The Third Rwandan Health Sector Strategic Plan (HSSP III) provides strategic guidance to the health sector for six years, between July 2012 and Jun...e 2018. HSSP III has been inspired and guided by the VISION 2020, which will make Rwanda a lower-middle-income country by 2020; the Rwandan Health Policy of 2004; and the priorities set out by the Economic Development and Poverty Reduction Strategy (EDPRS 2008–2012).
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Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether ...ighlight medbox">the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
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The article outlines the prioritized research agenda for the prevention and control of chronic r...espiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastati...ng physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs), as they have a higher risk of severe illness and death from COVID-19. COVID-19 has been associated with an
excess in all-cause and cardiovascular disease (CVD) mortality beyond that related to the infection itself and its immediate consequences. Studies in the
United Kingdom (UK) and United States of America (USA) have clearly shown increasing deaths from ischemic heart disease, stroke and hypertensive disease due to COVID-19. Overall, the impact has been greater in individuals with lower socioeconomic status, even in high income nations.
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One of the first steps in developing a multisectoral action plan (MSAP) is to use a situation analysis to provide a comprehensive assessment of the health needs, prevailing risks and ...ttribute-to-highlight medbox">the context of the area to which the plan will apply. This will help countries, regions, provinces or cities intending to create a multisectoral action plan to align with the global commitments on targeting the four major NCDs: cardiovascular disease, diabetes, cancer and chronic respiratory diseases.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase... in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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A framework for action provides a guide for those involved in the development of the multisector...al action plan. It starts with a wide-ranging vision and, through a series of increasingly specific intentions, brings into focus actions with measurable outcomes that can be taken to achieve that vision.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health ...programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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To maintain a structured and well-organized implementation plan it is important to have a lead agency or sector. The ministry of health or a similar authority in government will be critical in facilitating development and implementation of ...ss="attribute-to-highlight medbox">the multisectoral action plan.
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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh...ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health ou...tcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases, injuries and risk factors in more than 200 countries and territories and at the subnational level in more than 20 countries. The GBD is now produced by an active collaboration of over 8,000 scientists and analysts from more than 150 countries. With each GBD iteration, the data, data processing and methods used for data synthesis have evolved, with the goal of enhancing transparency and comparability of measurements and communicating various sources of uncertainty. The GBD has many limitations, but it remains a dynamic, iterative and rigorous attempt to provide meaningful health measurement to a wide range of stakeholders.
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Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the
pancreas in sufficient quantities or is not utilized effectively by ...an class="attribute-to-highlight medbox">the body to control blood glucose levels. As a result, blood
glucose levels are abnormally high (hyperglycaemia). Chronic uncontrolled hyperglycemia leads to long-term target organ damage, such as: retinopathy, nephropathy and neuropathy (microvascular complications); stroke, coronary heart disease
and peripheral arterial disease (macrovascular complications).
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotyp...es. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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School health programmes are the most cost-effective way to influence health behaviours in young people. The purpose of this two-part handbook is to support schools as they seek to im...plement interventions in order to reduce the main modifiable risk behaviours for noncommunicable diseases. This Practical application handbook provides advice to schools on providing young people with the knowledge, attitudes, beliefs and life skills necessary for making informed decisions, and creating a healthy school environment that can reduce the risk of NCDs
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This guideline provides updated, evidence-informed guidance on the percentage of total fat in the diet to reduce the risk of unhealthy weight gain....
This guideline is intended for a wide audience involved in the development, design and implementation of policies and programmes in nutrition and public health. This guideline includes a recommended level of total fat intake which can be used by policy-makers and programme managers to address various aspects of dietary fat in their populations through a range of policy actions and public health interventions.
The guidance in this guideline replaces previous WHO guidance on total fat intake, including that from the 1989 WHO Study Group on Diet, Nutrition and the Prevention of Chronic Diseases and the 2002 Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. The guidance in this guideline should be considered in the context of that from other WHO guidelines on healthy diets.
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance deve...loped and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline is available both online and PDF.
This version of the living guideline (version 6.0) includes fifteen statements on IPC measures in health-care settings (screening and patient placement, ventilation, physical barriers, environmental cleaning, waste management, amongst others) as well as one statement on mask fit in the community context.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known... about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Vaccines are powerful weapons in the fight against pandemic viruses as shown by responses to both the 2009 H1N1 influenza and the COVID-19 pandemic...s. However, planning for accessing, allocating and deploying vaccines in a pandemic situation is a complex endeavour, beset with multiple challenges at all levels – local, regional and global. The World Health Organization (WHO) and its partners have prepared this revised guidance document to assist countries update their national deployment and vaccination plans (NDVPs) by leveraging global learnings from past pandemic responses, including the recent COVID-19 vaccination effort. The development and testing of a NDVP would not only advance pandemic preparedness efforts but would also have benefits in terms of increasing national capabilities to manage other health emergencies which require emergency vaccination campaigns.
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Due to high routine vaccination coverage, overall counts of diphtheria case have significantly declined in the Western Pacific Region recently. However, diphtheria is still prevalent in several countries and areas of ...ght medbox">the Region and remains a public health issue due to its high case fatality rate.
This Field Guide for Preparedness and Response to Diphtheria Outbreaks in the Western Pacific Region is a reference resource for Member States to develop national guidelines adapted to their local context. Countries may also use this Guide to facilitate outbreak preparedness and public health responses to reduce morbidity and mortality due to diphtheria.
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