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Myanmar continues to present a complex and dynamic operating context where ongoing socio-economic and political challenges, including conflict, displacement, widespread poverty and food insecurity, hinder development efforts. An estimated 24.8 perce
...
nt of its 54 million population live near or below the poverty line. Many struggle with inadequate physical, social and economic access to sufficient, safe and nutritious food, with women, girls, persons with disabilities and minorities affected most.
more
Burkina Faso remains one of the poorest countries in the world, with 44.5% of the population living below the poverty line. To promote the rights of persons with disabilities, the country has adopted almost all of the relevant initiatives and intern
...
ational legal texts on the rights of persons with disabilities including the Convention on the Rights of Persons with Disabilities (CRPD) that was ratified in 2009. The country has also adopted a National Strategy for the Protection and Promotion of Persons with Disabilities (SN-3PH, 2012), based on, amongst other approaches, Community Based Rehabilitation (CBR), promoted by the WHO and LIGHT FOR THE WORLD. Following on from the 2011-2015 country strategy that enabled LIGHT FOR THE WORLD to contribute strongly to the national dialogue on disability, the present strategy 2016-2020 aims to strengthen our achievements in order to work towards an inclusive society in which persons with disabilities fully enjoy their rights.
more
Based on Human Rights Watch (HRW)'s reporting on the human rights dimensions of the COVID-19 pandemic (see Related Summary, and the video, below), this document presents 40 questions to provoke thinking about a rights-respecting response to the crisis. The questions address the needs - including aro
...
und issues of information and communication - of groups most at risk, such as people living in poverty, ethnic and religious minorities, women, people with disabilities, older people, migrants, refugees, children, and lesbian, gay, bisexual, and transgender (LGBT) people. The resource also identifies a variety of responses to the crisis, some of which are positive and others problematic - with many links to related stories and resources online.
more
The arrival of COVID-19 in Afghanistan has brought heartache to millions of people who are now battling a deadly pandemic while simultaneously fighting for their survival amid poverty, disaster and war. Over my three years as Humanitarian Coordinato
...
r, I have marvelled at the resilience of the people of this country to cope with the hardships of life in the world’s deadliest conflict – but even this remarkable strength is now being tested by the health, social and economic consequences of COVID-19. The virus is spreading across the country with frightening speed. Every province is now impacted, and people are understandably frightened.
more
The progressive development of peoples is an object of deep interest and concern to the Church. This is particularly true in the case of those peoples who are trying to escape the ravages of hunger, poverty, endemic disease and ignorance; of those w
...
ho are seeking a larger share in the benefits of civilization and a more active improvement of their human qualities; of those who are consciously striving for fuller growth.
more
This report presents three scenarios on the impact of COVID-19 in Africa using economic growth forecasts, mortality and efforts to ameliorate impact through social grants. Likely effects are examined on per capita income, poverty and the attainment
...
of selected Sustainable Development Goals targets. Africa’s development trajectory has suffered a severe setback, with extreme poverty rising in all the scenarios. The pandemic threatens Africa in several ways, and the report provides policy recommendations to reduce vulnerability and strengthen resilience.
more
Asia is home to more than half of the world’s 1.1 billion girls. Gender inequality in many parts of the region means that girls are often systematically disadvantaged and oppressed by poverty, violence, exclusion and discrimination. Girls’ devel
...
opment is hampered by child, early and forced marriage and high adolescent pregnancy rates. Across the region, genderbased violence against girls and women constitutes a serious and widespread rights violation, particularly with regard to domestic violence, marital rape, and trafficking in women and girls.
Emerging data shows that since the outbreak of COVID-19, violence against girls and women, particularly domestic violence, has intensified
more
Previous pandemics have demonstrated that more people could die from the indirect consequences of an outbreak than from the disease itself. As the fight against the pandemic is pushing millions into poverty and hunger, COVID-19 will likely be no dif
...
ferent.
more
The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising
...
poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
more
Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in children
...
and poor oral hygiene, several social and environmental factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
more
The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising
...
poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
more
Palliative care has been shown to provide significant and diverse benefits for patients with serious, complex,or life-limiting health problem.
Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, Nugent R., editors. Disease Control Priorities, 3rd Edition,
Volume 9: Improving Health an
...
d Reducing Poverty. Washington DC: World Bank 2018. doi:10.1596/978-1-4648-0527-1
more
Lancet 2021; 398: Series: Heat and Health
Hot weather and heat extremes harm human health, with poverty, ageing, and chronic illnesses as aggravating factors. As the global community contends with even hotter weather in a changing climate, there i
...
s a pressing need to better understand the most effective prevention and response measures, particularly in low-resource settings. In this two-paper series, the physiological, social, and environmental factors that contribute to individual heat vulnerability, and the megatrends affecting future heat-related morbidity and mortality at the population level, are comprehensively reviewed. Solutions to address the physiological heat strain that underlies the negative health effects of heat extremes and hot weather, which can be employed across a range of settings at individual, building, and landscape scales, are presented.
more
Clean and sustainable household energy and appliances, for cooking, heating and lighting can improve health, increase productivity, reduce poverty and protect the environment while addressing air pollution.
