Environmental Health & Climate ChangeNational Health NewsPublic HealthPublic Health News

MOHP, Nepal banned the use of Mercury Dental Amalgam and Mercury based equipments

by Public Health Update
written by Public Health Update

MOHP, Nepal banned the use of Mercury Dental Amalgam and Mercury based equipments

Government of Nepal , Ministry of Health and Population (MOHP) banned the use of Mercury Dental Amalgam and Mercury based equipment’s towards ensuring Mercury Free Dentistry and Mercury Free Health Care Services in Nepal.

This is the results of research based campaign lead by Center for Public Health and Environmental Development (CEPHED) in close coordination and collaboration with all concerned organization.

Honorable Deputy Prime Minister & Minister for Health and Population Upendra Yadav on 21st August 2019 took very progressive decision to ban use of mercury dental amalgam and equipment’s in Nepal.

Ministry of Health and Population (MoHP) in consultation with all concerned professional associations like Nepal Dental Association (NDA), Nepal Medical Association (NMA), Universities (KU & TU), World Health Organization (WHO) Country Office for Nepal, Academies of Health Sciences like PAHS, NGOs and all other concerned stakeholder etc. has took this environment and health friendly decision.

This will immensely contribute towards effective implementation of Minamata Convention on Mercury, recommendations of Minamata Initial Assessment (MIA) report of Government of Nepal.

 

Mercury

WHO has identified mercury as one of the top 10 chemicals that can endanger health.

Mercury is a common ingredient found in cosmetics. Inorganic mercury is used in skin lightening soaps and creams. Organic mercury compounds are used as cosmetic preservatives in eye makeup cleansing products and mascara.

The main adverse effect of the inorganic mercury contained in skin lightening soaps and creams is kidney damage. Mercury in skin lightening products may also cause skin rashes, skin discoloration and scarring, as well as a reduction in the skin’s resistance to bacterial and fungal infections. Other effects include anxiety, depression or psychosis and peripheral neuropathy.

WHO

Mercury

Merc

Postdoctoral Researcher Climate Change and Health- DZNE

World Patient Safety Day: Speak up for patient safety!

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Fact SheetHealth in DataNational Plan, Policy & GuidelinesPublic Health UpdateReportsResearch & Publication

Family Planning Fact Sheet – 2019, Nepal

by Public Health Update
written by Public Health Update

Family Planning Fact Sheet – 2019, Nepal

Fact Sheet 2019 FPAN 1 Fact Sheet 2019 FPAN 2

Province wise mCPR (Source: DoHS, Annual Report,2074/075)

Screen Shot 2019 09 18 at 10.42.43

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PH Important DayPublic HealthPublic Health Update

World Patient Safety Day: Speak up for patient safety!

by Public Health Update
written by Public Health Update

World Patient Safety Day: Speak up for patient safety!

World Patient Safety Day was established by the 72nd World Health Assembly in May 2019. The first-ever World Patient Safety Day will observe globally on 17 September 2019. This global campaign will create awareness of patient safety and urge people to show their commitment to making healthcare safer.

WHO is prioritizing patient safety as a global health priority and urging patients, healthcare workers, policy makers and health care industry to “Speak up for patient safety!”

10 Facts about Patient Safety

  1. Patient safety is a serious global public health concern. It is estimated that there is a 1 in 3 million risk of dying while travelling by airplane. In comparison, the risk of patient death occurring due to a preventable medical accident, while receiving health care, is estimated to be 1 in 300. Industries with a perceived higher risk, such as the aviation and nuclear industries, have a much better safety record than health care does.
  2. One in every 10 patients is harmed while receiving hospital care
  3. Four out of every 10 patients are harmed in primary and outpatient health care
  4. At least 1 out of every 7 Canadian dollars is spent treating the effects of patient harm in hospital care
  5. Investment in patient safety can lead to significant financial savings
  6. Unsafe medication practices and medication errors harm millions of patients and costs billions of US dollars every year
  7. Inaccurate or delayed diagnosis is one of the most common causes of patient harm and affects millions of patients
  8. Hospital infections affect up to 10 out of every 100 hospitalized patients
  9. More than 1 million patients die annually from complications due to surgery
  10. Medical exposure to radiation is a public health and patient safety concern

Key Messages: How can you enhance patient safety?

