The COVID-19 pandemic has heterogeneously affected use of basic health services worldwide, with disruptions in some countries beginning in the early stages of the emergency in March 2020. These disruptions have occurred on both the supply and demand sides of healthcare, and have often been related to resource shortages to provide care and lower patient turnout associated with mobility restrictions and fear of contracting COVID-19 at facilities. In this paper, we assess the impact of the COVID-19 pandemic on the use of maternal health services using a time series modelling approach developed to monitor health service use during the pandemic using routinely collected health information systems data. We focus on data from 37 non-governmental organisation-supported health facilities in Haiti, Lesotho, Liberia, Malawi, Mexico and Sierra Leone. Overall, our analyses indicate significant declines in first antenatal care visits in Haiti (18% drop) and Sierra Leone (32% drop) and facility-based deliveries in all countries except Malawi from March to December 2020. Different strategies were adopted to maintain continuity of maternal health services, including communication campaigns, continuity of community health worker services, human resource capacity building to ensure compliance with international and national guidelines for front-line health workers, adapting spaces for safe distancing and ensuring the availability of personal protective equipment. We employ a local lens, providing prepandemic context and reporting results and strategies by country, to highlight the importance of developing context-specific interventions to design effective mitigation strategies.
Western and central Africa Country tablesAsia and the Pacific Country tablesLatin America Country tables Caribbean Country tables Middle East and North Africa Country tables Eastern Europe and central AsiaCountry tables Western and central Europe and North America Country tables Methods Methods for deriving UNAIDS estimatesMethods for deriving the 90-90-90 targets Distribution of new HIV infections by subpopulation ForewordState of the epidemic Global and regional data Eastern and southern AfricaCountry tables Western and central Africa Country tables Asia and the Pacific Country tablesLatin America Country tables Caribbean Country tables Middle East and North Africa Country tables Eastern Europe and central AsiaCountry tables Western and central Europe and North America Country tables Methods Methods for deriving UNAIDS estimatesMethods for deriving the 90-90-90 targets Distribution of new HIV infections by subpopulation Contents Michel Sidibé UNAIDS Executive Director State of the epidemic AT A GLANCEReductions in AIDS-related deaths continue at a pace that puts the milestone within reach.The global rate of new HIV infections is not falling fast enough to reach the 2020 milestone.As deaths decline faster than new HIV infections, the number of people living with HIV has grown to 36.9 million [31.1-43.9 million].The collection and analysis of more granular data is needed to guide efforts to reach key populations with services. New epidemic transition measures show whether countries and regions are on the path to ending the AIDS epidemic. Progress and gapsEnd the AIDS epidemic by 2030. United Nations Member States boldly included this objective in the 2030 Agenda for Sustainable Development. Billions of dollars of investment and the collective efforts of millions of health-care workers, social workers, community-based organizations and researchers are working towards this goal.
IntroductionThe establishment of effective community-based surveillance is an essential objective of all disease surveillance systems. Several studies and reports have found that the situation is far from optimal in several developing countries such as Cameroon.MethodsWe conducted a cross-sectional descriptive study to assess the contribution of community health workers to surveillance of vaccine-preventable diseases in Obala health district. The performance of community health workers was measured using: the number of cases referred to the health center, the percentage of accomplished referrals, the percentage of cases referred by community health workers confirmed by the staff of health centers. A questionnaire containing forty-seven questions (open-ended and closed-ended) was used for interviews with community health workers. The data were analyzed using SPSS 21 and Excel 2007. Counts and percentages are reported.ResultsThe study showed that the age ranged of community health workers was from 24 to 61 years with an average of 37.9 years ± 6.7 years. The most represented age group was between 40 and 50 with a percentage of 38.6%. The male sex was more represented than the female sex (61.4% vs 38.6%) or a sex ratio male man of 1.7. Forty-five percent of community health workers were selected at a village meeting, 93.1% of community health workers were involved in the surveillance of vaccine-preventable diseases and 87% experienced at least one preventable disease. Only 45.8% of them had the case definitions of the four diseases. Analysis of community health workers attendance at organized health committee meetings showed that 79% of community health workers attended at least one health committee meeting in 2015 and only 49% were monitored in 2015. Community health workers reported 42 suspected cases of measles, 37 of which actually went to the nearest Health Center, a baseline rate of 88%.ConclusionCommunity health workers play a key role in the control of vaccine-preventable diseases in the Obala health district. Community-based surveillance is the foundation of surveillance activities. It is a mechanism based on simple case definitions of priority diseases and unexpected events or unusual conditions. Our study also reaffirms the importance of mastering case definitions and home visits and early detection of vaccine-preventable diseases.
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