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The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra
...
nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
more
BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r
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eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
more
This module has been developed to provide training and guidance to improve the quality of care and human rights conditions in inpatient, outpatient and community based mental health and related serv
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ices, following the conduct of a comprehensive assessment using the WHO QualityRights assessment toolkit.
more
This operational guidance on MHPSS provides a practical orientation and tools for UNHCR country operations. It covers specific points of good practice to consider when developing MHPSS programming and offers advice on priority issues and practical difficulties, while also providing some background i
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nformation and definitions. Since MHPSS is a cross cutting concept this operational guidance is relevant for programming in various sectors, including health, community based protection, education, shelter, nutrition, food security and livelihoods.
The focus of this operational guidance is on refugees and asylum seekers, but it may apply to other persons of concern within UNHCR operations such as stateless persons, internally displaced persons and returnees. The guidance is meant for operations in both camp and non-camp settings, and in both rural and urban settings in low and middle-income countries with a UNHCR presence.
The guidance should be adapted according to different contexts. A standardized format for programme implementation cannot be offered because this depends to a large extent on existing national capacities and local opportunities.
more
Village Hope Core International works in collaboration with the Ministry of Health and along with the Kenya Red Cross and Plan International are training their community health workers with these materials. Village HopeCore has reassigned their hand
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washing stations from schools to health facilities and are working on other solutions such as telemedicine, digital communication and other community-based interventions.
more
The checklist and reference list has two parts: high-level cross-cutting content (Part A) and specific programme content (Part B). Part A applies to all countries and contains situation and response analysis, the NSP development process, the goal, targets and priority-setting of the NSP and the prin
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ciples of human rights and gender equity and sustainability. Part B comprises the programme requirements of prevention, treatment and care, comorbidities and integration, social protection, health systems, community engagement, human rights and gender equity, efficiency and effectiveness, governance, management and accountability, HIV and the humanitarian response
more
Knowledge, attitudes and practices about human African trypanosomiasis and their implications in designing intervention strategies for Yei county, South Sudan
Bukachi, SA.; Mumbo, AA.; Alak, ACD.; Sebit, W.; Rumunu, J. et al.
PLOS Neclected Tropical Diseases
(2018)
CC
A clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into So
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uth Sudan, as part of integrated delivery of primary healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy.
more
WASH and Health working together: a ‘how-to’ guide for neglected tropical disease programmes
recommended
2nd edition. This toolkit provides step-by-step guidance to NTD programme managers and partners on how to engage and work collaboratively with the WASH community to improve delivery of water, sanitation and hygiene services to underserved population
...
affected by many neglected tropical diseases. The toolkit draws on tools and practices used in the delivery of coordinated and integrated programmes for control, elimination and eradication of NTDs. This second edition include revisions and new tools based on experiences of using the toolkit in more than 20 countries.
more
The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, c
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hronic respiratory diseases, and cancers. Designed for implementation in primary healthcare settings, especially in low-resource environments, the package includes protocols for screening, diagnosis, treatment, and management of these diseases. The document emphasizes an integrated approach, supporting universal health coverage by empowering healthcare workers with practical tools to improve NCD care. It aims to reduce premature mortality from NCDs and enhance global health equity.
more
This module covers common Non-Communicable Diseases such as Hypertension, Diabetes and three common cancers (Cervical,
Breast and Oral cancer). The focus of this module is on building the knowledge and skills of the Multi-Purpose Workers (MPW) in
undertaking Population
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Based Screening, identifi cation of cases for referral, follow up, recognition of complications, prevention
and health promotion. This module can be used by the female
or male MPW. However, while the content of the overall module
is the same for both some tasks will be different, particularly
those related to screening which the female MPW will have to
undertake. It is expected that the ANM/MPW will work closely
with the ASHA in her area. Together they form a front line worker
team to serve the needs of the community. The content of this
module will be covered in three days.
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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 navigate an increased client load and demands at work while also being concerned for their own health and
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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.
more
PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interagency team has developed a person-centered, district-tailored and Malawi Population-
...