If you are a patient or caregiver

  • Be actively involved in your own care
  • It is good to ask questions; safe health care starts with good communication
  • Be sure to provide accurate information about your health history

If you are a health worker or health care leader

  • Engage patients as partners in their care
  • Work together for patient safety
  • Ensure continuous professional development to improve your skills and knowledge in patient safety
  • Create an open and transparent safety culture in health care settings
  • Encourage blame-free reporting of and learning from errors

If you are a policy maker

  • Investing in patient safety results in financial savings
  • Invest in patient safety to save lives and build trust
  • Make patient safety a national health priority

If you are a researcher, student, academic, or professional institution

  • Generate evidence to improve patient safety, your research matters
  • Encourage research in patient safety
  • Incorporate patient safety in educational curricula and courses

If you are from a professional association, international organization or foundation

  • Promote patient safety for achieving universal health coverage
  • Provide learning and development opportunities for patient safety

If you are a public health advocate or from a patient organization

  • Promote patients’ voices in their own safe care
  • Advocate for safety in health care as a requirement

READ MORE: WHO

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World Patient Safety Day: Speak up for patient safety!

WHO calls for urgent action to reduce patient harm in healthcare

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Global Health NewsPublic HealthPublic Health NewsPublic Health Update

WHO calls for urgent action to reduce patient harm in healthcare

by Public Health Update
written by Public Health Update

WHO calls for urgent action to reduce patient harm in healthcare

Millions of patients are harmed each year due to unsafe health care worldwide resulting in 2.6 million deaths annually in low-and middle-income countries alone.  Most of these deaths are avoidable. The personal, social and economic impact of patient harm leads to losses of trillions of US dollars worldwide. The World Health Organization is focusing global attention on the issue of patient safety and launching a campaign in solidarity with patients on the very first World Patient Safety Day on 17 September.

“No one should be harmed while receiving health care. And yet globally, at least 5 patients die every minute because of unsafe care,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We need a patient safety culture that promotes partnership with patients, encourages reporting and learning from errors, and creates a blame-free environment where health workers are empowered and trained to reduce errors.”

Four out of every ten patients are harmed during primary and ambulatory health care. The most detrimental errors are related to diagnosis, prescription and the use of medicines. Medication errors alone cost an estimated US$ 42 billion annually. Unsafe surgical care procedures cause complications in up to 25% of patients resulting in 1 million deaths during or immediately after surgery annually.

Patient harm in health care is unacceptable. WHO is calling for urgent action by countries and partners around the world to reduce patient harm in health care. Patient safety and quality of care are essential for delivering effective health services and achieving universal health coverage. 

 

Investment in improving patient safety can lead to significant financial savings. The cost of prevention is much lower than the cost of treatment due to harm. As an example, in the United States alone, focused safety improvements led to an estimated US$28 billion in savings in Medicare hospitals between 2010 and 2015.

Greater patient involvement is the key to safer care. Engaging patients can reduce the burden of harm by up to 15%, saving billions of dollars each year.

 

On the very first World Patient Safety Day WHO is prioritizing patient safety as a global health priority and urging patients, healthcare workers, policy makers and health care industry to “Speak up for patient safety!”. Cities around the world will light up monuments in orange color to show their commitment to safety of patients on 17 September. These include the Jet d’Eau in Geneva, the Pyramids in Cairo, the Kuala Lumpur Tower, The Royal Opera House in Muscat,  and the Zakim bridge in Boston among others.

17 September was established as World Patient Safety Day by the 72nd World Health Assembly in May 2019.

WHO

World Patient Safety Day: Speak up for patient safety!

