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Caregivers' views on stigmatisation and discrimination of people affected by leprosy in Ghana

ASAMPONG, Emmanuel
DAKO-GYEKE, Mavis
ODURO, Razak
January 2018

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In Ghana, the social interpretation of leprosy regardless of the language, culture and tradition engenders stigmatisation and discrimination that leads to social rejection and exclusion of persons who have been cured of the disease. Often, these persons are cared for by relatives who happen to live with them in a confined place. From the views of these caregivers, this paper identifies areas of stigmatising and discriminatory tendencies against people affected by leprosy who reside in a Leprosarium in Accra. A qualitative interview with semi-structured interviews were conducted for twenty caregivers.

Report of the informal consultation on stopping discrimination and promotion inclusion of persons affected by Leprosy. New Delhi, 14–16 Nov 2017

COOREMAN, Erwin
WHO SEARO/Department of Control of Neglected Tropical Diseases
et al
2018

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An Informal Consultation on Stopping Discrimination and Promoting Inclusion of Persons Affected by Leprosy was held in New Delhi from 14 to 16 November 2017. Forty delegates with diverse backgrounds, experience and expertise enriched the discussions. Persons affected by leprosy brought to the table the challenges faced in daily life and suggested actions to be taken to reduce stigma and discrimination related to leprosy. Representatives of national programmes presented actions taken in their respective countries. The participants acknowledged the fact that stigma and discrimination related to leprosy still exists at a significant level. Information about stigma and discrimination related to leprosy needs to be collected in a more systematic manner to assess the magnitude of the problem and to further plan activities to reduce it.

Key recommendations from the consultation included counselling and reporting of incidences of discrimination. Efforts should be continued to inform facts about leprosy to the community.

The participants strongly recommended that leprosy programmes should adopt a ‘rights-based approach’ in line with the Sustainable Development Goals.

Strengthening community and primary health systems for tuberculosis. A consultation on childhood TB integration

UNICEF
2016

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An estimated one million children between the age of 0-14 fall ill with tuberculosis (TB) every year, over 67 million children are infected and might develop active disease at any time. In 2013, the WHO with key partners launched the Roadmap for Childhood TB, outlining ten key actions to improve outcomes for children affected by TB, including improved data, development of child-friendly tools for diagnosis and treatment, engagement of key stakeholders at all levels of the system, and the development of integrated family- and community-centred strategies to provide comprehensive and effective services at the community level. A consultation on childhood TB integration took place in New York on June 1 and 2, 2016 to stimulate further the dialogue. The meeting addressed 7 topics: perspectives on childhood TB; country discussions on integration; integrating childhood TB interventions into service delivery; an opportunity for TB risk assessment at the community level: TB/HIV adapted integrated community case management (iCCM); childhood TB integration at the national, district, and community level; and financing childhood TB integration 

Surviving polio in a post-polio world

GROCE, Nora
BANKS, Lena Morgan
STEIN, Michael Ashley
April 2014

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This paper reviews what is currently known about disabled survivors of polio and highlights areas of need in public health research, policy and programming. Based on a literature review, discussion and field observations, the authors identify continuing challenges posed by polio and argue that the attention, funding and commitment now being directed towards eradication be shifted to provide for the rehabilitative, medical, educational and social needs of those for whom the disabling sequelae of polio will remain a daily challenge for decades to come

Social Science & Medicine, Vol 107

World health statistics 2010

WORLD HEALTH ORGANIZATION (WHO)
2010

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This annual compilation of health-related data for the World Health Organization's 193 member states, includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets

A handbook for network support agents and other community workers supporting HIV prevention, care, support and treatment

March 2009

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This manual is intended to help network support agents and other community workers be more effective in disseminating standardised information about HIV and AIDS. It "...emphasises the importance of the acquisition of knowledge, skills and the right attitude needed to identify the psychosocial needs of people of people infected and affected by HIV/AIDS and address these needs by giving information, counselling and appropriate referrals. Knowledge of counselling and psychosocial care, is combined as much as possible with prevention activities such as adopting HIV basic care positive prevention and adherence to treatment"

Evidence for the effectiveness of rehabilitation-in-the-community programmes

VELEMA, Johan P
EBENSO, Bassey
FUZIKAWA, Priscila L
March 2008

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"The present literature review identified 29 reports from 22 countries in Asia, Africa and Central America reporting on the outcomes of rehabilitation-in-the-community programmes in low and middle income countries published between 1987 and 2007. Interventions included home visits by trained community workers who taught disabled persons skills to carry out activities of daily living, encouraged disabled children to go to school, helped find employment or an income generating activity, often involving vocational training and/or micro-credit. Many programmes had a component of influencing community attitudes towards disabled persons. The information collected shows that such programmes were effective in that they increased independence, mobility and communication skills of disabled persons, helped parents of disabled children to cope better and increased the number of disabled children attending schools. Economic interventions effectively increased the income of disabled persons although they rarely made them financially independent. CBR activities result in social processes that change the way community members view persons with disabilities, increase their level of acceptance and social inclusion and mobilise resources to meet their needs"
Leprosy Review, Vol 79, Issue 1

The essentials of antiretroviral therapy for health care and program managers

HOPE, Ruth
ISRAEL, Ellen
April 2007

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This book provides health care workers and mangers with information and practical guidance relating to antiretroviral therapies (ART). It also considers wider care and treatment issues such as; opportunistic infections, the integration of ART with antenatal and midwifery services, the particular needs of children and young people, support relating to nutrition, spiritual needs, psycho-social and economic issues. In addition, the need for community level support to help with adherence to treatment and address stigma and discrimination are also considered, as is end-of-life care for people whose disease does not respond to treatment