The war in Ukraine has had devasting impact on women and girls
worldwide, widening gender gaps and increasing rates of food insecurity, malnutrition and energy poverty. This brief reviews the available evidence of that impact, recommending urgent a
...
ttention to its consequences for women and girls. Its findings underline the global impacts on gender equality and women’s rights that have been compounded by climate change, environmental degradation and the COVID-19 pandemic,
demonstrating further entrenched inequalities and human rights violations.
more
2.4 billion reasons to end the global climate and inequality crisis. An estimated 774 million children across the world – or one third of the world’s child population - are living with the dual impacts of poverty and high climate .The country wi
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th the highest percentage of children impacted by this double burden is South Sudan (87%), followed by the Central African Republic (85%) and Mozambique (80%).risk,
more
2.4 billion reasons to end the global climate and inequality crisis. An estimated 774 million children across the world – or one third of the world’s child population - are living with the dual impacts of poverty and high climate .The country wi
...
th the highest percentage of children impacted by this double burden is South Sudan (87%), followed by the Central African Republic (85%) and Mozambique (80%).risk,
more
Cotonou declaration on buruli ulcer
recommended
Cotonou Declaration oBuruli Ulcer
Cotonou, Benin, 30 March 2009
Neglected tropical diseases kill, weaken or incapacitate millions of people every year, causing permanent physical suffering, social stigmatization and reduced productive capacity. Buruli ulcer, one such disease, causes immense suffer
...
ing and disabilities, especially among children. Delayed schooling and loss of productivity are considerable among the affected populations. These adverse consequences tend to aggravate poverty in affected communities. Globally, the disease has been reported in 30 countries. In WHO’s African Region, Buruli ulcer has been confirmed in 12 countries and is suspected in 10 others.
Significant progress has been made in the past 10 years in knowledge of Buruli
ulcer, investments in related research, control of the disease, and improvement
of tools for case diagnosis and development of treatment protocols. Substantial achievements have been made in diagnosis, treatment, immunology and epidemiology. Despite these achievements, little is known about the exact mode of transmission of the disease, and there is no simple diagnostic test usable in the field.
The use of antibiotics has revolutionized treatment and contributed to reducing the need for surgery by half. However, efforts are still needed to develop simple diagnostic tools usable in the field as well as disability prevention methods. The Global Buruli Ulcer Initiative has adopted the strategy recommended by WHO. The strategy is based on early diagnosis of the disease and the use of antibiotics for treatment upon the onset of the first signs by improving access to screening and case management at the most peripheral level of the health system.
more
The State of the Climate in Asia 2021 report highlighted how climate change impacts are wreaking an ever-increasing human, financial and environmental toll, worsening food insecurity and poverty and holding back sustainable development.
Chagas disease (CD) is endemic in the Americas, being present in 21 countries, where it affects about 6 million
people.(1) With such relevant numbers of people affected and disability adjusted life years lost, CD is a poverty-related
and
...
poverty-promoting disease.
Although data describe a relevant ongoing public health problem for the American continent, significant results
in the interruption of transmission has been achieved by coordinated multi-country programs. In particular, the
Southern Cone Initiative (SCI), officially formalised in November 1991 by the Ministers of Health of Argentina, Brazil, Bolivia, Chile, Paraguay and Uruguay, has shown how a well-designed control program can significantly reduce
CD transmission.(2) Before this initiative, in these countries, there were 11 million infected persons and 50 million at
risk, 62% of the infected individuals of the whole continent.
more
Clinical Spectrum of Schistosomiasis
Carbonell, C.; Rodríguz-Alonso, B.; López-Bernús, A.; et al.
MDPI Journal of Clinical Medicine
(2021)
CC
Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those wi
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thin the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
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Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significa
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nt morbidity, including stigma and discrimination.
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The slow global response to the Ebola crisis in west Africa suggests that important gaps exist in donor financing for key global functions, such as support for health research and development for diseases of poverty and strengthening of outbreak pre
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paredness. In this Health Policy, we use the International Development Statistics databases to quantify donor support for such functions. We classify donor funding for health into aid for global functions (provision of global public goods, management of cross-border externalities, and fostering of leadership and stewardship) versus country-specific aid. We use a new measure of donor funding that combines official development assistance (ODA) for health with additional donor spending on research and development (R&D) for diseases of poverty.
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Neglected tropical diseases (NTDs) are a category of chronic, disabling, and at times disfiguring diseases and conditions that occur most commonly in the setting of extreme poverty. Historically, NTDs have received less attention and funding when co
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mpared to other diseases occurring in the same regions of the world. Several NTDs have internationally agreed upon targets for their control, elimination, and eradication. Nineteen countries in the WHO African Region have successfully eliminated at least one NTD, however recent gap analyses identified moderate to severe gaps across technical, strategy and service delivery, and enabling factors. This report summarizes the findings of a scoping review of published literature undertaken to highlight control, elimination, and eradication efforts towards NTDs across the WHO African Region over the last 30 years.
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The Sustainable Development Goals (SDGs) aim to transform our world. They are a call to action to end poverty and inequality, protect the planet, and ensure that all people enjoy health, justice and prosperity. It is critical that no one is le
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ft behind. In 2015, all the countries in the United Nations adopted the 2030 Agenda for Sustainable Development. It sets out 17 Goals, which include 169 targets. These wide-ranging and ambitious Goals interconnect. SDG 3 is to ensure healthy lives and promote well-being for all at all ages. It has 13 targets measured through 26 indicators. However, a person’s health and well-being are affected not only by disease and treatment, but also by social and economic factors such as housing, poverty and education. Health targets can therefore also be found across the other SDGs. This fact sheet shows how alcohol consumption undermines commitments to achieve 13 of the 17 SDGs, impacting on a range of health-related indicators, such as child health, infectious diseases and road injuries as well as much broader range of indicators related to economic and social development, environment and equality. The inclusion of a specific target on harmful use of alcohol (SDG 3.5: strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol) into the SDGs demonstrates the key role of alcohol within the global development agenda. The factsheet highlights positive examples of Member States’ experiences. It provides a short overview of the most cost-effective and feasible policy recommendations to reduce alcohol consumption and alcohol-attributable burden in the WHO European Region, in line with the European Action Plan to Reduce the Harmful Use of Alcohol. It also suggests some important resources for Member States. This factsheet was launched as part of the European Awareness Week on Alcohol Related Harm 2020.
