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Publication Years
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Toolboxes
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La Región de las Américas constituye un territorio extremadamente rico desde el punto de vista de la diversidad cultural, en la cual se presentan una variedad de desafíos relacionados con el reconocimiento y el respeto de los derechos humanos de los miembros de los pueblos indígenas, los afrodes
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cendientes, los romaníes, así como de otros grupos étnicos. A lo largo del curso de la vida, estas personas experimentan discriminación estructural y poca representatividad e inclusión en los procesos de toma de decisiones, lo cual dificulta su acceso a los servicios de salud, afecta la calidad de la atención que reciben y tiene un efecto general en sus condiciones de vida. Por tanto, la protección y la promoción de su salud y seguridad socioeconómica es una cuestión no solo de política pública, sino también de protección y ejercicio de los derechos humanos. En esta publicación se presentan los instrumentos internacionales y regionales de derechos humanos y los sistemas de protección de esos derechos instaurados por las Naciones Unidas y el Sistema Interamericano de Derechos Humanos, así como medidas para hacerlos efectivos, con especial hincapié en el derecho a la salud, al medio ambiente sano y otros derechos relacionados con el cuidado del planeta.
more
This document summarizes current WHO guidance for public health surveillance of coronavirus disease 2019 (COVID-19) in humans caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
New elements include:
update of contact definitions, in line with latest cont
...
act tracing guidance
update of detection strategies in line with updated version of WHO SARS-CoV-2 testing guidance
reinfection evidence standardization and surveillance: molecular, genomic and immunological evidence of reinfection
inclusion of clinical case definition of Post COVID-19 condition as defined by WHO
definition of breakthrough infection
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mhGAP Intervention Guide Mental Health Gap Action Programme Version 2.0 for mental, neurological and substance use disorders in non-specialized health settings
The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and
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simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Essential Care and Practice that includes general guidelines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile,
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coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C infection and the 2017 WHO Guidelines on hepatitis B and C testing. These priority areas are:
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direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
simplified HCV service delivery (decentralization, integration and task sharing)
HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing.
These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.
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This document was prepared by UNICEF Regional Office for West and Central Africa, under the leadership of Christophe Valingot and the review of Joachim Peeters (WASH Specialist) and Arnaud Laillou (Nutrition Specialist), on behalf of the WASH Regional Group and the Nutrition Regional Group.
This
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WASH - Nutrition strategic guidance note for West and Central Africa builds on the precedent WASH-in-NUT strategy elaborated in 2012 and is the regional outcome of a multiyear collaborative work conducted at country level between 2018 and 2022, in Mali, Niger, Nigeria Chad, Burkina Faso. This work is based on a strong multi-partner collaboration, involving national technical directorates of the water and sanitation sector as well as technical directorates of Health and Nutrition, civil society organizations, national and international NGOs as well as United Nations agencies.
This document can serve as a technical and strategic guide for any partner wishing to strengthen the intersectorality of WASH-Nutrition programmes. It presents the regional WASH & Nutrition context, a brief review of the latest scientific evidence, and proposes an integrated WASH-Nutrition programming framework adapted to the regional context of West and Central Africa. Beyond the implementation of programmes, this document also calls for the explicit and concrete inclusion of WASH-Nutrition integration into national policy documents.
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The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la
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test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
more
States have committed and assumed obligations to address multiple and intersecting forms of discrimination against refugees, internally displaced persons, asylum seekers, returnees and stateless persons. The Global Compact on Refugees places ending discrimination of any kind based on the grounds of
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race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, disability, age, or other status at the centre of action to prevent displacement and to ensure peaceful coexistence between refugee and host communities. Narratives about cultural diversity and inclusion are important, but there is also a pressing need in many societies for conversations and action to address racism, racial discrimination, xenophobia and related intolerance.
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We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organi
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zation. We searched nine electronic databases for intervention-based
studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative
study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD:
1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore,
we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).
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This report presents a framework to link science, policy and practice for a comprehensive assessment of climate mitigation and adaptation investments and their impact on human health.The framework proposes to use weather and climate data to forecast health impacts over time, as well as biophysical a
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nd economic models to quantify the outcomes of investments in climate change adaptation and mitigation for relevant sectoral indicators and health co-benefits. It provides guidance on the economic valuation of health co-benefits of climate action, for inclusion in sector-specific cost–benefit analysis (CBA), including the spatial allocation of such costs and benefits.
