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Toolboxes
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a
...
risk factor for other noncommunicable diseases and comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
more
The health and socioeconomic crisis triggered by the COVID-19 pandemic has hit the countries of Latin America hard and laid bare the profound inequities about which numerous international, regional
...
and national reports have sounded warnings in recent decades. In this context, the historical political and economic exclusion and marginalization of the more than 800 indigenous peoples in the region has been accentuated as a result of insufficient State responses to the crisis, which have not adequately considered the collective rights of these peoples and have had little cultural relevance.
This document provides an overview of the situation of indigenous peoples in the region in the face of the COVID-19 pandemic. It analyses both the State’s and indigenous peoples’ own responses to the crisis, as well as offering a set of recommendations to rectify the neglect of these peoples in the management of the pandemic, centring on their collective rights.
more
In 2016, the risk of premature mortality1 from noncommunicable diseases (NCDs) in Ethiopia was 18.3%. The economic costs of NCDs are significant and are due principally to their
...
impact on the non-health sector (reduced workforce and productivity). In this study, it is estimated that NCDs cost Ethiopia at least 31.3 billion birr (US$ 1.1 billion) per year, equivalent to 1.8% of the gross domestic product (GDP). Less than 15% of the costs are for health care.
more
In the present report, the Special Rapporteur on the sale and sexual exploitation of children, including child prostitution, child pornography and other child sexual abuse mate
...
rial, Mama Fatima Singhateh, focuses on the impact of the coronavirus disease (COVID-19) pandemic on increased risk and various manifestations of sale and sexual exploitation of children. The Special Rapporteur outlines the push and pull factors, protection challenges and good practices, and provides recommendations on measures to address the heightened risks of sale and sexual exploitation of children, both online and offline, during and in the aftermath of the COVID-19 crisis and the ensuing lockdowns.
more
Hypertension in adults: diagnosis and management
the National Institute for Health and Care Excellence (NICE)
the National Institute for Health and Care Excellence (NICE)
(2023)
CC
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults o
...
ver 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm diagnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
more
Today more people are exposed to hazards. While humanitarian action to mitigate the impact of disasters will always be vitally important, the community is facing critical challenge- how to better anticipate, manage
...
and reduce - disaster risks by integrating the potential threat into its planning and policies at the community level. This manual aims to improve the capacity of the Panchayati Raj Institutions - the local self government and communities that face hazards due to environmental reasons. To help such capacity development efforts, we need learning materials focusing on key areas - water supply, environmental sanitation for better disaster management and preparedness.
more
Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines
...
and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and technologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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 multisectoral 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 chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series tit
...
led “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the Caribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
more
The report provides an overview of the disaster risk reduction and management in Nepal, a country under threat of multiple natural hazards: earthqu
...
akes, floods, landslides, fires, storms, the epidemics, and others. It presents background information on the country, its disaster profile, its legal and institutional framework, the country's achievements in regards to the Hyogo Framework for Action, and looks at the challenges and future steps in the area of disaster management in Nepal.
more
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality
...
and is growing in impact, with cases projected to rise from 537 million in 2021 to 784 million by 2045.1 As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030.2 Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
more
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality
...
and is growing in impact, with cases projected to rise from 537 million in 2021 to 784 million by 2045. As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030. Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
more
Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public hea
...
lth issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwide represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
more
The Resolution Population and Individual Approaches to the Prevention and Management of Diabetes and
...
Obesity was approved by the 48th Directing Council of the Pan American Health Organization, September 29- October 3, 2008, in response to the epidemic of obesity and diabetes currently affecting the countries of the Americas. Its main goal is to call on Member States to prioritize the prevention of obesity and diabetes and their common risk factors by establishing and/or strengthening policies and programs, integrating them into public and private health systems and working to ensure adequate allocation of resources to carry out such policies and programs.
more
Safe drinking-water management must consider drinking-water quality, acceptability and quantity in the context of public health protection. In this manual, the term “safety” encompasses these th
...
ree elements. Although the principles in this manual can be broadly applied to all types of drinking-water supplies, the guidance is primarily intended for piped water supplies that are professionally managed (by a water supplier or equivalent management entity).The guidance may be applied to existing drinking-water supplies, or adapted for water supplies that are in the planning stage before construction.
more
A recent survey of the literature and experience identified five broad actions that development institutions and governments, as well as their partners an
...
d stakeholders, can take to improve disability-inclusive disaster risk management. Those five actions are:
- Include persons with disabilities as valued stakeholders in disaster risk management activities
- Help remove barriers to the full participation of persons with disabilities
- Increase awareness among governments and their partners of the safety and security needs of persons with disabilities
- Collect data that is disaggregated by disability
- Ensure that new construction, rehabilitation and reconstruction are accessible to persons with disabilities more
- Include persons with disabilities as valued stakeholders in disaster risk management activities
- Help remove barriers to the full participation of persons with disabilities
- Increase awareness among governments and their partners of the safety and security needs of persons with disabilities
- Collect data that is disaggregated by disability
- Ensure that new construction, rehabilitation and reconstruction are accessible to persons with disabilities more
Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its manage
...
ment.
Newer technologies, including those driven by artificial intelligence, have the potential to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
more
Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of
...
children under 5 years old and
one-fi fth of adolescents are obese, while rates of overweight and obesity among adults approach 60%. Obesity is the major modifi able risk factor for diabetes.
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 c
...
ountries, 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
Policy Guidance Brief 2
• The potential health risks from climate change include: increase of waterborne and vector-borne diseases, heat-related illnesses, injuries and deaths, food insecurit ... y and increased malnutrition. The poor, women, children and the elderly, as well as communities living in remote high-risk areas are most vulnerable.
• The expected results to achieve this outcome are: (i) climate risk management system is well-established, robust and nationally integrated to respond efectively to increased intensity and impact of risks and hazards on people’s health and wellbeing; (ii) improved social protection, gender consideration and risk finance capacity to prepare for and recover from potential loss and damage resulting from climate change; (iii) Myanmar’s health system is improved and can deal with climate-induced health hazards and support climate-vulnerable communities to respond effectively to disaster and health hazards from climate change. more
• The potential health risks from climate change include: increase of waterborne and vector-borne diseases, heat-related illnesses, injuries and deaths, food insecurit ... y and increased malnutrition. The poor, women, children and the elderly, as well as communities living in remote high-risk areas are most vulnerable.
• The expected results to achieve this outcome are: (i) climate risk management system is well-established, robust and nationally integrated to respond efectively to increased intensity and impact of risks and hazards on people’s health and wellbeing; (ii) improved social protection, gender consideration and risk finance capacity to prepare for and recover from potential loss and damage resulting from climate change; (iii) Myanmar’s health system is improved and can deal with climate-induced health hazards and support climate-vulnerable communities to respond effectively to disaster and health hazards from climate change. more