Ƙa'idar kula da lafiyar jama'a ita ce, ko ita ce, don samar wa jama'a sahihin bayanai domin su yi zaɓen lafiya ga kansu da al'ummarsu.
Shekaru 3 da suka gabata an ga wannan tsari ya koma kan kansa, inda ake amfani da kudaden jama’a wajen yaudara da tilasta su, ta tilasta musu bin tsarin kiwon lafiyar jama’a. Jama’a sun ba da tallafin nasu zaman kurkuku da talauta ta hanyar harajin su, inda kudaden jama’a ke tuka kayan aikin da ba a taba ganin irin su ba, sai kuma magunguna, martani ga kwayar cutar da ke kashe tsofaffin marasa lafiya a kusa da karshen rayuwarsu.
Yara sun samu raguwar karatunsu, an kuma karkatar da tattalin arzikin kasa, ta yadda al’ummomin da za su zo su ma za su biya. To, me jama'a suka biya a zahiri?
COVID-19 ba labari bane, amma bambanci ne akan cututtukan numfashi na baya.
Yawancin mutane masu lafiya sun kamu da SARS-CoV-2 murmurewa ba tare da tsangwama ba, samun rigakafi na halitta wanda, in babu allurar rigakafi, yana haifar da ƙarin robust da kuma tsawon lokaci kariya tare da Kadan kasadar ga reinfections idan aka kwatanta da daidaikun mutane da ke kare su ta hanyar allurar rigakafi kaɗai. A duk duniya, adadin masu kamuwa da cuta (IFR) na SARS-CoV-2 game da 0.15% kuma kwatankwacin mura na yanayi (IFR 0,1%). IFR na waɗanda ke ƙasa da shekaru ashirin ya kasance kawai 0.0013%, kuma mafi girma ga waɗanda suka wuce shekaru 70. IFR na COVID-19 tsakanin tsofaffi mazauna al'umma yana ƙasa fiye da yadda aka ruwaito a baya a cikin tsofaffi gaba ɗaya.
An sami IFR mafi girma a cikin ƙasashe masu yawan wuraren kulawa na dogon lokaci, watakila saboda fallasa yakan faru ne ta hanyar wasu tsofaffi waɗanda ba su da rigakafi, maimakon yara masu ƙwarewa da ƙananan ƙwayoyin cuta. An tsufa yawan ta hanyar aiwatar da Maganin rigakafi kuma ana sa ran karuwar yawan kamuwa da cututtuka.
Mai tsanani COVID-19, ko COVID-19 Associated ARDS, ciwo ne a cikin sanannen bakan ARDS. Ciwon Ciwon Ciwon Hankali (ARDS) da kuma guguwar cytokine mai alaƙa an gane fiye da shekaru 50. Yana faruwa a lokacin da nau'ikan abubuwan da ke haifar da kumburin huhu na huhu na huhu da kuma haɓakar capillary wanda ke haifar da gazawar numfashi na hypoxemic.
Ko da yake kulawar tallafi ta inganta hasashen, mace-mace da nakasa rikice-rikice a cikin waɗanda suka tsira a cikin kulawa mai zurfi har yanzu suna da girma, kuma sun kasance ba su canza ba. a cikin shekaru 20 da suka gabata. a 2013 An kiyasta mutuwar mutane miliyan 2.65 a duk duniya da Cutar Cutar Cutar Cutar Kwalara.
Kamar yadda yake tare da sauran cututtukan ARDS, mutanen da ke fama da (COVID-19) ARDS galibi tsofaffi ne waɗanda ke da cututtukan da suka haɗa da kiba, hauhawar jini, ciwon sukari na 2 da cututtukan zuciya, galibi suna amfani da magunguna da yawa. Sauran ƙuntatawa akan tsarin rigakafi, kamar bitamin D kasawa, sanya mutane a ƙara haɗari.
