Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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This situation analysis has gathered information about the current state of AMR, contributing factors and antimicrobial use in Zimbabwe from the human, animal, agricultural and environmental sectors. Data has been gathered from different sectors such as the general public, academia, the Ministry of ...Health and Child Care, the Ministry of Agriculture Mechanization and Irrigation Development and the Ministry of Environment, Water and Climate. It shows that AMR is a real concern in Zimbabwe and a threat to the health outcomes of humans, to the economic productivity of the livestock industry and a risk to the environment.
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The global emergence of antimicrobial resistance (AMR) is posing a threat to human health. Putting resources into the containment of AMR – including surveillance – is one of the highest-yield investments a country can make to mitigate its impact. In 2015, WHO launched the Global Antimicrobial Re...sistance Surveillance System (GLASS), the first global collaborative effort to foster AMR surveillance in bacteria causing acute infections. As of December 2018, 71 countries are enrolled in GLASS. The aim of this report is to document participation efforts and outcomes across these countries, and highlight differences and constraints identified to date. This report follows on from the first GLASS Report – Early implementation 2016-17, published in January 2018, and drawing on data from GLASS first data call in 2017.
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This curricula guide builds on several existing products of WHO and partners, aimed at supporting countries in their effort to address the first objective of the GAP-AMR (to improve awareness and understanding of AMR). It is targeted specifically at health educators and policy planners, and applies ...a systematic modular and submodular collection of learning objectives and outcomes that are organized according to the key occupational groups involved in the use of antimicrobials in human health. It is hoped that educators, faculties of heath personnel training institutions, health regulatory institutions and other users will find it a useful resource in meeting their respective needs for strengthening health workers’ contributions to containing AMR.
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High levels of storage iron may increase malaria susceptibility. This risk has not been investigated in semi-immune adolescents. We investigated whether baseline iron status of nonpregnant adolescent girls living in a high malaria transmission area in Burkina Faso affected malaria risk during the fo...llowing rainy season. For this prospective study, we analysed data from an interim safety survey, conducted six months into a randomised iron supplementation trial. We used logistic regression to model the risk of P. falciparum infection prevalence by microscopy, the pre-specified interim safety outcome, in relation to iron status, nutritional indicators and menarche assessed at recruitment.
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The WHO Guidelines on physical activity and sedentary behaviour provide evidence-based public health recommendations for children, adolescents, adults and older adults on the amount of physical activity (frequency, intensity and duration) required to offer significant health benefits and mitigate he...alth risks. For the first time, recommendations are provided on the associations between sedentary behaviour and health outcomes, as well as for subpopulations, such as pregnant and postpartum women, and people living with chronic conditions or disability.
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Modelling the health impacts of disruptions to essential health services during COVID-19 Module 1
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVI...D-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea...rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
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Standards for nursing practice are based on the following philosophy and principles:
•the client is the central focus of the professional service nurses provide, and is a partner in the decision-making process and ultimately makes his or her own decisions
•improvement is a necessary component ...of practice, and the public interest is best served when nurses continually improve their application of knowledge, skill and judgment
•the public has entrusted CRNPEI to honour the social contract that we have made with Canadians to act in the public interest through the licensing and regulation of its members •quality practice settings contribute to the provision of competent and professional service
•the goal of professional nursing service is the outcome desired by the client that poses noun necessary exposure of risk of harm
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The goal of this best practice guideline is to strengthen collaborative practice among nurses, because effective collaborative practice is essential for working in health-care organizations.
In this guideline, we focus on collaborative practice amongst three types of nursing professionals – reg...istered nurse (RN), registered practical nurse (RPN) and nurse practitioner (NP) – and explore what fosters healthy work environments for them, aware that collaboration must align with the needs of the patient or client.
This best practice guideline was developed to assist nurses, nursing leaders, other health professionals and senior managers to enhance positive outcomes for patients/clients individual/family/group/community), nurses, and the organization through intra-professional collaborative practice.
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A systematic approach to holistic wound care is essential for the delivery of high quality wound care. Holistic wound assessment considers the whole person and should comprise the components of the generic wound assessment minimal data set. Therefore holistic assessment is key to gathering informati...on on the
patient and their wound. This information should be documented at each review so that it can act as a baseline against which wound progress can be tracked and used to guide management decisions.
Inaccurate or lack of assessment can result in appropriate care and delays in healing, unnecessary patient suffering, poor outcomes and the inappropriate use of resources
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The WHO End TB Strategy aims to end the global TB epidemic by 2030, in alignment with Goal 3 of the United Nations (UN) Sustainable Development Goals (SDGs). Member States of the World Health Organization (WHO) and the UN committed to ending the TB epidemic through adoption of WHO’s End TB Strateg...y and the UN SDGs in 2014 and 2015, respectivel
Almost half of the deaths worldwide caused by TB in 2019 occurred in the WHO South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this Region is therefore essential if the global goal of ending the TB epidemic is to be realized. Despite substantial gains made in the Region, the threat to
health worldwide posed by the COVID-19 pandemic has the potential to reverse these gains and eclipse the focus on the global TB emergency.