The framework developed and presented in this study is comprehensive, and provides various entry points for different audiences, including decision-makers in the public and private sectors, researchers and scientists, working in the health sector as well as in other thematic areas and related sectors affected by climate action.
more
This document provides technical guidance on concepts, definitions, indicators, criteria, milestones and tools to assist leprosy programmes in their journey towards the goals of interruption of transmission and elimination of leprosy disease and through the post-elimination period. Importantly, it p
...
rovides criteria with benchmarks, where possible, for all key aspects of leprosy programmes and services. Not only those related to elimination efforts, but also those related to diagnosis and management of leprosy, leprosy-related disabilities, mental wellbeing, stigma and discrimination and inclusion and participation of persons affected by leprosy. The document emphasises that the elimination of leprosy is a long-term, continuous journey on the one hand, while, on the other, clear milestones can be recognised on the way and programme implementation can be assessed against benchmarks, guiding appropriate action to keep the programme on track.
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Little is known about foreign aid provided by private donors. This paper contributes to closing this research gap by comparing the allocation of private humanitarian aid to that of official humanitarian aid awarded to 140 recipient countries over the 2000-2016 period. We construct a new database tha
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t offers information on the country in which the headquarters of private donors are located to test whether private donors follow the aid allocation pattern of their home country. Our empirical results confirm that private aid “follows the flag.” This finding is robust against the inclusion of various fixed effects, estimating instrumental variables models, and disaggregating private aid into corporate aid and NGO aid. Donor country-specific estimations reveal that private aid from China, Sweden, the United Kingdom, and the United States “follow the flag.”
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca
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l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Background
Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access
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to medication treatment.
Methods and Results
We used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest‐price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low‐ and lower‐middle‐income countries and 60% in high‐ and upper‐middle‐income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low‐ and lower‐middle‐income countries compared with high‐ and upper‐middle‐income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days’ wage for brand medicine and 1.8 days’ wage for generics. Affordability was lower in low‐ and lower‐middle‐income countries than high‐ and upper‐middle‐income countries for both brand and generic medications.
Conclusions
The availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low‐ and lower‐middle‐income countries.
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Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent measles outbreaks which started in August 2021, and t
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he highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
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Developed as part of the UN Women–WHO Global Joint Programme on Violence Against Women Data, this briefing note focuses on the measurement of violence against women with disability and is one in a series of methodological briefing notes for strengthening the measurement and data collection of viol
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ence against particular groups of women or specific aspects of violence against women.
The briefing note is meant for researchers, national statistics offices, and others involved in data collection on violence against women. It provides an overview of the challenges in the availability, measurement, and collection of data on violence against women with disability and outlines recommendations for good practice in measurement, with the aim of strengthening ongoing and future data collection efforts and increasing the availability of such data.
The inclusion of women with disability and the issue of disability within population-based surveys and research on violence against women is necessary for an improved understanding of populations of women at specific risk of violence. This knowledge would also allow more tailored prevention strategies and response/services and programmes to be designed in a way that addresses the specific needs of women with disability.
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The Framework serves to guide efforts to deliver safe and sustainable water, sanitation and hygiene (WASH), health care waste management and reliable electricity in all health care facilities. The ultimate aim is to provide quality care for all. The Framework reflects a global consultative process a
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nd includes data and recommendations articulated in recent WHO/UNICEF global reports on WASH, waste and electricity in health care facilities. It also provides an operational roadmap for implementing the 2023 United Nations General Assembly (UNGA) resolution on WASH, waste and electricity in health care facilities. The target audiences for this Framework include health leaders and programme managers at the global and national levels; policymakers; WASH, waste and energy leaders and technical experts; development partners and finance institutions; and actors and experts on gender equality, disability and social inclusion and climate; and, more generally, civil society. The Framework addresses the WASH, waste and electricity elements of the WHO comprehensive approach to build safe, climate-resilient and environmentally sustainable health care facilities.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence
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-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Frame
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work 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.
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Antibiotics have been a critical public health tool since the discovery of Penicillin in 1928, saving the lives of millions of people around the world. In developing country like ours, where the burden of treatable disease is very high and access to health facilities and laboratories is difficult, a
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ntibiotics have long acted as miracle drugs. Today, however, the emergence of drug
resistance in bacteria is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and in some cases, nonexistent. Diseases previously regarded as relatively easy to manage are much harder to treat as doctors must use “last-resort” drugs that are more costly, take longer to work
and are often unavailable or unaffordable in developing countries. Moreover, regular prescription of antibiotics, random treatment, over the counter sales, inadequate dosage, inclusion of antibiotics in animal feeds and agriculture has contributed equally to emergence of antibiotics resistance as silent epidemic within the country.
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