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1
Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should h
...
ave some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
more
More than 700 000 people lose their life to suicide every year. The world is not on track to reach the 2030 suicide reduction targets. WHO advocates for countries to take action to prevent suicide, ideally through a comprehensive national suicide pr
...
evention strategy. Governments and communities can contribute to suicide prevention by implementing LIVE LIFE – WHO’s approach to starting suicide prevention so that countries can build on it further to develop a comprehensive national suicide prevention strategy. The guide is for all countries, with or without a national suicide prevention strategy; national or local focal points for suicide prevention, mental health, alcohol or NCDs; and community stakeholders with a vested interest or who may already be engaged in implementing suicide prevention activities.
Excecutive Summary available in English, French, Arabic, Chinese, Russian and Spanisch here:
more
Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers a
...
nd salaried, professional or lay health workers with a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
more
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.
The Lancet Published Online
October 8, 2021 https://doi.org/10.1016/ S0140-6736(21)02143-7
Containment strategies: lessons from early COVID-19 responses in five African countries
World Health Organization WHO, Regional Office of Africa; AHOP
WHO Regional Office for Africa
(2021)
C_WHO
The number of COVID-19 cases is on the rise again, with South Africa nearing half of all confirmed cases in the WHO African Region. Threats of new variants loom and low vaccination coverage raises questions on the future of the response to COVID-19. Prevention remains the key strategy in most sub-Sa
...
haran countries. Five National Centres (NCs) from the African Health Observatory Platform on Health Systems and Policies (AHOP), based in Ethiopia, Kenya, Nigeria, Rwanda and Senegal, reflect on lessons to be learnt from their containment responses in the initial phases. They construct timelines to highlight the policies and challenges associated with introducing a range of public health containment measures and
discuss the extent to which these measures continue to be valuable given the ever-changing nature of the pandemic.
more
Due to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the
...
countries of the Amazon agreed that the development and strengthening of preventive actions based on comprehensive surveillance and detection of effective vectorial transmission, based on mandatory notification of acute or chronic cases, was required. In addition, it was recommended that surveillance and prevention and/or vector control actioDue to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the countries of the Amazon agreed that the development and strengthening of preventive actions based on comprehensive surveillance and detection of effective vectorial transmission, based on mandatory notification of acute or chronic cases, was required.
more
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical socie
...
ties and contacted international organizations.
Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
more
This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low- and middle-income countries, the report conclud
...
es that 38% lack access to even rudimentary levels of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
more
An Economist Intelligence Unit briefing paper | The Economist Intelligence Unit (EIU) undertook a study aimed at assessing the degree of commitment of 15 countries within the AsiaPacific region to integrating those with mental illness into their co
...
mmunities. The research was commissioned and funded by Janssen Asia Pacific, a division of Johnson & Johnson Pte. Ltd. This report focuses on the results of this benchmarking study, called the Asia-Pacific Mental Health Integration Index. Drawing on lessons from the EIU’s 2014 European Mental Health Integration Index, this edition index compares the level of effort in each of the countries on indicators associated with integrating individuals suffering from mental illness into society. Data for the Index was collected between March and May 2016. The set of 18 indicators were grouped into four categories.
more
PlosOne January 20, 2021
https://doi.org/10.1371/journal.pone.0241899
Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antim
...
icrobial resistance (AMR) and toxicity.
more
Lancet Planet Health 2022;6: e760–68
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden. But emerging pandemic threats are just one dimension of the complex relationship between agriculture
...
and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. This changing relationship is examined through four current disease issues.
more
The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatmen
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t of CVDs on national essential medicines lists (NEMLs) of LMICs and potential determinants for selection.
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to
...
prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
This document contains a series of desk reviews for the eight ENGAGE-TB priority countries supported by the Global Fund (DRC, Kenya, Indonesia, Mozambique, Myanmar, Nigeria, Pakistan and Tanzania). The document provides a situation assessment and ga
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p analysis about the state of community based TB activities in these countries. The focus on these eight countries was justified by the high prevalence of TB and the very high number of missed/unreported cases.
more
Research Article
PLOS ONE | https://doi.org/10.1371/journal.pone.0189770 January 2, 2018
This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ
...
e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
more
J of Pharm Policy and Pract 14, 27 (2021). https://doi.org/10.1186/s40545-021-00309-8