Based HIV Impact Assessment (MPHIA)-informed strategy through extensive engagement with Government of Malawi (GoM) and Civil Society Organizations (CSOs) to sustain HIV epidemic control. At the end of COP21, PEPFAR Malawi was commended for contributing to reaching epidemic control in strong collaboration with GoM and stakeholders including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This includes enrollment of 88% of recipients of care on three or more months of antiretroviral treatment (ART), better outcomes for Malawian children through remarkable efforts in Orphans and Vulnerable Children (OVC) programming and progress made towards reaching men with more intentional and focused programming.
more
Vol 5 No 27 | ISSN 2039-2117 (online) | ISSN 2039-9340 (print) | The rate of sexual victimization of mentally retarded children is alarming and it goes unnoticed because the perpetrators could be parents, step- parents, relatives, well-respected individuals by family members, neighbours and educator
...
s. Drawing from labelling theory that the mentally retarded have low IQ, majority of perpetrators tend not to get arrested because of lack of evidence. Research indicates that educators struggle to identify the psychological, behavioural and physical symptoms of sexual abuse owing to their limited training. Having employed systematic review as methodology, this research study found that mentally retarded children are prone to HIV/AIDS, PTSD and feelings of helplessness owing to uninvolvement of parents, dysfunctional communities, poverty and their inability to differentiate between abuse and affection. Based on the findings, the recommendations are that: (1) extensive training for professionals, families and community members be executed to protect children with intellectual disability. Furthermore, the rights of the mentally retarded children must be respected in the court of law when reporting sexual abuse.
more
Information on 102 commonly used medicinal plants in the South Pacific WHO regional publications. Western Pacific series ; Plants from this part of the world represent an especially diverse flora and include several species currently undergoing scientific investigation. Common traditional uses inclu
...
de the treatment of minor injuries, childhood ailments, and complications of pregnancy. Plants described in the book are also used as emetics and as ointments and dressings applied to surface wounds or used to treat skin problems.
Addressed to ethnobotanists, phytochemists, and pharmacologists, the book aims to document traditional clinical uses and bring these to the attention of the international scientific community, while also preserving knowledge about the distinctive indigenous practices in these island communities. Full-colour photographs are included to facilitate identification of plants and plant parts used for medicinal purposes. Each plant is described according to a common format, which includes information on scientific name, local names, English name, a description of the plant and its habitat and distribution, and a summary of what is known about its chemical constituents, biological activity, and traditional uses.
more
Using the WHO model list of essential medicines to update a national essential medicines list
Since 1977, WHO has been working with countries to design the package of essential medicines as an integral component of treatment within the continuum of
...
care, developing and disseminating the Model List of Essential Medicines (Model List). WHO is committed to supporting Member States in sharing best practices in selecting
essential medicines, and in developing processes for the selection of medicines for national essential medicines lists (national EMLs, or NEMLs) consistent with the evidence-based methods used for updating the WHO Model List.
more
Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatm
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ent for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas, the high burden of new N. gonorrhoeae infections (estimated at 11 million new cases a year), the complexity of the disease epidemiology, and in many countries the limited resources, make it difficult to fully understand the burden of disease and the burden of antimicrobial resistance (AMR) in N. gonorrhoeae.
PAHO has developed this document to facilitate the navigation of available guidance and recommendations for N. gonorrhoeae AMR surveillance by public health and health care professionals, at the national and subnational levels, involved in designing, implementing, and/or strengthening AMR surveillance of N. gonorrhoeae and overall surveillance of sexually transmitted infections.
more
Palliative care for children with life-limiting illness is the active total care of the child’s body, mind, and spirit. It begins at diagnosis and continues regardless of whether the child receives treatment directed at the disease. It seeks to co
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ntrol all forms of suffering related to the illness, including pain. It involves social, psychological, spiritual, and legal support to siblings, parents, and other close family members. Effective palliative care for children requires health professionals trained to assess symptoms, care for children of different ages and developmental stages, and to provide medicines in pediatric formulations. Care may be provided in tertiary care facilities, community health centers, and at home. The child’s best interest must inform all aspects of the treatment andcare, and the child’s rights must be protected at all times.
more
Guidelines on Management of COVID-19 in Kenya
recommended
It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi-sectoral technical working groups on testing, case management, risk communication and
...
community engagement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
more
Effective malaria case management requires quick access to diagnostics and antimalarial treatments to reduce illness and death. Artemisinin-based combination therapy (ACT) has been essential to malaria tre
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atment since 2001, as it combines artemisinin for rapid parasite reduction with a partner drug to ensure complete cure. However, resistance to antimalarial drugs, where parasites survive standard doses, threatens malaria control.
more
The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t
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o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
more
This document builds on the Background document prepared for the September 4-5, 2014 Consultation. It includes proposed elements to consider during the development of a framework to assist decision-making at global and national level.