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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 countries by development level. Using internatio
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nally 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.
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With this World Health Day, WHO is drawing attention to a group of diseases that are spread by insects and other vectors, the heavy health and economic burdens they impose, and what needs to be done to reduce these burdens. Many of these diseases have been historically confined to distinct geographi
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cal areas, but this situation has become more fluid due to a host of ills, including climate change, intensive farming, dams, irrigation, deforestation, population movements, rapid unplanned urbanization, and phenomenal increases in international travel and trade. The control of vector-borne diseases can make a major contribution to poverty reduction, as it precisely targets the poor
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Sharing Smart Solutions in Water
Diego J. Rodriguez, Matthijs Schuring, Nansia Constantinou et al.
The World Bank; Water Partnership Program
(2013)
C1
Water security, or having the right amount and quality of water in the right place at the right time, fosters social and economic progress. Where water is sufficient to meet demand, it can promote economy wide growth and enable countries to reach their food security, energy security, and human devel
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opment goals. Where it is scarce, excessive, or unclean it can exacerbate multiple dimensions of poverty. Neither of these two worlds is protected from future water crises, which are heavily influenced by changing local circumstances
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This document addresses preparedness as an important investment against natural and man-made disasters. Through good practices, it urges the humanitarian community, governments and regional bodies to use preparedness thinking to be aware of risks, to reduce them and to plan ahead to combat them in o
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rder to respond more effectively and reduce the threat of hunger, disease, poverty and conflicts. It uses examples from Bangladesh, Bhutan, Bolivia, Colombia, Cook Islands, Ghana, Haiti, Indonesia, Kazakhstan, Korea, Democratic People’s Republic of Korea, Kyrgyzstan, Madagascar, Malawi, Mozambique, Namibia, Niger, Panama, Philippines, Samoa, Solomon Islands, South Africa, Sudan, Tanzania, Tonga, Turkmenistan, Uzbekistan, Vanuatu, Zambia and Zimbabwe
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Offers expanded content on social/emotional aspects of having cancer and how to talk with others including children; Features many direct quotes from patients, caregivers, providers; Specifies that cancer is not contagious; Corrects perception that sin or wrongdoing causes cancer; Gives
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detailed information on managing side effects; Provides details on how to make appointments, register for treatment, account for wait times, and register for poverty certificate to cover treatment costs.
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Guideline ‒ Alternative mass drug administration regimens to eliminate lymphatic filariasis
recommended
Lymphatic filariasis is a vector-borne neglected tropical disease that causes damage of the lymphatic system and can lead to lymphoedema (elephantiasis) and hydrocele in infected individuals. The global baseline estimate of persons affected by lymphatic filariasis is 25 million men with hydrocele an
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d over 15 million people with lymphoedema. At least 36 million persons remain with these chronic disease manifestations. The disease is endemic in 72 countries. In 2016, an estimated total population of 856 million were living in areas with ongoing transmission of the causative filarial parasites and requiring mass drug administration (MDA). Lymphatic filariasis disfigures and disables, and often leads to stigmatization and poverty. Hundreds of millions of dollars are lost annually due to reduced productivity of affected patients. WHO has ranked the disease as one of the world’s leading causes of permanent and long-term disability.
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UN, international agencies and experts released a groundbreaking report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis.
If no action is taken - warns the UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance who release
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d the report – drug-resistant diseases could cause 10 million deaths each year by 2050 and damage to the economy as catastrophic as the 2008-2009 global financial crisis. By 2030, antimicrobial resistance could force up to 24 million people into extreme poverty.
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Vol 5 No 27 | ISSN 2039-2117 (online) | ISSN 2039-9340 (print) | The rate of sexual victimization of mentally retarded children is alarming and it goes unnoticed because the perpetrators could be parents, step- parents, relatives, well-respected individuals by family members, neighbours and educator
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s. Drawing from labelling theory that the mentally retarded have low IQ, majority of perpetrators tend not to get arrested because of lack of evidence. Research indicates that educators struggle to identify the psychological, behavioural and physical symptoms of sexual abuse owing to their limited training. Having employed systematic review as methodology, this research study found that mentally retarded children are prone to HIV/AIDS, PTSD and feelings of helplessness owing to uninvolvement of parents, dysfunctional communities, poverty and their inability to differentiate between abuse and affection. Based on the findings, the recommendations are that: (1) extensive training for professionals, families and community members be executed to protect children with intellectual disability. Furthermore, the rights of the mentally retarded children must be respected in the court of law when reporting sexual abuse.
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Background paper for the Oslo Summit on Education for Development.