Ya zuwa Yuli 2022, WHO ta ba da rahoton fiye da miliyan 601 da aka tabbatar da kamuwa da cuta da kuma mutuwar sama da miliyan 6.4 da ke da alaƙa da COVID-19 a duk duniya. Fiye da rabin (miliyan 3.5) sun mutu bayan bullar rigakafin COVID-19, kodayake kashi 67.7% na yawan mutanen duniya sun karɓi aƙalla. alurar riga kafi daya. Hukumar ta WHO ta kiyasta jimillar Sama da miliyan 14.9 sun mutu a cikin 2020-2021 mai alaƙa da COVID-19 kai tsaye saboda cutar ko a kaikaice saboda tasirin martanin lafiyar jama'a akan tsarin kiwon lafiya da al'umma.
Tun lokacin da aka gane COVID-19 a cikin ƙasashen Yamma a farkon 2020, kashe kuɗi kan lafiyar jama'a a yawancin su fiye da ninki biyu, wanda ya sanya sama da dala biliyan 500 a ciki farashin kowane wata akan tattalin arzikin duniya. Wasu tiriliyan kuma an kashe su don biyan diyya da fakitin kara kuzari ga wadanda aka bari ba tare da samun kudin shiga ba saboda martanin lafiyar jama'a, yayin da tattalin arzikin kasa, da kuma damar samun aikin yi a nan gaba, ya lalace sosai. Wannan kusan duk masu biyan haraji ne ke ba da kuɗaɗen kuɗi, ko kuma aro don a ba su kuɗi tare da riba daga masu biyan haraji na gaba.
'Yan siyasa da masana daban-daban sun yi iƙirarin cewa tilastawa manufofin kiwon lafiyar jama'a na COVID-19 ita ce kawai hanyar da za a bi don dakile COVID-19, kodayake WHO ta ba da shawarar yin watsi da irin waɗannan matakan a cikin cutar ta mura. jagororin na 2019. Za su ƙara talauci da rashin daidaito, alhali suna da (har yanzu) rashin tabbatar da inganci.
Jama'a sun biya lissafin ta hanyar haraji don sabbin hanyoyin ba da magunguna (kullewa, umarnin rufe fuska da gwaji akai-akai) da kuma maimaita allurar rigakafin cutar. masu garkuwa da mutane tare da alluran rigakafin da ke raguwa da sauri, alhalin suna ganin an rage musu kudaden shiga. Ƙaruwar kuɗin da aka samu don biyan agaji ga rashin aikin yi na tilastawa ya motsa inflation, bayar da gudummawa ga karuwar abinci, ruwa, makamashi, lafiya da farashin inshora. Waɗannan martanin sun cutar da iyalai marasa kuɗi daidai gwargwado.
Gwamnatoci sun dauki nauyin kula da lafiya
Da farko a cikin annoba ya bayyana a fili cewa intubating mai haƙuri na COVID-19 na iya ƙara lahani na dogon lokaci da mace-mace. Abin takaici, asibitoci da yawa sun ci gaba da ɗan ƙaranci don amfani da na'urorin hura iska tsoron cewa sauran hanyoyin na oxygenation zai yada cutar. A cikin 2020 Amurka ta kashe biliyoyin daloli tara injinan iska da ba a yi amfani da su ba.
A cikin ƙasashe da yawa wani sabon maganin rigakafin ƙwayar cuta, remdesivir, wanda aka haɓaka tare da tallafin Jiha, ya zama zaɓi na farko na jiyya ga mutanen da ke asibiti tare da COVID-19. The aminci da guba na remdesivir mai tsada ya yi yawa jayayya. Duk da haka ko bayan sakamakon farko na binciken hadin kai na WHO ya gano kadan ko babu tasiri akan rage zaman asibiti ko mutuwar Covid, EU ta ci gaba da biyan Yuro biliyan 1.2 yarjejeniya tare da Gileyad don jiyya 500,000 kuma an ci gaba da ba da fifiko don amfani a Amurka.
