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A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some E
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uropean countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.
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Patient-centred care (PCC) is a pillar of quality health services, where decision-making power is shared between the clinician and the patient. Although, this approach could be adopted with easiness in high income settings or in countries with unified health systems, in settings such as Peru, where
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universal access and other structural problems remain a challenge, the practice of PCC is not a priority. In Peru, research on PCC has been conducted for almost two decades, but this has not generated a need for development in academia, decision makers, health personnel or patients. Here, we give an overview of the road that PCC research has taken in Peru and the challenges that remain to translate it into clinical practice.
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Jordan has more than 3 million migrants (one third of the country's total population) and has witnessed three major waves of refugees in its modern history: Palestinians (1948 and 1967), Iraqis (1990 and 2000) and Syrians (since 2010). Under its commitment to achieving universal health coverage (UHC
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), Jordan has been continually supporting vulnerable populations such as refugees and migrants by offering subsidized access to essential health services.
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The objective of this paper is to summarise and critically review the available data about onchocerciasis in Mozambique, in order to report epidemiological and clinical aspects related to the disease and identify gaps in knowledge. The paper is intended to raise awareness of the existence and import
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ance of this disease and to define research priorities
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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
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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.
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High prevalence of target diseases in rural and developing nations, increased prevalence of malnutrition across the globe, lack of hygiene and poor sanitation facilities, Migratory patterns of population, introduction of new chemical entity in the field of therapeutics, favorable government regulati
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ons, and increased R&D investments are key factors contributing to high CAGR of point of care diagnostics market during the forecast period.
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Technical meeting to support Ebola affected countries on the recovery and resilience plans with a focus on GAVI, the Global Fund and other partners' funding - Report, 9-11 June 2015
World Health Organization
(2015)
The objectives of the meeting were to agree on coordinated and aligned support to the 3 countries’ national health recovery plans (Guinea, Liberia, Sierra Leone); to identify cross-cutting areas and opportunities for integration; to identify ways
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to improve implementation modalities; and to identify actions including technical assistance needed to support the countries in the process of building resilient health systems.
The outcomes of the meeting consisted in proposed country action plans to move forward with the implementation of the recovery plans. The action plans includes:priorities and areas of work; activities needed to improve implementation modalities; technical assistance needs.
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Looking forward, the 2019-2020 Regional Refugee Response Plan (RRRP) for the DRC situation aims at addressing the needs of new arrivals of Congolese refugees in the region, and those in protracted situations. By supporting livelihoods opportunities
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and through a resilience-based approach, refugees will be able to contribute to the development of their host countries, and of their country of origin upon their return. Given the limited capacity of host communities to support the impact of massive numbers of refugees, the response strategy will also address the needs of local populations, strengthening peaceful co-existence and building social cohesion.
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Integrating WASH and MHCP interventions will always require imagination and creativity to adapt the approach to specific conditions, opportunities and constraints in each context. The book is designed to stimulate reflection and encourage initiative
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s to seek opportunities for closer integration of these two sectors. It provides examples and tools for integration, highlights possible obstacles and proposes strategies for overcoming them. It provides ideas, examples and resources that can be used at all stages of the project cycle. It is intended for readers at strategic and operational levels, in ACF country missions and at headquarters.
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Rohingya Refugee Response Gender Analysis: Recognizing and responding to gender inequalities
Toma, Iulia; Chowdhury, Mita; Laiju, Mushfika; Gora, Nina; Padamada, Nicola
Oxfam, Action Against Hunger, Save the Children
(2018)
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This gender analysis was conducted to understand the different risks and vulnerabilities but also opportunities and skills for Rohingya and host community women, men, boys and girls. Data collection was conducted over three weeks from 8 April to 29
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April 2018. The work aimed to identify the different needs, concerns, risks and vulnerabilities of women, girls, boys and men in both Rohingya refugee communities and host communities in the Cox’s Bazar district of Bangladesh. The analysis shows various gaps in the humanitarian response for both communities, especially in terms of accountability, communication with affected communities and disaster preparedness, but also in equitable access to services, in particular for women and girls, and especially for the Rohingya community. The key findings are presented below, along with recommendations for action.