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National Guideline on Prevention,  Management and Control of Dengue in Nepal
Public HealthNational Plan, Policy & GuidelinesResearch & PublicationVector-Borne Diseases(VBDs)

National Guideline on Prevention,  Management and Control of Dengue in Nepal

by Public Health Update
written by Public Health Update

National dengue guidelines was first developed in Nepal in 2008 based on the World Health Organization (WHO) guidelines 1997 which was revised in 2011. This revised national guidelines on dengue prevention, management and control, 2019 aims to provide a technical ‘gold-standard’ advice on all aspects of dengue using the latest internationally adopted definitions, protocols and guidelines. It also provides simple, and easy to reference content, which can be printed and displayed on the walls of doctors rooms, wards or simply held in the hands of health workers who are spreading awareness on dengue within their local communities.

Aim of the guidelines

  • To provide current and robust guidelines for each of the core areas of seasonal and epidemic dengue prevention, management and control in Nepal.

Objectives

  1. To support dengue control and prevention activities.
  2. To provide pragmatic country-specific guidelines with reference to international gold standards.
  3. To provide guidance and new standards to all stakeholders.
  4. To provide country case studies for dengue prevention, management and control.
  5. To align and build collaboration between stakeholders.
  6. To provide a number of annexes that can be used as quick reference tools.

DOWNLOAD PDF FILE

DOWNLOAD PDF FILE

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Health Literacy, Health Education & PromotionNoticePublic HealthVector-Borne Diseases(VBDs)

Key Facts, Prevention & Control of Dengue

by Public Health Update
written by Public Health Update

Key Facts, Prevention & Control of Dengue

Key Facts

  • Dengue is a viral infection spread by mosquitoes causing a severe flu-like illness and, sometimes causing a potentially lethal complication called severe dengue haemorrhagic fever. Therefore, close monitoring of platelet count while undergoing treatment is important.
  • The Aedes aegypti mosquito is the main vector that transmits the viruses that cause dengue. The viruses are passed on to humans through the bites of an infective female Aedes mosquito, which mainly acquires the virus while feeding on the blood of an infected person.
  • Victims of dengue often have intense joint and muscle pain.
  • Complications arise due to depletion of cellular components in the blood which prevent normal clotting.

Look for these symptoms

  • High grade fever (104° F)
  • Body ache
  • Joint or bone pain
  • Severe headache
  • Eye pain,
  • Swollen lymph nodes
  • Rash and in some cases mild bleeding from gums or nose

Risk factors

  • Living or traveling in tropical areas
  • Prior infection with dengue fever virus.

Do’s

Prevention

  • Adapt protective measures/ Avoid mosquito bites
    – Use of Mosquito repellent products.
    – Wearing protective clothing; loose fitting full sleeved shirts and pants or similar dresses.
  • Favorable environment for mosquito breeding
    – Tightly cover water containers, wells and water storage tanks.
    – Prevent stagnation of water by topping up all defective ground surfaces, disposal of plastic containers, automobile tyres etc safely.
  • Create awareness about the spread of dengue in your locality.
  • Protect the infected person from further mosquito bites to avoid transmission of the disease.

Treatment

  • Take adequate rest.
  • Consume plenty of fluids to avoid dehydration.
  • Keep body temperature below 102º F.
  • Take paracetamol as per prescribed by doctor.

Don’ts

Prevention

  • Don’t apply mosquito repellent on your palms, or near your eyes or mouth. ALWAYS read instructions before using repellents, especially those pertaining to infants, breastfeeding and mothers pregnant women.
  • Don’t wear tight clothes, for mosquitoes find it easier to bite through tight-fitting garments.
  • If you are using mosquito repellents, don’t use them on children below two months of age. For children older than two months, use insect repellents containing 10% DEET.
  • Avoid activities in areas with lots of mosquitoes and going outdoors at dawn and dusk when mosquitoes are most active.

Treatment

  • Avoid use of NSAIDs (nonsteroidal antiinflammatory drugs) like aspirin, ibuprofen and steroids as they can lead to complication of severe bleeding.
  • Do not wait for symptoms to worsen. Immediately, consult a doctor. It is crucial to quickly get treatment in case of complications.