Sakamakon karshe na binciken Solidarity ya tabbatar da gano kadan ko babu tasiri. Ya bambanta, yin amfani da kwayoyi masu rahusa tare da aikin antiviral, kamar ivermectin da kuma hydroxychloroquine, an danne. Kodayake ivermectin yanzu an haɗa shi a ciki lists na Cibiyar Kiwon Lafiya ta Amurka a Agusta 2022, gwamnatoci sun yi shiru game da amfani da shi, sun gwammace a tura kuɗi zuwa Pharma don sababbin magungunan kan-hanyar hannu.
Fadada kulle-kulle daga gidajen yari zuwa al'umma
Makulli na iya zama ɗaya daga cikin manyan gazawar gwamnati na zamani. Binciken fa'idar farashi na martani ga COVID-19 ya gano makullin zama mafi cutarwa zuwa lafiyar jama'a (aƙalla sau 5-10) dangane da jin daɗin rayuwa fiye da COVID-19. Babban lalacewar haɗin gwiwa ba ba zato ba ne, saboda rufewar kasuwanci da taƙaita zirga-zirga sun shafi biliyoyin mutane a duniya ta hanyar talauci, rashin abinci, kaɗaici, rashin aikin yi, katsewar ilimi, da katsewar kiwon lafiya. Abin da bai sanya kanun labarai ba ya wuce 3 miliyan yara wadanda suka mutu sakamakon rashin abinci mai gina jiki a farkon shekarar cutar. Tare da karuwar rashin abinci mai gina jiki, duniya na fuskantar hauhawar nauyi yaro aure da kuma aikin yara, matsalolin ci gaba da tunani, talauci, kashe kansa da cututtuka na yau da kullum.
Reviews na illolin lockdowns akan mutuwar COVID-19 an kammala babu wata fa'ida mai fa'ida ta fa'idar COVID-19. Samfuran cututtukan da suka jagoranci talauci ba kawai sun yi kiyasin tasirin COVID-19 ba amma gaza don yin la'akari da lalacewar lamuni na kulle-kulle. Hankalin tsoro, damuwa da rashin taimako ya kawo wa iyalai da Yara biliyan 2.2 a duk faɗin duniya tare da kawar da iyawar samun kuɗi a nan gaba da ƙarancin samun damar kiwon lafiya zai yi tasiri ga rayuwa ta hanyar da ba a taɓa yin irin ta ba ga tsararraki.
Wani binciken da aka yi kwanan nan wanda ke nazarin jihohi 50 na Amurka, tare da jihohi 10 waɗanda ba su da takunkumin kulle-kulle, yana da ƙarfi da goyon bayan hasashen da ke cewa kulle-kulle yana sanya nauyin damuwa kwatsam da matsananciyar damuwa akan alƙaluma masu rauni kuma suna da alaƙa da mahimmanci. yana ƙaruwa da mutuwa a cikin waɗancan jihohin da suka yi amfani da kulle-kulle a matsayin ma'aunin kula da cututtuka.
Matsalolin lafiyar kwakwalwa, mara sadarwa kumburi cututtuka, ciwon daji da kuma mutuwar kwatsam da ƙara a cikin mutane daban-daban na shekaru daban-daban, yana nuna miliyoyin mutane iya yanzu samun ƙarin m tsarin rigakafis. Alaka tsakanin damuwa/damuwa, rashin lafiya da kuma farkon mutuwa sun dade gane.
A cikin kasashen yamma, da mafi yawan masu tauyewa kuma unguwannin suna da babban haɗari ga COVID-19 mai tsanani, da yawan mace-mace. Marasa galihu a cikin al'umma suna fama da cututtuka masu yaduwa saboda talauci, rashin abinci mai gina jiki, damuwa mai tsanani, damuwa da damuwa, rashin tsarin rigakafi rashin kulawa da lafiya. Maimakon inganta juriyar wadannan al'ummomi, martanin lafiyar jama'a ya kara musu talauci, ya kawar da damar ilimi, don haka ya kara musu rauni ga wannan annoba da kuma gaba.
