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1
Several challenges face asthma management in Egypt, including the high percentage of uncontrolled patients, inadequate compliance, and overuse of short-acting beta-agonists (SABAs) leading to increased asthma-related morbidity and mortality. In this regard, the recent Global Initiative for Asthma (G
...
INA) recommendations included inhaled corticosteroids containing therapy for mild asthma. Local healthcare systems and healthcare professionals (HCPs) often experience practical challenges when implementing global guidelines.
more
In 2018, the Intergovernmental Panel on Climate Change announced that to restrict global temperature rise to 1·5°C, greenhouse gas emissions must decrease 45% by 2030 compared with 2010, and reach net zero by 2050.1
Briefing note | 16 March 2020
Do no harm, equality, transparency, humanity: values should guide the criminal justice sector’s response to coronavirus
At the time of publishing there were more than 164,000* confirmed cases of COVID- 19, the novel form of Coronavirus, affecting 110 countries wit
...
h more than 6,470 deaths. In this briefing we assess the current situation of COVID-19 outbreaks and prevention measures in prisons** and wider impacts of responses to governments on people in criminal justice systems. This briefing note argues for action to be taken now and immediately, given the risk people in prison are exposed to, including prison staff.
more
COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across
...
four WHO regions, this article outlines the targeted actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550
more
The video titled "Personalizing Selection of Inhaled Delivery Systems in COPD" discusses the complexities healthcare professionals face when prescribing inhaled therapies for chronic obstructive pul
...
monary disease (COPD). It highlights the diverse range of available medications and delivery systems, noting that while medication categorization has been extensively studied, guidance on selecting appropriate inhaler devices remains limited and lacks consensus in COPD guidelines. The video proposes a novel strategy to address this issue, aiming to enhance the personalization of inhaled therapy for COPD patients.
more
Written by international experts in the fields of infection control and hospital epidemiology, the ISID’s Guide to Infection Control in the Healthcare Setting brings together the most up-to-date principles and interventions that can reduce the rat
...
e of infection and the impact of associated consequences for patients, their families, and healthcare systems including: lengthier hospital stays; long-term disability; increased anti-microbial resistance; higher financial costs; and unnecessary deaths.
As the field of infection prevention grows in importance and the science supporting it continues to evolve, the Guide’s objectives are to facilitate the implementation of effective prevention and control measures across different resource levels to improve quality of care; minimize risk; save lives; reduce costs; and limit the use of antibiotics to fight these often preventable infections around the world.
The chapters herein are intended to facilitate the implementation of effective infection prevention and control measures across different resource levels, improve quality of care, minimize risk, save lives, and reduce costs.
To explore the Guide click on the sections below to view the chapters. Chapters have been divided into four parts
more
In many of Myanmar’s contested regions, healthcare services are provided through two parallel governance systems – by the government’s Ministry of Health, and by providers linked to ethnic arm
...
ed organizations. Building upon efforts to build trust between these two actors following ceasefires signed in 2011 and 2012, the new National League for Democracy-led government offers an unprecedented opportunity to increase cooperation between these systems and to ensure health services reach Myanmar’s most vulnerable populations.
The report provides an overview of existing health service arrangements in these areas, from both the Ministry of Health and from ethnic and community-based health organizations. It then unpacks the concept of “convergence”, highlighting key opportunities and policy recommendations for both government and non-government actors. more
The report provides an overview of existing health service arrangements in these areas, from both the Ministry of Health and from ethnic and community-based health organizations. It then unpacks the concept of “convergence”, highlighting key opportunities and policy recommendations for both government and non-government actors. more
The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcar
...
e access, limited diagnostic tools like spirometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
more
Antimicrobial Resistance and our Food Systems - Challenges and Solutions
Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumu
...
lation of cholesterol-containing atherogenic lipoproteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.
more
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 (
...
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.
more
Since the introduction of penicillin in the early twentieth century, antimicrobial treatments have been utilized not only in human medicine but also in veterinary care – initially to ward off diseases, prevent post-surgery infections, and treat sick farm animals.Global food production
...
has intensified over the past 50 years due to economic expansion and popu-lation growth. The use of antimicrobials in agriculture – in livestock, fish farming, and even on crops – has grown as well. Antimicrobials are not only used as medicines, but are sometimes also added in low concentrations to animal feed as a way of stimulating growth.
more
Briefing note | 16 March 2020
Do no harm, equality, transparency, humanity: values should guide the criminal justice sector’s response to coronavirus
At the time of publishing there were more than 164,000* confirmed cases of COVID- 19, the novel form of Coronavirus, affecting 110 countries wi
...
th more than 6,470 deaths. In this briefing we assess the current situation of COVID-19 outbreaks and prevention measures in prisons** and wider impacts of responses to governments on people in criminal justice systems. This briefing note argues for action to be taken now and immediately, given the risk people in prison are exposed to, including prison staff.
more
Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. D
...
espite LIMCs spending an average of 6% of their GDP on health, there have been minimal impacts compared to high-income countries. Health sector reform is a gradual process with complex systems; hence, the need for a vision and long-term strategies to realize the desired goals. In this chapter, we present our proposal to advance universal health coverage (UHC) in LMICs. Overall, our main aim is to provide strategies for achieving actual UHC and not aspirational UHC in LMICs by strengthening health systems, improving health insurance coverage and financial protection, and reducing disparities in healthcare coverage especially on prioritized health problems, and enhancing a primary care-oriented healthcare system.
more
Towards Sustainable Community Health and Social Welfare Services
Leaving No One Behind. This Operational Guideline for Community-Based Health Services (CBHS)
in line with the CBHS Policy Guideline map an integrated and coordinated
national approach to community-based health services in Tanzania.
...
The
approach builds on and furthers national priorities for decentralization,
community empowerment and strengthened systems for expansion of
access to essential health services at the village level and below.
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector
...
al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
For the Fiscal Year 2014-2015, the Health Sector continued to implement interventions and strategies meant to improve the availability, accessibility and utilization of quality healthcare services across public and private health facilities; and to
...
ensure the reduction of the burden of communicable and non-communicable diseases in Rwanda. This annual report highlights key achievements registered by the health sector during the Fiscal Year 2014-2015. Achievements are highlighted under three big components: Health Programs, Health Systems Support and Budget Execution.
more
Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health s
...
ystems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
The United Nations Population Fund (UNFPA) is the lead UN agency working to further gender equality and women’s empowerment in Sri Lanka. We are pleased to be a part of the joint effort with the Ministry of Health to develop the first ‘Standard Operating Procedures on sexual and gender-based vio
...
lence for first-contact-point healthcare providers’.
These operating procedures were developed alongside the ‘National guidelines on sexual and gender-based violence’, which aims to strengthen Sri Lanka’s health systems response to survivors of violence. We are grateful to the British High Commission in Colombo for their support in developing these guidelines and procedures as they mark an important milestone in creating a safer Sri Lanka for all women and girls. UNFPA is proud to be a part of this journey, and we stand ready to provide continued assistance to the Government of Sri Lanka and all key stakeholders to ensure women and girls receive essential services that support their safety, well-being and access to justice and to create a violence-free Sri Lanka.
more
For over 23 years, CDC has collaborated in Malawi with local and international partners to strengthen health systems. The office works to prevent, detect and respond to diseases. Efforts include building h
...
ealthcare workforce capacity, strengthening laboratory systems, and increasing the capacity of surveillance and health information systems. CDC also implements high-impact HIV and tuberculosis programs through the President's Emergency Plan for AIDS Relief and supports malaria control activities under the U.S. President's Malaria Initiative.
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