DOWNLOAD PDF FILE

Screen Shot 2019 09 14 at 09.02.12

DENGUE PREVENTION DENGUE

DENGUE1

DENGU6 DENGUE2 DENGUE3 DENGUE4 DENGUE5

DENGE

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PH Important DayPublic Health

World Sepsis Day 2019 : Stop Sepsis Save Lives

by Public Health Update
written by Public Health Update

World Sepsis Day 2019 : Stop Sepsis Save Lives 

World Sepsis Day is held on September 13th every year and is an opportunity for people worldwide to unite in the fight against sepsis. It is estimated to affect more than 30 million people worldwide every year, potentially leading to 6 million deaths.

Sepsis arises when the body’s response to an infection injures its own tissues and organs, potentially leading to death or significant morbidity.

There are two main steps to preventing sepsis

  • Prevention of infection in the community involves using effective hygiene practices, such as hand washing, and safe preparation of food, improving sanitation and water quality and availability, providing access to vaccines, particularly for those at high risk, as well as appropriate nutrition, including breastfeeding for newborns.
  • Prevention of infection in health care facilities mainly relies on having functioning infection prevention and control (IPC) programmes and teams, effective hygiene practices and precautions, including hand hygiene, along with a clean, well-functioning environment and equipment.

Together we can help prevent sepsis and save millions of lives every year.

World Health Organization South-East Asia Region – WHO SEARO

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Global Health NewsPublic HealthPublic Health NewsPublic Health UpdateVaccine Preventable Diseases

Global Vaccination Summit update: Ten Actions Towards Vaccination For All

by Public Health Update
written by Public Health Update

Global Vaccination Summit update: Ten Actions Towards Vaccination For All

The European Commission organises, in cooperation with the World Health Organisation, a Global Vaccination Summit on 12 September 2019, in Brussels. The event takes place under the joint auspices of the European Commission President Jean Claude Juncker and WHO Director General Tedros Adhanom Ghebreyesus. The overall objective is to give high level visibility and political endorsement to the topic of vaccination, which is the most successful public health measure saving millions of lives every year. It will demonstrate EU leadership for global commitment to vaccination, boost political commitment towards eliminating vaccine preventable diseases and engage political leaders and leaders from scientific, medical, industry, philanthropic and civil society in global action against the spread of vaccine misinformation. The Global Vaccination Summit published Ten Actions towards vaccination for all. 

Ten Actions Towards Vaccination For All

Everyone should be able to benefit from the power of vaccination.

Despite the availability of safe and effective vaccines, lack of access, vaccine shortages, misinformation, complacency towards disease risks, diminishing public confidence in the value of vaccines and disinvestments are harming vaccination rates worldwide. Vaccination is indisputably one of public health’s most effective interventions. We must endeavor to sustain vaccinations hard-won gains but also aim to do more and to do better, in view of achieving effective and equitable health systems and reduce the harm that is caused as a result of the illness and suffering that is otherwise preventable. This also includes making the necessary R&D investments to address unmet medical needs by developing new vaccines and improving existing ones.

Lessons from the day and actions needed towards vaccination for all and elimination of vaccine preventable diseases:

  1. Promote global political leadership and commitment to vaccination and build effective collaboration and partnerships -across international, national, regional and local levels with health authorities, health professionals, civil society, communities, scientists, and industry- to protect everyone everywhere through sustained high vaccination coverage rates.
  2. Ensure all countries have national immunisation strategies in place and implemented and strengthen its financial sustainability, in line with progress towards Universal Health Coverage, leaving no one behind.
  3. Build strong surveillance systems for vaccine-preventable diseases, particularly those under global elimination and eradication targets.
  4. Tackle the root-causes of vaccine hesitancy, increasing confidence in vaccination, as well as designing and implementing evidence-based interventions.
  5. Harness the power of digital technologies, so as to strengthen the monitoring of the performance of vaccination programmes.
  6. Sustain research efforts to continuously generate data on the effectiveness and safety of vaccines and impact of vaccination programmes.
  7. Continue efforts and investment, including novel models of funding and incentives, in research, development and innovation for new or improved vaccine and delivery devices.
  8. Mitigate the risks of vaccine shortages through improved vaccine availability monitoring, forecasting, purchasing, delivery and stockpiling systems and collaboration with producers and all participants in the distribution chain to make best use of, or increase existing, manufacturing capacity.
  9. Empower healthcare professionals at all levels as well as the media, to provide effective, transparent and objective information to the public and fight false and misleading information, including by engaging with social media platforms and technological companies.
  10. Align and integrate vaccination in the global health and development agendas, through a renewed Immunisation agenda 2030.