Gwaji saboda gwaji
An sanya hannun jari na jihohi don gwajin COVID-19: Gwajin PCR da gwaje-gwajen kulawa gami da saurin gwajin antigen. Yayin da aka yi amfani da biliyoyin gwaje-gwaje, ba su da talauci wajen bambance cututtuka da rashin daidaituwa bayar da a ƙarya ji na tsaro, tare da sakamako mai kyau ba dole ba tuƙi tsoro da rashin lafiya hutu.
WHO a baya, a hankali, shawara akan tuntuɓar ganowa da zarar an sami yaɗuwar al'umma - mutane za su kamu da cutar a ƙarshe, kuma su sami rigakafi. Bayar da albarkatu don nemo ɗan ƙaramin rabo, wanda bai isa ya isa ya dakatar da watsawa ba, ba shi da ma'ana. Ba a bayar da wani dalili na juyar da wannan nasiha ta al'ada da ma'ana ba.
Boye fuska don gurbata muhalli
Duk da yake babu ingantaccen tallafin kimiyya ga tasiri na wajibcin rufe fuska a cikin al'umma, gami da yara, gwamnatocin jihohi sun saka hannun jari don samar da abin rufe fuska kyauta ga duk 'yan ƙasa. The biyu wallafa gwaje-gwajen da bazuwar sarrafawa na abin rufe fuska yayin COVID-19 ya nuna kadan or babu tasiri, yayin da meta-nazari of karatun da suka gabata nuna babu tasiri mai mahimmanci. Duk da haka a farkon rabin 2020 shigo da abin rufe fuska a cikin EU ya canza zuwa +1,800%. zuwa Yuro biliyan 14, yayin da masana'antar a cikin 2021 ke da daraja $ 4.58 biliyan a duniya. Makullin fuska tare da microplastics da kuma nanoparticles yanzu gurɓata da yanayi, kuma mai yuwuwa haɓaka hadarin of nakasa tsarin rigakafi.
Samun fasaha mai ban tsoro ta wuce masu gudanarwa
Duk da tsananin COVID-19 da aka mayar da hankali sosai a cikin tsofaffi tun farkon 2020, tare da manyan cututtuka da kuma tabbataccen shaidar tasiri. post-kamuwa da cuta immunity, WHO ta bayyana a farkon 2021 cewa allurar rigakafin COVID-19 shine alurar riga kafi a duniya dabarun dogon lokaci kawai don ɗaukar rikicin coronavirus; "Babu wanda yake lafiya sai kowa ya tsira” An ce hauhawar adadin allurar rigakafin ya zama dole don inganta kiwon lafiya, fatan aikin yi da tsare-tsaren ilimi na gaba.
Abin takaici, mafi girman ingancin 97% da 96% bi da bi da'awar na Moderna da Pizer COVID-19 alluran rigakafin COVID-6 sun ragu da sauri bayan rigakafin. Watan XNUMX bi-up rahotanni ya nuna babu raguwa a duk-dalili mutuwa. Alurar rigakafin COVID-19 adenovector daga Astra-Zeneca da Johnson & Johnson sun nuna mafi kyawun kariya a kan mace-mace amma ba a yi amfani da su don ƙarfafa rigakafi a yawancin ƙasashe saboda haɗarin illolin da ke da alaka da allurar rigakafi.
Labari na baya-bayan nan da aka duba ta Fraiman et al. an lura da wuce gona da iri na munanan abubuwan da suka faru tare da yin nazarin bayanan gwaji na allurar rigakafin mRNA guda biyu waɗanda ke nuna buƙatar yin nazari na fa'ida na yau da kullun, musamman waɗanda aka keɓance bisa ga haɗarin babban sakamakon COVID-19. Marubutan sun bukaci a fitar da jama'a na bayanan matakin mahalarta daga kamfanonin da ke daukar nauyin magunguna, wanda har yanzu ba a samu a fili ba.
