For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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This report, which involved input from across WaterAid, in particular from the Programme Support Unit (PSU) of WaterAid UK, includes case studies from a variety of countries, including Bangladesh, Burkina Faso, Eswatini, Ethiopia, Ghana, India and Nepal, each demonstrating what must be done now to i...mprove WASH services and address current challenges, in order to increase community resilience to climate change.
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EQUIP: Ensuring Quality in Psychological Support is a joint WHO/UNICEF project to improve the competence of helpers and the consistency and quality of training and service delivery. The EQUIP platform makes freely available competency assessment tools and e-learning courses to support governments, t...raining institutions, and non-governmental organizations, both in humanitarian and development settings, to train and supervise the workforce to deliver effective psychological support to adults and children.
EQUIP enhances training and supervision for improved mental health and psychosocial support services.
EQUIP used a consensus-building approach including key stakeholders to develop the evidence-informed competency-based training materials and guidance, as well as the competency assessment tools. These resources have been tested in Ethiopia, Jordan, Kenya, Lebanon, Nepal, Peru, Uganda and Zambia, with results demonstrating training improvements in groups that used the EQUIP platform. For example, use of EQUIP in Lebanon with children and adolescents led to an increase in mastery of core helping skills compared to standard training approaches.
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MEDBOX Issue Brief 26. Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the
bacterium Vibrio cholerae. Cholera remains a global threat to public health and is an indicator of inequity and lack of
social development. Researchers have esti...mated that every year, there are 1.3 to 4.0 million cases of cholera, and 21
000 to 143 000 deaths worldwide due to the infection.
However, cholera remains a neglected and underreported disease. Many cases are not recorded due to limitations in
surveillance systems and fears of potential impact on trade or tourism.
Today cholera affects 47 countries across the globe. Almost every developing country faces cholera outbreaks or
the threat of cholera. Major ongoing outbreaks are being reported from Afghanistan, Bangladesh, Democratic
Republic of Congo, Ethiopia and Nigeria. Major outbreaks are currently in Syria and Haiti.
Therefore, MEDBOX decided to produce issue briefs on cholera and available resources in Arabic, English and
French.
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Currently, Mauritius and Seychelles have 85 and 82 percent vaccination rates, respectively, surpassing the 70 percent target set by the WHO in 2021. Countries that have attained vaccination rates of between 50 and 70 percent include Liberia
at 67 percent, Rwanda at 66 percent, Morocco at 62 percent..., and Tunisia at 53 percent. Meanwhile, about 25.3 percent of the continent's population is fully vaccinated.
Africa has registered over 12 million COVID-19 cases since the beginning of the pandemic. The following countries have recorded the highest number of cases: Egypt, Ethiopia, Libya, Morocco, South Africa, and Tunisia
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WHO needs US$2.54 billion to provide life-saving assistance to millions of people around the world facing health emergencies. WHO’s Health Emergency Appeal is a consolidation of WHO’s priorities and financial requirements for 2023 to carry out health interventions in emergency and humanitarian r...esponses. The number of people in need of humanitarian relief has increased by almost a quarter compared to 2022, to a record 339 million. WHO is responding to an unprecedented number of intersecting health emergencies: climate change-related disasters such as flooding in Pakistan and food insecurity across the Sahel in the greater Horn of Africa; the war in Ukraine; and the health impact of conflict in Yemen, Afghanistan, Syria and north eastern Ethiopia – all of these emergencies overlapping with the health system disruptions caused by the COVID-19 pandemic and outbreaks of measles, cholera, and other killers. Contributions to the appeal can be fully flexible, flexible across a region, or flexible within a country appeal.
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Anopheles stephensi, a highly competent vector of Plasmodium falciparum and P. vivax, is considered an efficient vector of urban malaria. Until 2011, the reported distribution of An. stephensi was confined to certain countries of South Asia and parts of the Arabian Peninsula. Since then, the vector ...has been collected in Djibouti (2012), Ethiopia (2016), Sudan (2016), Sri Lanka (2017), Somalia (2019), and most recently Nigeria (2020) and Yemen (2021). WHO considers the spread of An. stephensi to be a major potential threat to malaria control and elimination in Africa and southern Asia and has recently launched an initiative against the spread of this vector in Africa.