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National Plan, Policy & GuidelinesPublic Health UpdateResearch & Publication

Health Management Information System (HMIS) Guideline 2075

by Public Health Update
written by Public Health Update

Health Management Information System (HMIS) Guideline 2075

(2nd Edition, Revised)

Register, Card and Reporting Formats

Common Tools

  • 1.1 Master Register
  • 1.2 Health Service Card
  • 1.3 Outpatient Register
  • 1.4 Referral/Transfer Slip
  • 1.5 Defaulter/Discontinuation Tracking Slip
  • 1.6 Tally Sheet

2. Infant and Child Health

  • 2.1 Child Health Card
  • 2.2 Immunization Register
  • 2.3 Children’s Nutrition Register
  • 2.4 CBIMNCI Register
  • 2.5 IMAM Child Health Card
  • 2.6 IMAM Register
  • 2.7 IMAM Register- Hospital

3. Family Health

  • 3.1 Face Sheet
  • 3.2 Pills, Depo Register
  • 3.3 IUCD/Implant Service Register
  • 3.4 Sterilization Service Register
  • 3.5 Maternal and Newborn Health Card
  • 3.6 Maternal and Newborn Health Service Register
  • 3.7 Safe Abortion Service Register

4. Community Services

  • 4.1 ORC Register
  • 4.2 FCHV Register
  • 4.3 Vitamin A register

5. Malaria, leprosy and Kala-azar

  • 5.1 Malaria, leprosy and Kala-azar Specimen Collection Form
  • 5.2 Malaria, leprosy and Kala-azar  laboratory Register
  • 5.3 Malaria and Kala-azar Treatment Register
  • 5.4 Leprosy Examination Treatment card
  • 5.5 Leprosy Treatment Register

6. Tuberculosis

  • 6.1 Tuberculosis Sample Collection Form
  • 6.2 Tuberculosis Laboratory Register
  • 6.3 Tuberculosis Treatment Card (Health Facility)
  • 6.4 Tuberculosis Treatment Card (Patient)
  • 6.5 Tuberculosis Treatment Register
  • 6.6 PAL: Smoking cessation Register
  • 6.7 DR Tuberculosis Laboratory Register
  • 6.8 DR Tuberculosis Treatment Register

7. HIV/AIDS and STI

  • 7.1 HIV Testing and Counseling Register
  • 7.2 Sexual Transmitted Infection Treatment Register
  • 7.3 PMTCT Service Register
  • 7.4 HIV Treatment and Care Register
  • 7.5 HIV Patient Treatment Card
  • 7.6 Opioid Substitution Therapy (OST) Register

8. Hospital

  • 8.1 admission Register
  • 8.2 Discharge Register
  • 8.3 Emergency Service Register

9. Monthly Reporting Forms

  • 9.1 FCHV Report Collection
  • 9.2 Community Level Health Service Monthly Reporting Form- Immunization & PHCORC
  • 9.3 PHCC, HP, SHP, Urban Health Clinic/ Center and Community Health Unit Monthly Reporting Form
  • 9.4 Public Hospital Reporting Form
  • 9.5 Non-public Health Facility Reporting Form

DOWNLOAD HMIS GUIDELINE PDF FILE

DOWNLOAD HMIS GUIDELINE PDF FILE

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National Plan, Policy & GuidelinesPublic Health UpdateResearch & Publication

A Guide to Early Warning and Reporting System (EWARS)

by Public Health Update
written by Public Health Update

A Guide to Early Warning and Reporting System (EWARS) (Revised Edition- 2019)

