Health ramifications and recovery avenues for Sudan's April 2023 armed conflict: A review

Background: Sudan's history is marred by ongoing sociopolitical challenges, with deep cultural divisions fueling numerous wars. A new conflict erupted on April 15, 2023, pushing the country closer to a full-scale civil war. This war has severely crippled Sudan's already fragile healthcare system, rendering 70% of hospitals in combat zones nonoperational, causing 12,000 deaths, thousands of injuries, and leaving 11 million in dire need of healthcare. More than seven million people are displaced, half of which are children, and are facing severe health challenges, especially vulnerable groups. Heath situation is threatening with unchecked spread of outbreaks of communicable diseases that were previously controlled and marked failure in meeting the health demands of patients with noncommunicable diseases, reproductive and child health issues, and people with serious conditions that require adequate follow-up. Moreover, the projections threaten with more catastrophic consequences including famine, environmental destruction, and further displacement of people. This review article highlights the urgency of the situation and explores potential solutions to enrich global understanding of crisis management. Methods: To comprehensively assess the impact of the crisis and propose a way forward, we drew data by exploring search engines and databases such as Google, Humanitarian Agencies Websites, Google Scholer, and PubMed along with some relevant reports. The search terms included are "Sudan's war", "impact of war on healthcare systems", and "Sudan's armed conflicts". Results: More than 19 publications on the impact of the war on health in addition to periodic reports from international organizations and governmental authorities were reviewed. Conclusion: Although all publications point to the gravity of the situation and the need for prompt response, this crisis offers a unique opportunity to rebuild Sudan's struggling healthcare system with the principles of social accountability. Through domestic and international collaboration, this sector can become a model for similar nations, meeting the needs of its people and promoting sustainable development.

Gestão em foco / Management in focus

Este e-book tem como objetivo trazer um compêndio de relatos de experiência relacionados à gestão de saúde do Estado de Goiás. Cada capítulo traz a descrição dos projetos desenvolvidos no âmbito da Secretaria de Estado da Saúde de Goiás, que são vinculados aos objetivos estratégicos do órgão. Estes projetos têm como objetivo fortalecer as ações estratégicas para otimizar o planejamento do Sistema Único de Saúde

This e-book aims to bring a compendium of experience reports related to health management in the State of Goiás. Each chapter brings a description of the projects developed within the scope of the State Department of Health of Goiás, which are linked to the strategic objectives of the agency. These projects aim to strengthen strategic actions to optimize the planning of the Unified Health System

Interprofessional work in health in the context of the COVID-19 pandemic: a scoping review / Trabajo interprofesional en salud en el contexto de la pandemia del COVID-19: revisión del alcance / O trabalho interprofissional em saúde no contexto da pandemia de COVID-19: revisão de escopo

ABSTRACT Objective: to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. Method: this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals; Concept = interprofessional relationships; Context = health services) and respective search strategies. Results: fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration; 2 - Collaborative practice; 3 - Interprofessional work; 4 - Interactive and interprofessional learning. Conclusion: the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.

RESUMEN Objetivo: mapear la producción científica sobre las relaciones interprofesionales en salud en el primer año de la pandemia del COVID-19. Método: revisión del alcance, realizada en las bases de datos PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar y Science Direct, cubriendo el período de publicación 2020, utilizando las siglas del PCC (Población = profesionales de la salud; Concepto = relaciones interprofesionales; Contexto = salud servicios) y las respectivas estrategias de búsqueda. Resultados: se seleccionaron 14 artículos científicos y el contenido discutido en los manuscritos fue estandarizado, analizado y organizado en categorías de afinidades y similitudes de sus resultados: 1 - Colaboración interprofesional; 2 - Práctica colaborativa; 3 - Trabajo interprofesional; 4 - Aprendizaje interactivo e interprofesional. Conclusión: la pandemia exigía respuestas rápidas y eficaces que solo eran posibles a través de las dimensiones de la colaboración y la interprofesionalidad. El trabajo interprofesional en salud durante el primer año de la pandemia COVID-19 confirma la importancia del trabajo interprofesional y sus dimensiones para la prestación de servicios de salud más integrales, decididos y seguros.

RESUMO Objetivo: mapear a produção científica sobre relações interprofissionais em saúde no primeiro ano da pandemia de COVID-19. Método: revisão de escopo, realizada nas bases PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar e Science Direct, abrangendo o período de publicação do ano de 2020, utilizando o acrônimo PCC (População = profissionais de saúde; Conceito = relações interprofissionais; Contexto = serviços de saúde) e respectivas estratégias de busca. Resultados: foram selecionados 14 artigos científicos e o conteúdo discutido nos manuscritos foi uniformizado, analisado e organizado em categorias de afinidades e semelhanças de seus resultados: 1 - Colaboração interprofissional; 2 - Prática colaborativa; 3 - Trabalho interprofissional; 4 - Aprendizagem interativa e interprofissional. Conclusão: a pandemia demandou respostas rápidas e eficazes que só foram possíveis através das dimensões da colaboração e da interprofissionalidade. O trabalho interprofissional em saúde durante o primeiro ano de pandemia de COVID-19 confirma a importância do trabalho interprofissional e suas dimensões para a oferta de serviços de saúde mais integrais, resolutivos e seguros.

