Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and
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Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile populations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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National Tuberculosis Programme
The National Strategic Plan (NSP) for Tuberculosis (TB) 2016-2020 builds on the past experiences
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for the National Tuberculosis Programme and its partners. This NSP provides a roadmap for delivering quality TB prevention and care service to the entire population, as an integral part of the country's move toward Universal Health Coverage. Between 1990 and 2015, Myanmar reduced the prevalence of TB by 50%, meeting the targets set by the Millennium Development Goals. Going forward, the country aims to further accelerate the rate decline.
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Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will
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be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the country’s commitment expressed in the national constitution, National Strategy for Transformation (NST) and the aspirations of the Health Sector Policy 2015. The strategies herein adhere to the Universal Health Coverage (UHC) principles towards realisation of the Sustainable Development Goals (SDGs). HSSP4 therefore lays a foundation for Vision 2050 (“The Rwanda We Want”), which will transform Rwanda into a high-income country by 2050. HSSP4 anticipates the epidemiological transition of the country, the increase in population and life expectancy and the expected increase of the health needs of the elderly, notably in Non Communicable Diseases (NCDs). HSSP4 also anticipates a decrease in external financial inflows, hence it is imperative to build secure / resilient health systems.
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The consolidated guidelines are expected to provide the basis and rationale for the development of nati
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onal guidelines for LTBI management, adapted to the national and local epidemiology of TB, the availability of resources, the health infrastructure and other national and local determinants. The guidelines are to be used primarily in national TB and HIV control programmes, or their equivalents in ministries of health, and for other policy-makers working on TB and HIV and infectious diseases. They are also appropriate for officials in other line ministries with work in the areas of health.
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Monitoring of implementation of collaborative TB/HIV activities and evaluation of impact is critically important. This requires efficient monitoring and evaluation system so as to establish accounta
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bility mechanisms between programmes, the population they serve, and donors. The Guide to monitoring and evaluation for collaborative TB/HIV activities will facilitate this process. The first version of the guide was developed in 2004 placing collaborative TB/HIV activities as integral part of national TB/HIV response. It was revised in 2009 to harmonize the approaches and indicators for monitoring and evaluation across key stakeholders. The current revision builds upon remarkable progress in implementation of collaborative TB/HIV activities and aims to strengthen the implementation further through improved quality of data.
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Ethiopia met the MDG target for drinking water access with a unique and high degree of success. The magnitude of the country’s success in providing improved drinking water to nearly half of its
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population in 25 years despite its diversity, size, and challenges cannot be overstated. This case study documents the progress of the Ethiopian WASH sector from 1990 to 2015, and analyzes the impact of local systems created in Ethiopia to respond to water and sanitation challenges.
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The primary audience for the guideline is health programme managers, including governmental and non-governmental organizations, and policy makers w
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ho are responsible for designing maternal, newborn and child health programmes, primarily in low-income settings. The guideline is also aimed at health providers and teaching institutions, to increase knowledge of interventions. Development programmes and organizations supporting women’s empowerment and rights will also find this guideline of use.
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The magnitude of urban disasters, high population densities, and a complex social, political and institutional environment has challenged the manne
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r in which humanitarian agencies are used to working. Humanitarian agencies are now grappling with how to change their approaches to this reality. This desk review aims to provide an audit and analysis of existing needs assessments, response analysis frameworks and targeting approaches for use in urban post-conflict emergency response.
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Cambodia drafted and adopted the National Action Plan for Disaster Risk Reduction 2014-2018 in 2014. This plan finalized the required policies
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and legal processes to strengthen DRM in Cambodia. It also focused on capacity building at national and sub-national levels and provided dedicated resources for strengthening the NCDM and the Sub-National Committees for Disaster Management. Cambodia’s legislature then passed the Law on Disaster Management in June 2015. This legal framework for disaster management assigns legally binding roles and responsibilities, establishes institutions, and assists with the allocation of resources and coordination. NCDM is Cambodia’s lead government agency for emergency preparedness and relief. The NCDM provides the overall leadership of the Plan of Action for Disaster Risk Reduction (DRR) coordination in Cambodia. Cambodia has adopted the Cambodia Red Cross (CRC) as the primary partner for relief operations.
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The MHPSS MSP is an easy-to-follow intersectoral package, which spells out the activities and actions that all humanitarian actors should put in place in all emergencies for an effective MHPSS respo
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nse. It speaks to different actors at the global, regional, national, and local levels to plan, coordinate and implement an effective MHPSS response.