Public health surveillance is the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice. Main objectives of public health surveillance are:

  • Early detection and timely response to outbreaks and other public health emergencies
  • To monitor trends of diseases, health problems and determinants of health

Importance of surveillance

Early warning and detection of outbreaks

  • Timely detection and response to outbreaks and other public health emergencies
  • Surveillance provides alerts on the burden of notifiable diseases
  • Helps in emergency planning and preparedness

Assessing the health status and issues of the population

  • Keeps the record of existing health problems
  • Helps in the interpretation of mortality and morbidity status

Detecting change in the trend of diseases

  • Continuous recording/reporting of data notifies about the disease trend
  • Keeps the track of disease

Collection of data for Planning, Monitoring and Evaluation

  • Helpful for evidence-based planning and policy formation and setting priorities
  • Useful to monitor the progress and evaluate the effectiveness of health programmes

Early Warning and Reporting System (EWARS) in Nepal

Early Warning and Reporting System (EWARS) is operational in Nepal to perform EWAR function. EWARS is a hospital based sentinel surveillance system where the selected hospitals send immediate and weekly reports (including zero reports) on six priority diseases and outbreaks of any diseases. It is designed to provide timely report of selected epidemic prone, vector-borne, water and food borne diseases for the early detection of outbreaks. It was established in 1997 first in 8 sentinel sites and expanded to 24 sites in 1998, 26 sites in 2002, 28 sites in 2003, 40 sites in 2008 and 82 sites in 2016. In May 2019, additional 36 sites (private hospitals and medical colleges across Nepal) were declared as sentinel sites by the DOHS. Thus,  the total number of current sentinel sites is 118.

 

Sentinel sites include all the central hospitals, provincial hospitals, district hospitals, medical colleges including selected private hospitals. The main objective of EWARS is to strengthen the flow of information on outbreak prone infectious diseases and vector borne diseases from the districts and to facilitate prompt outbreak response to be carried out by rapid response teams (RRTs) at federal, provincial and local level. It is designed to provide timely report for the early detection of selected vector-borne, water and food borne diseases with outbreak potential.

Reportable diseases/health events

Currently, six diseases are reported in EWARS as shown in the box.

Epidemic prone diseases

  1. Acute Gastroenteritis (AGE)
  2. Cholera
  3. Severe Acute Respiratory Infection (SARI)

Vector borne diseases

  1. Malaria
  2. Dengue
  3. Kala-azar
  4. Scrub typhus and ILI cases have also been reported since few years. So these diseases have also been included in this guide. Besides these prioritized diseases, other infectious diseases also need to be reported in EWARS in case of their outbreaks.

Early Warning Reporting System (EWARS), Nepal

Mechanism of information flow

Screen Shot 2019 09 10 at 22.13.12

Immediate reporting

The sentinel hospitals should immediately report, i.e. within 24 hours of confirmation of diagnosis (clinical and/or laboratory) of EWARS reportable diseases in following cases:

  • One confirmed case of Cholera
  • One case of confirmed Malaria
  • One case of confirmed case of Dengue
  • Five or more cases of AGE or SARI from same geographical area within one week
  • One case of confirmed Kala-azar

Consolidated immediate reports should be verified and forwarded by medical recorder of the hospital and sent to EDCD and VBDRTC.

Weekly reporting

The sentinel hospitals should prepare weekly report based on the epidemiological week calendar which starts on the first week of January (Epidemiological Week 1) and ends on lasts week of December (Epidemiological Week 52). Each week starts on Sunday and ends on Saturday.  For example, for the year 2019, Epidemiological Week 1 is or starts from December 30, 2018 (Epidemiological Week 1) and ends on December 28, 2019 (Epidemiological Week 52).

Consolidated weekly reports should be prepared for the epidemiological week and sent to EDCD and VBDRTC by Friday of the following week.

Based on timeliness of reporting, reports are categorised as:

  • On time: Report of an epidemiological week received within Friday of the following week.
  • No Report: Not receiving of Report till Friday

READ MORE INFORMATION: DOWNLOAD GUIDE

 

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