The aim of the document is to assist Member States and releva
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nt partners in their discussions to identify the best approaches to ensure the accelerated evaluation and use of available or near-term therapies and vaccines for the treatment and prevention of EVD. The document calls for a coordinated effort by the international community to remove unnecessary obstacles towards this goal.
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Resource Manual on Flash Flood Risk Management - Module 3: Structural Measures
A. Bhakta Shrestha; E. GC; R. Prasad Adhikary; S. Kumar Rai
International Centre for Integrated Mountain Development, ICIMOD, Nepal
(2012)
This publication, the third module of a resource manual to support the training of planners and practitioners in managing flash flood risk, deals with structural measures. It presents bioengineering techniques, physical measures for slope stabilisation and erosion control, and physical measures for
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river training. It also presents the concept of integrated flood management as a component of integrated water resource management. It emphasizes that structural measures are most effective and sustainable when implemented together with appropriate non-structural measures. The manual is aimed at junior to mid-level professionals with a civil engineering background working on flash flood risk management at the district level.
Flash floods are among the most destructive natural disasters in the Hindu Kush Himalayan region. Flash flood mitigation is generally addressed by community-based organisations, local non-governmental organisations, or district and local-level staff in government organisations. But these groups often lack adequate understanding of the processes causing flash floods and knowledge of flash flood risk management measures.
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Manual for step-by-step risk management for safely managed sanitation systems. 2nd edition.
This Sanitation safety planning (SSP) manual provides practical, step-by-step guidance to assist in the implementation of the 2018 World Health Organization (WHO) Guidelines on sanitation and health and the
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2006 WHO Guidelines for safe use of wastewater, excreta and greywater in agriculture and aquaculture. The approach and tools should be applied to all sanitary systems to ensure that they are managed to meet health objectives.
The SSP manual is targeted at a variety of users at different levels including; health authorities and regulators, local authorities, sanitation utility managers, sanitation enterprises and farmers, community-based organizations, farmers associations and nongovernmental organizations.
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A broad range of UNHCR’s key priorities overlap with MHPSS issues – for example, child protection and sexual and gender-based violence [SGBV] prevention and response.
Despite all these existent synergies, UNHCR’s current policies and guideli
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nes do not sufficiently link with MHPSS principles. For example, the Community Services section, which is closely aligned to the principles of MHPSS and could be well-positioned to guide the implementation of related programs, has not adopted the MHPSS language or approach.
There are opportunities for UNHCR to engage more strongly and clearly in this field. However, this requires a vision for how the organisation as a whole, and particular sectors within the organisation, will engage within the field of MHPSS activities. For a start, UNHCR can work to improve its understanding and framing of mental health and psychosocial issues, and how these issues fit within its broader mandate.
While the majority of MHPSS activities are delivered by implementing partners, UNHCR staff require familiarity with core principles in the field, such as the Intervention Pyramid contained in the IASC Guidelines, in order to support and monitor quality MHPSS activities.
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This field guide is a practical tool for improving and maintaining drinking-water safety. It is designed to be used by YOU as a rural community member who shares responsibility for operation and management of the drinking-water supply in your
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community. It can also be used by YOU as a staff member of the local health or water supply office, local government authority, nongovernmental organization (NGO) or other community-based organization that supports drinking-water safety in rural communities. Ensuring the safety of the community water supply is a daily job, and community members and other stakeholders have to work jointly to achieve this goal.
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This updated Comprehensive Mental Health Action Plan 2013-2030 builds upon its predecessor and sets out clear actions for Member States, the WHO Secretariat and international, regional and national partners to promote mental health and well-being for all, to prevent mental health conditions for thos
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e at-risk and to achieve universal coverage for mental health services. While the updated action plan includes new and updated indicators and implementation options, the original four major objectives remain unchanged: more effective leadership and governance for mental health; the provision of comprehensive, integrated mental health and social care services in community-based settings; implementation of strategies for promotion and prevention; and strengthened information systems, evidence and research.
