Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Regi...on, necessitating urgent action at the highest levels of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and ...undertreatment persist. There are substantial global variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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Summary of the main report: Direct and indirect effects of COVID-19 pandemic and response in South Asia .
It uses a series of exercises based on actual observed changes in services and intervention coverage to model impacts on mortality, hospita...lizations, and ICU admissions due to COVID-19. It also models the impact of nationwide stay-at-home orders to curb the spread of COVID-19 on maternal and child mortality, educational attainment of children, and the region’s economy. The study focuses on South Asia’s six most populous countries: Afghanistan, Bangladesh, Nepal, India, Pakistan and Sri Lanka and makes the case for interventions and strategies to minimise these indirect consequences.
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Breast cancer is the most common cancer worldwide and the leading cause of cancer deaths among women, disproportionately affecting low- and middle-income countries. The Global Breast Cancer Initiative strives to reduce breast cancer mortality by 2.5... percent per year, which over a 20-year period can save 2.5 million lives. The purpose of this core technical package is to outline a pathway for incremental, sustainable improvements tailored to country-specific needs based on three key strategies and objectives: health promotion for early detection; timely diagnosis; and comprehensive breast cancer management. This document provides a common framework linking policy makers, stakeholders, the clinical community, program managers and civil society to evidence-based systematic approaches that can facilitate health systems strengthening and reduce inequities in women’s health throughout their life cycles
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Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk for Chagas disease transmission is also expect...ed over the next several decades under climate change scenarios. Of particular interest is the predicted northern shift of triatomine species to central regions of the United States with historically unsuitable climates for T. cruzi vectors. The weight of evidence regarding the influences climate change may pose on T. cruzi vector species distributions demonstrates the sensitivity of Chagas disease transmission to future climate variability. In order to advance forecasts for the impact climate change may have on Chagas disease transmission in the Americas, it is imperative to
further develop, utilize, and perhaps combine predictive species distribution modeling approaches that integrate accurate, long term data on climate variables, vector species distributions, Chagas disease incidence, as well as other socio-ecological variables.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines up...date the recommendations that were first released in 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alco...hol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions.
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The maternal deaths audit is one of the three major strategies recommended by WHO for the
reduction of maternal and neonatal mortality.
Objective: To measure the impact of maternal death and nears miss review on maternal ...highlight medbox">mortality and morbidity
after 7 years of practice at the University Hospital of Mother and Child “Lagoon” of Cotonou.
Hounkpatin, et al., Clinics Mother Child Health
2016, 13:1
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s p...revious volume—and over 2.7 million deaths attributed to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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Guide for clinical case management and infection prevention and control during ameasles outbreak. This guide has been developed to reduce the high morbidity and mortality seen in some of the current outbreaks of measles. This short guide outlines pr...actical clinical care interventions and is derived from previously published WHO documents.
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This Eye health strategic plan presents the Ministry of Health’s five
year proposed strategies for eye care in Kenya. It sets the strategic
direction for the National Eye Health Care System and presents
information on the priorities, objectives... and indicators that the
Ministry has adopted especially with regard to the main eye diseases
and conditions in the country and health system strengthening.
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Cervical cancer is the fourth most common cancer in women worldwide in 2018, with 570,000 new cases and 311,000 deaths occurring annually.T he highest incidence rates are in Southern Africa, Eastern Africa, SubSaharan Africa, Western Africa, Melanes...ia, and Middle Africa . It also ranks as the leading cause of cancer-related death in most African countries. More than 85% of these deaths occur in low- and middle-income countries . In addition, women living with human immunodeficiency virus (HIV) are six times as likely to have cervical cancer
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communitie...s affected.
Infection prevention and control (IPC) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, water, sanitation and hygiene, logistics, community en...gagement and risk communication. All efforts must be well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
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The goal of this contingency plan for El Nino related epidemics is to contribute to the reduction in mortality and morbidity associated with El Nino epidemic threats by ensuring that appropriate systems to support health emergency preparedness, time...ly response and post disaster recovery and mitigation are in place at the national, district, health facility and community levels in Rwanda.
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It is often observed that educated women have lower birth rates than do the less educated, inviting a causal interpretation. However, educated women also differ from those who have never attended school in a
variety of other ways: the two factors a...re multiply related. This article analyzes the relationship between schooling and fertility in contemporary Cameroon as both a statistical and a social phenomenon, using data from the 1998 Cameroon DHS alongside ethnographic field data collected by
the author. T
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This report summarizes the findings of the 2010 Rwanda Demographic and Health Survey (RDHS). The 2010 Rwanda Demographic and Health Survey (RDHS) was designed to provide data for monitoring the population and health situation in Rwanda. The 2010 RDHS is the fifth Demographic and Health Survey to be ...conducted in Rwanda (DHS in 1992, 2000, and 2005 and Interim DHS in 2007-08). The objective of the survey was to provide up-to-date information on fertility, family planning, childhood mortality, nutrition including anemia testing, maternal and child health, domestic violence, malaria including malaria testing, maternal mortality, awareness and behavior regarding HIV/AIDS and other sexually transmitted infections, and HIV prevalence.
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The Indonesian government has reformed its laws, policies, and institutions to better manage disaster risk since the significant 2004 Indian Ocean Tsunami. The Government of Indonesia now has contingency plans for every disaster-prone city which identifies its vulnerabilities, outlines the relief re...sponse, and builds overall preparedness. In 2007, the government introduced a disaster management bill that incorporated disaster management prevention into disaster management response. In 2008, Indonesia created the National Disaster Management Agency (Badan Nasional Penanggulangan Bencana, BNPB). The new shift led to the strengthening of the country’s disaster management agency, and the addition of district branches and representatives. Despite the progress made, more work is needed at the local level as well as integration of disaster risk reduction in government departments.11 Under Indonesia’s 2007 Disaster Management law, provincial and district administrations are mandated to head disaster management during a crisis.
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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a...nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
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This document provides a snapshot view of Rwanda in terms of key socio-economic indicators, political and economic context and the situation of children. It also gives an overview of UNICEF's Country Programme and key achievements.
Rwanda has made significant progress towards economic prosperity an...d human development over the past two decades. Rwanda has one of the fastest growing economies in central Africa, and was one of the few countries to achieve all the Millennium Development Goals (MDGs). Political stability, strong governance, fiscal and administrative decentralization, and zero tolerance for corruption are among the key factors supporting the country’s inclusive growth and development.
Rwanda still faces some significant development challenges. Chronic malnutrition (stunting), early childhood development, neonatal mortality, the quality of education, and prevention of violence against children require continued attention.
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