The Tripartite AMR Country Self-Assessment Survey (TrACSS) helps to monitor country progress on the implementation of AMR national actions plans and has been administered on an annual basis by the Tripartite organizations (Food and Agriculture Organization of the United Nations (FAO), World Organisa...tion for Animal Health (OIE) and World Health Organization (WHO)) since 2016.
This report analyzes the global responses on the fourth round of TrACSS (2019-2020) and examines the global trends and actions towards addressing AMR in all sectors.
Complete country and global responses to all rounds of the survey can be accessed through the TrACSS database: https://amrcountryprogress.org/.
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Many critical questions remain about the effectiveness of COVID-19 vaccines in real-world settings. These questions can only be answered in post-introduction vaccine effectiveness studies.This guidance document outlines an approach to leverage existing surveillance systems ...highlight medbox">for Severe Acute Respiratory Infection (SARI) to estimate COVID-19 vaccine effectiveness (VE) in preventing SARI associated with laboratory-confirmed SARS-CoV-2 using existing SARI surveillance systems. The approach uses the test-negative design to evaluate VE; cases are SARI patients who tested positive for SARS-CoV-2, and controls are SARI patients who tested negative for SARS-CoV-2.
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Welcome to the World Health Organization pulse oximeter training manual. In many countries pulse
oximetry is mandatory for monitoring patients during anaesthesia. Although pulse oximetry is a simple and reliable technology that can detect low level...s of oxygen in the blood, it is only effective if the anaesthesia provider understands how an oximeter works and what to do when hypoxia is detected. This manual describes a simple plan to respond to this situation, and explains how oximeters work and how to use them. The manual contains essential information for all anaesthesia providers who are not experienced in using pulse oximetry and would be useful reading for all members of the theatre team.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in... low-staffed and low-resourced settings, and mortality rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Cancer centres are a major resource in ensuring a comprehensive approach to cancer treatment and its planning. As part of a new roadmap developed by WHO and IAEA to help countries design national cancer control programmes, this publication proposes ...a framework to develop a cancer centre and/or to strengthen the provision of services in an existing cancer centre. The publication provides the features of multidisciplinary cancer care and details the infrastructure, human resources and equipment for different services. This framework is expected to be used as a guide to implementation, taking into consideration the local context and resources.
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The practical guidance in the operational handbook aims to inform the development or revision of national policies and related implementation guidance on the management of TB in children and adolescents under programmatic circumstances and at different levels of the health system. The operational ha...ndbook can also help countries adequately plan for the uptake of interventions to better address the specific needs of children and adolescents with or at risk of TB. It can contribute to national efforts to build capacity among national and subnational programme managers and among health workers at all levels of the health care system.
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The marathon to eradicate polio is on its final lap: the world is more than 99% of the way to success. After millennia of living with poliovirus and suffering the paralysis it causes, today nearly all the world’s people live in polio-free countrie...s; two of the three strains of wild poliovirus (WPV) have been eradicated. Some 20 million people are walking who would have been paralysed had it not been for the efforts of national governments and health workers. If eradicating polio has been a marathon, the finishing line is in sight.
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This brief advocacy document highlights the burden, risks and prevention of injuries and violence, which took the lives of 4.4 million people in 2019 and constitute 8% of all deaths. Among the injury-related causes of death include road traffic cras...hes, drowning, falls, burns, poisoning and violence against oneself or others. For people age 5-29 years, three of the top five causes of death are injury-related, including road traffic injuries, homicide, and suicide. Injuries and violence are not evenly distributed across or within countries – some people are more vulnerable than others depending on the conditions in which they are born, grow, work, live and age; in general, being young, male and of low socioeconomic status all increase the risk of injury. This document, aimed at public health professionals; injury prevention researchers, practitioners and advocates; and donors, draws attention to specific strategies based on sound scientific evidence that are effective and cost-effective at preventing injuries and violence; it is critical that these strategies are more widely implemented.
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Climate change presents the single biggest threat to human development, and its widespread impacts disproportionately burden the poorest and most vulnerable households in fragile and rural developing contexts – particularly women and children.