Nurses' perception of the multidisciplinary team approach of care for adolescent mothers and their children in Ugu, KwaZulu-Natal

Background: Adolescent childbearing has numerous consequences on maternal health, child health and the well-being of society. Because of the high-risk nature of adolescent pregnancy, a multidisciplinary team (MDT) approach is recommended to achieve satisfactory pregnancy outcomes. Aim: The aim of this study was to explore nurses' perceptions of the MDT approach in the continuum of care for adolescent mothers and their children. Setting: The study was conducted in a local district hospital in Ugu, KwaZulu-Natal. Methods: An explorative and descriptive qualitative study design was used. The first author and hospital staff (clinical midwives and the clinical manager of obstetrics and gynaecology) collaborated on the development of the focus group discussion (FGD) guide to explore nurses' perception of the MDT approach of care for adolescent mothers and their children. A total of three FGDs were conducted. Data were analysed using thematic analysis. Results: Six overarching themes emerged from the data analysis which included professional benefits of adopting the MDT approach of care for adolescent mothers and their children, barriers to the multidisciplinary collaboration, clinical benefits of adopting the MDT approach of care for parenting adolescent mothers, problems and needs of adolescent mothers, and nurses' reasons regarding their willingness to participate in a multidisciplinary collaboration in the care of parenting adolescent mothers.Conclusion: In the opinion of nurses, the MDT approach of care for adolescent mothers and their children is an important strategy to improve maternal and child health outcomes. This study has important implications for the design of an intervention

Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa

Background: In 2011, South Africa established ward-based outreach teams (WBOTs) comprising Community Health Workers as part of strategies to strengthen primary healthcare. The new community health workers (CHWs) lacked experience of the programme. This study aimed at assessing perceptions of community health workers on their training, teamwork and practice.Methods: This was a cross-sectional study conducted among CHWs in the seven regions of Tshwane health district between October and November 2015. Data were collected from 431 CHWs in eight Community Health Centres and 11 clinics using a pre-tested, self-administered questionnaire. Outcome measures were CHWs' perceptions on training, teamwork and practice regarding WBOT programme.Results: A total of 431 CHWs formed the study sample. Participants had a mean age of 36 years (SD ± 9.46). The majority (88.2%) were female. Some 77% had completed secondary school. Overall, most CHWs perceived their training (86.4%), teamwork (87.6%) and practices (67.7%) to be good (p = 0.001). The majority were able to provide efficient health care despite the challenges experienced, which were lack of equipment, walking long distances, and safety on the streets and in households with patients who had mental health problems among others. Fisher's exact test showed a significant association between training and work challenges (p = 0.006).Conclusion: The study findings showed that most CHWs had good perceptions regarding their training, teamwork and practice. Several concerns raised by CHWs suggest the need for stakeholders to ensure availability of resources for optimal functioning of CHWs

Urgências e emergências em saúde mental: a experiência do Núcleo de Saúde Mental do SAMU/DF / Urgencies and emergencies in mental health: the experience of the SAMU / DF Mental Health Center

INTRODUÇÃO: A demanda crescente de atendimento a pessoas com transtornos mentais, aliada a uma política de garantia de direitos e proteção dessas pessoas, fomentou a criação de um serviço de saúde mental no SAMU/DF. MÉTODO: Por meio de teleatendimento e de uma viatura tripulada por equipe multiprofissional, o serviço surgiu em 2013 e se tornou 24h em julho de 2016. Capacitações são oferecidas a profissionais para cobrir um déficit de formação. RESULTADOS: Prevenção do suicídio e de agravos psíquicos, redução de remoções e internações hospitalares, maior encaminhamento à rede e otimização dos recursos. CONCLUSÃO: Trata-se de importante ferramenta de apoio à rede que merece ser ampliada futuramente.

Implementation of Electronic EWARN Platform in EMRO

In collaboration with ITT unit of the Regional Office, the IHM unit of the Department of WHO Health Emergencies Programme in EMRO is developing a regional electronic platform for EWARN [Early warning Alert and Response Network] for humanitarian crisis affected settings

Sentimentos de pessoas renais crônicos e interferências em atividades sociais / Feelings of people with chronic kidney disease and interferences in their social activities / De las personas renales crónicas y las interferencias en sus actividades sociales

A doença renal crônica pode causar alterações emocionais e físicas nas pessoas. Objetiva-se relacionar sentimentos mencionados por pacientes renais crônicos em hemodiálise referentes a problemas de saúde física e emocional e interferências em atividades sociais. Pesquisa quantitativa, descritiva, transversal, com base em investigação realizada em unidade nefrológica do Rio Grande do Sul, em maio-julho de 2010, com 77 pacientes. Os resultados mostram que tanto a doença crônica quanto o tratamento dialítico, interferem na saúde física, emocional e nas atividades sociais de que participam, em graus variados. Concluiu-se que é necessário qualificar o planejamento, a gestão e a assistência para um cuidado personalizado.