Bugu da kari, mataimakin shugaban Pfizer, ya amsa tambayar Rob Roos, dan kasar Holland Europarlementarier a lokacin Hukumar Tarayyar Turai a ranar 11 ga Oktoba, 2022, game da ko an gwada rigakafin mRNA na Pfizer don rigakafin kamuwa da kwayar cutar kafin fitar da maganin a 2021. Ta ce a'a, don haka ya nuna tallan rigakafin da kuma tilastawa ya dogara ne akan karya.
Don izini don amfani aikin likita amfanin ya kamata ya wuce kasadar. Waɗannan allurar rigakafin mRNA ba su haɗu da wannan mashaya a fili ga mutanen da ba su kai shekara 70 ba. A nazarin kwanan nan Masana kiwon lafiya guda tara daga manyan jami'o'i sun gano cewa kowane asibiti na COVID-19 da aka hana a cikin matasan da ba su kamu da cutar a baya ba, ana samun munanan abubuwa tsakanin 18 zuwa 98. A cikin ƙasashen Scandinavia an taƙaita amfani da rigakafin Moderna mRNA don yuwuwar haɗarin kumburin zuciya a cikin samari
Ko da yake rahotannin hukuma akan illar rigakafin COVID-19 ta Cibiyoyin Kiwon Lafiyar Jama'a an iyakance su, akwai girma bayanai a kan myocarditis, rashin daidaituwa na al'ada ko fiye da duk abin da ke haifar da mace-mace da sakamako mai tsanani a cikin kungiyoyin da aka yi wa alurar riga kafi. Yabo na baya-bayan nan na Bayanan aminci na Isra'ila da saki US CDC V bayanan lafiya nuna matsalolin tsaro masu tsanani tare da allurar COVID-19 waɗanda ke buƙatar ƙarin bincike da gangan.
Kasashen da ke da mafi girman adadin allurar rigakafi da matakan tilastawa sun sami adadi mai yawa asibiti da kuma mutuwar, yayin da wasu da ke da ƙarancin allurar rigakafi, gami da yawancin ƙasashen da ke kudu da hamadar Sahara sun sami ƙarancin mutuwar Covid-19. Ana nuna martanin antibody sun yi ƙasa a ciki tsofaffi yayin da rage martani or mafi girma kamuwa da cuta rates sun faru bayan maimaita alluran rigakafi. The CDC bayyana yadda sauri masu haɓaka mRNA zasu iya kasawa.
Wannan yana sanya ayar tambaya game da yawan allurar rigakafi da dabarun haɓakawa. Pascal Soriot, Shugaba na Astra-Zeneca, ya ba da shawarar cewa "ƙarfafa jabs ga mutane masu lafiya a kowace shekara sune almubazzaranci da kudin haraji.
Jinkirin ɗan lokaci
A ranar 11 ga Agusta, 2022, Cibiyar Kula da Cututtuka da Cututtuka ta Amurka (CDC) ta bayyana cewa yanzu kwayar cutar tana haifar da raguwar haɗari sosai saboda babban matakan rigakafi daga alluran rigakafi da cututtuka. A ranar 19 ga Agusta, ta canza shawarwarinta don nuna wannan, daina banbance tsakanin matsayin rigakafi ko rigakafi bayan kamuwa da cuta. Shugaba Biden ya ayyana a cikin Satumba 2022 "Cutar ta ƙare," kodayake har yanzu ba a san abin da wannan ke nufi da matakan 'gaggawa' da suka rage a wurin ba.
Duk da yake tattalin arzikin duniya ya sha wahala, wannan ya fito fili ne kawai daga wani takamaiman yanayi. Ya bambanta da yawan jama'a, kamfanoni masu zaman kansu suna da hannu wajen mayar da martani, musamman a fannin harhada magunguna, fasahar kere-kere da na yanar gizo. Wadannan kamfanoni sun kara arzikinsu da daruruwan biliyoyin daloli a shekarar 2020 da 2021, kamar yadda suka yi. mutane masu daraja, da yawa daga cikinsu sun kasance shawara don martanin da ya tabbatar da hakan.
