROUND: A 15 million health workforce shortage is still experienced globally leading to a sub-optimal healthcare worker-to-population ratio in most countries. The use of low-skilled care assistants has been suggested as a cost-saving human resource for health strategy that can significantly reduce the risks of rationed, delayed, or missed care. However, the characterisation, role assignment, regulation, and clinical governance mechanisms for unlicensed assistive workforce remain unclear or inconsistent. The purpose of this study was to map and collate evidence of how care assistants are la

Acceptability, feasibility, and impact of a pilot tuberculosis literacy and treatment counselling intervention: a mixed methods study.

BACKGROUND: There is a need for innovative strategies to improve TB testing uptake and patient retention along the continuum of TB care early-on in treatment without burdening under-resourced health systems. We used a mixed methods approach to develop and pilot test a tuberculosis literacy and counselling intervention at an urban clinic in KwaZulu Natal, South Africa, to improve TB testing uptake and retention in tuberculosis care. METHODS: We engaged in discussions with clinic staff to plan and develop the intervention, which was delivered by senior social work students who received one-week

Frontline healthcare workers' experiences in implementing the TB-DM collaborative framework in Northern Ghana.

BACKGROUND: Over the past decade, global health policy has increased its focus on measures to halt further increase in tuberculosis (TB) incidence and management of diabetes mellitus (DM). However, the vertical management of these two diseases have not achieved much in addressing the adverse effects of the rising tuberculosis-diabetes co-epidemic. This necessitated the World Health Organisation and the International Union Against Tuberculosis and Lung Disease to develop a framework to manage this dual disease burden. TB-DM co-epidemic is a public health concern in Ghana, adversely threatening

Использование больничного вспомогательного работника и услуг по борьбе с туберкулезом в течение 24 часов в качестве потенциальных инструментов для преодоления задержек с госпитализацией туберкулеза: квазиэкспериментальное исследование.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Внутрибольничные логистические барьеры (ЛМБ) рассматриваются в качестве важных факторов риска задержек в диагностике и инициировании лечения туберкулеза (ТБ-ДТ), которые увековечивают передачу туберкулеза и развитие заболеваемости и смертности от туберкулеза. Мы оценили вклад вспомогательных больничных работников (HAWs) и 24-часовых лабораторий по борьбе с туберкулезом с использованием Xpert (24h-Xpert) в связи с задержками в смертности от туберкулеза и туберкулеза в центральной больнице Бейра, Мозамбик. Методика: Использулась квазиэкспериментальная конструкция. В связи

Совпадение в аннотации оригинала
BACKGROUND: In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatm … tality in Mozambique are common and probably due, in part, to LMB amenable to poor-quality TB care. Task shifting of TB logistic management services to HAWs and lower laboratory technicians, to ensure 24h-Xpert through "on-the-spot strategy," may contribute to timely TB detection, proper treatment, and reduction of TB mortality.

Qualitative evaluation of the outcomes of care and treatment for children and adolescents with nodding syndrome and other epilepsies in Uganda.

BACKGROUND: In 2012, the Ugandan Government declared an epidemic of Nodding Syndrome (NS) in the Northern districts of Gulu, Kitgum, Lamwo a … multidisciplinary team (MDT) to provide for the complex rehabilitation needs of the patients and a task shifting model with inadequate support supervision was employed, leading to loss of skills learnt. Reported psychosocial and psychosexual issues associated with NS included early pregnancies, public display of sexual behaviours and child abuse. CONCLUSIONS: …

Safety of Tubal Occlusion by Minilaparotomy Provided by Trained Clinical Officers Versus Assistant Medical Officers in Tanzania: A Randomized, Controlled, Noninferiority Trial.

BACKGROUND: Tubal occlusion by minilaparotomy is a safe, highly effective, and permanent way to limit childbearing. We aimed to establish wh … ttings. Our results provide evidence to support policy change in resource-limited settings to allow task shifting of minilaparotomy to properly trained and supported COs, increasing access to female sterilization and helping to meet the rising demand for the procedure among women wanting to avoid pregnancy. They also suggest high demand for these services in Ta …

Integrating depression management into HIV primary care in central Malawi: the implementation of a pilot capacity building program.

BACKGROUND: In Malawi, early retention in HIV care remains challenging. Depression is strongly associated with reduced anti-retroviral therapy (ART) adherence and viral suppression. Appropriate depression care for people initiating ART is likely to be supportive of early and continued engagement in the HIV care continuum. This paper aims to provide an overview of a task-shifting program that integrates depression screening and treatment into HIV care and the strategy used to evaluate this program, describes the implementation process, and discusses key challenges and lessons learned in the fir

A home-based rehabilitation intervention for people living with HIV and disability in a resource-poor community, KwaZulu-Natal: study protocol for a randomised controlled trial.

BACKGROUND: In the era of highly active antiretroviral therapy HIV is now viewed as a chronic disease. Although people living with HIV are l … changes between intervention and control groups. DISCUSSION: The researchers aim to employ a novel task shifting approach to implement a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. It is hoped that this study will provide rehabilitation professionals and researcher …

Synergistic approaches to Alzheimer's disease: exploring the combined efficacy of phytoconstituents and conventional drugs.

BACKGROUND: Cognitive functions deteriorate with Alzheimer's disease (AD), a kind of degenerative disease. Problems with memory, interpersonal interactions, problem-solving, and other cognitive functions that limit a person's ability to do daily tasks are the hallmarks of dementia. This condition affects about 50 million individuals globally. Traditional therapies for AD, like galantamine, donepezil, and memantine, only offer symptomatic alleviation through glutamatergic regulation and cholinergic augmentation, making AD a significant worldwide health concern. OBJECTIVE: This review assesses

FedSemiDG: Domain generalized federated semi-supervised medical image segmentation.

Medical image segmentation is challenging due to the diversity of medical images and the lack of labeled data, which motivates recent developments in federated semi-supervised learning (FSSL) to leverage a large amount of unlabeled data from multiple centers for model training without sharing raw data. However, what remains under-explored in FSSL is the domain shift problem which may cause suboptimal model aggregation and low effectiveness of the utilization of unlabeled data, eventually leading to unsatisfactory performance in unseen domains. In this paper, we explore this previously ignored

Dual-Level Domain Alignment Meets Fine-Grained Contrast: Advancing Cross-Scene Few-Shot Hyperspectral Image Classification.

In hyperspectral image classification, existing cross-domain few-shot learning (CDFSL) approaches primarily focus on feature-level adaptation yet often neglect distribution-level shifts, which restricts the model's transferability across different domains. This limitation is further exacerbated in challenging environments like coastal wetlands, where highly mixed vegetation, significant intra-class spectral variability, and strong inter-class similarity result in severe inter-class overlap and intra-class dispersion. To address these challenges, we propose a cross-domain few-shot HSI classific