While continuing to tackle COVID-19-related challenges, countries will need to rapidly and urgently deploy supplementary measures to address the large numbers of missed cases, poor treatment outcomes and, potentially, a higher TB burden.
The Regional Strategic Plan towards Ending TB in the Region 2021–2025 clearly articulates priority interventions, analyses the challenges, bottlenecks and opportunities, and focuses on implementation considerations in the Region.
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This Global Competency Standards sets the benchmark for the health workforce in providing equality of care to refugees and migrants. Refugee and migrant populations are highly diverse, with significant variation in life experiences, health needs and access to health care. The standards described out...line expected behaviours of health workers in delivering quality care to refugees and migrants and can be used to inform the outcomes of education programmes aligned with standards for care. The Competency Standards is designed to provide a foundation to support the development of competency-based curricula tailored to the local context and for health workers to achieve a minimum level of competence. The importance of person-centred, culturally responsive care is emphasized in the nine competency standards, which recognize the need for health workers to be trained, supported and empowered within strong health systems
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This Curriculum Guide accompanies the Refugee and Migrant Health: Global Competency Standards for Health Workers and the Knowledge Guide to support the operationalization of the Standards. The Curriculum Guide provides guidance for institutions, health organizations and individuals engaged in the ed...ucation and training of health practitioners and health administrators to support incorporation of the knowledge, skills and attitudes set out in the Knowledge Guide into curricula and for assessment of the achievement of the relevant learning outcomes and Competency Standards.
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The Knowledge Guide provides guidance on how health workers can apply the Standards to their own practice. For each of the nine competencies and their specific behaviours in the Standards, the Knowledge Guide examines in detail how a health worker's knowledge, skills and attitudes can reach the stat...ed benchmark for providing people-centred health services to refugees and migrants. The Knowledge Guide also details the learning outcomes that reflect the behaviours that a health worker will demonstrate once they have achieved the Competency Standards.
The Knowledge Guide is designed for educators and health workers to assist in designing or integrating learning content to enable attainment of the identified knowledge, skills and attitudes.
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Climate change and health vulnerability and adaptation assessment
In 2013 the World Health Organization (WHO) published the report Protecting health from climate change:
vulnerability and adaptation assessment. The aim was to provide basic and flexible guidance on conducting national or subnati...onal assessments of current and future vulnerability (the susceptibility of a population or region to harm) to the health risks of climate change, and of policies and programmes that could increase resilience, taking into account the multiple determinants of climate-sensitive health outcomes.
That guidance has been a very useful tool, applied to more than 50 countries and settings, and has helped countries to prepare their health contributions to United Nations Framework Convention on Climate Change national adaptation plans.
Since the launch of the guidance, WHO, technical partners such as Health Canada, and countries have learned much in terms of its applicability in different countries, at national and local levels.
At the same time, knowledge on climate change and health has increased.
WHO, the Pan American Health Organization and Health Canada have produced this updated version, which aims to better support countries in their assessments by proposing a simpler tool that incorporates all lessons learned.
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Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change. ...Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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This recommendation is an update of one of the 49 recommendations that were published in the WHO recommendations on antenatal care for a positive pregnancy experience. The recommendation was developed initially using the standardized operating procedures described in the WHO handbook for guideline d...evelopment.
In summary, the process included: (i) identification of priority question and outcomes; (ii) retrieval of evidence; (iii) assessment and synthesis of the evidence; (iv) formulation of recommendation; and (v) planning for the implementation, dissemination, impact evaluation and updating of the recommendation. This recommendation was identified by the Executive Guideline Steering Group (GSG) as a high priority for updating in response to new evidence on this question.
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PNAS | March 4, 2014 | vol. 111 | no. 9
Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate factors, as well as the local capacity to control the disease. Malaria is also ...one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution.
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In 2013 the World Health Organization (WHO) published the report Protecting health from climate change:vulnerability and adaptation assessment. The aim was to provide basic and flexible guidance on conducting national or subnational assessments of current and future vulnerability (the susceptibilit...y of a population or region to harm) to the health risks of climate change, and of policies and programmes that could increase resilience, taking into account the multiple determinants of climate-sensitive health outcomes.
That guidance has been a very useful tool, applied to more than 50 countries and settings, and has helped countries to prepare their health contributions to United Nations Framework Convention on Climate Change national adaptation plans.
Since the launch of the guidance, WHO, technical partners such as Health Canada, and countries have learned much in terms of its applicability in different countries, at national and local levels.
At the same time, knowledge on climate change and health has increased.
WHO, the Pan American Health Organization and Health Canada have produced this updated version, which aims to better support countries in their assessments by proposing a simpler tool that incorporates
all lessons learned.
more