Global Health and Study Design Flashcards
What disease does B3 (Niacin) deficiency cause?
Pellagra
- photosensitive rash
- dementia
- diarrhoea
Health system building blocks (6)
Governance/ Leadership
Financing
Health workforce
Information
Medical products and technology
Service delivery
Health system goals (5)
Improved health
responsiveness
social risk protection (for those accessing)
financial risk protection (for those accessing)
Efficiency
WHO antenatal care model (ANC)
8 CONTACTS (rather than visits)
- 12 weeks
- 20 weeks
- 26 weeks
- 30 weeks
- 34 weeks
- 36 weeks
- 38 weeks
- 40 weeks
(8, 6, 4, 4, 2, 2, 2)
Important diseases in the EMTCT
Elimination of mother to child transmission
HIV
Malaria
Syphilis
Hep B
Congenital chagas
Recommended maternal interventions
Tetanus
Iron and folate
Elimination of mother to child transmission
IPT - malaria
insecticide treated nets
de-worming
Antenatal health system recommendations
Women-held case-notes
Midwife-lead continuity of care
Group antenatal care
Community based intervention
Task shifting
Recruitment and retention of staff
Antenatal care contact schedules
What are the levels of emergency obstetric care
Basic
- oxytocin, antibiotics, anti-convulsants, manual vaccume delivery, manual removal of placenta, assisted vaginal delivery, neonatal bag and mask resus
Comprehensive
- blood transfusion, operative delivery
Emergency obstetric care recommendations by UN
1 comprehensive and 4 basic facilities per half million population
1 comprehensive and 4 basic facilities per area (subnational level)
% of all births should be at a EmOC facility (to be set depending on local area)
100% of women with obstetric complications should be treated at EmOC
C-sections should be 5-15% of all births
Case fatality <1%
Causes of post partum haemorrhage
TONE - RF - fever, bladder, rapid, prolonged.
trauma
thrombus
tissue (retained products)
Management of atony in delivery
skilled personnel - Oxytocin
un-skilled personnel - Misoprostol
Stabilising measures for PPH
Bimanual uterine compression
External aortic compression
Anti-shock garments
Uterine balloon tamponade
Management of pre-eclampsia and eclampsia
high risk - aspirin prophylaxis
pre-ecc - anti-hypertensives
ecc - ABCs, MgSO4 infusion
Signs of MgSO4 toxicity and management
Reduced urine output (<30ml/hr)
Depressed tendon reflex
Resp depression
(breathe slow, kick slow, pee slow)
Management
- calcium gluconate
Management of obstetric fistula
Use urinary catheter - leave insitu for 2 weeks - if no signs of fistula can remove
If fistula present leave catheter for 6 weeks (small fistulas may heal if bladder is not contracting)
If not healed after 6 weeks → refer for surgery
Monitoring of labour
Labour partograph
Labour care guide
What are the 6 WHO pillars of quality
Equity
Efficiency
Safety
Patient centeredness
Timeliness
Effectiveness
Powers that make an issue a global health priority
Power of actors
Power of ideas
Power of political context
Power of the issue
Features of potable water (drinking water)
Potable water = drinking water
Odourless, colourless
Safe - no harmful microorganisms
Safe concentrations of chemicals and minerals
Clear
Not salty
How to assess safety of water from micro-organisms
count coliform numbers (can be used as a generalised marker)
Types of sweet water
- surface water
- ground water
- precipitation
Points of water contamination
- contamination can occur at any point in the water chain from collection source to consumption.
What is public health
the art and science of preventing disease, prolonging life and promoting health by the organised efforts of society
What are the 3 aspects of public health
- health promotion
- health protection
- health systems
All of this is underpinned by information and intelligence
Causes of death based on income bracket of country
High income countries: IHD, Alzheimer’s, Stroke, Lung ca, COPD
Upper-middle-income countries: IHD, Stroke, COPD, Lung ca, LRTIs
Lower-middle-income countries: IHD, Stroke, neonatal complications, COPD, LRTIs
Low income countries: Neonatal complications, LRTIs, IHD, stroke, diarrhoea
