Transformation of World Health Organization’s management practice and workforce to fit the priorities of African countries | The Pan African Medical Journal | PMC.
[Open Access] [Received: 14/06/2019 - Accepted: 17/06/2019 - Published: 14/11/2019]
The WHO Regional Office for Africa developed an evidence-based tool, called the Dalberg tool to guide the functional review and restructuring of the workforce and management of the country offices to better fit the health priorities of Member States.
The Dalberg tool was used in conjunction with a series of consultations and dialogues to review twenty-two countries have undergone the functional review. Results: the “core functions” in WHO country offices (WCOs) were identified. These are health coordination, strengthening of health systems, generation of evidence and strategic information management, and preparedness against health emergencies.
In order to standardize country office functions, categorization of countries was undertaken, based on specific criteria, such as health system performance towards Universal Health Coverage (UHC), health emergencies, burden of communicable and non-communicable diseases, subnational presence and national population size.
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Following the functional review, the staff is now better aligned with country and organizational priorities. For example, the functional review has taken into consideration: (i) the ongoing polio transition planning; (ii) the implementation of the WHO emergency programme in countries; (iii) the investment case for strengthening routine immunization in Africa; and (iv) regional flagship programmes, such as adolescent health and UHC. The delivery of the core functions above will require the hiring of additional capacities and expertise in most country offices if deemed fit-for-purpose.
Detection of immunoglobulin G levels produced by oral polio vaccine in HIV infected children in Jos, Plateau State, Nigeria | The Pan African Medical Journal via PMC.
[Open Access] [Received: 26/07/2018 - Accepted: 24/09/2019 - Published: 06/12/2019]
Disease eradication requires a long time and efficient management as compared to disease control program. After successful small pox eradication, polio virus causing poliomyelitis is choice for next eradication. The corner stone of the global polio eradication initiative is the immunization of children with multiple doses of Oral Polio Vaccine (OPV) through both Routine Immunization (RI) and Supplemental Immunization Activities (SIAs). This informed our design of this prospective study. Objective is to determine levels of Immunoglobulin G antibodies produced in HIV infected children aged (one to ten years) vaccinated with Oral Polio Vaccine (OPV) in Jos, Plateau State, Nigeria.
One hundred and eighty-two children infected with HIV who had received Oral Polio Vaccine (OPV) at least four times had their blood samples collected and assayed for the presence of Polio Specific IgG antibodies using IgG ELISA test kit (DEMEDITEC Diagnostic GmbH, Germany). Three millilitre (3ml) of venous blood samples were collected aseptically by venepuncture. Sera obtained were assayed using Enzyme immunoassay detection and quantitative determination of human IgG antibodies against poliomyelitis virus in serum and plasma (Demeditic Poliomyelitis Virus IgG ELISA DEPOL01-Germany).
The result showed that 95.6% (174/182) of the tested children had detectable IgG antibodies against polio virus. The high proportion of 95.6% recorded in this study indicates HIV infected children responded effectively to the Oral Polio Vaccine (OPV) being used in the ongoing polio eradication initiative. In this study, 4.4% (8/182) of the HIV infected children were not producing detectable amount of antibodies that could protect them from exposure to wild type of polio virus.
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This study shows that HIV infected children had detectable antibodies (Immunoglobulin G) against polio virus. Despite the overall progress recorded in the fight against poliomyelitis in Nigeria, a lot needs to be done to further strengthen the fight against poliomyelitis in Nigeria.
Video: 955 POLIO OUTBREAK AWARENESS FILM "REMEMBER ME" 88444 | Periscope Film.
Made in the 1950s by the March of Dimes, REMEMBER ME is a poignant reminder of the polio crisis that gripped the United States in the 20th Century. Made just after the Salk vaccine had been developed, the film attempts to remind the audience of the suffering of infantile paralysis victims, and continue to fund the fight against the disease. It also encourages the audience to respect the abilities of these children and adults and not their disabilities. At 1;44, a man is seen typing with his toes. At 2:00, empty summer camps and swimming pools are seen in the wake of a 1955 outbreak. At 2:30 a shopping center is seen, its parking lot empty because of the outbreak. At 3:00, a polio victim arrives at a hospital. At 3:25, a hospital in Boston is seen, with young patients in the hospital. At 4:00, a hospital in Wisconsin is seen with many child patients. At 4:30, an extremely weak adult victim is shown, and at 5:20 the crutches and braces used for treating deformed victims are shown. At 5:50, a patient immobilized in a cast is seen. At 6:10 children are shown being treated in iron lungs with round-the-clock nursing care. The film ends with the reminder -- polio is not over.
Two vaccines are used throughout the world to combat polio. The first was developed by Jonas Salk, first tested in 1952, and announced to the world by Salk on April 12, 1955. The Salk vaccine, or inactivated poliovirus vaccine (IPV), consists of an injected dose of killed poliovirus. In 1954, the vaccine was tested for its ability to prevent polio; the field trials involving the Salk vaccine would grow to be the largest medical experiment in history. Immediately following licensing, vaccination campaigns were launched, by 1957, following mass immunizations promoted by the March of Dimes the annual number of polio cases in the United States would be dramatically reduced, from a peak of nearly 58,000 cases, to just 5,600 cases.
