Water, sanitation and hygiene (WASH) are critical in the prevention and care for all of the 17 neglected tropical diseases (NTDs) scheduled
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for intensified control or elimination by 2020.
Provision of safe water, sanitation and hygiene is one of the five key interventions within the global NTD roadmap. Yet to date, the WASH component of the strategy has received little attention and the potential to link efforts on WASH and NTDs has been largely untapped.
Focused efforts on WASH are urgently needed if the global NTD roadmap targets are to be met. This is especially needed for NTDs where transmission is most closely linked to poor WASH conditions such as soil-transmitted helminthiasis, schistosomiasis, trachoma and lymphatic filariasis.
This strategy aims to mobilise WASH and NTD actors to work together towards the roadmap targets.
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The National Strategic Plan for HIV/AIDS and STIs 2017-2024 spells out the objectives and targets that we have jointly committed to achieve. The pl
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an describes the strategies and activities that will need to be implemented on the ground across India's 36 States and Union Territories with the help of AIDS Control Societies, District AIDS Prevention and Control Units, Regional Institutes, communities, development partners and the private sector. We must urgently scale up our efforts to avert new HIV infections and provide care and treatment to people living with HIV to materialise our commitment of ending AIDS in India by 2030.
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The Government of the Republic of Zambia has placed priority on ensuring that Zambians are healthy and productive as a catalyst to the attainment of socioeconomic development . The Vision 2030 aims to transform Zambia into a prosperous middle-income
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country as articulated also in the 7th National Develop-ment Plan (7NDP) and National Health Strategic Plan 2017 – 2021 (NHSP 2017-2020). However, this aspiration is threatened by the double burden of Communicable and Non-Communicable Diseas¬es. Zambia has been recording an increase in morbidity and mortality due to Non-Communicable Diseases (NCDs) such as cancers, diabetes, chronic respiratory and cardiovascular diseases. According to the 2016 WHO NCD country profiles, 29% of all deaths in Zambia are attributed to NCDs. This is unacceptably high, considering that most of these diseases can be reduced by modifying four main behavioural risk factors for NCDs which are tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity.
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Thesis presented in partial fulfilment of the requirements for the degree of Master of Nursing Science in the Faculty of Health Sciences at Stellenbosch University.
The mobile clinic
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health care services fulfil an essential role in delivering primary health care to the dwellers in the rural communities of the Western Cape. However, occupational health and safety, as well as quality assurance are issues that need to be addressed urgently. It is thus recommended that policy makers take cognizance of the specific needs of every individual mobile clinic team.
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The scale of West Africa’s Ebola epidemic has been attributed to the weak health systems of affected countries,
their lack of resources, the mobility of communities
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and their inexperience in dealing with Ebola. This briefing for African Affairs argues that these explanations lack important context. The briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. To move past technical discussions of “weak” health systems, it highlights how structural violence has contributed to the epidemic. As part of this, local people – their beliefs, concerns and priorities – have been marginalised. Both the crisis response and post-Ebola ‘reconstruction’ will be strengthened by acknowledgment of its long term structural underpinnings and from a more collaborative inclusion of local people.
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For centuries, indigenous peoples around the world have used their traditional knowledge to prepare for, cope with and survive disasters. Their met
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hods and practices originated within their communities and have been maintained and passed down over generations. Until recently, policy makers have largely ignored this vast body of knowledge, in favor of ‘Western’ science and technologybased methods of disaster risk reduction and response. Today, however, many of these traditional practices are considered important and necessary contributions to the conservation of biodiversity and environmental sustainability. Yet at the same time, this knowledge is under constant threat of being eroded or lost, making these communities more vulnerable...
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential
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health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient
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health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targeted actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550
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Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its management.
Newer technologies, including those d
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riven by artificial intelligence, have the potential to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal
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throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death
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and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve universal health coverage and the Sustainable Development Goals, the beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
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Countries, partners, and donors are committed to
the global elimination of blinding trachoma by 2020.
Achieving this public health milestone requires more
than funding; it requires
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health personnel with the
right mix of skills, and well supported and managed
health systems. Mass drug administration (MDA)
with Zithromax®, the Pfizer, Inc. donated antibiotic,
is a key component of the SAFE strategy, endorsed
by the World Health Organization. There is growing
recognition that improving all aspects of MDA, from
planning to training, recording to reporting, and
receipt of drug to distribution (the supply chain), will
be necessary if MDA programmes are going to reduce
the community burden of Chlamydia trachomatis, and
eliminate trachoma as a cause of blindness by 2020.
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The aim of the present paper is to review capacity building in public health nutrition (PHN), the need for which has been stressed for many years b
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y a range of academics, national and international organisations. Although great strides have been made worldwide in the science of nutrition, there remain many problems of undernutrition and increasingly of obesity and related chronic diseases. The main emphasis in capacity building has been on the nutrition and health workforce, but the causes of these health problems are multifactorial and require collaboration across sectors in their solution. This means that PHN capacity building has to go beyond basic nutrition and beyond the immediate health workforce to policy makers in other sectors. The present paper provides examples of capacity building activities by various organisations, including universities, industry and international agencies. Examples of web-based courses are given including an introduction to the e-Nutrition Academy. The scope is international but with a special focus on Africa. In conclusion, there remains a great need for capacity building in PHN but the advent of the internet has revolutionised the possibilities.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these c
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ountries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic resp
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iratory diseases, following the commitments made at high-level United Nations meetings. It highlights the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
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A Toolkit for Implementation. Module 1: An Overview of Implementation at National, Province and District Levels
A toolkit for Implementation. Module 3: Participatory community assessment in maternal and newborn health
This document contains guidance for strengthening the disability inclusiveness of MHPSS responses and programmes in emergency settings. It is intended to supplement the IASC Guidelines on Mental
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Health and Psychosocial Support in Emergency Settings (2007).
Overall Objective
To consider and address the mental health and psychosocial support (MHPSS) requirements of persons living in emergency settings with all types of disabilities on an equal basis to the MHPSS requirements of all persons, using a human rights-based approach and implementing social-ecological frameworks.
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This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face criti
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cal shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the
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health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 2030, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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