This evaluation is the first systematic effort by UNICEF to generate evidence on how well its global as well as country level Community Management of Acute Malnutrition (CMAM) strategies have worked, including their acceptance and ownership in vario...us contexts and appropriateness of investments in capacity development and supply components. Overall, the evaluation recommends that UNICEF continue to promote and support CMAM as a viable approach to preventing and addressing severe acute malnutrition (SAM), with an emphasis on prevention through strengthening community outreach and integrating CMAM into national health systems and with other intervention
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This is the fourth guidance note in a four-part series of notes related to impact evaluation developed by InterAction with financial support from the Rockefeller Foundation.This fourth guidance note..., Use of Impact Evaluation Results, highlights three themes crucial for effective utilization of evaluation results. Theme one states that use does not happen by accident. Impact evaluations are more likely to be used when uses have been anticipated and planned from the earliest stages of the evaluation and, even better, from the planning stages of the work that is being evaluated. Theme two concerns the operations and systems required in an organization to use impact evaluations well. Theme three builds from the premise that the first two themes are necessary but insufficient conditions for the effective and widespread use of impact evaluations. The guidance note is also available in French, Arabic and Spanish on https://www.interaction.org/impact-evaluation-notes.
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This report started with a simple question—“How can we tell how much funding is devoted to global health programs?”—and ended (more than two years later) with an answer that is far from simple. As those who have tried know well, tracking health-related funding is challenging in any setting, ...given the range of public and private sources and the many types of services and programs that fall within the definition of “health sector.” It is made all the more complicated when significant external support from donors and private charities plus in-kind donations of drugs and other inputs are taken into account. The task is made yet harder by inadequate public expenditure management systems in countries where public agencies’ capacity is stretched very thin and by donor accounting structures that are not designed to respond in a timely way
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SITUATION ANALYSIS
• In Syria, nine years into the crisis, access to sucient quantities of safe water remains limited, with increased water quality assurances and support to water ...tribute-to-highlight medbox">systems rehabilitation, operation and maintenance unconditionally needed.
• There is a need to maintain the provision of adequate WASH services and supplies for IDPs especially in the northeast and northwest, and to promote transition to more sustainable solutions while acknowledging that more emphasis on IDPs in collective centers and open areas is also needed.
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The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental health conditions. Meanwhile, those wit...h pre-existing mental health conditions may experience a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
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The biosphere underlies the whole sustainable development concept, as the layer on
which society and the economy rely. Nature and biodiversity fuel the natural cycles
and life-support systems ...n class="attribute-to-highlight medbox">of the planet, on which humanity ultimately depends.
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Health care-associated infection (HCAI) places a serious disease burden and has a significant economic impact on patients and health-care systems throughout the world. Yet good hand hygiene, the simple task ...box">of cleaning hands at the right times and in the right way, can save lives. World Health Organization (WHO) has developed evidence-based WHO Guidelines on Hand Hygiene in Health Care to support health-care facilities to improve hand hygiene and thus reduce HCAI.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompan...iment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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This is the fifth report of the Global Evidence Review on Health and Migration (GEHM) series. The publication focuses on the mental health needs of refugees and migrants by providing an overview ...an class="attribute-to-highlight medbox">of the available evidence on patterns of risk and protective factors and of facilitators and barriers to care at all levels (individual, family, community and national government). It identifies five high-level themes, each of which has implications for research and policy and is relevant across refugee and migrant groups, contexts and stages of the migration process: self-identity and community support; basic needs and security; cultural concepts of mental health as well as stigma; exposure to adversity and potentially traumatic events; navigating mental health and other systems and services.
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid ...unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve health and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed... across all domains of quality health services: effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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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.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimin...ation, whilst highlighting challenges caused by high disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities ...for personal autonomy and self-realization. To promote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities ...for personal autonomy and self-realization. To promote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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Under the newly established Africa Trust Fund on Disability, World Bank-UNICEF and USAID are jointly organizing a series of 3 webinars on the topic of disability-inclusive education. The series expl...ores essential components of the enabling environment and service delivery that can support efforts to create inclusive education systems for all, including students with disabilities, and help reach the Sustainable Development Goal of equitable quality education for all by 2030. World Bank will be hosting the first webinar. The rest of the webinars will be hosted subsequently by other institutions. This webinar seeks to: 1) Increase knowledge regarding the policy development process and regional policy diagnostics 2) Strengthen understanding around disability data collection, instruments of collection, dis-aggregation and how that fits into the broader context of education data.
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The Global Breast Cancer Initiative aims to address disparities in access to care to reduce mortality rates globally. Patient navigation is an evidence-based personalized intervention designed to guide patients through often complex cancer care systems...an> to receive timely access, particularly in low-income and minority populations. It is useful in settings with limited availability, fragmented healthcare systems and socioeconomic barriers that hinder early detection and treatment. It is proven to significantly reduce delays, improve patient adherence to care and enhance survival rates. The model involves helping individuals and their families to tackle barriers such as cultural stigma, misinformation, and psychosocial, among others, that can delay or prevent access to timely care. It can also reduce financial strain, streamline care coordination and improve the overall quality of life by connecting patients with affordable treatment options and support systems to address their needs in the course of treatment.
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The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile health systems are further stressed as health workers navi...gate an increased client load and demands at work while also being concerned for their own health and that of their families. Health facilities have been redesigned to care for patients with COVID-19, posing challenges to other services. Governments and civil society organizations have redirected scarce resources and shifted programming priorities to respond to the pandemic. Several countries have reported intermittent declines in HIV testing and diagnosis, antenatal care visits, collection of antiretroviral medicines (ARVs) by people living with HIV, and attendance at clinic appointments. Community-based education and support programmes have had to rapidly adapt to restrictions on movement and public gatherings. Children, adolescents, and women have experienced multiple deprivations due to the adverse impact of the pandemic.
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By almost any measure, human health is better now than at any time in history. Life expectancy has soared from 47 years in 1950–1955, to 69 years in 2005–2010, and death rates in children younger than 5 years of age have decreased substantially,... from 214 per thousand live births in 1950–1955, to 59 in 2005–2010. But these gains in human health have come at a high price: the degradation of nature’s ecological systems on a scale never seen in human history. A growing body of evidence shows that the health of humanity is intrinsically linked to the health of the environment, but by its actions humanity now threatens to destabilise the Earth’s key life-support systems.
As a Commission, we conclude that the continuing degradation of natural systems threatens to reverse the health gains seen over the last century. In short, we have mortgaged the health of future generations to realise economic and development gains in the present.
Despite present limitations, the Sustainable Development Goals provide a great opportunity to integrate health and sustainability through the judicious selection of relevant indicators relevant to human wellbeing, the enabling infrastructure for development, and the supporting natural systems, together with the need for strong governance.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c...ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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