This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ...e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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World Report 2021, Human Rights Watch’s 31st annual review of human rights practices and trends around the globe, reviews developments in more than 100 countries.
In his introductory essay, Executive Director Kenneth Roth calls on the incoming US administration to more deeply embed respect for ...human rights as an element of domestic and foreign policy to counter the “wild oscillations in human rights policy” that in recent decades have come with each new resident of the White House. Roth emphasizes that even as the Trump administration mostly abandoned the protection of human rights, joined by China, Russia and others, other governments—typically working in coalition and some new to the cause—stepped forward to champion rights. As it works to entrench rights protections, the Biden administration should seek to join, not supplant, this new collective effort.
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PlosOne January 20, 2021
https://doi.org/10.1371/journal.pone.0241899
Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antim...icrobial resistance (AMR) and toxicity.
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COVID-19 has heavily emphasized how contact tracing is crucial for managing outbreaks, and as part of the strategy for adjusting, and eventually lifting, lockdowns and other stringent public health and social measures. As the pandemic develops further, it will be a core measure to manage further wav...es of infection. In early June 2020, the World Health Organization (WHO) convened an online global consultation on contact tracing in the context of COVID-19, looking at the lessons of the pandemic to date; known and emerging best practices; and the measures necessary for urgent implementation, scale-up, maintenance and enhancement of contact tracing activities.
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In: Bonk M., Ulrichs T. (eds). Global Health: Das Konzept der Globalen Gesundheit. Berlin: De Gruyter, 2021, pp. 557–580
After ten years of war, the vast majority of Syria’s children cannot imagine a future in their country, according to a new report by Save the Children. On average, 86% of Syrian refugee children surveyed in Jordan, Lebanon, Turkey and the Netherlands said they would not want to return to their cou...ntry of origin. Of children displaced inside Syria, one in three would rather be living in another country. Children who fled their homes are struggling to feel safe where they are now, as around two in five children of those surveyed by Save the Children said they face discrimination and a lack of education. Many feel they have no say over their future.
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The COVID-19 pandemic led to school closures around the world, affecting almost 1.6 billion students. The effects of even short disruptions in a child’s schooling on their learning and well-being have been shown to be acute and long lasting. The capacities of education systems to respond to the cr...isis by delivering remote learning and support to children and families have been diverse yet uneven.
This report reviews the emerging evidence on remote learning throughout the global school closures during the COVID-19 pandemic to help guide decision-makers to build more effective, sustainable, and resilient education systems for current and future crises.
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Climate change and health vulnerability and adaptation assessment
In 2013 the World Health Organization (WHO) published the report Protecting health from climate change:
vulnerability and adaptation assessment. The aim was to provide basic and flexible guidance on conducting national or subnati...onal assessments of current and future vulnerability (the susceptibility of a population or region to harm) to the health risks of climate change, and of policies and programmes that could increase resilience, taking into account the multiple determinants of climate-sensitive health outcomes.
That guidance has been a very useful tool, applied to more than 50 countries and settings, and has helped countries to prepare their health contributions to United Nations Framework Convention on Climate Change national adaptation plans.
Since the launch of the guidance, WHO, technical partners such as Health Canada, and countries have learned much in terms of its applicability in different countries, at national and local levels.
At the same time, knowledge on climate change and health has increased.
WHO, the Pan American Health Organization and Health Canada have produced this updated version, which aims to better support countries in their assessments by proposing a simpler tool that incorporates all lessons learned.
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COVID-19 vaccine hesitancy is currently one of the main obstacles to worldwide herd immunity and socioeconomic recovery. Because vaccine coverage can vary between and within countries, it is important
to identify sources of variation so that policies can be tailored to different population groups. ...In this paper, we analyze the results from a survey designed and implemented in order to identify early adopters and
laggers in six big cities of Latin America. We find that trust in government and science, accurate knowledge about the value of vaccination and vaccine effects, perceived risk of getting sick, and being a student
increase the odds to get vaccinated. We also identify potential laggers as women and populations between 20 and 35 years old who are not students. We discuss specific strategies to promote vaccination among
these populations groups as well as more general strategies designed to gain trust. These findings are specific to the context of Latin America insofar as the underlying factors associated with the choice to be
vaccinated vary significantly by location and in relation to individual-level factors.
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What near-term climate impacts should worry us most?
Supporting the most exposed and vulnerable societies to reduce
regional and global climate risks
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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To support countries in adapting their response to different COVID-19 scenarios, the World Health
Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey literature. The objective was to identify interventions... implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions. The review included outbreaks of Ebola virus disease (EVD), severe acute respiratory syndrome (SARS), Zika virus disease (ZVD), the ongoing COVID-19 pandemic, and natural disasters and humanitarian emergencies that caused disruption to services, transport and other activities.
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Human use of land has been transforming Earth's ecology for millennia. From hunting and foraging to burning the land to farming to industrial agriculture, increasingly intensive human use of land has reshaped global patterns of biodiversity, ecosystems, landscapes, and climate. This review examines ...recent evidence from archaeology, paleoecology, environmental history, and model-based reconstructions that reveal a planet largely transformed by land use over more than 10,000 years. Although land use has always sustained human societies, its ecological consequences are diverse and sometimes opposing, both degrading and enriching soils, shrinking wild habitats and shaping novel ones, causing extinctions of some species while propagating and domesticating others, and both emitting and absorbing the greenhouse gases that cause global climate change. By transforming Earth's ecology, land use has literally paved the way for the Anthropocene.
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