Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
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Technical report
This manual aims to provide information about the methods for investigating outbreaks of hepatitis E, and measures for their prevention and control. In addition, the manual gives information about the causative agent – known as the hepatitis E virus (HEV) – its epidemiology..., clinical manifestations of the disease and diagnosis.
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The purpose of Volume 2 is to provide a full set of reference data showing performance over the period of the previous National Health Plan 2001–2010, to provide a baseline against which performance over the next ten years can be measured, and to highlight in greater detail some of the contex...t against which the policies and strategies described in Volume 1 can be understood.
This Part A of Volume 2 provides data and context from a whole-of-country perspective. The data will be useful for provinces and national-level program staff within the National Department of Health to establish benchmarks and targets in the Five-year Strategic Implementation Plans to be developed to support implementation of this Plan. Additionally, this Volume will serve as a reference manual for all health sector stakeholders.
Original file: 77 MB
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Provincial profiles
Original file: 96 MB
Guidance has been updated on a number of chemicals: asbestos, bentazone, chromium, iodine, manganese, microcystins, nickel, silver, tetrachloroethene and trichloroethene. Guidance has also been added for chemicals not previously assessed in the Guidelines: anatoxin-a and analogues, cylindrospermopsi...ns and saxitoxins. The new guidance on organotins has replaced the prior guidance focused on dialkyltins. With these updates, the guideline values for tetrachloroethene and trichloroethene have been revised while new guideline values for cylindrospermopsins, manganese, microcystins, and saxitoxins have been established .
Updated information on cyanobacteria has been included, introducing an alert level framework for early-warning and to guide short-term management responses. Guidance has also been updated in the sections on adequacy of water supply, climate change, emergencies, food production and processing, and radiological aspects, particularly on managing radionuclides when exceeding WHO screening values and guidance levels.
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Drinking-water quality regulations and standards developed or revised in accordance with this guidance will reflect the best practices identified in the WHO Guidelines for Drinking-water Quality to most effectively protect public health. Moreover, the regulations and standards will consider local ne...eds, priorities and capacities to ensure that they are realistic and appropriate. Topics covered include:
- Guiding principles
- Getting started
- Selecting parameters and parameter limits
- Setting out compliance monitoring requirements
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Disinfection of drinking-water supplies has been one of the most significant public health advancements of the last century with respect to reducing waterborne disease.
Although chlorine has been used as the disinfectant of choice for public drinking-water supplies for the past century, a numbe...r of emerging or alternative compounds are used or are being considered for the disinfection of drinking-water.
This series reviews the state of the knowledge on the application, efficacy and toxicity of bromine, iodine and silver as drinking-water disinfectants.
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The WHO/IWA document A practical guide to auditing water safety plans provides guidance on developing and implementing a WSP auditing scheme, covering such topics as the aim and role of auditing, auditor training and certification, audit criteria, audit timing and frequency and audit reportin...g. The guidance document includes examples, tips, tools and case studies from more than a dozen low-, middle-, and high-income countries, and it serves as a practical resource for policy makers, government bodies responsible for drinking-water regulation or surveillance and water suppliers implementing WSPs.
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This guide is intended for people involved in the management and operation of small- to mediumsized organized water supply systems. The content has been developed with particular consideration for operational-level personnel with responsibility for chlorination (for example, water treatment plant op...erators and technicians). The material presented within this guide may also be relevant for engineers and representatives from public health, local government, non-governmental organizations, as well as any other individuals supporting water safety planning activities for the supply of safe drinking-water.
Part 1. Chlorination principles: Describes key chlorination concepts, providing a knowledge foundation for the implementation of effective chlorination practices.
Part 2. Chlorination practices: Describes the practical application of the concepts presented in Part 1, including calculations and procedures for safe and effective chlorination of drinking-water supplies.
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The guide is presented in two parts:
Part 1. Principles of Operational Monitoring: Describes the key principles of operational monitoring, alongside the types of operational monitoring that may be performed and the information required within an OMP.
Part 2. Operational Monitorin...g Plan Development: Describes the stepwise development of an OMP for a water supply system, including the source, water treatment, intermediate storage, distribution and household. For illustration purposes, practical guidance is provided using a specimen water supply system considered to be representative of a conventional small- to medium-sized supply in a lower resource setting. This template may be used to develop system-specific OMPs for individual water supply systems.
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A review of proactive risk assessment and risk management practices to ensure the safety of drinking-water
Based on information gathered from 118 countries representing every region of the globe, this report provides a picture of WSP uptake worldwide. It presents information on WSP implementati...on and the integration of WSPs into the policy environment. It also explores WSP benefits, challenges and future priorities.
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In many of Myanmar’s contested regions, healthcare services are provided through two parallel governance systems – by the government’s Ministry of Health, and by providers linked to ethnic armed organizations. Building upon efforts to build trust between these two actors following ceasefires s...igned in 2011 and 2012, the new National League for Democracy-led government offers an unprecedented opportunity to increase cooperation between these systems and to ensure health services reach Myanmar’s most vulnerable populations.
The report provides an overview of existing health service arrangements in these areas, from both the Ministry of Health and from ethnic and community-based health organizations. It then unpacks the concept of “convergence”, highlighting key opportunities and policy recommendations for both government and non-government actors.
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Policy note: Cambodia Health Systems in Transition.
The health system includes a mix of public and private providers. The use of private providers is much greater among the wealthy, while the use of informal-sector health providers is greater among the poor. Due to these circumstances there is ...considerable scope to establish appropriate public-private cooperation and to reinforce the regulatory mandate of the Ministry of Health (MOH).
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Policy Note: Thailand Health Systems in Transition
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the Civil Servant Medical Benefit Scheme (CSMBS) for civil servants and their dependents, Social Health Insurance (SHI) for formal sector employees, and the U...niversal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing.
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Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop...le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC.
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Policy Note #2: Myanmar Health Systems in Transition Policy Notes Series
Myanmar is a country in which people’s access to health services is determined more by where they live than their need for care – a situation that is fundamentally inequitable. The challenge is to reduce levels of ineq...uity between different groups in the population and different geographical areas, and most particularly to ensure that health services reach poor and disadvantaged groups, including minorities and those living in conflict-affected areas.
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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the ...township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis.
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Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ...revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty.
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