By IGHI guest blogger, Chris Bird, PG student in the Centre for Health Policy and Project Manager in the System Engagement Programme at the National Institute for Health and Care Excellence (NICE)
Systems under pressure
Rwanda and the developing world face even more acute pressure on frontline healthcare services.
Health systems around the world face the twin pressures of a rising demand for services, coupled with financial pressure on resources to deliver them. For publicly-funded universal health services in developed countries such as the UK’s National Health Service (NHS), new investment is at an all-time low. Funding for the NHS in England has seen a real-terms rise of 4.4% over 6 years, meaning that the average annual rise was just 0.7% per year.
By guest bloggers Sophie Uyoga and Charles Kamau, Research Scientists in Kilifi, Kenya
Africa has the highest risk of road traffic accident globally.
Most blood prescribed for transfusion in the developing world is mainly in emergency care. According to the WHO 2015 Report on Road Safety, the African Region has the highest risk of road traffic accident, one of the greatest contributors of emergencies needing blood transfusions. However, hospitals in this region are constantly facing blood stock outs, greatly contributes to the poor outcome all forms of medical emergencies as well as among admissions with severe anaemia. A clinical trial in East Africa by Kiguli et al., demonstrated how timely access reduces the risk of mortality among children with severe anaemia with a high proportion of those not transfused dying within 2.5 hours post admission.
5 May 2017 marked the International Day of the Midwife. Recognising the important role that midwives play to families and mothers, the day was first established in 1992. Midwives endure rigorous training to ensure that they can provide quality care for those in need. The level of skills amongst midwives however, can vary across the world.
March 2017 saw the arrival of Dr Beverly Donaldson, her midwifery colleagues Maggie Welch and Judith Robbins and paediatrician Dr Anna Battersby from Imperial College London/Imperial NHS Trust to facilitate the third midwifery training programme at the MRC Fajara The Gambia. The aim of the training was to support local midwives in their clinical practice by teaching them the necessary skills to manage basic obstetric emergencies in order to save the lives of mothers and babies in their care.
By Dr Kike Olajide, Wellcome Global Health Clinical Research Fellow, Centre for Psychiatry, Imperial College London.
Globally, the number of people with depression and anxiety is on the rise – up from 416 million in 1990 to 615 million in 2013. The World Health Organisation estimates that mental illness is now the leading cause of disability worldwide, accounting for over 15% of years lost due to disability (YLD). In addition to disability, common mental illnesses such as depression can lead to suicide. If you are aged 15 to 29 and living in Europe, the thing most likely to kill you, is you – suicide is the leading cause of death in this age group.
By Professor Kathryn Maitland, Professor of Tropical Paediatric Infectious Diseases, Director of Centre for African Research and Engagement, Imperial College London
Approximately 1200 African children are estimated to die from malaria every day, accounting for the vast majority of the global deaths from this disease. Over the past decade there has been an unprecedented increase in funding for malaria-control activities and vaccine development – the two major tools in ‘Roll back Malaria’ prevention and elimination programme. This has resulted in major scaling-up in the distribution of bed nets treated with long-lasting insecticides and public-private funding for late phase multi-site trials of the most promising anti-malaria vaccine candidate developed to date (RTS,S).
By Dr John O’Donoghue, Senior Lecturer in eHealth & Deputy Director of Imperial’s Global eHealth Unit
Mr Masters Chisale (Mzuzu Central Hospital) and Dr Chris Watson (Queens Universty Belfast) preparing the samples in Mzuzu Central Hospital.
The last week has been very busy in Mzuzu, northern Malawi. Scientists there have been packing blood and urine samples collected from 506 children with pneumonia in preparation for shipment to Dublin, Ireland. These samples will travel 12,000km at -80oC with constant monitoring of their temperature and dry ice being packed around them at stops along the journey to ensure they remain frozen in the warm heat of Africa as they travel across the African and European continents.
By Professor Alan Fenwick of Imperial’s Schistosomiasis Control Initiative (SCI)
‘Oncho blind’ – 60 years ago blind older people were led by children
There are five neglected tropical diseases (NTDs) which are the scourge of Africa, the Indian sub-continent, the Far East and South America. Onchocerciasis is one of these 5 and until the late 20th century caused millions of people to gradually lose their sight and eventually go blind. The parasite is spread by infected Simulium blackflies which when they bite a human, transfer microscopic larvae to the human host, where they develop into adult worms and females produce millions of new larvae during their lifetime.
By Professor Kathryn Maitland, Director of the IGHI Centre of African Research and Engagement.
First published by the Hippocratic Post on 22/8/16.
Professor Kathryn Maitland
‘Back in 2011, my research team published the results of the largest trial of critically ill children ever undertaken in Africa (FEAST trial), a trial that examined fluid resuscitation strategies in children with severe febrile illnesses (including malaria and bacterial sepsis). Contrary to expectation, the trial showed that fluid boluses were associated with an increased mortality compared to no-bolus (control), the greatest effect was in children with the most severe forms of shock. We were delighted when the FEAST trial won the prestigious 2011 BMJ Research Paper of the Year award and expected that doctors around the world would sit up and take notice – and guidelines for management of children suffering from shock due to sepsis would change.
By Professor Kathryn Maitland, Professor of Tropical Paediatric Infectious Diseases and Director of Centre of African Research and Engagement, Imperial College London.
Each year, World Blood Donor Day highlights the importance of blood donations as the transfusion of blood is a life-saving intervention. In any health system, the provision of adequate supplies of safe blood for transfusion is an essential undertaking.
The World Health Organization (WHO) estimates the blood requirement for countries to be in the region of 10 – 20 units per 1000 population per year. Yet in many sub-Saharan African countries, donations are far lower, in some countries as low as 2 units/1000 population/year.
By Dr Michael Templeton, Reader in Public Health Engineering, Department of Civil and Environmental Engineering, Imperial College London
Wednesday, May 25th 2016 marks Africa Day, the 53rd anniversary of the founding of the Organisation of African Unity, the forerunner of the African Union. There have been so many wonderful developments in Africa in the last 53 years, but sadly the quality of life of many of the poorest people in Africa continues to be limited by the burden of a group of debilitating diseases known collectively as neglected tropical diseases (NTDs), which have afflicted millions of Africans since ancient times.