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Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme Implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea Increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. Objectif Evaluer les changements dans le recours aux services essentiels de sante maternelle et infantile a Konobo, au Liberia, apres la mise en oeuvre d'un programme de perfectionnement des agents de sante communautaires. Methodes Le ministere de la Sante liberien s'est associe avec Last Mile Health, une organisation non gouvernementale, afin de mettre en oeuvre un programme pilote destine a ameliorer le recrutement, la formation, l'encadrement et la remuneration des agents de sante communautaires. Pour evaluer les changements au niveau des soins de sante maternelle et infantile, nous avons realise plusieurs sondages transversaux par grappes avant (2012) et apres (2015) la mise en oeuvre du programme. Resultats Entre 2012 et 2015, 54 agents de sante communautaires, sept collegues superviseurs et trois superviseurs cliniques ont ete formes pour prendre en charge une population de 12127 personnes dans 44 communautes. Le pourcentage corrige par regression d'enfants recevant des soins de la part de prestataires de soins officiels a augmente de 60,1 (intervalle de confiance (IC) de 95%: 51,6 a 68,7) points de pourcentage pour la diarrhee, de 30,6 (IC 95%: 20,5 a 40,7) pour la fievre et de 51,2 (IC 95%: 37,9 a 64,5) pour les infections aigues des voies respiratoires. Les accouchements en maternite ont augmente de 28,2 points (IC 95%: 20,3 a 36,1). Les accouchements en maternite et la prise en charge dans le secteur formel des infections aigues des voies respiratoires et des cas de diarrhee ont davantage augmente dans les communautes agricoles que dans celles vivant de l'extraction de l'or. Nous n'avons pas observe de changements significatifs dans le fait de beneficier d'une ou plusieurs seances de soins prenataux dans une structure de soins ou de soins post-partum dans les 24 heures suivant l'accouchement. Conclusion Nous avons observe une augmentation significative de la prestation de services de sante maternelle et infantile par des prestataires officiels lors du programme pilote destine aux agents de sante communautaires dans les regions rurales isolees du Liberia. Des interventions supplementaires sont necessaires pour obtenir des resultats optimaux vis-a-vis de la prestation de services cliniques, comme les soins post-partum, et de services dans des zones specifiques, comme les regions minieres. Objetivo Evaluar los cambios en el uso de servicios de salud materna e infantil basicos en Konobo, Liberia, tras la implementacion de un programa mejorado de trabajadores comunitarios de salud (CHW, por sus siglas en ingles). Metodos El Ministerio de Salud de Liberia se asocio con Last Mile Health, una organizacion no gubernamental, para implementar un programa piloto de CHW con una mejora en la contratacion, formacion, supervision y compensacion. Para evaluar los cambios en el uso de la atencion sanitaria materna e infantil, se realizaron repetidas encuestas transversales de conglomerados antes (2012) y despues (2015) de la implementacion del programa. Resultados Entre 2012 y 2015, 54 CHW, 7 supervisores homologos y 3 supervisores clinicos recibieron formacion para trabajar para una poblacion de 12 127 personas en 44 comunidades. El porcentaje ajustado a la regresion de ninos que recibieron atencion de profesionales sanitarios formales aumento un 60,1% (intervalo de confianza (IC) del 95%: 51,6 a 68,7) para la diarrea, un 30,6% (IC del 95%: 20,5 a 40,7) para la fiebre y un 51,2% (IC del 95%: 37,9 a 64,5) para la Infeccion respiratoria aguda. El suministro en centros aumento un 28,2% (IC del 95%: 20,3 a 36,1). El suministro en centros y la atencion del sector formal para la Infeccion respiratoria aguda y la diarrea aumentaron mas en comunidades agricolas que en las de minas de oro. La recepcion de una o mas sesiones de atencion prenatal en un centro sanitario y de atencion posparto a las 24 horas del parto no experimento cambios importantes. Conclusion Se identificaron aumentos significativos en la aceptacion de los servidos de atencion sanitaria materna e infantil de profesionales formales durante la version piloto del programa de CHW en la Liberia rural remota. Los servicios clinicos, como la atencion posparto y los servicios en lugares concretos, como zonas mineras, requieren intervenciones adicionales para lograr unos resultados optimos., Introduction Over 95% of global maternal and child deaths occur in 75 low-and middle-income countries and remote populations within these countries often bear the greatest burden. (1,2) Many countries are [...]

COVID-19 has further exacerbated trends of widening health inequalities in the UK. Shockingly, the number of years of life lived in general good health differs by over 18 years between the most and least deprived areas of England. Poor diets and obesity are established major risk factors for chronic cardiometabolic diseases and cancer, as well as severe COVID-19. For doctors to provide the best care to their patients, there is an urgent need to improve nutrition education in undergraduate medical school training. With this imperative, the Association for Nutrition established an Interprofessional Working Group on Medical Education (AfN IPG) to develop a new, modern undergraduate nutrition curriculum for medical doctors. The AfN IPG brought together expertise from nutrition, dietetic and medical professionals, representing the National Health Service (NHS), royal colleges, medical schools and universities, government public health departments, learned societies, medical students, and nutrition educators. The curriculum was developed with the key objective of being implementable through integration with the current undergraduate training of medical doctors. Through an iterative and transparent consultative process, thirteen key nutritional competencies, to be achieved through mastery of eleven graduation fundamentals, were established. The curriculum to facilitate the achievement of these key competencies is divided into eight topic areas, each underpinned by a learning objective statement and teaching points detailing the knowledge and skills development required. The teaching points can be achieved through clinical teaching and a combination of facilitated learning activities and practical skill acquisition. Therefore, the nutrition curriculum enables mastery of these nutritional competencies in a way that will complement and strengthen medical students' achievement of the General Medical Council (GMC) Outcome for Graduates. As nutrition is an integrative science, the AfN IPG recommends that the curriculum is incorporated into initial undergraduate medical studies before specialist training. This will enable our future doctors to recognise how nutrition is related to multiple aspects of their training, from physiological systems to patient-centred care, and acquire a broad, inclusive understanding of health and disease. In addition, it will facilitate medical schools to embed nutrition learning opportunities within the core medical training, without the need to add in a large number of new components to an already crowded programme or with additional burden for teaching staff. The undergraduate nutrition curriculum for medical doctors is designed to support medical schools to create future doctors who will understand and recognise the role of nutrition in health. Moreover, it will equip frontline staff to feel empowered to raise nutrition-related issues with their patients as a fundamental part of enhanced care and to appropriately refer on for nutrition support with a registered associate nutritionist/registered nutritionist (ANutr/RNutr) or registered dietitian (RD) where this is likely to be beneficial. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To learn about the experience of early phase cancer research nurses during the COVID-19 pandemic • To appreciate the challenges and positive developments brought about by the COVID-19 pandemic in relation to nurses working on early phase cancer clinical trials • To recognise the positive implications for future cancer research nursing practice This service evaluation examined the experiences of adult and children's cancer research nurses working on early phase cancer clinical trials during the coronavirus disease 2019 (COVID-19) pandemic. A questionnaire was provided to early phase cancer research nurses at experimental cancer medicine centres, and alongside this there was an online discussion with eight of the nurses. The themes developed from the findings and online discussion provided an insight into the challenges faced by early phase cancer nurses during this unprecedented time and into some of the innovations, such as virtual appointments, adopted to overcome them. COVID-19 had a significant negative effect on the cancer research nurse workforce. However, peer support, networking opportunities, reflection and embracing innovation provided support for nurses and enhanced person-centred care. [ABSTRACT FROM AUTHOR]