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Draft for consultation
The purpose of this Operational Guideline is to support state health authorities, programme managers and health care professionals with recommendations on appropriate management of children with SAM in the health facilities. Facility based management includes setting up and managing within the healt
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h facility premises, a functional space where these children are cared for. This Facility Based Unit is referred to as Nutritional Rehabilitation Centre or NRC in the document. While the scale and design may vary in a given situation, it is intended that the document provide the basis for a consistent set of principles that can be used by all states for facility based management of children with SAM. The Operational Guideline focuses on the Facility/Hospital based approach for the management of SAM children under 5 years of age based on the WHO and revised IAP protocols.
more
Level of stunting among Bangladeshi children <5years declined from 51% in 2004 to 36% and underweight from 41% in 2007 to 33% (BDHS 2014). But the decrease in wasting rate is not as expected, which is only from 17% to 14.3 % over last decade. Approximately 3.1 % (BDHS 2014) of under-5 children suffering from SAM only b
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y weight-for-length or height z-score (WHZ) <-3 criterion and estimated to be a total of ~ 450,000. Because, there are no national information on prevalence of SAM using mid upper arm circumference (MUAC) and presence of bipedal oedema in under-5 children, thus the actual number of children suffering from SAM could be much higher than the current estimate.
more
The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra
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nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both inpatient and outpatient management of severe acute malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 i
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n the WHO Pocketbook for Hospital Care for Children, and the 2013 update on SAM (outpatient management). The global threat of increasing antimicrobial resistance and new data on efficacy and safety profiles requires a re-review of the current evidence to ensure recommendations are the most appropriate. The evidence base for the use of antibiotics in children presenting with uncomplicated SAM has been recently enlarged.
more
The objectives of this guidance document are to:
1. Strengthen the capacity of country teams to effectively scale up and manage programmes to address severe acute malnutrition
2. Extend the geographic reach of quality treatment for SAM to all vulnerable communities in need
3. Maximize ... access to appropriate and quality treatment for SAM among all eligible children in the community at all times
4. Aid the formulation and implementation of national policies and strategies that support objectives 1 to 3
5. Aid the creation of an enabling environment that supports objectives 1 to 3 through advocacy, documentation of successful practices, support for operational research, mobilization of resources and collaboration with partners more
1. Strengthen the capacity of country teams to effectively scale up and manage programmes to address severe acute malnutrition
2. Extend the geographic reach of quality treatment for SAM to all vulnerable communities in need
3. Maximize ... access to appropriate and quality treatment for SAM among all eligible children in the community at all times
4. Aid the formulation and implementation of national policies and strategies that support objectives 1 to 3
5. Aid the creation of an enabling environment that supports objectives 1 to 3 through advocacy, documentation of successful practices, support for operational research, mobilization of resources and collaboration with partners more
The Indonesian government has reformed its laws, policies, and institutions to better manage disaster risk since the significant 2004 Indian Ocean Tsunami. The Government of Indonesia now has contingency plans for every disaster-prone city which identifies its vulnerabilities, outlines the relief re
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sponse, and builds overall preparedness. In 2007, the government introduced a disaster management bill that incorporated disaster management prevention into disaster management response. In 2008, Indonesia created the National Disaster Management Agency (Badan Nasional Penanggulangan Bencana, BNPB). The new shift led to the strengthening of the country’s disaster management agency, and the addition of district branches and representatives. Despite the progress made, more work is needed at the local level as well as integration of disaster risk reduction in government departments.11 Under Indonesia’s 2007 Disaster Management law, provincial and district administrations are mandated to head disaster management during a crisis.
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Myanmar has made significant progress in its disaster management policies, plans, and procedures since 2008, when Cyclone Nargis impacted the country leaving devastation in its aftermath. The Government of Myanmar (GoM) has modified the government structure and created new authorities and plans to i
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mprove the effectiveness of disaster management at all levels. While this progress is encouraging and shows the determination of the government to make necessary adjustments, the resources to implement the policy changes have been slower to develop. Myanmar has made significant progress in its disaster management policies, plans, and procedures since 2008, when Cyclone Nargis impacted the country leaving devastation in its aftermath. The Government of Myanmar (GoM) has modified the government structure and created new authorities and plans to improve the effectiveness of disaster management at all levels. While this progress is encouraging and shows the determination of the government to make necessary adjustments, the resources to implement the policy changes have been slower to develop.
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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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The Philippine Government, International Non-government Organizations (INGOs) and local NGOs are all making attempts to address the impact of disasters and climate change at various levels. The Philippine Government has made significant strides in the implementation of disaster risk reduction (DRR)
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planning and activities through the development of the National Disaster Risk Reduction and Management Council (NDRRMC) which acts as the lead agency for DRR in the Philippines. The disaster focal points are the NDRRMC and the Office of Civil Defence (OCD). The Department of Social Welfare and Development (DSWD) is responsible for leading immediate disaster relief efforts.
The Armed Forces of the Philippines (AFP) is a primary responder in disasters and have been deployed frequently to several disaster relief operations in the country in recent years. The Philippines has endured disasters that involve national and international assistance. more
The Armed Forces of the Philippines (AFP) is a primary responder in disasters and have been deployed frequently to several disaster relief operations in the country in recent years. The Philippines has endured disasters that involve national and international assistance. more
The National Strategy for Natural Disaster, Prevention, Response and Mitigation to 2020, which outlines Vietnam’s main disaster risk management objectives and the National Target Program (NTP) form the overarching policy framework for disaster risk management and climate change adaption activities
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. The CCFSC’s main mandate is to translate this strategy into action. Other decrees and laws are also complementary. The Government of Vietnam has prioritized disaster preparedness, recognizing that the most cost-effective measures to mitigate flood related disasters are often non-structural. These measures include flood mapping, river flood warning systems, television-based disaster information and warning systems, training at all government and grassroots levels on disaster preparedness, and reforestation of certain areas. Land use and development have also been addressed through government regulations.