In English, French, Spanish, Arabic and Russian available
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The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care services and systems to deliver integrated care in community settings and support the development of ICOPE implementation action p
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lans. There are 19 actions needed to implement ICOPE on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements
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Infectious diseases like COVID-19 can disrupt the environments in which children grow and develop. Disruptions to families, friendships, daily routines and the wider community can have negative consequences for children’s well-being, development a
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nd protection. In addition, measures used to prevent and control the spread of COVID-19 can expose children to protection risks. Home-based, facility-based and zonal-based quarantine and isolation measures can all negatively impact children and their families.
The aim of this brief is to support child protection practitioners to better respond to the child protection risks during a COVID-19 pandemic. Part 1 presents the potential child protection risks COVID-19 can pose to children. Part 2 presents programmatic options in line with the 2019 Minimum Standards for Child Protection in Humanitarian Action (CPMS) and the Guidance Note: Protection of Children During Infectious Disease Outbreaks.
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Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as h
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igh as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
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his course is intended for decision-makers and programme managers who want to learn more about neglected tropical diseases (NTDs) in the context of the COVID-19 pandemic. Its 5 modules introduce NTDs, outline the impact of COVID-19 on NTD programmes and WHO’s response to mitigate its consequences,
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and finally present WHO’s recommendations on maintenance of essential health services for NTDs as well as guidance on adaptation and safe resumption of community-based NTD activities during the pandemic.
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These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the t
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reatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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GUIDE PRATIQUE À L’INTENTION DES PROGRAMMES DE LUTTE CONTRE LES MALADIES TROPICALES NÉGLIGÉES
This toolkit provides step-by-step guidance to NTD programme managers and partners on how to engage and work collaboratively with the WASH community
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to improve delivery of water, sanitation and hygiene services to underserved population affected by many neglected tropical diseases. The toolkit is based on real-life programme experience, which users can match to their needs and local context. It includes a series of tools to help build multisectoral partnerships, mobilize resources, and design, implement and evaluate interventions.
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Strengthening mental health responses to COVID-19 in the Americas: A health policy analysis and recommendations
A. Tausch; Oliveira e Souza, R.; Martinez Viciana, C.; et al.
Pan American Health Organization
(2021)
CC
The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies
show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young
people, those with pre-existing mental health conditions, health workers, and p
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ersons living in vulnerable condi-
tions. Mental health systems and services have also been severely disrupted. A lack of financial and human resource
investments in mental health services, limited implementation of the decentralized community-based care approach
and policies to address the mental health gap prior to the pandemic, have all contributed to the current crisis. Coun-
tries must urgently strengthen their mental health responses to COVID-19 by taking actions to scale up mental
health and psychosocial support services for all, reach marginalized and at-risk populations, and build back better
mental health systems and services for the future.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the
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European Society of Cardiology Guidelines for the treatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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The Mexico Declaration for Circulatory Health brings together global health
organizations committed to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. These diseases presently represent the biggest health burden world-wide, accounting
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for over 17 million deaths every year. We are united around existing global strategies and targets to reduce the burden of heart disease and stroke. We are committed to achieving the World Health Organization (WHO) “25 by 25” non-communicable disease (NCD) targets, and the United Nations’ NCDrelated Sustainable Development Goals, based on known, effective and affordable
interventions for secondary prevention, primary prevention and primordial prevention in populations. As heart disease and stroke make up half of all NCD deaths, our efforts, working together as the international cardiovascular community, are central to achieving these global goals.
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab
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ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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The "Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases: Report of the 2021 Global Survey" by WHO examines the global state of readiness and infrastructure for managing noncommunicable diseases (NCDs) across countries. B
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ased on the 2021 survey, it analyzes national capabilities in public health infrastructure, policies, health systems, and the impact of the COVID-19 pandemic on NCD-related resources. The report highlights gaps and strengths in NCD prevention, treatment, and health policy integration, offering insights for improving NCD care worldwide. It emphasizes the need for multisectoral collaboration and targeted actions to meet global health goals.
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The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria,
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Uganda, and South Africa, the review identifies key challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
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This WHO Guidance Note advocates for a comprehensive approach to cervical cancer prevention and control and is aimed at senior policy makers and programme managers. It describes the need to deliver effective interventions across the female life course from childhood through to adulthood. These inclu
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de community education, social mobilization, HPV vaccination, screening, treatment and palliative care. It outlines the complementary strategies for comprehensive cervical cancer prevention and control, and highlights collaboration across national health programmes (particularly immunization, reproductive health, cancer control and adolescent health), organizations and partners.
