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4
1
Mental health problems are common and cause great suffering to individuals and communities around the world. They have a significant impact not only on the physical and mental health of those affect
...
ed but also on their families and the communities they live in. At the same time, all communities have their own traditional mechanisms for support and contain a range wide of resources that can be helpful in preventing mental health conditions from developing, promoting positive mental health and supporting the recovery of people that are struggling with a mental health condition.
In the wider context, people living with a mental health condition are often excluded from their communities and experience various violations to their basic human rights (discrimination, violence, exclusion from employment opportunities). The World Health Organization (WHO) estimates that the mean prevalence of global mental health disorders is 10.8% while the prevalence in emergency settings is 22.1% in any conflict-affected population.
During emergencies and crisis, the stigma, exclusion and discrimination towards people living with mental health conditions is often higher, which can cause isolation and protection issues. Communities can play a crucial role in promoting mental health as well as enhancing primary care and access. Their role is to help reduce mental health inequalities by providing community resources that connect people to community-based resources and by providing mental health education. This also helps to reduce the massive mental health treatment gap.
more
The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental health conditions. Meanwhile, those wit
...
h pre-existing mental health conditions may experience a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
more
Person-centred recovery planning for mental health and well-being: self-help tool: WHO QualityRights
Ensuring mental health and well-being has become a worldwide imperative and an important target of the Sustainable Development Goals. But in all countries around the world, our response has been woefully insufficient, and we have made
little progre
...
ss to advance mental health as a fundamental human right.
One in ten people are affected by a mental health condition, up to 200 million people have an intellectual disability and an estimated 50 million people have dementia. Many persons with mental health conditions, or psychosocial, intellectual, or cognitive disabilities lack access to quality mental health services that respond to their needs and respect their rights and dignity.
more
Ensuring mental health and well-being has become a worldwide imperative and an important target
of the Sustainable Development Goals.
But in all countries around the world, our response has been woefully insufficient, and we have made
little prog
...
ress to advance mental health as a fundamental human right.
One in ten people are affected by a mental health condition, up to 200 million people have an
intellectual disability and an estimated 50 million people have dementia. Many persons with mental
health conditions, or psychosocial, intellectual, or cognitive disabilities lack access to quality mental
health services that respond to their needs and respect their rights and dignity.
more
People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to
...
health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.
more
Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in fa
...
ilure to provide adequate, accessible and quality maternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
more
Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries
...
where the problem seems to be worsening. Globally, research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
more
To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and contro
...
l. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
more
The International Classification of Functioning, Disability and Health, known more commonly as ICF, provides a standard language and framework for the description of health and
...
health-related states. Like the first version published by the World Health Organization for trial purposes in 1980, ICF is a multipurpose classification intended for a wide range of uses in different sectors. It is a classification of health and health-related domains -- domains that help us to describe changes in body function and structure, what a person with a health condition can do in a standard environment (their level of capacity), as well as what they actually do in their usual environment (their level of performance).
These domains are classified from body, individual and societal perspectives by means of two lists: a list of body functions and structure, and a list of domains of activity and participation. In ICF, the term functioning refers to all body functions, activities and participation, while disability is similarly an umbrella term for impairments, activity limitations and participation restrictions. ICF also lists environmental factors that interact with all these components.
more
Blueprint for a Public Health and Safety Approach to Drug Policy
Tracy Pugh, Julie Netherland, Ruth Finkelstein
The New York Academy of Medicine, Drug Policy Alliance
(2013)
C2
"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re
...
lapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing."
more
Background: The World Health Organization (WHO) published a clinical case definition of post COVID-19
condition, by a Delphi consensus, on 6 October 2021. That process concluded that a separate def
...
inition
may be applicable for children. It is important to understand the frequency, characteristics and risk factors
that lead to post COVID-19 condition, along with its impact on everyday functioning and development of
children and adolescents. Long-term outcomes of the condition are currently unknown and need to be
studied. For these reasons, a globally standardized clinical case definition is needed.
Aim: To develop a globally relevant standardized clinical case definition for children and adolescents by
building on the WHO clinical case definition for post COVID-19 condition in adults.
more
Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated wi
...
th a number of conditions, disability, and causes of death. These include: strokes; myocardial infarction; end-stage renal disease; congestive heart failure; peripheral vascular disease and blindness. According to Stats SA, in 2017, hypertensive disorders resulted in 19 900 deaths with a further 44 357 deaths associated with cerebrovascular diseases and other heart diseases. This means around 30% of all deaths in 2017 were associated with increased blood pressure.
more
This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public health care. The Standards identify major compo
...
nents and features of effective systems for the treatment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
more
On 9 February 2021, a first webinar entitled “Expanding our understanding of Post COVID-19 condition” was held under the auspices of WHO and in consultation with the International Severe Acute Respiratory and Emerging Infection Consortium(ISARIC
...
), Global Research Collaboration for Infectious Disease Preparedness (GloPID-R), National Institutes of Health/National Institute of Allergy and Infectious Diseases(NIH/NIAID), Long Covid SOS and patient representatives.
more
The WHO COVID-19 Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients throughout their entire illness is
...
important. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges. No further updates to the previous existing recommendations were made in this latest version.
This updated (fifth) version contains 16 new recommendations for the rehabilitation of adults with post COVID-19 condition (see Chapter 24)
This updated (fourth) version contains three new recommendations regarding hospitalized patients with severe or critical COVID-19
more
This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed sinc
...
e the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
more
Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right and an indispensable condition for human
...
dignity. The model outlined here demonstrates that it is within our reach to close the financing gap even for the poorest countries by 2020 if all governments, from the privileged and underprivileged parts of the world alike, just fulfil the commitments and recommendations for financing human development and health that already were agreed many years ago.
more
Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs
...
) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
more
Overview
Learning objectives
• Name the general principles of essential care and practice.
• Name management principles of priority MNS conditions.
• Use effective communication skills in interactions with people with MNS conditions.
• Perform assessments for priority MNS conditions.
...
Assess and manage physical health in MNS conditions.
• Know the impact of violence and gender-based violence on mental health.
• Provide psychosocial interventions to a person with a priority MNS condition and their
carer.
• Deliver pharmacological interventions as needed and appropriate in priority MNS
conditions considering special populations.
• Plan and perform follow-up for MNS conditions.
• Refer to specialists and links with outside agencies for MNS conditions as appropriate and
available.
• Promote respect and dignity for people with priority MNS conditions.
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Policy Brief.
Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, short
...
ness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk.
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