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Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns
...
of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
more
The World Food Programme (WFP) has taken important steps to progress disability inclusion across its programming and operations. In late 2022, WFP commissioned the Nossal Institute, University of Melbourne in partnership with the Faculty of Psychology, Universitas Gadjah Mada, Indonesia to identify
...
pathways for increasing disability inclusion in WFP’s emergency preparedness and response (EPR) programming.
The study explored WFP’s programming in Indonesia and the Philippines, including WFP’s advisory, technical assistance and service provision roles to government and partners and informed the development of this guide (see appendix 2). As general guidance on disability inclusion is increasingly available, the purpose of this guide is to contextualize disability inclusion in WFP’s emergency preparedness and response programming. The guide builds on core reference materials, such as the Inter-Agency Standing Committee (IASC) Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, 2019. While of wider relevance, this guide is directed at WFP’s EPR programming in Asia and the Pacific.
more
Since 2016, the Pan American Health Organization (PAHO) has been promoting the implementation of the HEARTS Initiative in the Americas as a regional adaptation of the World Health Organization's Global HEARTS Initiative. During this time, 33 countries in the Region of the Americas have committed to
...
implementing HEARTS, and PAHO has developed many technical resources to support them. Most of these resources are clinical tools for primary healthcare teams and focus on quality improvement. This compendium aims to group all these clinical tools in a single document under a simple format that facilitates their practical implementation in daily clinical practice. The reader will notice that each tool is summarized on a single page and presented in a modular format. Therefore, each tool can be used together or separately as needed. In addition, at the bottom of each tool, the reader will find the references and hyperlinks to access full texts in case deeper knowledge is required.
more
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan
...
ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
more
The document "Diabetes and Ramadan: Practical Guidelines 2021," published by Elsevier, provides updated guidance for managing diabetes during Ramadan fasting. Developed by the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance, the guidelines address ke
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y aspects for individuals with diabetes who choose to fast, including risk assessment, blood glucose monitoring, insulin and medication adjustments, and the management of special populations (such as pregnant women, the elderly, and those with chronic conditions). Emphasis is placed on individualized patient education before Ramadan to ensure safe fasting practices and minimize risks like hypoglycemia and hyperglycemia.
more
The far-reaching impacts of the COVID-19 pandemic underscore the critical need for evidence-informed, transparent and inclusive decision-making. Policy-makers have grappled with complex choices amidst uncertainty. They have constantly reassessed response measures while navigating their economic impl
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ications and unintended consequences on societal well-being. Effective communication of the basis for these decisions has also posed a challenge, requiring transparency and public trust.
more
The risk communication and community engagement (RCCE) competency framework is a resource that details the essential behaviours and activities necessary for effective communication and engagement with communities before, during and after public health emergencies. The purpose of this framework is to
...
establish and promote a common understanding of behavioural competencies and how they should be applied for high-performing and community-centred health emergency programmes. It is intended to support the development of standardized training programmes, professional development and talent acquisition and to enhance the capabilities of public health professionals involved in RCCE. Its goal is to inform the establishment of a skilled, well-trained RCCE workforce that consistently understands and executes the necessary behaviours and activities required to conduct RCCE activities with competence and professionalism.
more
The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the
provision of basic health services in rural and urban communities with the participation of people who live there.
Historically, Community Health has significantly contributed to im
...
provements in Malawi’s health outcomes in particular
attainment of MDG4. However, the community health system faces resource constraints and inconsistencies around quality
of service – which negatively affect health outcomes.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta
...
in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
CC
Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Met
...
hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
more
This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit
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ies, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
more
This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N
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CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
more
The Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 by the World Health Organization (WHO) outlines a comprehensive strategy to address the global rise in noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, chronic respiratory diseases,
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and diabetes.
more
Communicable and non-communicable diseases in Africa in 2021/22
World Health Organization Africa Region; WHO Africa
World Health Organization Africa Region; WHO Africa
(2023)
C_WHO
This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease burden and control in the WHO African region. It tra
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cks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
more
Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-to-human transmission of the disease, and reducing spillover of the virus from ani
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mals to humans.
Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks.
There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks.
A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world.
Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years.
The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission.
more
WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situation in a country, including the state of the health s
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ector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
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World Health Organization. (2022). Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 4: developing an implementation plan.
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 the multisectoral action plan.
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 the context of the area to which the plan will apply. This will help countries, regions, provinces or cities intendi
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ng 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.
more
The document is a policy brief by the NCD Alliance for the 2023 United Nations High-Level Meeting on Universal Health Coverage (UHC). It highlights the importance of integrating non-communicable diseases (NCDs) into UHC efforts, with the goal of ensuring equitable health access worldwide.
