As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3,
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and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapters (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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Persons with disabilities are one of the most vulnerable and socially excluded groups in any crisis-affected community. They may be in hidden in homes, overlooked during needs assessments and not co
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nsulted in the design of programs.4 While gender-based violence (GBV) affects women, girls, men and boys, the vast majority of survivors globally are women and girls.5 Persons with disabilities have difficulty accessing GBV programs, due to a variety of societal, environmental and communication barriers, increasing their risk of violence, abuse and exploitation.
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The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering quality care
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services to patients over a long time. The new National Guidelines for Prevention and Management of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
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The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale
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and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
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In this report, we describe early childhood trauma and its effects, offer promising strategies for ECE programs and systems to help young children
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who have experienced trauma, and present recommendations for state policymakers and other stakeholders looking to support trauma-informed ECE for this vulnerable group.
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World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole
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populations, the importance of promoting community awareness about mental illness to increase levels of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
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This document will be continuously updated. Version as of April 27th, 2020
Migrant and displaced children are at heightened risk to the immediate and secondary impacts of COVID-19. They often li
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ve in cramped conditions with limited access to water, sanitation, and hygiene (WASH), may be in immigration detention or “left behind,” live with disabilities, unaccompanied or separated from their families, and can be hardest to reach with accurate information in a language they understand. Migrant workers and refugees can live in the most disadvantaged urban areas, where access to essential services is already limited. Refugee and migrant children may also be prevented from accessing essential services due to legal, documentation, linguistic or safety barriers. Further, the misinformation on the spread of COVID-19 exacerbates the xenophobia and discrimination that migrant and displaced children and their families already face.
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This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and
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proven interventions in Latin American and Caribbean countries. Four areas of work are identified with the respective guidelines or suggestions for action, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
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This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the
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Americas. The Pan American Health Organization (PAHO) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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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, par
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tly 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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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t
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o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Section 1, Introduction to Men's Reproductive Health Services, Revised Edition, is designed to help sites and health care workers address organizational a
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nd attitudinal barriers that may exist when initiating, providing, or expanding a men's reproductive health services program. It also provides basic information on a variety of reproductive health issues relevant to reproductive health services for men, including sexuality, gender, anatomy and physiology, contraception, and sexually transmitted infections.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data co
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llection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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This Plan envisions a future with the elimination of cervical cancer as a public health problem as a result of universal access to sexual health and STI prevention services, HPV vaccines, effective
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screening and precancer treatment services, treatment of invasive cervical cancer, and palliative care. It foresees that all women and girls, regardless of age, race, ethnicity, socioeconomic status, HIV status, or disability will have timely access to quality cervical cancer prevention, care, and treatment so that they can live in good health throughout the life course and enjoy the health-related human rights.
The goal is to accelerate progress toward the elimination of cervical cancer as a public health problem in the Americas by reducing incidence and mortality rates by one-third by 2030.
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MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the situation in nine countries where MSF runs program
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mes: Central African Republic, Democratic Republic of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
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This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated
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solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment, design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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In the course of implementing a recently funded network of hubs for building capacities in mental health service development, training, and research (RedeAmericas), the peer support workers are being introduced into the mental health workforce in th
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ree Latin American countries for the very first time. They will be part of a team, along with community mental health workers, that provides a modified Critical Time Intervention to individuals with severe psychiatric disorders living in the community. This article reviewed the background of this increasingly widespread development, and discussed its merits, as well as potential obstacles within local contexts.
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The Strategy provides a high-level unifying framework to leverage existing capacities, address barriers and strengthen the use of genomic surveillance in the detection, monitoring and response to pu
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blic health threats. Genomic surveillance is part of the broader surveillance and laboratory system, and its implementation should reinforce end-to-end capacities including sample collection, diagnostics, data sharing and analysis. The strategy aims to facilitate the connectivity between different disease control programs and surveillance networks. This interoperability will strengthen the cross-cutting essential public health laboratory functions underpinning genomics holistically. The strategy articulates the overarching goal, objectives and strategic actions needed. These are dependent on commitments from countries, partners and WHO for their implementation.
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Each humanitarian setting provides distinct opportunities and challenges for actors to coordinate and collaborate at strategic and operational leve
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ls. The Health and Protection Joint Operational Framework has been developed to ensure that the health and protection response during humanitarian emergencies can adapt to each environment and is adequately coordinated to ensure high-quality services to meet the needs of affected individuals and at-risk groups based on their situation or vulnerabilities.
The Health and Protection JOF was conceived in 2019 as a collaboration between the Global Health Cluster (GHC), the Global Protection Cluster (GPC) and its Areas of Responsibility (AoRs), the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG), and the Inter-Agency Working Group for Reproductive Health in Crisis (IAWG), in addition to key technical experts.
A Steering Group (SG) comprised of representatives from each of these entities guided the framework through a joint global analysis of good practices, gaps, and barriers to integrated and inter-sectoral response coordination. This included a mixed methods review of policy and practice, a survey of humanitarian experts, multiple case studies, structured stakeholder interviews, and field visits. This exercise produced a zero-draft which was then reviewed by field practitioners in three operational contexts to clarify and fully coordinate its operationally focused lens. Finally, the JOF was reviewed by the SG including via a series of consultations in early 2023 to consolidate the current framework.
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Trials (2018) 19:271 https://doi.org/10.1186/s13063-018-2604-9
Based on the findings of this trial, we will examine the potential use and scale up of iSupport for caregiver distress in India. This style of online self-help
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programs could be expanded to other regions or countries or to other suitable caregiver groups
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