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Dracunculiasis, also known as Guinea-worm disease is a parasitic disease caused by the nematode Dracunculus medinensis. The infection is transmitted to humans by drinking water contaminated with the small crustacean copepods (Cyclops) which contain the larvae of D. medinensis. Humans are the princip...al definitive host and Cyclops being the intermediate host. The disease is endemic to the rural and poorer areas of the world and is most common in African countries like Chad, South Sudan, Ethiopia, and Mali. Efforts are underway towards global eradication of this disease. Due to its rarity in developed countries, this activity describes the interprofessional team's role in the assessment and treatment of patients with this condition.
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In East Africa, the trend in cross-border FGM puts at risk the progress achieved in eliminating the practice. The only way we can reach zero FGM by 2030 is by concerted and immediate action to address all aspects of FGM.
This policy brief highlights the cross-border dimension of FGM (Ethiopia, Keny...a, Somalia, Tanzania and Uganda) in the East Africa region. The brief describes the factors that perpetuate cross-border FGM and the work that is being done to reduce the rates.
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This webinar provides an overview of the new IEC & Social Mobilization NTD Tool Kit, which leads users through a step-by-step process to systematically review, revise, develop and adapt current IEC materials and social mobilization approaches towards stronger, evidence-based practices in support of ...positive behavior change for MDA programs in the control of NTDs. Experiences from Ethiopia and Uganda are shared.
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The cholera outbreak has affected 14 countries in the WHO African Region. The climate-induced natural disasters such as cyclone and flooding in the southern African region and drought in the Horn of Africa led to increase in cases of cholera in many of the affected countries. With the rainy season c...ommencement in the west African region there is risk of more cholera outbreaks on the horizon. The trend across the region is being closely monitored and this highlights the need for Member States to enhance readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border infection. Since 1 January 2022, a cumulative number of 213 443 cholera cases has been reported to the WHO Regional Office for Africa (AFRO), including 3 951 deaths with a case fatality ratio (CFR) of 1.9% as of 16 July 2023 (Table 1). Malawi accounts for 28% (58 941) of the total cases and 45% (1 766) of all deaths reported, and together with Cameroon, Democratic Republic of the Congo, Mozambique, and Nigeria contribute to 85% (181 300) of the overall caseload and 88% (3 464) of cumulative deaths. In Epidemiologic week 28, six countries Burundi, Cameroon, Ethiopia, Kenya, Malawi and Mozambique reported a total of 667 new cases.
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During Epidemiological week (Epiweek) 5, 20 countries in the WHO African region (WHO AFR) contributed virological data for analysis - Algeria, Burkina Faso, Cameroon, Central African Republic, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, Mali, Mauritania, Mozambiq...ue, Niger, Nigeria, Rwanda, South Africa, South Sudan, Togo, Uganda, and Zambia
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Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence,
mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethio...pia using the American Thoracic Society/European Respiratory Society case definition of severe asthma.
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Background
Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017.
Methods
Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators.
Findings
After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million).
Interpretation
Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention.
Funding
Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health.
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The Ethiopian Food and Drug Administration (EFDA) is mandated, in the proclamation 661/2009, to ensure the safety, quality and efficacy of medicines. To achieve this, the authority has been working on different regulatory activities. The medicine market authorization system is one of the top priorit...y areas that have been implemented. In addition to the dedicated assessors, the authority uses a national drug advisory committee for the assessment and registration of medicines.
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Ein Lehr- & Lernheft für den Einstieg ins Deutsche mit Alltagsbezug entwickelt. Es gibt sieben Versionen zum Herunterladen (mit Dank an diverse Flüchtlinge und das Netzwerk Asyl Wiesloch für Hilfe bei Übersetzung. Gerne können die Hefte nicht-kommerziell und mit Qüllenangabe weiterverbreitet w...erden, vorzugsweise mit den Links von oben. Bestellen können Sie im Prinzip die Hefte mit Englisch und Arabisch.
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DHS Working Papers No. 103