This paper covers the four topics of the Oslo Summit: investment in education, quality of learning, education in emergencies and girls’ education. Disability continues to be one of the primary causes of educational disadvantage a
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nd exclusion,
creating the largest single group of girls and boys who remain out of school. Even in those countries
close to achieving universal primary enrolment, children with disabilities are still not in school,accessing opportunities to meaningful employment and on sustainable routes out of poverty
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The survey is representative of the Union Territory, its states and regions and urban and rural areas. It was conducted in all the districts and in 296 of the 330 townships of Myanmar. A total of 13,730 households were interviewed. It collects data on the occupations of people, how much income they
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earn, and how they use this to meet the food, housing, health, education and other needs of their families. The main focus of the survey is to produce estimates of poverty and living conditions, to provide core data inputs into the System of National Accounts and the Consumer Price Index and to support monitoring of the Sustainable Development Goals.
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Disability-inclusive social protection research in Nepal
Banks, Lena M., Walsham, Matthew and others
International Centre for Evidence in Disability
(2018)
C1
A national overview with a case study from Tanahun district. The overall aims of this study are (1) to assess the extent to which social protection systems in Nepal address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, in th
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e design and delivery of social protection for people with disabilities. As most social protection programmes in Nepal are targeted to various groups considered to be a high risk of poverty or marginalisation (e.g. orphans, widows), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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The Third Rwandan Health Sector Strategic Plan (HSSP III) provides strategic guidance to the health sector for six years, between July 2012 and June 2018. HSSP III has been inspired and guided by the VISION 2020, which will make Rwanda a lower-middle-income country by 2020; the Rwandan Health Policy
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of 2004; and the priorities set out by the Economic Development and Poverty Reduction Strategy (EDPRS 2008–2012).
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.
... The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. more
... The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. more
NUDOR’s first strategic plan (2010-2016) focused on establishing NUDOR as a viable, well-run organisation. Significant progress has been made towards these aims and therefore the strategy and has been reviewed by NUDOR board, secretariat and member organisations. The updated strategic plan now cov
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ers the period 2015 – 2020 for which three strategic aims have been agreed.
1. Representation and accountability: NUDOR will be accountable to and effectively represent members’ interests through the delivery of projects and priorities agreed by member organisations, and by facilitating joint working amongst members.
2. Capacity building and resource mobilization: NUDOR and its member organisations are strengthened to fulfil its mandates by developing its technical skills, research and insight, sustainability and outreach.
3. Advocacy and influencing: NUDOR will work to ensure that the needs and rights of all persons with disabilities are recognised by all, mainstreamed in laws and policies at all levels of government, and in programmes of other institutions focusing on areas of education, health and poverty reduction.
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Lesotho’s predominantly rural population faces significant health challenges within a setting of inadequate human resources for health. It is essential that nurses and nurse-midwives, who together make up the largest health workforce in the country, be adequately prepared to address Lesotho’s He
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alth Priorities according to the Poverty Reduction Strategy Paper (PRSP) in the settings where they work. Under the HRAA project, Jhpiego conducted a task analysis study to obtain data on job duties or tasks performed by these cadres, as well as information about how often the tasks are performed, if and where tasks were learned, and the self-perceived level of competence in performing the tasks.
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Punjab Province Report: Nutrition Political Economy, Pakistan
Zaidi, Shehla; Bhutta, Zulfiqar et al.
Institute of Development Studies, Aga Khan University
(2015)
C1
In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a
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nd grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
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Recently, Sri Lanka has been impacted by multiple natural disasters. Sri Lanka experienced a landslide in October 2014, and flooding in December 2014.8 Sri Lanka withstood the worst drought conditions witnessed in four decades in 2016; the extreme drought conditions extended into 2017 and produced s
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ubstantial economic and social effects. The drought was responsible for an increase in national poverty levels, due to reduced cultivation income, especially for rural farmers. ... In May 2017, Sri Lanka experienced continuous rains causing flash floods and extreme devastation. However, despite natural disasters and challenges posed by a complex political environment, Sri Lanka’s financial performance remained largely satisfactory in the first half of 2017.
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Policy Guidance Brief 1
• Climate change has already challenged the agriculture sector in Myanmar by afecting rice yields and livestock production, while disasters such as foods and cyclones have caused massive destruction in rural areas.
• Without adaptation, the long-term consequenc ... es of climate change will likely include reduced productivity and huge economic losses, food insecurity, poverty and migration.
• According to the Climate Change Action Plan for the Agriculture, Fisheries and Livestock sector, by 2030 Myanmar should achieve climate-resilient productivity and promote climate-smart responses to support food security and livelihood strategies while also introducing resource-efficient and lowcarbon practices. more
• Climate change has already challenged the agriculture sector in Myanmar by afecting rice yields and livestock production, while disasters such as foods and cyclones have caused massive destruction in rural areas.
• Without adaptation, the long-term consequenc ... es of climate change will likely include reduced productivity and huge economic losses, food insecurity, poverty and migration.
• According to the Climate Change Action Plan for the Agriculture, Fisheries and Livestock sector, by 2030 Myanmar should achieve climate-resilient productivity and promote climate-smart responses to support food security and livelihood strategies while also introducing resource-efficient and lowcarbon practices. more
Ending Child Marriage: Child Marriage Laws ad Their Limitations
Wodon, Q., Tavares, P., Fiala, O., Nestour, A. & Wise, L.
