Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical can...cer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness,... equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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Nat Med (2021). https://doi.org/10.1038/s41591-021-01381-y
Lessons learned from an M&E task-shifting initiative in Botswana
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 112
The Essential Health Benefit (EHB) is known as Essential Health Care Package (EHCP) ..."attribute-to-highlight medbox">in Swaziland. This desk review provides evidence on the experience of EHCPs in Swaziland and includes available policy documents and research reports.
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Shoman et al. Globalization and Health (2017) 13:1 DOI 10.1186/s12992-016-0224-2
This report is not a country scorecard. Rather, its purpose is to act as a compass to guide progress towards health in the SDGs.
There has been a significant improvement in the state of health ...an class="attribute-to-highlight medbox">in the region with healthy life expectancy - time spent in full health - in the region increasing from 50.9 years to 53.8 between 2012 and 2015 - the most marked increase of any region in the world.
What is making Africans sick is changing. The top killers are still lower respiratory infections, HIV and diarrhoeal disease and countries have routinely focused on preventing and treating this trio, often through specialized programmes. The payoff has been significant declines in deaths due to these diseases. There has been a 50% reduction in the burden of disease caused by what have been the top 10 killers since 2000 and death rates have dropped from 87.7 to 51.1 deaths per 100,000 persons between 2000 and 2015...
Chronic diseases like heart disease and cancer are now claiming more lives with a person aged 30 to 70 in the region having a one in five chance of dying from a noncommunicable disease (NCDs).
Countries are specifically failing to provide essential services to two critical age groups – adolescents and the elderly...
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The Bolivarian Republic of Venezuela has been facing a sociopolitical and economic situation that has negatively impacted social and health indicators. There have been intensified population movements both within the country and to other countries, particularly to Argentina, Brazil, Chile, Colombia,... Costa Rica, Curaçao, Dominican Republic, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, and Uruguay. Since 2017, an estimated 5.2 million Venezuelans have migrated to other countries, including an estimated 4.3 million who have gone to countries in Latin America and the Caribbean.
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To support countries in adapting their response to different COVID-19 scenarios, the World Health
Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey lite...rature. The objective was to identify interventions implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions. The review included outbreaks of Ebola virus disease (EVD), severe acute respiratory syndrome (SARS), Zika virus disease (ZVD), the ongoing COVID-19 pandemic, and natural disasters and humanitarian emergencies that caused disruption to services, transport and other activities.
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Sectors in which Priority Adaptation Projects should be implemented first include:
- 1) Agriculture, Early Warning Systems and Forest (First Priority Level Sectors). This is followed by:
- 2) Public Health and Water Resources (Second Pri...ority Level Sectors);
- 3) Coastal Zone (Third Priority Level Sector); and
- 4) Energy and Industry, and Biodiversity (Fourth Priority Level Sectors).
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The WHO Global strategy on human resources for health: workforce 2030 encourages development partners and global health initiatives to leverage their support to health systems in countries to sustainably strengthen the health workforce. To assess th...e impact of these investments, a methodology was developed and pilot tested by WHO.
The impact assessment tool (consisting of an MS Excel calculator with two subsets) supports users to:
• assess and quantify the health impact of HRH investments made in the context of HIV, tuberculosis (TB) and malaria programmes through their modelled effect on health service coverage of these three diseases; and
• provide aggregate indicative estimates of the range of health workers required to attain high coverage of selected health services.
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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.
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Int. J. Environ. Res. Public Health 2018, 15(12), 2626; https://doi.org/10.3390/ijerph15122626
Climate change is increasing risks to human health and to the health systems that seek to protect the safety and well-being of populations. Health authorities require information about current associatio...ns between health outcomes and weather or climate, vulnerable populations, projections of future risks and adaptation opportunities in order to reduce exposures, empower individuals to take needed protective actions and build climate-resilient health systems. An increasing number of health authorities from local to national levels seek this information by conducting climate change and health vulnerability and adaptation assessments. While assessments can provide valuable information to plan for climate change impacts, the results of many studies are not helping to build the global evidence-base of knowledge in this area. They are also often not integrated into adaptation decision making, sometimes because the health sector is not involved in climate change policy making processes at the national level. Significant barriers related to data accessibility, a limited number of climate and health models, uncertainty in climate projections, and a lack of funding and expertise, particularly in developing countries, challenge health authority efforts to conduct rigorous assessments and apply the findings. This paper examines the evolution of climate change and health vulnerability and adaptation assessments, including guidance developed for such projects, the number of assessments that have been conducted globally and implementation of the findings to support health adaptation action. Greater capacity building that facilitates assessments from local to national scales will support collaborative efforts to protect health from current climate hazards and future climate change. Health sector officials will benefit from additional resources and partnership opportunities to ensure that evidence about climate change impacts on health is effectively translated into needed actions to build health resilience.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As ...light medbox">in so many crises, women and girls are disproportionately affected and shoulder the consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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Results from the baseline study indicated that schoolgirls in the southwestern refugee settlement context lacked access to the menstrual hygiene knowledge and products required for them to manage their menstruation ...t medbox">in a healthy and dignified manner. Although UNHCR mandates that all women and girls of reproductive age are to receive distributions of disposable sanitary pads, soap and underwear, 71% of the girls reported not having enough menstrual products, 65% reported not having enough soap and 59% reported not having enough underwear. 44% percent also reported that they didn’t have enough information about menstrual hygiene.
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The report provides lessons and recommendations for other organizations and the wider humanitarian community on engaging persons with disabilities at all levels of humanitarian work. It draws on consultations with over 700 displaced persons—including persons with disabilities, their families, and ...humanitarian staff—in eight countries.
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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 pr...actices, or providers who lack adequate training and 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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