WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de
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aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes im
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plementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
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In In recent years, China has increased its international engagement in health. Nonetheless, the lack
of data on contributions has limited efforts to examine contributions from China. Existing estimates that track
development assistance for health (DAH) from China have relied primarily on one data
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set. Furthermore, little is known
about the disbursing agencies especially the multilaterals through which contributions are disbursed and how these
are changing across time. In this study, we generated estimates of DAH from China from 2007 through 2017 and
disaggregated those estimates by disbursing agency and health focus area.
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Development assistance for health (DAH) is an important part of financing healthcare in low- and middle-income countries. We estimated the gross disbursement of DAH of the 29 Development Assistance Committee (DAC) member countries of the Organisation for Economic Co-operation and Development (OECD)
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for 2011–2019; and clarified its flows, including aid type,
channel, target region, and target health focus area. Data from the OECD iLibrary were used. The DAH definition was based on the OECD sector classification. For core funding to non-healthspecific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for
calculating imputed multilateral official development assistance (ODA).
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This paper is motivated by the global spread of the coronavirus referred to as COVID-19 and its efect on Sub-Saharan African (SSA) economies. The International Monetary Fund (IMF) has alluded to the COVID-19 not only afecting the global health but also trade and tourism, commodity prices, and fnanci
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al conditions that calls for an additional policy response to support demand and ensure an adequate supply of credit
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African countries, like many regions of the world, are affected by the legacy of atrocity crimes. Genocide, the transatlantic slave trade and slavery, colonialism and post-independence violence committed during dictatorships, not to mention civil war and violent extremism, have severely violated hum
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an rights and left devastating marks on societies across the continent. The way in which societies deal with violent pasts has profound implications for the present and the future, as well as their chances of building sustainable peace.
Strengthening education about atrocity crimes, including genocide, crimes against humanity and war crimes, is an essential part of addressing violent pasts and preventing future atrocity crimes. Echoing a series of United Nations resolutions on the importance of educational measures for genocide prevention,1 in 2013, the Secretary-General’s annual report Responsibility to protect: State responsibility and prevention included the recommendation: “Education curriculums should include instruction on past violations and on the causes, dynamics and consequences of atrocity crimes” as an important means to promote societal resilience to atrocity crimes.
This recognition is in line with the Education 2030 Agenda and, more specifically, target 4.7 of Sustainable Development Goal (SDG) 4 on Education. This target calls on countries to promote education that fosters sustainable development, human rights, gender equality, a culture of peace, global citizenship and an appreciation of cultural diversity.
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The International Rescue Committee (IRC) is a leading humanitarian agency dedicated to helping people whose lives have been shattered by conflict and disaster to survive, recover, and gain control of their future. Health comprises nearly half of IRC’s program portfolio globally and encompasses thr
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ee sectors: 1) Primary Health (including child health, sexual and reproductive health and rights, and mental health); 2) Nutrition; and 3) Environmental Health. IRC health programming across its portfolio, in terms of the size and breadth, responds to significant needs in crisis affected settings, improving health and wellbeing while reducing causes of ill-health.
This five-year Health Strategy sharpens our focus on where we can have the most impact. It guides our efforts in planning, technical assistance, business development, advocacy, and internal and external collaboration. Through this strategy, we will invest and grow in areas that will help us achieve high impact at scale for our clients. For the next five years these priorities will include: Nutrition; Immunization: Infectious Disease Prevention and Control; Last Mile Delivery of Primary Health Care: Clean Water.
Our strategy aligns with Strategy 100 (S100) and Strategy Action Plans (SAPs). It lays out how IRC, through health, nutrition, and Environmental Health (EH) programming, will advance the IRC’s S100 ambitions, respond to global trends, and capitalize on our value add. The strategy will be complemented by delivery plans that detail investments, actions, and roles and responsibilities to advance our priorities. At the end of FY24, we will take stock of the implementation of the strategy, measure progress towards achieving our goals, and review if it continues to be fit for purpose.