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The National Strategy for Natural Disaster, Prevention, Response and Mitigation to 2020, which outlines Vietnam’s main disaster risk management o
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bjectives and the National Target Program (NTP) form the overarching policy framework for disaster risk management and climate change adaption activities. The CCFSC’s main mandate is to translate this strategy into action. Other decrees and laws are also complementary. The Government of Vietnam has prioritized disaster preparedness, recognizing that the most cost-effective measures to mitigate flood related disasters are often non-structural. These measures include flood mapping, river flood warning systems, television-based disaster information and warning systems, training at all government and grassroots levels on disaster preparedness, and reforestation of certain areas. Land use and development have also been addressed through government regulations.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control
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in these communities, it is necessary to respond to communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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This global guidance provided the framework for over 100 countries to develop their NDVPs. This updated (second) version supersedes the previous version published in 16 November 2020. New information has been added on the following areas:
th
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e COVID-19 Partners Platform;
the use of COVID-19 simulation exercises to test deployment strategies;
the indemnity agreement and no-fault compensation programme for vaccines secured through the COVAX Facility in the Advance Market Commitment (AMC) eligible economies;
the availability and use of the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool;
the COVAX Facility’s humanitarian buffer that enables allocation of vaccine to cover high-risk populations in humanitarian settings;
recommendations for vaccination of pregnant and lactating women;
supplementary information on infection prevention and control (IPC) measures to be used to deliver COVID-19 vaccines safely;
the WHO licensed COVID-19 vaccines product-specific information;
use of geospatial data and digital micro plans for equitable access and delivery of COVID-19 vaccines;
lessons learned from the development of NDVPs and early experiences in COVID-19 vaccine deployment in countries; and
updated additional resources at the end of each chapter.
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Nationally, Senegal met the MDG target for water supply access. It did this by engaging the public and private sectors to effectively invest and re
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port on investments. It focused on larger population centers, less on remote regions of the country. Its achievements set the stage for more equitable and widespread service provision as the country now works to achieve the SDGs, requiring sustainable management of universal access. This case study documents the progression of the sector between 1990 and 2015, and analyzes the impact of local systems created in Senegal to respond to the water and sanitation challenge.
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The building damage assessment, conducted between March 2010 and February 2011 by the Government of Haiti and the United Nations system, showed that more than 400,000 buildings were damaged or destr
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oyed, of which approximately 218,000 could be occupied without repairs (green category), 105,000 were damaged but could be repaired (yellow category), and 80,000 were severely damaged and remained uninhabitable (red category).
The destruction of buildings and infrastructure generated a huge amount of debris, estimated at 10 million cubic meters, blocking streets and land in affected areas. In the absence of a national debris management strategy, debris could, thus, be cleared and disposed of in an uncontrolled manner, hindering relief, recovery and reconstruction activities.
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Democratic dispensation in 1994 created a political and social platform that reshaped life in South Africa. There was a surge in common belief that the inequity and wrong of Apartheid should
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and could be rectified. Equity of access to water and sanitation were obvious targets for improvement. In 1994, an estimated 14–15 million South Africans were without access to an improved water supply, while close to 21 million - more than half of the population at that time - did not have access to improved sanitation facilities. These problems were most severe in poorer rural areas. The water and sanitation sector became unified by the vision of universal access for all South Africans. This case study documents the progression of the sector between 1994 and 2016, and analyzes the impact of local systems created in South Africa to respond to the water and sanitation challenge.
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Submitted to the US Agency for International Development by the Systems for Improved Access to
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Pharmaceuticals and Services (SIAPS) Program.
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Myanmar, as a country going through rapid socio-political transition and institutional development also suffers with a high burden of infectious disease. An ongoing challenge has been to effectively
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reach its 51 million population, most of whom battle tuberculosis, acute respiratory infections, diarrhoea and malaria including amongst under-five children.
Limited research data on the occurrence of resistant organisms in the nation have, makes it hard to estimate the exact antimicrobial resistance (AMR) scenario. Limited peer reviewed evidence indicates significant divergence from the average resistance trends in APAC region. Nevertheless, several key steps by Government of Myanmar have been instrumental in paving the way for the country to join other nations in the South East Asia Region to speed up its plan on addressing the AMR crisis. Combating antimicrobial resistance would, however, require highest political commitment, multi-sectoral coordination, sustained investment and technical assistance.
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