Save the Children and The World Bank
(2017)
C1
Child marriage is defined as a formal or informal union before the age of 18. The practice affects mostly girls. While child marriage is especially prevalent in low and lower-middle income countries, it is also observed in other countries. It endangers the life trajectories of girls in multiple ways
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. Child brides are at greater risk of experiencing a range of poor health outcomes, having children at younger ages when they are not yet ready to do so, dropping out of school, earning less over their lifetimes and living in poverty compared to their peers who marry at later ages. Child brides may also be more likely to experience intimate partner violence, have restricted physical mobility, and limited decision making ability. M
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Lancet Glob Health 2019 Published Online January 24, 2019 http://dx.doi.org/10.1016/S2214-109X(18)30479-0
The health-care system collapse underway in Venezuela is a cause of utmost concern for its people and, increasingly, for the wider region. Declines in provision of basic services, such as
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childhood immunisation, malaria control, water, sanitation, and nutritional support, have led to increasing morbidity and mortality rates from an array of preventable diseases, including malaria, measles, and diphtheria. Secondary and tertiary care have also been greatly affected, due to declining investment, out-migration of providers, and spiralling hyperinflation that has driven the country and its people into poverty.1 As is so often, and so tragically, the case, the most affected populations have been the most vulnerable: infants and children, their mothers, the poor (now the great majority of the populations), and indigenous people
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The attainment of Zambia’s goal of being a prosperous and middle-income country by 2030 as stipulated in its Vision 2030 is dependent on among others, a healthy and productive population. Therefore, the Government of the Republic of Zambia (GRZ) has prioritized health as a key socio-economic inves
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tment in the Seventh National Development Plan 2017-2021. The government is also committed to achieving the targets under the health goal number three and other health related targets under other goals of the 2030 Sustainable Development agenda. Despite progress which has been made in improving the health of Zambians, the country still faces a high burden of communicable diseases and a growing burden of non-communicable diseases. Structural and social deprivation including poverty, inequalities and marginalisation also remain major threats to health. In order to effectively address all the social determinants of health, all sectors should take into account health and well-being as a key element of policy development.
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This timely report comes at a decisive moment in history where
we can reshape urban environments and health systems for the
majority of the world’s population that live in cities. Enabling
this transformation are the SDGs, which have reconfigured how
governments and the international community
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need to plan and
implement actions to eradicate poverty and inequality, create
inclusive economic growth, preserve the planet and improve
population health. Central to this quest is to create equitable,
healthier cities for sustainable development.
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The ECA, says over 300,000 Africans could lose their lives due to COVID-19. This, as the pandemic continues to impact on the Continent’s struggling economies whose growth is expected to slow down from 3.2 percent to 1.8 percent in a best-case scenario, pushing close to 27 million people into extr
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eme poverty.
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The COVID-19 pandemic is causing untold fear and suffering for older people across the world. As of 26 April, the virus itself has already taken the lives of some 193,710 people, and fatality rates for those over 80 years of age is five times the global average. As the virus spreads rapidly to devel
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oping countries, likely overwhelming health and social protection systems, the mortality rate for older persons could climb even higher.
Less visible but no less worrisome are the broader effects: health care denied for conditions unrelated to COVID-19; neglect and abuse in institutions and care facilities; an increase in poverty and unemployment; the dramatic impact on well-being and mental health; and the trauma of stigma and discrimination.
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Children living in humanitarian crises face an increased risk of abuse. While the threats of harm are increasing, the established systems in place to protect them are breaking down. Faced with the COVID-19 pandemic and its impacts, vulnerable families suffer multiple hardships. Schools are closed an
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d families have been pushed to the brink of poverty, sometimes having been denied the opportunity to protect and provide for their children.
The report provides an in-depth analysis of 19 Humanitarian Response Plans and Refugee Response Plans from 2019
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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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In Kenya, 12.7 percent of sick Kenyans do not seek health care when they are ill with high cost of services being one of the major barriers that accounted for upto 21 percent of those who did not seek care in 2013. Further, 2.6 million Kenyans (6.2 percent) of households were at risk of impoverishme
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nt as a consequence of expenditure on health care depleting household savings and were at a risk of falling into poverty (Republic of Kenya 2015b).
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—and over 2.7 million deaths attrib
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uted to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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The discourse on climate change and migration has shifted from labelling migration merely as a consequence of climate impacts, to describing it as a form of human adaptation. This article explores the adaptation framing of the climate change and migration nexus and highlights its shortcomings and ad
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vantages. While for some groups, under certain circumstances migration can be an effective form of adaptation, for others it leads to increased vulnerabilities and a poverty spiral, reducing their adaptive apacities. Non-economic losses connected to a change of place further challenge the notion of successful adaptation. Even when migration improves the situation of a household, it may conceal the lack of action on climate change adaptation from national governments or the international community. Given the growing body of evidence on the diverse circumstances and outcomes of migration
in the context of climate change, we distinguish between reactive and proactive migration and argue for a precise differentiation in the academic debate
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The Comprehensive Rural Health Project, Jamkhed (CRHP), has been working among the rural poor and marginalized for the past 45 years. Founded in 1970 by Drs. Raj and Mabelle Arole to bring healthcare to the poorest of the poor, CRHP has become an organization that empowers people and communities to
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eliminate injustices through integrated efforts in health and development. CRHP works by mobilizing and building the capacity of communities to achieve access to comprehensive development and freedom from stigma, poverty, and disease. Pioneering a comprehensive approach to community-based primary healthcare (also known as the Jamkhed Model), CRHP has been a leader in public health and development in rural communities in India and around the world. At the core of this comprehensive community-based approach is its embrace of equity for all, utilizing healthcare as a means to break the cycle of poverty. The work of CRHP has been recognized by the WHO and UNICEF, and has been introduced to communities around the world.
accessed 23.07.2021
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People on the move – migrants, refugees, asylum seekers and other displaced populations – face extraordinary risks to their lives, safety, dignity, human rights and well-being.