Guidelines for inclusion of individuals with disability in HIV/AIDS outreach efforts

GROCE, Nora
TRASI, Reshma
YOUSAFZAI, Yousafzai
2006

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The strategies for interventions proposed here can provide a framework upon which disability advocates and HIV and AIDS advocates, educators and policy makers can begin to build interventions and support mechanisms for ‘at-risk’ disabled populations. To date, there have been few HIV and AIDS interventions that have directly targeted (or indirectly included) individuals with disability and almost none of these interventions have been systematically monitored or evaluated. The framework proposed here therefore, is intended only as a ‘first step’ in a series of publications on various aspects of disability-inclusive HIV and AIDS interventions and tool kits

The HELP guide for community based rehabilitation workers : a training manual

LOVEDAY, Marion
2006

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This is a training manual for community based rehabilitation workers based upon physiotherapist's work on a rehabilitation project in Cape Town, South Africa. The manual is aimed at trainers of rehabilitation workers who are assumed to have adequate medical knowledge. The manual is divided into the following 4 main topics: health in the community; normal body functions; conditions and treatment; management of patients. Each section contains a summary of the learning aims for the rehabilitation workers, and the teaching is based mainly on a question and answer format
Note: originally published in 1990 by SACLA Health Project

ILEP learning guide four : how to prevent disability in leprosy

CROSS, Hugh
MAHATO, Margaret
2006

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"This book is for all health workers who may have to help people who have nerve damage to their eyes, hands and feet. It will help them to encourage patients to develop a lifetime habit of caring for nerve-damaged parts. The content of this book complements the recommendations in the Operational Guidelines of the World Health Organization"
Note: This resource is available to download in three parts

Palliative care in Sub-Saharan Africa : an appraisal

HARDING, Richard
HIGGINSON, Irene
2004

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This report was written from the belief that palliative care is, and will be for the forseeable future, an essential component in the continuum of managing HIV/AIDS in sub-Saharan Africa. There is now a wealth of experience in sub-Saharan Africa about the ways in which palliative care can be delivered both affordably and effectively. However, there remains a lack of properly documented evidence and research to demonstrate the importance of this work and promote its development. This report provides a review of existing evaluations of palliative care projects in sub-Saharan Africa with an emphasis on isolating the factors that lead to sustainability, local ownership and scaling up; the role of palliative care in the management of HIV/AIDS and how to integrate palliative care and Anti-Retroviral Therapy (ART); primary health based care projects in two countries, Kenya and Malawi, that could provide lessons for the implementation of palliative care; lessons from other parallel programmes which mirror palliative care delivery, for example, tuberculosis programmes, and primary care programmes with good links to local clinics and hospitals, and community mobilization and empowerment projects linked to health facilities. In this way it contributes to the effort of providing an evidence base to demonstrate the importance of palliative care and provides a source of reference for policy makers, practitioners, donors and researchers

Handbook on paediatric AIDS in Africa

TINDYEBWA, Denis
et al
2004

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This handbook intends to provide users in resource-poor countries with a tool that can be adapted to their needs. It follows the four principles of the United Nations Convention on the Rights of the Child and aims to provide a simple, accessible and practical handbook for health workers involved in preventing infection and caring for children infected and affected by HIV. It includes substantial chapters on caring for HIV-exposed and HIV-infected children, infants and orphans; diagnosis and the clinical stages of HIV infection; clinical conditions associated with HIV (diarrhoea, malnutrition, neurological manifestations, skin manifestations and more); pulmonary conditions; anti-retroviral therapy for children; youth issues, long-term and terminal care planning; psychosocial support. The primary targets are medical students and their lecturers, nurses, clinicians, community health workers and other service providers in resource poor settings where there is a significant HIV and AIDS burden

Gender mainstreaming in health : the possibilities and constraints of involving district-level field workers

DUNN, Alison
2004

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This policy brief concerns the involvement of district-level workers in local-level practical approaches to mainstreaming gender. This involvement is central to facilitating change and informing health strategies. MKP led a project in Ghana to facilitate district-level health management teams and district-level field workers to conduct qualitative and participatory research on gender aspects of access to health care for malaria. The results have informed strategies to improve gender equity in health at the community level

Sociocultural explanations for delays in careseeking for pneumonia

CENTRE FOR HEALTH AND POPULATION RESEARCH
December 2003

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This article is printed in the Health and Science Bulletin produced by the Centre for Health and Population Research, based in Bangladesh. It outlines research conducted among parents in Matlab, Bangladesh, revealing how their beliefs affect household treatment of childhood pneumonia and influence delays in seeking care from trained providers. Many indigenous beliefs and social factors prevent primary care providers, particularly mothers, of pneumonia cases from obtaining prompt and appropriate help. For example, in fear of being blamed for poor caring practices, mothers are reluctant to share information about the illness with other family members. Intervention strategies designed to reduce child mortality associated with pneumonia need to address the cultural beliefs and challenges. Efforts should focus on involving family members such as the child's father or grandmother in early recognition of pneumonia cases. It also suggests that health workers use local terminology and cultural knowledge to communicate the need for prompt treatment with a trained provider

Anthropological perspectives on injections : a review

REELER, A V
2000

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There is evidence that injections and injection equipment are now often used by lay people in developing countries. Epidemiological evidence links the large number of unsafe injections to serious bloodborne infections such as viral hepatitis b and c, and HIV. This article examines the reasons behind the demand for injections by consumers and the administration of unnecessary or unsafe injections by different types of provider. Interventions aimed at reducing the risk of unsafe injections are discussed in relation to cultural and social factors as well as those factors associated with health systems. Suggestions are made for approaches to the design of such interventions

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