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1
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
The management of information and logistics is an essential component of health product systems. In a context of limited financial resources and morbidity and mortality sustained by persistent diseases, it is necessary to strengthen
...
health systems through competent resources, especially human resources (HR), to ensure performance, sustainability and independence from external funding. In Burkina Faso, a strong and lasting partnership between the Ministry of Health and the Bioforce Institute has existed since 2005 to address this issue. This partnership has created a favorable environment for the professionalization of health logistics and for the recognition of its significant role in health system performance.
more
This open access book not only describes the challenges of climate disruption, but also presents solutions. The challenges described include air pollution, climate change, extreme weather, and relat
...
ed health impacts that range from heat stress, vector-borne diseases, food and water insecurity and chronic diseases to malnutrition and mental well-being.
more
PLOSONE| https://doi.org/10.1371/journal.pone.0204882October17,2018
This third regional report discusses gaps and challenges in reducing the harmful use of alcohol and how countries can reverse current trends in a cost-effective and expedited way.
Globalization and Health201612:63; DOI: 10.1186/s12992-016-0195-3
Mental health disorders remain widely under-reported — in our section on Data Quality & Definitions we discuss the challenges of dealing with this data. Figures presented in this entry should be t
...
aken as estimates of mental health disorder prevalence — they do not strictly reflect diagnosis data (which would provide the global perspective on diagnosis, rather than actual prevalence differences), but are imputed from a combination of medical, epidemiological data, surveys and meta-regression modelling where raw data is unavailable. Further information can be found here.
Accessed April 15, 2019
more
13 May 2021
To avoid a reversal of progress from the adverse impacts of the COVID-19 pandemic, new knowledge and lessons from successful programmatic innovations are urgently needed to improve TB prevention and care. Experience can provide evidence for innovative approaches and strategies to mainta
...
in and scale up high-quality TB services. WHO therefore called for case studies on programmatic innovations that address emerging challenges in TB prevention and care during the pandemic in order to collect and disseminate the findings to the TB community. Between November 2020 and February 2021, a total of 23 case studies relevant to the call were accepted from 19 countries in the six regions of WHO. The lessons learnt from these country activities to ensure the continuity of essential services like TB care in the face of the crippling crisis may also inform strategies for minimizing the impact of future emerging pathogens on health services.
more
Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the
...
challenges identified. This emerging movement has not yet agreed upon a code of ethics to underpin the rapidly expanding body of research being carried out in its
name. However, a code of ethics might support the principles for planetary health set out in the Canmore Declaration of 2018. Phrases such as “Public Health 2.0”, “Human Health in an Era of Global Environmental Change”, or “A safe and just operating space for humanity” are often used in planetary health discussions, but are not always clearly defined and so far, the field lacks a strong guiding ethical framework. In this paper, we propose a starting point towards a code of ethics for planetary health that builds on the Canmore Declaration.
more
In spite of the work carried out by the EU institutions, the Member States, many cities and grassroot movements in Europe, the general public is still not engaging enough in air quality policy initiatives and the level of awareness and knowledge of the effects of poor air quality on
...
health is often low.
HEAL, within its work with the EU urban air quality partnership has put together a toolkit on ‘Communicating on air quality and health – Inspiring practices, challenges and tips’, providing hands-on examples of how communication on air quality, the health links and (policy and behavioural) changes takes place, as an inspiration particularly for urban authorities wanting to communicate on clean air.
The Partnership on Air Quality was founded in 2016 with the main objective of improving air quality in cities and bringing the ‘healthy city’ higher on the local, national and EU agendas as part of the urban agenda.
more
BackgroundClimate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the entire scientific community. Rising temperatures, heat
...
waves, floods, tornadoes, hurricanes, droughts, fires, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental.
more
Small island developing states (SIDS) are a set of islands and coastal states that share similar sustainable development challenges, as a result of their size, geography and vulnerability to climate change. Thirty-nine WHO member states in four regi
...
ons – the African Region, the Region of the Americas, the South-East Asian Region, and the Western Pacific region – are classified as SIDS. Whilst the individual countries differ in many respects, collectively they face unique social, economic and environmental challenges.
more
There is growing international consensus that food systems transformation is important to address the challenges of malnutrition in all its forms, the burden of noncommunicable diseases (NCDs), environmental sustainability, increasing inequality and
...
ensuring the welfare of workers and animals. In light of the urgency of these challenges, there are questions about the role of red and processed meat in healthy and sustainable food systems. Globally, production and consumption of all types of meat has increased substantially in the last 50 years, and – although red meat consumption is now plateauing in high-income countries (HICs) – is predicted to increase by a further 50% by 2050. Meat consumption remains highly unequal both between and within countries, and animal-source food intakes, including red meat, are lowest among those at most risk of undernutrition
more
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise f
...
or the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
more
It highlights the numerous challenges to quality service provision, along with the organisation’s response to mental health needs, and recommendations for international and regional decision-maker
...
s including:
- Advocating and working towards mental health policies that support adequate funding for mental health care and government suppor
- Legislation to protect the rights of people with mental disorders and vulnerable communities
- Advocating for multi-year funding to support the sustainability of MHPSS programs
- Creating capacity building opportunities consistent with the IASC guidelines and supported with continuous supervision
more
This paper provides case studies of several food product improvement policies from across the WHO European Region. The aim is to share country experience, assess the various merits of the different approaches, discuss lessons learned, and provide guidance for best practice that may be more widely ap
...
plicable across the European Region.
more
Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit
...
viper Bothrops asper (family Viperidae), locally known as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
more
Frontiers in Public Health | www.frontiersin.org 1 June 2017 | Volume 5 | Article 127