Eight years after Salk's success, Albert Sabin developed an oral polio vaccine (OPV) using live but weakened (attenuated) virus. Human trials of Sabin's vaccine began in 1957 and it was licensed in 1962. Following the development of oral polio vaccine, a second wave of mass immunizations would lead to a further decline in the number of cases: by 1961, only 161 cases were recorded in the United States. The last cases of paralytic poliomyelitis caused by endemic transmission of poliovirus in the United States were in 1979, when an outbreak occurred among the Amish in several Midwestern states.
Poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840. Its causative agent, poliovirus, was identified in 1908 by Karl Landsteiner. Polio had existed for thousands of years in certain areas, with depictions of the disease in ancient art. Major polio epidemics started to appear in the late 19th century in Europe and soon after the United States, and it became one of the most dreaded childhood diseases of the 20th century. The epidemics are attributed to better sanitation which reduced the prevalence of the disease among young children who were more likely to be asymptomatic. Survivors then develop immunity. By 1910, much of the world experienced a dramatic increase in polio cases and epidemics became regular events, primarily in cities during the summer months. These epidemics -- which left thousands of children and adults paralyzed -- provided the impetus for a "Great Race" towards the development of a vaccine. Developed in the 1950s, polio vaccines have reduced the global number of polio cases per year from many hundreds of thousands to under a thousand today. Enhanced vaccination efforts led by Rotary International, the World Health Organization, and UNICEF should result in global eradication of the disease, although in 2013 there were reports by the World Health Organization of new cases in Syria.
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Podcast + text: Polio Epidemic Offers Guidance For Getting Through COVID-19 | NPR Here & Now WBUR.
[March 16, 2020]
This is a scene in the emergency polio ward at Haynes Memorial Hospital in Boston, Ma., on Aug. 16, 1955. The city's polio epidemic hit a high of 480 cases. The critical patients are lined up close together in iron lung respirators so that a team of doctors and nurses can give fast emergency treatment as needed. (AP Photo)
Robin Young writes:
Clues on how to fight the coronavirus lie within history’s past epidemics, including devastating outbreaks of polio.
A vaccine was developed in 1955, the same year thousands were infected by the polio virus — including Here & Now host Robin Young and her siblings. In some states, 50 new cases popped up each day.
During the summer of 1955, beaches and playgrounds were empty. Dr. Howard Markel teaches the history of medicine at the University of Michigan, and he says measures taken in the 1950s like containment and closing schools offer some hope in fighting COVID-19.
“What we can learn is that our predecessors have met these contagious crises with far less armaments and tools in their tool box,” he says. “And they came through on the other end. And we can do this and we will do this with COVID-19.”
[View videos and listen to and/or download audio of full interview (11:03) in source article.]
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Pakistan: Plan to enable differently-abled children to study in regular schools in KP | DAWN.
[March 16, 2020] Ashfaq Yusufzai writes:
PESHAWAR: The Khyber Pakhtunkhwa government is considering a plan to start inclusive education in general schools to enable the special children to study along with normal students and become useful citizen, according to sources.
“We have presented a concept to Chief Secretary Dr Kazim Niaz about inclusive education for special children as well as their rehabilitation,” Dr Mahboobur Rehman, a former head of physiotherapy department at Hayatabad Medical Complex, told this scribe.
He said that a comprehensive plan was also being chalked put in collaboration with social welfare department to help the special children.
“We are also in touch with the education department to implement a plan whereby the children with autism, cerebral palsy and those affected by polio could learn along with normal students in the same classrooms and become useful citizens of the society,” he said.
Physiotherapist says concept of inclusive education presented to chief secretary.
Dr Rehman, who has launched the first inclusive education school in 2016, said that he had shared his experience with chief secretary and informed him that inclusive education made the children with disabilities useful members of society.
“This concept, if applied, can enable the disabled children to be enrolled along with normal students in government as well as private schools,” he said. He added that government could ask the private schools to give admission to specific number of physically challenged children so that they could learn with normal students and participate in learning together.
Dr Rehman said that the chief secretary also desired to visit Khushal Bagh Public School (KBPS), the first inclusive school in Peshawar. He said that disabled people needed services to improve their life style and reduce their dependency on others for carrying out routine work.
“Our first training is to enable the special children on how to hold pen, change clothes, wear socks and shoes and attend bathrooms,” he said. He added that inclusive education gained worldwide currency where people with disabilities were training on how to drive vehicles through modification to ensure their accessibilities through changing patterns and alternation.
Dr Rehman said that inclusive education could play an important role in educating the people suffering from cerebral palsy and autism besides slow learners and mild physically challenged children.
“The government’s response is highly encouraging towards the implementation of the plan. The country has about 10 per cent people with disabilities who become burden on their families and society only because they do not get education,” he said.
Dr Rehman, who is chairman of Habib Physiotherapy Complex, said that special children required an environment where they could be given exercises, behavioural therapy and psychotherapy sessions prior to putting them with normal students.
“In this system, the students are encouraged and socially included in the normal stream. Social inclusion is possible. They are not prone to inferiority complex. This is a wonderful solution for these children,” he said.
Dr Rehman said that he also informed chief secretary that he in his capacity as provincial coordinator of rehabilitation services in health department had helped the government to start physiotherapy services in 25 district hospitals that were later replicated in former Fata.
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