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Cambodia drafted and adopted the National Action Plan for Disaster Risk Reduction 2014-2018 in 2014. This plan finalized the required policies and legal processes to strengthen DRM in Cambodia. It also focused on capacity building at national and sub-national levels and provided dedicated resources
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for strengthening the NCDM and the Sub-National Committees for Disaster Management. Cambodia’s legislature then passed the Law on Disaster Management in June 2015. This legal framework for disaster management assigns legally binding roles and responsibilities, establishes institutions, and assists with the allocation of resources and coordination. NCDM is Cambodia’s lead government agency for emergency preparedness and relief. The NCDM provides the overall leadership of the Plan of Action for Disaster Risk Reduction (DRR) coordination in Cambodia. Cambodia has adopted the Cambodia Red Cross (CRC) as the primary partner for relief operations.
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Lao People’s Democratic Republic (Lao PDR), also referred to as Laos, or Lao, is exposed to natural disasters such as flooding, typhoons, cyclones, drought, and earthquakes. The country is vulnerable to recurrent, sudden-onset and slow onset natural disasters with flooding, storms and typhoons hav
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ing a large effect on the population. The country remains highly vulnerable to agricultural shocks and natural disasters.
Lao has established Community Based Disaster Risk Reduction (CBDRR) practices as a result of the many natural disasters the country faces. CBDRR is implemented at the village level to enhance community preparedness and to decrease village vulnerabilities to disasters.
Lao established the National Disaster Management Committee (NDMC) as its national disaster management platform and the National Disaster Management Office (NDMO) to be responsible for DRM (Disaster Risk Management) and DRR activities in the country. more
Lao has established Community Based Disaster Risk Reduction (CBDRR) practices as a result of the many natural disasters the country faces. CBDRR is implemented at the village level to enhance community preparedness and to decrease village vulnerabilities to disasters.
Lao established the National Disaster Management Committee (NDMC) as its national disaster management platform and the National Disaster Management Office (NDMO) to be responsible for DRM (Disaster Risk Management) and DRR activities in the country. more
The 2012 NDRMP lays out the Disaster Risk Management (DRM) architecture of the country and provides guidance for DRM intervention at all levels. However, implementation has been slow and resource challenges exist throughout the government.
The PNG government’s policy and institutional framework ... for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks. more
The PNG government’s policy and institutional framework ... for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks. more
Thailand is exposed to flooding, landslides, drought, earthquakes, tsunamis, heat waves, forest fires, and epidemics. Thailand is also exposed to technological hazards such as chemical accidents. Flooding is the natural hazard with the most significant impact on human life, livelihoods, and the econ
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omy for the country. The occurrence of droughts has increased in recent years due to the effects of the El Niño-Southern Oscillation (ENSO) cycle, which brings drier-than-average rainfall conditions. Drought has adversely impacted the country’s agriculture sector, which employs around one third of the country’s workforce.
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Timor-Leste’s vulnerability to natural hazards means if particular care is not taken in the development of the country’s infrastructure, it will remain at risk to disruption.
Timor-Leste developed the 2008 National Disaster Risk Management Policy, which lays out the government’s vison of ... its disaster management process from the national to the village level. Additionally, through the United Nations Development Program (UNDP), they have conducted national hazards, vulnerability and risk assessments. Through Plan International they have initiated the integration of disaster management education into public schools. Although the Government of Timor-Leste considers DRM as a priority and supports the dissemination of DRM policy to the district levels, the current Strategic Development Plan 2011-2030 of Timor-Leste has not explicitly reflected nor integrated DRM as one of its development priorities. Disaster Management is included in the Strategic Plan Document of MSS 2009-2012. more
Timor-Leste developed the 2008 National Disaster Risk Management Policy, which lays out the government’s vison of ... its disaster management process from the national to the village level. Additionally, through the United Nations Development Program (UNDP), they have conducted national hazards, vulnerability and risk assessments. Through Plan International they have initiated the integration of disaster management education into public schools. Although the Government of Timor-Leste considers DRM as a priority and supports the dissemination of DRM policy to the district levels, the current Strategic Development Plan 2011-2030 of Timor-Leste has not explicitly reflected nor integrated DRM as one of its development priorities. Disaster Management is included in the Strategic Plan Document of MSS 2009-2012. more
National Tuberculosis Control Program; Mycobacterial Disease Control National AIDS/STD Program
Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the propagation and dissemination of MDR TB.
The term "Programmatic Management of Drug Resistant TB" (PMD ... T) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases. more
The term "Programmatic Management of Drug Resistant TB" (PMD ... T) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases. more
This programmatic brief explores how to expand HIV and STI prevention and contraceptive method options in contraceptive services and, thus, to reduce HIV and STI incidence among adolescent girls and women. It focuses on settings with extremely high HIV prevalence and incidence. This brief complement
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s existing guidance on HIV prevention and sexual and reproductive health and rights (SRHR), amplifies calls for action and outlines more comprehensive approaches to integration of SRHR and HIV services. It also emphasizes the importance of SRHR for women living with HIV. It aligns with updated WHO recommendations for contraceptive eligibility for women at high risk of HIV and other HIV guidance for adolescent girls and young women.
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