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Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
Many patients who present to district (first-referral) level hospitals require surgical treatment for trauma, obstetric, abdominal or orthopedic emergencies. Often surgery cannot be safely postponed to allow their transfer to a secondary or tertiary-level hospital but many district hospitals in developing countries have no specialist surgical teams and are staffed by medical, nursing, and paramedical personnel who perform a wide range of surgical procedures often with inadequate training. The quality of surgical and acute care is often further constrained by poor facilities, inadequate low-technology apparatus and limited supplies of drugs, materials, and other essentials. The mission of the team responsible for Clinical Procedures in the World Health Organization Department of Essential Health Technologies (EHT) is to promote the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level. WHO/BCT has identified education and training as a particular priority, especially for non-specialist practitioners who practice surgery and anesthesia. It has therefore developed Surgical Care at the District Hospital as a practical resource for individual practitioners and for use in undergraduate and postgraduate programs in-service training and continuing medical education programs. The manual is a successor of three earlier publications that are widely used throughout the world and that remain important reference texts: General Surgery at the District Hospital (WHO 1988), Surgery at the District Hospital: Obstetrics Gynecology Orthopedics and Traumatology (WHO 1991), Anesthesia at the District Hospital (WHO 1988; second edition 2000). This new manual draws together material from these three publications into a single volume which includes new and updated material, as well as material from Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors (WHO 2000).
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
This practical manual is designed to help medical officers in small hospitals provide safe and effective anesthesia for patients. Intended for doctors with at least one year of postgraduate clinical experience, it describes anesthetic techniques suitable for use in hospitals with limited resources. Chapter 2 describes fundamental principles and techniques underlying the practice of anesthesia and outlines immediate and continuing care of critically ill or unconscious patients. Chapter 3 focuses on continuing care of unconscious and anesthetized patients. The focus of Chapter 4 is on the principles of fluid and electrolyte therapy. Chapters 5 and 6 cover patient assessment before anesthesia and general anesthesia. Chapter 7 concerns safe clinical use of anesthetic equipment best-suited for and most likely found in district hospitals. Chapter 8 contains examples of general anesthetic techniques feasible in small or medium-sized hospitals. Chapter 9 provides information on drugs. Chapter 10 suggests techniques for conduction anesthesia. Chapters 11 and 12 discuss choosing and planning the anesthetic technique and postoperative care of the patient. Chapters 13 and 14 discuss special needs of pediatric and obstetric anaesthesia and important medical conditions. Chapter 15 covers oxygen, gas supplies, equipment, and maintenance. Numerous illustrations convey technical details; tables, charts, and checklists summarize lines of action and points to remember. Checklists and an index are appended. (YLB)
Written by leading experts in the field, this book examines and analyses key advances and developments in haematology. With contributions from international experts and assisted by flow charts and images, the text offers a multidisciplinary approach to topical issues related to haematology. Key topics examined include anaemia, thalassaemia, multiple myeloma, haematological malignancies and acute leukaemia.
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.