mhGAP is based on evidence-based technical guidelines (4) and provides a set of tools and
training packages to extend service provision. The mhGAP Intervention Guide (mhGAP-IG)
for MNS disorders in non-specialized health settings (8) is a clinical
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decision-making tool
for assessing and managing priority MNS conditions (depression, psychoses, epilepsy, child
and adolescent mental and behavioural disorders, dementia, disorders due to substance
use, self-harm and suicide).
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The publication aims to establish the rationale for inclusion and provides technical advice and tools for putting theory into practice. It is intended to be used as a reference during organizational and program/project development with a focus on gender responsiveness and
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disability inclusion as well as a tool to support good practice in implementation.
This first part guides the reader through the process of assessing whether or not the organization is ready to change towards becoming a more inclusive organization. The second part introduces the ACAP framework, which sets up a way of approaching inclusion via focus on the areas: Access, Communication, Attitude and Participation. It then demonstrates how the framework can be applied to projects and programmes. The third part provides guidelines for the people who will guide organizations through the process of change towards becoming inclusive of persons from marginalized groups.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack
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of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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Water, sanitation and hygiene (WASH) are critical in the prevention and care for all of the 17 neglected tropical diseases (NTDs) scheduled for intensified control or elimination by 2020.
Provision of
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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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According to WHO, around 22% of adults in conflict settings have mental health conditions.
This is almost triple to non-conflict settings. There is no generally accepted estimate for children but i
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t is clear that children who are refugees, IDPs or who live in conflict settings have high levels of mental health issues.
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Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk
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factors such as air pollution. This article discusses the implications of such a focus. It then outlines the opportunities for those in public health and environmental science to work together across three key areas to address air pollution, NCDs and climate change: (a) acknowledging the shared drivers, including corporate determinants; (b) taking a ‘co-benefits’ approach to NCD prevention; and (c) expanding prevention research and evaluation methods through investing in systems thinking and intersectoral, cross-disciplinary collaborations.
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This document focus on the direct consequences of the virus (morbidity and mortality) in specific populations and on the results of measures aimed at mitigating the spread
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of the virus, with indirect impacts on socio-economic conditions. In this complex scenario, the gender approach has not received due attention during the pandemic. Gender is one of the structural determinants of health, but it does not appear in analyses of the direct and indirect effects of the pandemic, despite being essential in the recognition and analysis of the differential impacts on men and women and their interaction with the different determinants of health.
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Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable
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morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 2021 to 784 million by 2045. As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030. Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
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In recent years, high prices of pharmaceutical products have posed challenges in high- and low-income countries alike. In many instances, high prices of pharmaceutical products have led to significa
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nt financial hardship for individuals and negatively impacted on healthcare systems’ ability to provide population-wide access to essential medicines.
Pharmaceutical pricing policies need to be carefully planned, carried out, and regularly checked and revised according to changing conditions. Strong, well-thought-out policies can guide well-informed and balanced decisions to achieve affordable access to essential health products.
This guideline replaces the 2015 WHO guideline on country pharmaceutical pricing policies, revised to reflect the growing body of literature since the last evidence review in 2010. This update also recognizes country experiences in managing the prices of pharmaceutical products.
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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
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) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and chall
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enges”. This document aims to provide an outline of the current situation in Latin America and the Caribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster
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of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease burden and control in the WHO African region. It tracks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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The mhGAP community toolkit: field test version is an integral part of WHO's Mental Health Gap Action Programme (mhGAP), and aims at scaling up services for people with mental health conditions to a
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chieve universal health coverage.
The toolkit provides guidance for programme managers on how to identify local mental health needs and tailor community services to match these needs. It offers practical information and necessary tools for community providers to promote mental health, prevent mental health conditions and expand access to mental health services.
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This brief advocacy document highlights the burden, risks and prevention of injuries and violence, which took the lives of 4.4 million people in 2019 and constitute 8%
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of all deaths. Among the injury-related causes of death include road traffic crashes, drowning, falls, burns, poisoning and violence against oneself or others. For people age 5-29 years, three of the top five causes of death are injury-related, including road traffic injuries, homicide, and suicide. Injuries and violence are not evenly distributed across or within countries – some people are more vulnerable than others depending on the conditions in which they are born, grow, work, live and age; in general, being young, male and of low socioeconomic status all increase the risk of injury. This document, aimed at public health professionals; injury prevention researchers, practitioners and advocates; and donors, draws attention to specific strategies based on sound scientific evidence that are effective and cost-effective at preventing injuries and violence; it is critical that these strategies are more widely implemented.
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People with underlying noncommunicable diseases (NCDs) such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer have a high risk for developing severe and even fatal COVID-19. It is important for them to strictl
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y follow basic protective measures and make sure their chronic diseases are well managed. However, pandemics cripple health systems and compromise provision routine medical care. This technical note gives general guidance to people living with NCDs, their caregivers and family members, the public, health programme managers and health-care workers on how to reduce risks of a COVID-19 infection and maintain care for people living with NCDs during the outbreak.
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LEAVING NO-ONE BEHIND | “A Journey to End NTDs – Elimination and Care” records what we have achieved over the last year and where we are now. It presents our plan of action for the coming years, bringing our ‘traditional’ NTD work together
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with ‘Disease Management Disability and Inclusion’ (DMDI), Community Based Inclusive Development (CBID) and Livelihoods. We care for those affected and we’re working to enhance community and government ownership through national
health system strengthening, community engagement and cross-sectoral action. Ultimately, we are working to free future generations from these menacing diseases, improving prevention and treatment, without forgetting those for whom prevention and treatment are too late because they already have a disability.
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and
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comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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The Quality Criteria for Health National Adaptation Plans (HNAPs) presents examples of good practice in HNAP development to assist countries in developing a comprehensive, feasible and implementable plan. The criteria are also intended to guide coun
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tries in setting the foundation for a long-term iterative HNAP process. The proposed criteria are not prescriptive and should be adapted to dynamic country contexts, uncertain and changing climatic conditions, and new knowledge and technologies.
9 February 2021
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This Module, Count me in! Inclusive WASH in Ethiopia, was prepared by Ethiopian authors with support from The Open University UK. It was first published in June 2018. The contributors of original material are:Girma Aboma, Manager, GAA Economic Devel
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opment ConsultBethel Shiferaw, SPCC Disability Inclusion Advisor, Ethiopian Center for Disability and Development
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The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di
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agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
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