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Guidance on temporary malaria control measures in Ebola-affected countries
World Health Organization
(2014)
Malaria is a prevalent cause of febrile illnesses in areas with high transmission, and its clinical presentation overlaps with initial signs of Ebola disease. For this reason, the effectiveness of the Ebola response in Guinea, Liberia and Sierra Leone can be optimized through the deployment of targe
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ted measures to reduce the number of fever cases due to malaria
WHO recommends specific adaptations in the diagnosis of malaria and in LLIN distribution in countries heavily affected by the Ebola outbreak and mass drug administration using artemisinin-based combination therapies (ACTs) in areas where transmission of both Ebola and malaria is high and access to malaria treatment is very low.
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The Facilitator's Guide has been piloted in Borno (Nigeria) and in Fafan zone (Somali region, Ethiopia) and improved iteratively after each test.
What does the ROAP have that you won't find in other methodologies?
It is based on holistic, pe
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ople-centred approaches that span across sectors and consider people's perceptions, priorities, ways of coping, and assistance preferences.
It introduces the concepts of inter-sector needs profile and inter-sector causal analysis, and how to use these to articulate shared objectives and better integrated and holistic response packages, as opposed to siloed plans.
It introduces the concept of basic needs basket, and how to define the BN basket based on both households' perspective and sector experts' opinions, and acknowledging that needs have different frequencies and timings, and units of analysis (individual, household, community).
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The booklet starts with a general overview of how illicit drugs and the environment are linked within the bigger picture of the Sustainable Development Goals, climate change and environmental sustainability. It highlights direct and indirect linkages and gives examples of the significant local and i
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ndividual-level impact that drugs can have on the environment. This is followed by a more in-depth overview of the latest scientific evidence for plant-based drugs and for synthetic drugs. For plant-based drugs, for example, this includes an analysis of the relationship between illicit crop cultivation and deforestation. For synthetic drugs, it includes an analysis of waste composition, volumes, and dumping and discharge, as well as the relation with wastewater treatment.
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Communicable Diseases: Part 4 Other Diseases of Public Health Importance and Surveillance.
HEAT, UNICEF, Open University, AMREF
Ministry of Health, Federal Democratic Republic of Ethiopia
(2015)
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Blended Learning Modulef or the Health Extension Programme
In this study session, you will learn about the general features of faeco-oraldiseases: the main types commonly found in Ethiopia, their general symptomsand signs, how to treat mild cases and when to refer patients with severeconditions for
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specialised treatment, or laboratory tests to confirm thediagnosis. You will also learn about the importance of giving effective healtheducation to your community on ways to prevent and control faeco-oraldiseases.
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Integrated Management of Newborn and Childhood Illness, Part 1 Blended Learning Module for the Health Extension Programme
HEAT, UNICEF, Open University, AMREF, WHO
Ministry of Health, Federal Democratic Republic of Ethiopia
(2011)
C1
These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia. A strong focus is on enabling Ethiopi
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a to meet the Millennium Development Goals to reduce maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery, postnatal care, the integrated management of newborn and childhood illness, communicable diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases), family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene and environmental health, non-communicable diseases, health education and community mobilisation, and health planning and professional ethics.
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Antimicrobial resistance (AMR) surveillance plays an important role in the early detection of resistant strains of public health importance and prompt response to outbreaks in hospitals and the community. Surveillance findings are needed to inform m
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edical practice, antibiotic stewardship, and policy and interventions to combat AMR. Appropriate use of antimicrobials, informed by surveillance, improves patients’ treatment outcomes and reduces the emergence and spread of AMR. This protocol describes the steps and procedures to establish/enhance AMR surveillance in Latin America and the Caribbean.
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No education system is effective unless it promotes the health and well-being of its students, staff and community. These strong links have never been more visible and compelling than in the context of the COVID-19 pandemic. Towards making every sch
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ool a health-promoting school: Let’s start with a shared vision based on the standards and indicators presented in this publication.
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Health Care Facilities (HCFs) are primarily responsible for management of the healthcare waste generated within the facilities, including activities undertaken by them in the community. The health care facilities, while generating the waste are resp
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onsible for segregation, collection, in-house transportation, pre-treatment of waste and storage of waste, before such waste is collected by Common Bio-medical Waste Treatment Facility(CBWTF) Operator. Thus, for proper management of the waste in the healthcare facilities the technical requirements of waste handling are needed to be understood and practiced by each category of the staff in accordance with the BMWM.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of
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Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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Global tuberculosis report 2022
recommended
The WHO Global Tuberculosis Report 2022 provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context
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of global TB commitments, strategies and targets.
