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This document presents an evidence-informed Checklist for implementing rural pathways to train and support the rural
health workforce in low and middle income countries (LMIC). Rural areas are the most underserviced around the world.
A report demonstrating the urgent need to support groups at the local level if COVID-19 misinformation and mistrust is to be tackled effectively.
7 April 2022. Aimed at national policymakers, public health and healthcare planners, staff working in reception centres, and healthcare staff caring for displaced persons, the information note concludes that universal testing of incoming refugees from Ukraine for tuberculosis (TB) infection is not r
...
ecommended. Specific groups, such as household contacts of bacteriologically confirmed pulmonary cases, or those who are immunocompromised should however be considered for TB infection testing.
Available in Czech, Hungarian, Polish, Romanian, Slovakian, Ukranian
more
It explains the importance of faecal sludge management in urban areas in which many people rely on on-site and decentralized sanitation facilities and emphasizes the place of treatment in the overall sanitation service chain. It defines terms used throughout the book, explains why faecal sludge and
...
septage treatment is important, and identifies broad treatment objectives.
more
Surveillance, prevention and control of leishmaniases in the European Union and its neighbouring countries
European Centre for disease prevention and control (ECDC)
European Centre for disease prevention and control (ECDC)
(2022)
C_CDC
This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countr
...
ies of southern Europe, northern Africa, and the Middle East and that there is a need to improve leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
more
Rabies is a neglected zoonotic disease with a global burden of approximately 59,000 human deaths a year. Once clinical symptoms appear, rabies is almost invariably fatal; however, with timely and appropriate post-exposure prophylaxis (PEP) consisting of wound washing, vaccine, and in some cases rabi
...
es immunoglobulin (RIG), the disease is almost entirely preventable. Access to PEP is limited in many countries, and when available, is often very expensive.
more
Those who clean are the first line of defense against health care-associated infections (HAIs), and support efforts to reduce antimicrobial resistance (AMR).
Strengthening the training of this important group can contribute to resolving many of today’s public health challenges. This is importan
...
t given that cleaning both surfaces and hands is vital to control the transmission of a number of HAIs.
This two-part training package targets those who clean heath care facilities.
The Trainer’s Guide takes the user through how to prepare, deliver and sustain an effective training for those who clean. The Modules and Resources provides instructions, definitions, photographs, posters and specific illustrations of recommended practices
The package can be used by those who deliver environmental cleaning training programmes and/or those with a background in IPC including ministries of health, nongovernmental organizations, academic institutions, experts working in Quality of care, IPC and environmental cleaning/ Water, sanitation and Hygiene (WASH) and Health facility IPC focal points and onsite cleaning supervisors
more
Childhood immunisation is one of the most cost-effective health interventions. However, despite its known value, global access to vaccines remains far from complete. Although supply-side constraints lead to inadequate vaccine coverage in many health systems, there is no comprehensive analysis of the
...
funding for immunisation. We aimed to fill this gap by generating estimates of funding for immunisation disaggregated by the source of funding and the type of activities in order to highlight the funding landscape for immunisation and inform policy making.
more
Estimates of government spending and development assistance for tuberculosis exist, but less is known
about out-of-pocket and prepaid private spending. We aimed to provide comprehensive estimates of total spending on
tuberculosis in low-income and middle-income
...
countries for 2000–17.
more
Background: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards
...
UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country’s UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios.
more
Background: Primary health care (PHC) is a driving force for advancing towards universal health coverage (UHC). PHC-oriented health systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments and project the associated resource
...
needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs.
more
This report analyses the intersection of HIV, COVID-19 and public debt in developing countries. The collision between COVID-19 and a crippling debt crisis have reversed decades of progress - putting present and future investments in health and HIV a
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t risk. Pragmatic options to address the pandemic triad are proposed.
more
Introduction
In 2017, development assistance for health (DAH) comprised 5.3% of total health spending in lowincome countries. Despite the key role DAH plays in global health-spending, little is known about the characteristics of assistance that ma
...
y be associated with committed assistance that is actually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.
Methods
We extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.
Results
Factors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).
Conclusion
Substantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.
more
Background
In the prevention of cardiovascular disease, a WHO target is that at least 50% of eligible people use statins. Robust evidence is needed to monitor progress towards this target in low-income and middle-income countries (LMICs), where mos
...
t cardiovascular disease deaths occur. The objectives of this study were to benchmark statin use in LMICs and to investigate country-level and individual-level characteristics associated with statin use.
more
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.
more
The report provides an overview of alcohol consumption, related health harm, and policy responses in 30 European countries (EU Member States, Norway, and Switzerland). It highlights the high levels of alcohol consumption in the WHO European Region,
...
which contribute to a significant disease burden compared to other regions. The report covers trends in alcohol consumption and harm between 2010 and 2016, noting some progress in reducing alcohol-attributable mortality but stagnation in consumption reduction and heavy episodic drinking.
The assessment of alcohol policies shows variability in implementation across countries, particularly in areas like pricing and reducing the negative consequences of drinking. It emphasizes the need for stronger evidence-based policies, such as better regulation, taxation, and accessibility restrictions, to further reduce alcohol-related harm and achieve health-related Sustainable Development Goals.
more
With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across coun
...
tries by development level. Using internationally comparable data on disability inequalities in 40 countries, we assess disability inequalities through the use of regression analyses with a variety of development measures. Results support the hypothesis only partially: disability inequalities related to education, employment, and multidimensional poverty are found to be significantly larger in countries at higher levels of development. However, this is not the case for rates of access to water, sanitation, clean fuel, electricity, housing, and assets. These results, overall, hold when using different development and
outcome indicators, and when focusing on specific subgroups of the population. The potential implications of these findings are discussed. Further research is needed to understand, for education and employment, the factors and processes that contribute to larger disability inequalities in countries at higher levels of development and what strategies might be pursued to reduce them.
more
Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity
and mortality in low-income and middle-income countries (LMICs). Access to safe, effective, quality-assured, and
affordable essential medi
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cines is variable. We aimed to review the existing literature relating to the availability, cost,
and affordability of WHO’s essential medicines for asthma and COPD in LMICs.
more
Health-care waste management is a critical aspect of health-care systems, crucial for public health and environmental sustainability. This report provides valuable insights into the existing health-care waste management frameworks across 16 countries
...
in the Western Pacific Region. It provides an overview of essential components of the legal framework and best practices, including adoption of environmental friendly technologies in policies and highlights both strengths and areas in need of improvement. The report provides recommendations to enhance the effectiveness and sustainability of future health-care waste management policies in the Region.
more