In part this is connected to the core reasons that lead to migration and displacement, ranging from violence, persec
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ution, conflict, poverty, political and social issues, as well as disasters and the adverse effects of climate change. In 2021, we are seeing the compounding factors of the COVID-19 pandemic and the climate crisis driving higher numbers of people to migrate, exacerbating risks and vulnerabilities.
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In 2020, the COVID-19 pandemic impacted the world beyond imagination. To date, it has infected more than 135 million people, killed over 2.9 million people, and is projected to plunge up to 115 million people into extreme poverty.1 As countries have
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gone into lockdown, gender-based violence has increased, unemployment has soared, and access to health care for the poorest and most vulnerable has been cut. COVID-19 has made people less likely to seek health care because they are afraid of getting infected with the virus. Fear and uncertainty surrounding COVID-19 have also increased stigma and discrimination. As frontline workers without enough access to personal protective equipment (PPE) risk their lives to treat patients, the virus pushes already fragile health systems to the brink.
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In 2007, WHO warned that infectious diseases are emerging and re-emerging at a rate that has not been seen before. The potential for infectious diseases to spread rapidly results in high morbidity and mortality, causing a potential global public health treat of major concern.
Several factors are
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contributing to the (re)emergence of infectious diseases such as population growth, living in close contact with animals, frequent travelling, poverty, destructive ecological changes due to economic development and land use and climate change result in global warming.
Especially Africa is at a threat for (re)emerging infectious diseases due to the huge population growth (expected to reach 2.5 billion by 2050) with rapid urbanisation. Additionally, people across and beyond the continent are excessively mobile which is combined with a weak health system. Moreover, the risk of (re)emerging infectious disease is further heightened by three newly adopted continental initiatives: African Continental Free Trade Area, Free Movement of Persons and African Passport and Single African Air Transport Market.
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The Arid and Semi-Arid lands (ASAL) constitute about 80% (467,200 sq. km) of Kenya’s total land mass and is grouped into geographical zones including the Savannah covering most of the North- eastern and South-eastern parts, the Coastal region, the North Rift Valley, the Highlands and the Lake Vict
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oria Basin. The ASAL host about 35% of Kenyas population (13 million people) and over 60% of its inhabitants live below the poverty line, subsisting on less than one US dollar per day.
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Cascading risks from rising prices and supply disruptions, April 2022.
Global resource markets are still reeling from the impacts of Russia’s invasion of Ukraine; the two countries are major suppliers of energy, food and fertilizers. Supply disruption and the sudden imposition, in response to the
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crisis, of unprecedented economic sanctions, trade restrictions and policy interventions have caused prices of commodities to skyrocket.
Before the conflict, demand for global resources already exceeded supply and drove up prices as economies rebounded after the COVID-19 pandemic. This gave rise to a global cost-of-living crisis, characterized by increasing levels of energy and food poverty. This situation is likely to become much worse as a consequence of the war in Ukraine, and poses a threat to human security, particularly among low-income and vulnerable populations.
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The 2021 Global monitoring report on financial protection in health shows that before the COVID-19 pandemic, the world was off-track to reduce financial hardship due to health expenditures because trends in catastrophic health spending were going in the wrong direction and the number of people incur
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ring impoverishing health spending remained unacceptably high (Chapter 1). Chapter 2 summarizes emerging evidence on the consequence of the pandemic and the related macroeconomic and fiscal crisis that points to the likely worsening of financial protection for households, particularly as a result of declining income and consumption, along with rising poverty and inequality
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Addressing gaps and improving health system performance is simply not enough to prepare a health system to tackle the effects of the climate crisis. Climate change’s impact on the health and well-being of people globally is reaching catastrophic levels. As the earth continues to warm, tens of mill
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ions of people are at increased risk from rapid and unpredictable spread of infectious diseases, heatwaves, water and food insecurity and scarcity, air pollution, poverty and homelessness. Health services are often regarded as a first line defense in preventing adverse health outcomes, especially from those caused by climate impacts
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WHO Guideline on self-care interventions for health and well-being, 2022 revision: executive summary
recommended
A global shortage of an estimated 18 million health workers is anticipated by 2030, a record 130 million people are in need of humanitarian assistance, and there is the global threat of pandemics such as COVID-19. At least 400 million people worldwide lack access to the most essential health service
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s, and every year 100 million people are plunged into poverty because they have to pay for healthcare out of their own pockets. There is, therefore, an urgent need to find innovative strategies that go beyond the conventional health-sector response.
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As a result of Russia’s invasion of Ukraine, the people of Ukraine, especially the most vulnerable, are paying an enormous price. Lives and livelihoods are being lost, with more than ten million people forced from their homes— and their country—in search of safety. The war has unleashed catast
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rophic damage to the country’s economy and threatens lasting increases in poverty and societal upheaval. The scale of the war and the devastation it has caused have jeopardized Ukraine’s hard-fought development gains, through destruction of production and property, disruption of trade, diminished investment due to amplified uncertainty, and erosion of human capita
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Noma (cancrum oris) is a serious gangrenous disease of the mouth and face, mainly affecting children aged 2 to 6 years in sub-Saharan Africa.
Despite substantial knowledge gaps, it is reported to be linked with malnutrition, poor oral hygiene, immunosuppression, and living in extreme
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poverty situations.
This course addresses epidemiology, pathogenesis, clinical features, diagnosis, treatment, and public health considerations, including the human rights perspective of noma.