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The report explores strategies for sustaining the country’s responses to the three diseases and eventually transitioning away from external funding and programmatic support. It takes stock of Kenya’s health financing landscape and identifies opportunit
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ies and challenges for sustaining effective coverage of HIV, TB, and malaria services in the long run, mindful of macro-fiscal and institutional constraints. The report informs ongoing dialogue within government, including among the Ministry of Health, National Treasury, Council of Governors, and National AIDS Control Council, as well as between government and development partners.
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The African report on children with disabilities: promising starts and persisting
by Mark Nunn, Annalies Borrel, Allison deFranco et al.
The African Child Policy Forum (ACPF)
(2014)
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This pan-African report describes and analyses the cultural, social, physical and other societal barriers preventing children with disabilities in Africa from realising their full human potential. It also describes the opportunities, initiatives and
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good practices that exist, that indicate the progress, albeit insufficient, that has been made towards realising the rights for children with disabilities in Africa. Recommendations and priorities for action are presented which promote inclusive and accessible laws, policies, and programmes for children with disabilities throughout Africa
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Nearly half the population of Sierra Leone is under the age of 18 years and the impact of the Ebola crisis on their lives now and on their future opportunities has been far-reaching: no school; loss of family members and friends to the virus; and ch
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anging roles and responsibilities in the home and the community.
While the priority now remains meeting the goal of zero cases, the Government of Sierra Leone (GoSL) is also developing a comprehensive strategy aimed at supporting communities to recover from this crisis, to put the country back on track to meet development targets. The Ebola Recovery Strategy – currently being finalised by the GoSL – represents a potentially transformative framework to support the immediate recovery of children from the crisis and to ensure their place in the future development of Sierra Leone.
To date, there has not been a formal process for children to outline their own priorities for recovery to decision-makers. In mid-March 2015, child-centred agencies conducted a Children’s Ebola Recovery Assessment (CERA) in nine districts across Sierra Leone to create a mechanism for more than 1,100 boys and girls, to discuss issues of concern; assess the impact of the crisis on their roles, responsibilities and future opportunities; and to formulate their recommendations for recovery.
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Emergencies, in spite of their tragic nature and adverse effects on mental health, are unparalleled opportunities to build better mental health systems for all people in need. This WHO publication shows how this was done in 10 diverse emergency-affe
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cted areas
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This resource presents "the minimum level of educational quality and access in emergencies through to recovery. The aim of the handbook is to enhance the quality of educational preparedness, response and recovery; to increase access to safe and relevant learning
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opportunities for all learners, regardless of their age, gender or abilities; and to ensure accountability and strong coordination in the provision of education in emergencies through to recovery...The INEE Minimum Standards are organised in five domains: Foundation standards; Access and learning environment; Teaching and learning; Teachers and other education; personnel; Education policy". Available in different languages: English, French, Arabic, Azerbajani, Bangla, Indonesia, Bosnian, Coratian, Serbian, Burmese, Chinese, Dari, Japanese, Nepali, Pashto, Portugese, Russian, Spanish, Turkish, Urdu, Vietnamese
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Ebola virus disease preparedness strengthening team Gambia country visit 17–22 November 2014
World Health Organization
(2014)
The document summarizes the infrastructure and activities for Ebola virus disease (EVD) preparedness that are already in place in the Gambia and identifies opportunities for improvement to strengthen the nation’s readiness in the event of an EVD i
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ncident.
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Sustainability Criteria for CBR Programmes – Two Case studies of Provincial Programmes in Vietnam
Mijnarends DM, Pham D, Swaans K, et al.
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2011)
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This paper aims to explore the conditions needed for sustainable community based rehabilitation (CBR) programmes for persons with disabilities in Vietnam, and to identify the conditions and opportunities missing at present for the implementation of
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such programmes.
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Lesotho HIV policy scan and action plan
Beardsley, Kip., A. Zapfel, and T. Williamson
Washington, DC: Palladium, Health Policy Plus
(2017)
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Policy and Legal Opportunities for HIV Testing Services and Civil Society Engagement
Common Good creates opportunities for those marginalised by poverty and injustice to realise their full, God-given potential, and mobilizes the church to engage and act justly. (South Africa)
It outlines key achievements, needs and opportunities for intervention in the field of rehabilitation in Ukraine. The content of this document is a snapshot in time – not an in-depth analysis of the entire rehabilitation sector. The analysis focus
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es on rehabilitation policy and governance, service provision, financing, information management and human resources, with the aim of improving access to high-quality rehabilitation services in Ukraine.
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