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Overview
The Practical Approach to Lung Health (PAL) is one of the strategies intended to overcome the challenge posed by weak health systems. This initiative is aimed at managing respiratory patients in primary health care settings while expanding TB detection and good-quality TB services. PAL focuses on the most prevalent respiratory diseases at first-level health facilities – pneumonia, acute bronchitis and other acute respiratory infections, TB, and chronic respiratory conditions including chronic bronchitis, asthma and chronic obstructive pulmonary disease.
This manual was developed by WHO to assist country institutions – health and other government ministries, social security agencies, nongovernmental organizations – that want to introduce the PAL strategy into case-management practices in primary health care. It describes a phased process of promotion, technical guideline development and adaptation, pilot testing, managerial planning and implementation. The standards and recommendations represent a synthesis of the observations and experience gathered in primary health care settings in 10 countries in all regions of the world in the past six years.
The manual provides practical guidance to health managers whose efforts are crucial to the achievement of global TB control goals and national targets for case- management of respiratory conditions. It will also be helpful for health care providers at both first-level health care facilities and the first referral level.
Contents
- Foreword
- Development of the manual and acknowledgements
- Acronyms and abbreviations
- Introduction: Scope and objectives of the manual
- 1. Enlisting support to initiate the PAL strategy
- 2. Estimating the burden of respiratory diseases
- 3. Assessing the capabilities of the health infrastructure to implement the PAL strategy
- 4. Developing standard PAL clinical guidelines
- 5. Communication activities in a PAL strategy
- Who is responsible for health education of patients and their families?
- Advising and counselling patients and their families on immunization
- Advising and counselling patients with acute respiratory infections
- Advising and counselling TB patients and their families
- Advising and counselling about HIV for patients with respiratory infections, particularly pneumonia or TB
- Advising and counselling asthma patients and their families
- Advising and counselling COPD patients and their families
- 6. Formulating a PAL information system
- 7. Developing PAL training materials
- 8. Testing the clinical guidelines and operational procedures
- Objectives of the feasibility study
- Establishment of a central-level coordination group for the feasibility study
- Development of the study protocol
- Selection of the study method
- Selection of study sites
- Selection of the season
- Phases of the feasibility study
- The baseline or “before” survey
- The impact or “after” survey
- Analysis of data
- Funding the feasibility study
- Report of results
- 9. Developing a national expansion plan
- Establishment of a central subunit for coordination of the extension plan
- Revised technical guidelines and the information instruments
- Training of trainers for implementation of the PAL strategy
- Equipment and essential drugs for implementation of the PAL strategy
- Plan for the expansion programme
- Budget for the expansion plan
- 10. Organizing systematic supervision, monitoring and evaluation
- Annex Source documents
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.
The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
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- Practical Approach to Lung Health - Experience from the Republic of Macedonia.[Open Access Maced J Med Sci. 2...]Practical Approach to Lung Health - Experience from the Republic of Macedonia.Ilievska-Poposka B, Zakoska M, Talevski S. Open Access Maced J Med Sci. 2018 Apr 15; 6(4):618-623. Epub 2018 Mar 31.
- Health benefits of Practical Approach to Lung health (PAL) experienced by patients with chronic respiratory diseases - Results from PAL pilot project in primary health care setting in Kerala, India.[Indian J Tuberc. 2018]Health benefits of Practical Approach to Lung health (PAL) experienced by patients with chronic respiratory diseases - Results from PAL pilot project in primary health care setting in Kerala, India.Viswanathan K, Rakesh PS, Balakrishnan S, Pradeep Kumar AS. Indian J Tuberc. 2018 Jul; 65(3):237-240. Epub 2016 Dec 16.
- Review National tuberculosis programme review: experience over the period 1990-95.[Bull World Health Organ. 1997]Review National tuberculosis programme review: experience over the period 1990-95.Pio A, Luelmo F, Kumaresan J, Spinaci S. Bull World Health Organ. 1997; 75(6):569-81.
- Development process of the Practical Approach to Lung Health in Kyrgyzstan.[Int J Tuberc Lung Dis. 2009]Development process of the Practical Approach to Lung Health in Kyrgyzstan.Erhola ML, Brimkulov N, Chubakov T, Niemi L, Bergman V, Lahdensuo A, Pio A, Ottmani SE. Int J Tuberc Lung Dis. 2009 Apr; 13(4):540-4.
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