Hasashen yaudara na gujewa masu biyan haraji don cin gajiyar kamfanoni masu zaman kansu
Amsar COVID-19 na yanzu ya kawar da nasarorin da aka samu daga ci gaban duniya shekaru da yawa a ciki kiwon lafiya da kuma samun kudin shiga, musamman ga mata kuma ya tsananta dage rashin daidaito. Abin takaici, duniyar da ke fuskantar da mafi munin matsalar lafiya a cikin karni kuma mafi munin rikice-rikicen tattalin arziki da zamantakewa tun yakin duniya na biyu a yanzu haka ma a kan ƙugiya don tallafawa waɗanda za su maimaita wannan.
Tare da WHO, shugabannin duniya a yanzu sun yi kira da a samar da yarjejeniyar shirye-shiryen rigakafin cutar ta duniya don mai da wannan yanayin cikin sauki. Suna ba da hujjar wannan kiran na ci gaba da karkatar da kudaden jama'a ta hanyar lahani, kudi da sauran abubuwan da aka tara yayin barkewar COVID-19.
Wannan yana haifar da hangen nesa cewa kiwon lafiya zabi ne na siyasa bisa haɗin kai da 'adalci' da za a kafa a cikin tsaka-tsaki. amsawar duniya ta hanyar kungiyoyin kasa da kasa ciki har da WHO, UNICEF, gavi, (Ƙungiyar Alurar rigakafi ta duniya) da haɗin gwiwar jama'a da masu zaman kansu Haɗin kai don Bayanin Shirye-shiryen Tattalin Arziki (CEPI), wanda aka ƙaddamar a cikin 2017 a WEF ta Bill Gates, Wellcome Trust, Gwamnatin Norway da sauransu. Cibiyoyin kudi, gami da Bankin duniya, yanzu sun shiga don kara habaka ci gaban wannan masana'antar ta annoba da ta kunno kai. Sabon Bankin Duniya wanda ya karbi bakuncin Asusun Matsakaicin Kuɗi (FIF) don rigakafin cutar, shirye-shirye da amsa an sanya su a taron ministocin lafiya na G20 a watan Yuni 2022.
Babban damuwa shine haɓaka cewa sabon hangen nesa na magani da amincewar allurar rigakafi ta FDA da EMA za su faɗaɗa kasuwan kasuwanci wanda masana'antun magunguna ke tafiyar da su ta hanyar ingantaccen nazari na kimiyya da tsari. Wannan yana haifar da lahani maras misaltuwa ga mutane da yawa yayin haɓaka ribar kamfanonin harhada magunguna da fasahar kere-kere. An riga an kiyasta magungunan da aka rubuta su uku mafi yawan abin da ke haifar da mutuwa a duniya bayan cututtukan zuciya da ciwon daji.
Duk da aniyarsu, saka hannun jari a cikin rigakafin COVID-19 da ba da magunguna na shekaru uku da suka gabata ba su inganta aikin ɗan adam ba, tattalin arziki da ayyukan zamantakewa. Haka kuma cututtuka, nakasa da kuma mutuwa nuna tashin hankali a cikin rukunin shekarun aiki (shekaru 25-64) kamar yadda kamfanonin inshora suka lura. Hasashen da kamfanonin shawarwari suka yi na tallafin rigakafin Covid-19 zai ba da tattalin arzikin ya kasance rashin gaskiya. Yanzu haka kasashe suna fuskantar karancin ma'aikatan kiwon lafiya a wani bangare saboda umarnin alurar riga kafi, rage samun damar kula da lafiya ga mutanen da ke fama da rashin lafiya waɗanda suka biya inshora da kuɗin haraji don kiwon lafiya. Yana iya ma haifar da fatarar asibitoci.
