The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health care. Central to the WASH FIT methodology is training and incremental improvements.
Implementat...ion of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
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The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, water, sanitation and hygiene, logistics, community engagement and risk communication. All efforts must b...e well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
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Azraq refugee camp located in Zarqa governorate was established in April 2014. As of June 2023, the camp continues to hosts 40,600 Syrian refugees, with 61% of the population children, and 25% of all households female-headed (UNHCR, 2023).
The water supply system in Azraq has been operational sin...ce 2017 across the four villages of the camp and consists of 300 tap stands, two boreholes and two storage locations (each with 16 T-95 steel tanks).
Based on data from UNICEF (2022), the community is provided on average 2100 cubic meters of safe, treated water a day, which is distributed across the camp via a gravity flow system. A distribution schedule is in place, with water pumped during two shift times each day in the morning and evening. Monthly data reported through ActivityInfo (2023) shows a range 53.5-76.3 million liters per month provided through the network in 2022 for an average of 57 liters/person/day – well above the locally agreed minimum standard of 35 liters/person/day and the SPHERE standard of 15 liters/person/day.
Latrine and shower facilities in the camp are organized through communal WASH blocks shared typically between three households and connected to water and greywater networks. However, based on an ACF and World Vision assessment (2022), 60% of the surveyed households are using private latrines (50% self-constructed latrines, and 10% constructed by WASH actors), 24% of households used communal latrines as private latrines not shared with other families, and 16% reported the use of communal latrines shared with other families.
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Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-...incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already d...eprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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Evidence-based psychological interventions are an important part of health, social, protection and education services and can help increase access to effective mental health treatments and progression towards universal health coverage.
This manual provides managers and others responsible for plan...ning and delivering services with practical guidance on how to implement manualized psychological interventions for adults, adolescents and children. It covers the five key implementation steps: make an implementation plan; adapt for context; prepare the workforce; identify, assess and support potential beneficiaries; and monitor and evaluate the service.
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This MHPSS in Emergencies training aims to prepare MHPSS responders, disaster managers, and emergency team leaders for work in the field by building understanding of basic concepts of MHPSS in emergencies as well as planning and implementing PSS activities. It is for MHPSS focal points from the Red ...Cross and Red Crescent Societies Movement and humanitarian organizations responsible for initiating or supporting the overall mental health and psychosocial activities and interventions during emergencies. The training modules in this guide have been developed to be flexible and adapted to different contexts and training needs. The guide and accompanying materials include the information and materials you will need to design and facilitate MHPSS in Emergencies training.
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Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a...ge of the population, an increase in obesity and also perhaps to increasing survival of those with diabetes.
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This review examines high-quality research evidence that synthesises the efects of extreme heat on human health in tropical
Africa. Web of Science (WoS) was used to identify research articles on the efects extreme heat, humidity, Wet-bulb Globe
Temperature (WBGT), apparent temperature, wind, Heat ...Index, Humidex, Universal Thermal Climate Index (UTCI), heatwave, high temperature and hot climate on human health, human comfort, heat stress, heat rashes, and heat-related morbidity
and mortality
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The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys...tems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including... asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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Men are underrepresented in HIV testing services throughout sub-Saharan Africa. HIV testing is critical to achieve the UNAIDS 95-95-95 goals, as it is the first entry point to HIV care. In Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiag...nosed. Improved HIV testing among men is key to reaching UNAIDS goals, and to curbing HIV epidemics in the region.
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Evidence- and rights-based national policies, guidelines and legislation play a key role in improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH), framing the enabling environment for equitable provision and accessibility of quality services. The SRMNCAH policy sur...vey monitors the existence of national SRMNCAH laws, policies, strategies and guidelines and the extent to which they are aligned with WHO recommendations on SRMNCAH. This publication reports on the findings from the 2023 WHO SRMNCAH policy survey.
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These standards for the quality of paediatric care in health facilities form part of normative
guidance for improving the quality of maternal, newborn, child and adolescent health care.
In view of the importance of the continuum of both the life-course and service delivery (1),
these standards bu...ild on the Standards for improving the quality of maternal and newborn
care in health facilities (2), during labour, childbirth and the early postnatal period.
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24 April 2020
Policy considerations
for the WHO European Region
This document provides key considerations for Member States to help them to decide on the modulation
of large-scale restrictive public health measures
(i.e. movement restrictions and large-scale physical distancing), while at the... same time strengthening core public health service capacities (to identify, isolate,
test and treat every patient and quarantine contacts) together with personal protective measures (hand hygiene and respiratory etiquette) and individual physical distancing (>1 metre distance). The transition should be informed by national, subnational or even community-level risk assessments as the transmission of COVID-19 is typically not homogeneous within a country.
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