According to the Intergovernmental Panel on Climate C...hange’s (IPCC) latest report, ‘between 2010 and 2020, droughts, floods and storms killed 15 times as many people in highly vulnerable countries, particularly in Africa — which is responsible for less than 3 percent of global emissions – than in the wealthiest countries’.
Recognising environmental degradation and climate change are key accelerators of extreme child vulnerability, World Vision (WV) approved the Environmental Stewardship Management Policy (‘the Policy’) and Guidelines (‘the Guidelines’) in 2021.
To support the implementation of the Policy and Guidelines, WV has developed this Environmental Stewardship and Climate Action Handbook (‘the Handbook’) to help offices across the WV Partnership implement best practice environmental management strategies both in the field and in our operations and facilities.
Integrating environmental stewardship and climate action into all our work – whether that be in our Area Programmes, grant projects, responses to disasters or advocacy – is critical to achieving WV’s strategy.
As a Christian organisation we are compelled to follow the ways of Jesus Christ, calling us to care for the ‘least of these’ (Matthew 25:40) – the vulnerable children who are disproportionately impacted by climate change. Our response to the degradation of the environment is not motivated by political expediency or funding – but because we are called to steward God’s creation (Genesis 1:28).
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Sexual exploitation, sexual abuse and sexual harassment (SEAH) violate the rights and wellbeing of the people we serve and the people with whom we serve. Such behaviours are directly in opposition to WHO’s values and our abiding responsibility to do no harm. WHO uses the umbrella term “sexual mi...sconduct” to encompass the full spectrum of prohibited and unwanted behaviour of a sexual nature (including rape and sexual assault) as described in WHO’s 2023 Policy for preventing and addressing sexual misconduct (1). This is because all such acts are prohibited – whether perpetrated by WHO’s own personnel or by implementing partners – and therefore constitute misconduct. The term sexual misconduct is also easier to communicate and translate, as
victims and survivors do not always understand the complicated acronyms and definitions used by the United Nations (UN) and the humanitarian sector. However, we use the terms sexual misconduct and SEAH interchangeably as required when we interact with UN and other stakeholders.
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This volume contains monographs prepared at the ninety-first meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA), which met virtually online from 1 to 12 February 2021.
The detailed monographs in this volume summarize data on specific contaminants in food. Individual monographs ...present the assessment of exposure to cadmium from all food sources, the technical, analytical, dietary exposure and toxicological data on ergot alkaloids, an assessment of five substances that may occur as previous cargoes, and a revision of the specifications for steviol glycosides. This volume and others in the WHO Food Additives series contain information that is useful to those who produce and use food additives and veterinary drugs and those involved with controlling contaminants in food, government and food regulatory officers, industrial testing laboratories, toxicological laboratories and universities.
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This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for...n> lending and investments have been disclosed since the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
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Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response r...emain woefully inadequate. We know by now that the world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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The annual Development Co-operation Report brings new evidence, analysis and ideas on
sustainable development to members of the OECD Development Assistance Committee (DAC) and the international community more broadly. The objectives are to promote best practices and innovation in development co-ope...ration and to inform and shape policy reform and behaviour change to realise better lives and the Sustainable Development Goals for all
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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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This volume on CVDs, renal, and respiratory disorders has particularly high value. It carries the potential to become the most effective game-changer in global health by helping all countries to combat, contain, and control the biggest killer presen...tly prowling the globe and by enabling us to reach the 2030 goals for NCDs and health overall. As one who has witnessed the epidemic of CVDs advance menacingly across the world in the past four decades, I fervently hope that the clear and convincing messages conveyed by the extensively researched and elegantly communicated analyses in this volume will be heard, heeded, and harmonized with policy and practice in all countries.
Large file: 33 MB. Please download directly from the website link.
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This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delivery, and timely postnatal care (PNC).This s...tudy uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12regions.We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use.We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for...span> heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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WHO has issued a new recommendation on the length of bladder catheterization following surgical repair of a simple obstetric urinary fistula. Currently the length of catheterization is not standard and ranges from 5 to 42 days. The new guidance recommends a 7–10 day period of bladder catheterizati...on to allow complete healing. Longer periods of catheterization can be inconvenient for the woman, her family and care providers as it is associated with more discomfort and inconvenience. It also increases the risk of infection and erosion related to catheterization; requires more intensive nursing care and costs more per patient.
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