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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence ... a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
Global Trends: Forced Displacement in 2023
recommended
At the end of 2023, an estimated 117.3 million people worldwide were forcibly displaced due to persecution, conflict, violence, human rights violations and events seriously disturbing the public order. The latest Global Trends report, published in...
This report provides an overview of the operations and activities of the WHO Country Office in Ukraine in 2023. Despite the acute health impacts of...
Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks ... a pox-like disease occurred in monkeys kept for research. The first human case was recorded in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
Infectious disease outbreaks are periods of
great uncertainty. Events unfold, resources
and capacities that are often limited
are stretched yet further, and decisions
for a public health response must be
made quickly, even though the evide...
In the Region of the Americas, between epidemiological week (EW) 1 and EW 52 of 2018, a total of 560,586 cases ... dengue were reported (incidence rate of 57.3 cases per 100,000 population), including 336 deaths. Of the total cases, 209,192 (37.3%) were laboratoryconfirmed and 3,535 (0.63%) were classified as severe dengue. Cases reported in 2018 were higher than the total reported in 2017 but lower than the historical average reported in the previous 11 years (2006-2016) (Figure 1). Similarly, the proportion of cases of severe dengue and dengue with warning signs reported in 2018 was higher than the previous two years, but lower than the preceding ten years, and it remains below 1% which was reached in 2015.
Gender-based Violence Area of Responsibility Working Group July 2010
Sepsis remains a leading cause of mortality and morbidity, especially during the first five days of life and in low and middle-income countries (LMIC) [1]. Hospital infection also remains a major ca...
The health impact of radiological and nuclear emergencies can last for decades. Lessons learned from past radiological and nuclear accidents have demonstrated that the mental health and psychosocial consequences can outweigh the direct physical heal...
The extensive use of natural resources threatens to exceed the carrying capacity of the Earth. The concept of a
circular economy offers an avenue ...
This publication articulates the WHO Botswana Country Office’s focus and investment needs for the biennium 2022–2023, building on achievements, networks, and partnerships fostered in 2020-2021.
As the leading health authority within the United Nations system in Botswana, the WHO Country Offi...
he global architecture for providing development assistance for health (DAH)
has become increasing complex in the last decade, with many new funding agencies entering the health sector.
This study presents a detailed picture of European Union (EU)...
: Development assistance for health (DAH) is one of the most important means for Japan to promote
diplomacy with developing countries and contribute to the international community. This study, for the first time,
estimated the gross disbursement <... Japan’s DAH from 2012 to 2016 and clarified its flows, including source, aid
type, channel, target region, and target health focus area
This consultative version of the guideline is the product of literature reviews, discussions and contributions from diverse stakeholders, as well as UNISDR-nominated experts appointed specifically f...
Dentists are uniquely positioned to play a role in pre enting the spread of antibiotic resistance. Here are se en simple “how-tos” for safe, appropriate antibiotic prescribing and use when treating dental infections
This Pharmaceutical Country Profile for Kenya (2010) has been developed by the Ministry of Medical Services with support of the World Health Organization. The Profile contains information on existin...
UNICEF Syria’s series of think pieces. Every day counts. An outlook on child protection for the most vulnerable children in Syria.To navigate the complex and continuously changing context and attain sustainable results for children, UNICEF – alo...
The executive summary of the WHO Global oral health status report presents a snapshot of the most recent data on major oral diseases, risk factors, health system challenges and opportunities for ref...
This report assesses the impact of the conflict in Ukraine and its implications for organized crime and security-related issues for neighbouring countries, with a focus on Moldova.
These include:
Organized crime and illicit trafficking (includin...
The revised package of BFHI materials includes five sections: 1. Background and Implementation, 2. Strengthening and Sustaining the BFHI: A course for decision-makers, 3. Breastfeeding Promotion and Support in a Baby-friendly Hospital: a 20-hour cou...