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Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 2018, despite ambitious health reforms, the incidence of catastrophic health spending and impoverishing
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spending at the relative poverty line have increased. These increases were mainly driven by out-of-pocket spending on medicines and inpatient care. In the same period, inequity in access to and utilization of health services remained constant among population groups. Evidence suggests health financing policies need to be further strengthened to make progress towards universal health coverage. Continuous tracking of out-of-pocket payments and service utilization to inform policymaking is needed.
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Women have less access to the development services and support – such as adequate healthcare, education and
modern technology – that make people more resilient to climate change and other shocks and stressors.2
Women’s unequal access to resources, their disproportionate responsibility for ca
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re of dependents (typically unpaid),
and the insecurity and precariousness of their paid labour all contribute to the feminisation of poverty and women’s
heightened vulnerability to climate hazards. Climate change is a multiplier of existing vulnerabilities and threatens to
reverse hard-earned development gains for all people, and particularly for women.
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Chagas disease is named after the Brazilian physician Carlos Chagas, who discovered the disease in 1909. It is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors and is found only in the Americas (mainly, in rural areas of Latin America where
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poverty is widespread). Chagas disease (T. cruzi infection) is also referred to as American trypanosomiasis
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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a
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dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with
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poverty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
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Leishmaniasis is a vector-borne disease with a wide variety of parasite species, reservoirs, and vectors involved in transmission. It is caused by different species of the protozoa Leishmania and is transmitted to animals and humans through a bite of insects in the Psychodidae family. Its presence i
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s directly linked to poverty, but social, environmental, and climatalogic factors directly influence the disease's epidemiology.
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In one of his final essays, statesman and former United Nations secretary general Kofi Annan said, ‘Snakebite is the most important tropical disease you’ve never heard of’. Mr. Annan firmly believed that victims of snakebite envenoming should be recognised and afforded greater efforts at impro
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ved prevention, treatment, and rehabilitation. During the last years of his life, he advocated strongly for the World Health Organisation (WHO) and the global community to give greater priority to this disease of poverty and its victims.
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The social context of schistosomiasis and its control: an introduction and annotated bibliography
Bruun, B.; Aagaard-Hansen, J.; Watts, S.
World Health Organization WHO; Institutional Repository for Information Sharing iris
(2008)
C_WHO
Schistosomiasis is widely recognized as a disease that is socially determined. An
understanding of the social and behavioural factors linked to disease transmission and
control should play a vital role in designing policies and strategies for schistosomiasis
prevention and control. To this must b
...
e added the awareness that schistosomiasis is
also a disease of poverty. It still survives in poverty-stricken, remote areas where there
is little or no safe water or sanitation, and health care is scarce or non-existent. For
a variety of complex reasons, many of which are addressed in this book, the disease
is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural
China. This concern for human behaviour in an environment of poverty echoes the
concerns of the new research priority for “diseases of poverty” identified by the
Special Programme for Research & Training in Tropical Diseases.
more
Leishmaniasis is a vector-borne disease with a wide variety of parasite species, reservoirs, and vectors involved in transmission. It is caused by different species of the protozoa Leishmania and is transmitted to animals and humans through a bite of insects in the Psychodidae family. Its presence i
...
s directly linked to poverty, but social, environmental, and climatalogic factors directly influence the disease's epidemiology.
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J Glob Health Sci. 2020 Jun;2(1):e3. A group of enzootic and zoonotic protozoan infections, the leishmaniases constitute among the most severely neglected tropical diseases (NTDs) and are found in all continents except Oceania. Representing the most common infectious diseases, NTDs comprise an open-
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ended list of some 20 parasitic, bacterial, viral, protozoan and helminthic infections. Called “diseases of the poor,” because of their characteristic prevalence in poor populations regardless of a country's income status, they infect over one billion people in over 140 countries, with about 90% of the global burden in Africa. While NTDs do not contribute significantly to global deaths, they are debilitating and remain the most common infections among the poor worldwide, preventing them from escaping poverty by impacting livelihoods such as agriculture and livestock, and affecting cognitive, developmental and education outcomes.
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Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan (GAP). With a limited number of new antibiotics in the developmental pipeline, many countries are in the process of establishing strategies for anti
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microbial stewardship (AMS). Within each country, different healthcare challenges have
contributed to AMR. This has also shaped individual AMS strategies and policies. In South Africa (SA), there is a high burden of infectious diseases, mainly of bacterial origin. In addition, SA also has the highest number of people living with
human immunodeficiency virus (HIV) globally. According to the 2019 statistics, there are approximately 7.97 million people living with HIV in SA. Together with this, SA has the fourth largest tuberculosis population globally.
Other important challenges include poverty, malnutrition, a high burden of non-communicable diseases, and a dire shortage of trained healthcare professionals (e.g. clinicians, pharmacists, and nurses).
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Background and aims: Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationshi
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p between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country's efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country.
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This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed sinc
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e the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
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Climate-induced water insecurity poses one of the biggest threats to humanity and will lead to more hunger, disease and displacement
Oxfam water engineers are having to drill deeper, more expensive and harder-to-maintain water boreholes used by some of the poorest communities around the world, mo
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re often now only to find dry, depleted or polluted reservoirs.
Today, during World Water Week, Oxfam publishes the first of its series of reports, “Water Dilemmas”, about the growing water crisis, in large part driven by global heating from greenhouse gas emissions. The report describes how climate change will impact water security in different regions, leading to more hunger, disease and displacement.
