Adapting essential care programs to Covid-19 pandemic times

As the ongoing Covid-19 pandemic grips the world, one of its most devastating indirect effects is the disruption to medical services for preventing and treating other life-threatening diseases—especially in countries with already-fragile health systems. For MSF and other global health actors this means not only responding to Covid-19 directly but also assessing its impact on other essential care and then adapting programs so they can keep serving patients despite the enormous obstacles.

In this Collection you will find a selection of published articles and conference content from this year’s MSF Scientific Days 2021 conference content, encompassing a range of approaches, settings and medical challenges—from malaria, TB and HIV/AIDS prevention and care to digital health promotion and sexual and reproductive health.

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Mental health in humanitarian settings

Complex humanitarian emergencies and other low-resource settings can be exceedingly difficult places to provide quality mental health (MH) care. Yet these environments also often have a high burden of mental health care needs. This collection presents a set of articles describing how MSF teams have adapted and evaluated ways of bringing clinically impactful MH care to neglected communities and patients—from forcibly displaced populations in northern Nigeria to Syrian refugees in Lebanon and typhoon survivors in the Philippines. It also highlights work on developing new tools for providing clinical supervision and for identifying those patients most in need of care in fragile settings, and on new approaches to delivering MH services during the Covid-19 pandemic.

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.

To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. One key limitation in most of these settings is a lack of clinical bacteriology laboratory capacity, which leaves medical providers without ways to accurately diagnose patient infections and to tailor antibiotic treatment accordingly. To help fill this critical gap, MSF and partners have developed the Mini-Lab—a small-scale, standalone lab that is easy to transport, set up and operate by staff after only a short training. Its six modules are stocked with everything needed to diagnose common bloodstream and urinary tract infections and to perform antibiotic sensitivity testing using methods adapted to extremely hot climates and remote settings. With Mini-Lab now being rolled out to selected MSF projects, here we highlight the background to its development and some of the research behind the bacteriological tests it incorporates.

BACKGROUND
'Tele-Mental Health (MH) services' are an increasingly important way to expand care to underserved groups in low-resource settings. In order to continue providing psychiat...

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Mental health in humanitarian settings

Safe abortion care at MSF

Mini-Lab—MSF's simplified bacteriology laboratory for low-res...

TACTiC - Implementation du nouvel algorithme oms pour le diagnostic de la tuberculose pulmonaire chez les enfants au Niger

Shifting to tele‑mental health in humanitarian and crisis settings: an evaluation of Médecins Sans Frontières experience during the COVID‑19 pandemic

Impact of COVID-19 on HIV/ AIDS service delivery in Philippines and Pakistan

Video/Virtually Observed Therapy for patients with drug-resistant tuberculosis in Eswatini: a rapid response to COVID-19 lockdown measures

Overcoming lockdown restrictions by digitising health promotion

Feasibility of large-scale mass drug administration for malaria in Angumu health zone, Ituri, Democratic Republic of Congo

Tuberculosis preventive therapy for children and adolescents: an emergency response to the COVID-19 pandemic

Now is the time: a call for increased access to contraception and safe abortion care during the COVID-19 pandemic