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Prompt, effective antimalarial treatment, and supportive care can substantially reduce the rate of mortality from severe malaria. However, many children in malaria-endemic countries do not have access to health facilities or a qualified health care provider and do not receive the necessary care in a
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timely fashion. Without rapid detection of danger signs and access to effective treatment, including pre-referral treatment that can be administered in the community level, many of these children with severe malaria die.
In situations where there is no immediate access to a health care facility, WHO recommends the administration of a standard dose of an effective antimalarial medicine as pre-referral treatment before referral to a facility at which complete treatment can be administered.
Rectal artesunate is the WHO-recommended pre-referral intervention in situations where artesunate injection are not feasible for children under the age of 6 years with suspected severe malaria. The intervention reduces the risk of death or permanent disability by up to 50% provided the child is referred to a health facility at which complete treatment can be administered.
This field guide is aimed at supporting the effective deployment of RAS as pre-referral treatment of suspected severe malaria in line with the WHO malaria guidelines.
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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be
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come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy
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2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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This checklist is an operational tool to help national authorities develop or revise national respiratory pathogen (inclusive of influenza and coronaviruses) pandemic preparedness plans.
This document lays out economic arguments for investing in the Access to COVID-19 Tools Accelerator (ACT-Accelerator). Framed within an overall context that recognizes the broader human health and societal impacts of the COVID-19 crisis, ACT-Accelerator's Economic Investment Case argues that investm
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ent in ACT-Accelerator is the world’s best bet and most viable solution for restarting the global economy. It is intended for governments, multilaterals, civil society, businesses and foundations and all those interested in the work required to change the course of the pandemic. The global deployment of ACT-Accelerator’s comprehensive package of tools will reduce the severity of COVID-19 disease, enabling countries to transition out of the crisis thereby restarting domestic and international economic engines driving our global economy.
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Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t
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he design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
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patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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This article analyzes the impact of the COVID-19 pandemic on foreign aid. Using examples from Canadian foreign aid, it argues that, despite the terrible toll it is exacting, the crisis has accelerated some significant positive pre-existing trends, both by destabilizing the perception of aid as flowi
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ng essentially from the Global North to Global South and by reinforcing awareness of the importance of joint efforts for global public goods and humanitarian assistance, as well as debt relief. However, it has also reinforced potentially harmful self-interested justifications for aid, which could align assistance more with donors’ priorities than the needs of the poor
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The guide to implementing the One Health Joint Plan of Action (OH JPA) at national level provides practical guidance on how countries can adopt and adapt the OH JPA to strengthen and support national One Health action.
Building on the OH JPA theory of change, this guide describes three pathways a
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nd five key steps to implement the OH JPA at national level:
Pathway 1 -- Governance, policy, legislation, financing and advocacy
Pathway 2 -- Organizational and institutional development, implementation and sectoral integration
Pathway 3 -- Data, evidence, information systems and knowledge exchange.
The stepwise approach comprises:
Situation analysis including stakeholder mapping and review of existing assessment results
Set-up/strengthening of a multisectoral, One Health coordination mechanism
Planning for implementation, including activity prioritization and leveraging of resources
Implementation of national One Health action plans
Review, sharing and incorporation of lessons learned.
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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 multisector
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al 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.
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The Global Appeal provides updated information for government, private donors, partners and other readers interested in UNHCR's priorities and budgeted activities for 2021 to protect and improve the lives of tens of millions of people of concern (refugees, internally displaced people, stateless pers
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ons and others)
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As the Group of Eight (G8) world leaders meet in Saint Petersburg, Russia for this year’s G8 Summit, it is important to take stock of international efforts to finance the response to the global HIV/AIDS epidemic. Financing a sufficient and sustained response to the epidemic has emerged as one of t
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he world’s greatest challenges, and one that will be with us for the foreseeable future. Often, those countries most affected are also least able to respond, increasing their vulnerability to HIV/AIDS and in turn further complicating their ability to address the epidemic, as is the case for many nations in sub-Saharan Africa. In addition, concerns have been raised about “second wave” nations, particularly China, India, and Russia, which stand on the brink of generalized epidemics if more is not done now
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Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu
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ral practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
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