Carlos Calderon, Humanitarian Advocacy and Partnerships Lead for Oxfam Aotearoa said, “This new Oxfam research is focused on the global Water, Sanitation and Hygiene (WaSH) situation, but it paints a picture that illustrates the complexity of elements that, combined, will continue to increasingly affect women, girls, boys and men in the decades to come. Changing weather, poverty, inequality, gender-based violence, political instability and conflicts are impacting the availability and quality of adequate water systems. All governments, particularly those from rich countries, should responsively take action at a global scale. The clock is ticking. Our children will judge us for our actions today, or for the lack of them.”
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The Commission on Macroeconomics and Health (CMH) was established by World Health Organization Director-General Gro Harlem Brundtland in January 2000 to assess the place of health in global economic development. Although health is widely understood to be both a central goal and an important outcome
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of development, the importance of investing in health to promote economic development and poverty reduction has been much less appreciated. We have found that extending the coverage of crucial health services, including a relatively small number of specific interventions, to the world’s poor could save millions of lives each year, reduce poverty, spur economic development, and promote global security.
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This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This is followed by key figures for the region, the role of WHO in country support and, recognizing the im
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portance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
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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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The region of Latin America and the Caribbean (LAC) has high levels of income inequality and urbanization. This leaves a large percentage of the population exposed and vulnerable to infectious disease outbreaks (1). The COVID-19 outbreak occurred suddenly, within a complex economic, social and polit
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ical context and at a time of low economic growth and high levels of informal labour. Structural challenges of poverty, deep inequality across different dimensions, and weak health and social protection systems exacerbated the region’s vulnerability to the pandemic
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Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue.
Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased health complications fo
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r older people, persons with disabilities and children. They also reinforce cycles of poverty, inequality and deprivation – particularly for women, children and marginalized groups, who are disproportionately impacted by a lack of equitable access to water and sanitation.
Launched on World Water Day, the guidelines address the knowledge gap on ways to practically implement inclusive approaches to WASH infrastructure development, particularly in developing countries and fragile contexts.
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poo
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rly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obliga
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tion to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
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In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors
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ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa
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l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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The Social Cash Transfer Programme (SCTP)
Ministry of Gender, Children and Community Development of the Government of Malawi, with support from UNICEF
Ministry of Gender, Children and Community Development of the Government of Malawi, with support from UNICEF
(2022)
CC2
The Social Cash Transfer Programme (SCTP)—locally known in Chichewa as Mtukula Pakhomo—is a non-conditional critical safety net for the most vulnerable, ultra-poor Malawians. By providing monthly cash transfers to over 1.3 million people annually, this programme helps ultra-poor families to meet
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their basic needs and build resilience, with the ultimate goal of building human capital and moving them out of poverty.
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What does the future hold for the world’s children?
In many ways, the future is now. Today’s actions and decisions will determine the future children inherit.
Unfortunately, today's children live in a world fraught with crises, poverty and
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discrimination. Where far too many are deprived of opportunities to meet their full potential.
We can and must do better.
The future of childhood hangs in the balance.
This year’s State of the World’s Children Report examines the forces and trends shaping our world today and reflects on how they might shape the future.
The report explores three megatrends that will profoundly impact children’s lives between now and 2050: demographics shifts, the climate and environmental crises and frontier technologies.
It also presents three future scenarios – possible outcomes, not predictions – for how children could experience the world of 2050.
As we consider what we can do today, our responsibility is clear: now is the time to shape a better future for every child.
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This document adopts a health determinants framework for examining the evidence related to women’s poor mental health. From this perspective, public policy including economic policy, socio-cultural and environmental factors, community and social support, stressors and life events, personal behavio
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ur and skills, and availability and access to health services, are all seen to exercise a role in determining women’s mental health status. Similarly, when considering the differences between women and men, a gender approach has been used. While this does not exclude biological or sex differences, it considers the critical roles that social and cultural factors and unequal power relations between men and women play in promoting or impeding mental health. Such inequalities create, maintain and exacerbate exposure to risk factors that endanger women’s mental health, and are most graphically illustrated in the significantly different rates of depression between men and women, poverty and its impact, and the phenomenal prevalence of violence against women.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in
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health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons
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in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons
...
in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
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SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Cardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. The term “cardiovascular disease” is used throughout the report to refer to cardiac disease, vascular diseases of the brain and kidney, and peripheral vascular disease. The report’s main focus is
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on the major contributors to global CVD mortality, coronary heart disease and stroke, and on the major modifiable risk factors for cardiovascular diseases. In fact, as the leading cause of death worldwide, CVD now has a major impact not only on developed nations but also on low and middle income countries, where it accounts for nearly 30 percent of all deaths. The terms “developed” and “high income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as high income economies. The terms “developing” and “low and middle income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as low, lower middle, and upper middle income economies. The increased prevalence of risk factors for CVD and related chronic diseases in developing countries, including tobacco use, unhealthy dietary changes, reduced physical activity, increasing blood lipids, and hypertension, reflects significant global changes in behavior and lifestyle. The term “chronic diseases” is used throughout the report to refer to CVD and the following related chronic diseases that share many common risk factors: diabetes, cancer, and chronic respiratory disease. These changes now threaten once-low-risk regions, a shift that is accelerated by industrialization, urbanization, and globalization. The potentially devastating effects of these trends are magnified by a deleterious economic impact on nations and households, where poverty can be both a contributing cause and a consequence of chronic diseases. The accelerating rates of unrecognized and inadequately addressed CVD and related chronic diseases in both men and women in low and middle income countries are cause for immediate action.
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