Kyakkyawan Lafiya, mafi kyawun kadari na rayuwa
Shugaba na CEPI ya bayyana a cikin wata hira da McKinsey cewa "Batun gaggawa na rage rigakafi kuma barazanar da juyin halittar kwayar cutar ke haifar mana yana gaya mana cewa muna buƙatar samar da mafi fa'ida kuma mafi jurewa martanin rigakafi." Mass kula, kulle-kulle, sanya abin rufe fuska da rashin inganci Alurar rigakafin COVID-19 sun ba da gudummawa ga matsananciyar damuwa, tsoro da damuwa waɗanda ke rage juriyar rigakafi. Abin baƙin ciki shine, lokacin da tsarin rigakafi (immunosenescence) ya raunana allurar rigakafi kuma ba su da ikon samar da kariya mai mahimmanci.
Ƙarin saka hannun jari na jihohi a cikin yawan rigakafi, yawan rarraba alluran rigakafi, haɓaka sabbin rigakafi a cikin kwanaki 100, haɓakar simulating model, Da kuma ƙarin gwaji na asibiti za su zama matalauta madadin ƙarfafa tushen rigakafi tsarin ta rayuwa a cikin 'yanci da high jarin zamantakewa, abinci mai kyau, ilimi, wasanni, wasa, hulɗar zamantakewa, daidaito a cikin yanke shawara da samun kudin shiga.
Kiwon lafiya mabuɗin ga tattalin arziƙin masu juriya a duk duniya. Dangantakar da ke tsakanin lafiya da tattalin arzikin kasa biyu ce, ta yadda bunkasar tattalin arziki ke ba da damar samar da kudade a cikin jarin da ke inganta lafiya; kuma jama'a masu lafiya suna ba da gudummawa da haɓaka tattalin arziki. Don haka, saka hannun jari na jama'a da masu zaman kansu a cikin lafiya ga kowa yana buƙatar canzawa daga haɓaka ƙimar kuɗi zuwa tasiri mai tasiri akan rayuwar mutane.
Inganta lafiya shine manufa ta ƙarshe da haƙƙin ɗan adam. Amsar da duniya ta yi game da cutar sankara ta coronavirus ta bayyana wani rikicin da'a a cikin lafiyar jama'a, inda aka watsar da ka'idojin da'a na lafiyar jama'a kafin barkewar cutar.
Wannan ya durkusar da lafiya, haƙƙin ɗan adam da tattalin arziƙin, yayin da ya kamata jama’a kiwon lafiyar jama’a su yi mata hidima ta biya kuɗin aiwatar da shi, kuma za ta biya kuɗaɗen cutar. Za a yi nisa da dawowa, kuma farfadowa zai buƙaci lafiyar jama'a don komawa ga yanayin bawa, kuma a bar abin da ya haifar da irin wannan bala'i.
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Carla Peeters ita ce ta kafa kuma darektan gudanarwa na COBALA Kyakkyawan Kulawa yana jin daɗi. Ita ce Shugaba na wucin gadi kuma mai ba da shawara kan dabarun don ƙarin lafiya da iya aiki a wurin aiki. Gudunmawarta ta mayar da hankali kan ƙirƙirar ƙungiyoyi masu lafiya, jagora zuwa ingantacciyar kulawa da jiyya masu tsada waɗanda ke haɗa abinci mai gina jiki da salon rayuwa a cikin magani. Ta samu digirin digirgir a fannin ilmin rigakafi daga sashen likitanci na Utrecht, ta karanci Kimiyyar Halittu a Jami’ar Wageningen da Bincike, sannan ta yi kwas na tsawon shekaru hudu a fannin Ilimin Kimiyyar Kimiyyar Halittu tare da kware a kan binciken dakin gwaje-gwaje na likitanci da bincike. Ta bi shirye-shiryen zartarwa a Makarantar Kasuwancin London, INSEAD da Makarantar Kasuwancin Nyenrode.
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