Chronic kidney disease can cause emotional and physical disruptions in the people with such condition. This study aims to relate feelings mentioned by hemodialysis patients, referring to physical health problems and emotional interference in social activities. This is a quantitative, descriptive and transversal research based on investigation conducted at the nephrology unit in Rio Grande do Sul, Brazil, from May to July / 2010, with 77 patients. The results show that both chronic disease and the dialysis treatment interfere with the physical, emotional and social activities of the patients who participated in several degrees. It could be concluded that it is necessary to qualify the planning, management and assistance in order to deliver a personalized care.

La enfermedad renal crónica puede causar cambios físicos y emocionales en las personas. El objetivo de este estudio es relacionar los sentimientos mencionados por los pacientes renales crónicos en hemodiálisis, en referencia a los problemas de salud física y emocional y las interferencias en sus actividades sociales. Investigación con enfoque cuantitativo, descriptivo y transversal, basado en una investigación realizada en una unidad de nefrología de Rio Grande do Sul, con 77 pacientes, de mayo a julio de 2010. Los resultados muestran que tanto la enfermedad crónica cuanto el tratamiento de diálisis, interfieren, en distintos grados, en la salud física, emocional y en las actividades sociales en las cuales participan. Se concluye que se hace necesario cualificar la planificación, la gestión y la asistencia para el cuidado personalizado.

Estudo sobre os pactos de gestão estabelecidos entre estados e municípios, a partir da implantação da NOB - SUS 01/96 / Study on the management pacts established between states and municipalities, since the implementation of NOB - SUS 01/96

INTRODUÇÃO: Este trabalho procurou refletir sobre determinados instrumentos criados para operacionalizar a estra- tégia de descentralização do Sistema Único de Saúde, enfocando especialmente a divisão de responsabi- lidades que se estabeleceu entre estados e municípios durante a vigência da Norma Operacional Básica NOB SUS 01/96. OBJETIVO: Seu objetivo geral é contribuir para o debate sobre as perspectivas da construção/ reorganização do sistema de saúde brasileiro considerando as relações interinstitucionais, interníveis e interserviços envolvidas com o processo de descentralização na saúde. O ângulo adotado para examinar as relações entre estados e municípios é a avaliação dos pactos inter-esferas governamentais mediados direta ou indiretamente pelas Normas Operacionais. MATERIAL E MÉTODO: Para ressaltar estes aspectos, foram utilizados dados relativos aos municípios habilitados na Gestão Plena do Sistema Municipal GPSM localizados em todos os estados brasileiros. Os aspectos analisados foram restritos à descentralização da assistência e buscaram entender possíveis fatores que influíram na formulação dos diferentes pactos estaduais. A situação encontrada atualmente, relativa aos pactos acorda- dos entre estados e municípios, foi ainda comparada com estudos realizados pelo Ministério da Saúde em 1995 e em 1999, que trataram do mesmo tema. CONCLUSÃO: O trabalho indica que alguns pactos estabelecidos entre estados e municípios em GPMS não contribu- íram para a organização do Sistema e apresenta como a Norma Operacional da Assistência à Saúde NOAS SUS 01/02, busca a superação deste problema.

INTRODUCTION: This work tried to reflect on certain tools created to carry out the strategy of decentralization of the Sistema Único de Saúde - SUS , focusing specially on the sharing of responsibilities between states and municipalities in accordance with the Norma Operacional Básica - NOB SUS 96 . OBJECTIVE: Its general goal is to contribute to the debate on the perspectives of construction/ re-organization of Brazilian Health System, regarding inter-institutional, inter-level and inter-services relations related to the process of decentralization in health system. MATERIAL AND METHOD: The angle adopted to examine the relations between states and municipalities is the evaluation of agr eements between gover nmental spheres dir ectly or indir ectly mediated by the Normas Operacionais . To stress these features, the work used data related to the municipalities qualified in Full Management of Municipal System - GPMS , located in all Brazilian states. The analyzed features were restricted to decentralization of Aid and were used to understand the possible factors that influenced the different state agreements. The current situation, concerning agreements between state and municipalities, was also compared with studies developed by the Health Department in 1995 and 1999, about the same subject. CONCLUSION: The work points that some agreements between state and municipalities in G PMS did not contribute to the organization of the System. It also pr esents how the Norma Operacional de Assistência - NOAS SUS 01/ 02 tries to overcome this problem.