The 2022 edition of the report is as usual, based primarily on data gathered by WHO from national ministries of health in annual rounds of data collection. In 2022, 202 countries and territories with more than 99% of the world’s population and TB cases reported data
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Antimicrobial resistance (AMR) is a threat to global health and development and it contributes to millions of deaths worldwide each year. Inappropriate use and overuse of antibiotics are driving an increase in AMR and have a detrimental impact on the effectiveness of these critical medicines. Throug
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h the Global Action Plan on AMR, WHO is working to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
There is a recognized need for high-quality resources to improve antibiotic prescribing globally. To address this need, a pragmatic approach was taken by WHO to develop actionable guidance for empiric antibiotic use.
The WHO AWaRe (Access, Watch, Reserve) antibiotic book provides concise, evidence-based guidance on the choice of antibiotic, dose, route of administration, and duration of treatment for more than 30 of the most common clinical infections in children and adults in both primary health care and hospital settings. The information included in the book supports the recommendations for antibiotics listed on the WHO Model Lists of Essential Medicines and Essential Medicines Children and the WHO AWaRe classification of antibiotics.
The WHO AWaRe antibiotic book is accompanied by summary infographics for each infection for both adults and children that provide a quick-reference guide for health care workers at the point of care.
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Breast cancer is the most common cancer worldwide and the leading cause of cancer deaths among women, disproportionately affecting low- and middle-income countries. The Global Breast Cancer Initiative strives to reduce breast cancer mortality by 2.5 percent per year, which over a 20-year period can
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save 2.5 million lives. The purpose of this core technical package is to outline a pathway for incremental, sustainable improvements tailored to country-specific needs based on three key strategies and objectives: health promotion for early detection; timely diagnosis; and comprehensive breast cancer management. This document provides a common framework linking policy makers, stakeholders, the clinical community, program managers and civil society to evidence-based systematic approaches that can facilitate health systems strengthening and reduce inequities in women’s health throughout their life cycles
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Outbreaks of mpox in newly affected countries have mostly been identified in communities of gay, bisexual and other men who have sex with men who have had recent sexual contact with a new partner or partners. Communities of trans and gender diverse people linked to the same sexual networks have also
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been affected.
This document (updated in March 2023) is intended for use by individuals, community leaders, influencers, health workers and others affected by or working on the mpox outbreak. It contains information to help people reduce their risk of mpox and to help slow the spread of the virus. This is the third version of this publication – it has been updated based on current public health advice.
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The Child Protection handbook provides a synthesis of good practice and learning and enables better advocacy and communication on child protection risks, needs and responses. Standards addressing child protection needs cover core work areas and critical issues. Those addressing strategy relate to ca
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se management, community-based child protection, child-friendly spaces and protection of excluded children. A fourth set of standards gives guidance on how workers in other sectors can ensure that their programmes are accessible and beneficial to children. DOCUMENT ALSO AVAILABLE IN: Arabic, Chinese, French, Indonesian, Korean, Spanish, Turkish, Urdu on http://cpwg.net/minimum_standards-topics/cpms-full-version/.
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To assess national-level responses to NCDs, WHO has implemented NCD country capacity surveys periodically since 2001. This report is the latest in that series. Since the first survey round, the NCD Country Capacity Survey (NCD CCS) has been conducted a further seven times, most recently in 2021. In
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the survey, completed by the NCD focal point within each country’s ministry of health or similar agency, countries are asked to report on the following topics relating to NCDs: (i) public health infrastructure, partnerships and multisectoral collaboration; (ii) policies, strategies and action plans; (iii) health information systems and surveillance; (iv) health system capacity for detection, treatment and care; and, added for 2021, (v) the impact of the COVID-19 pandemic on NCD-related resources and activities. The questionnaire is web-based and requires supporting documentation wherever possible. In the 2021 round, data were collected from May onwards, with the last survey responses arriving in September. Validation was carried out by WHO regional offices and WHO headquarters. Country responses to previous rounds of the survey were incorporated into the analysis to assess progress since 2010. Although all 194 Member States responded to the survey, data comparisons were restricted to the 160 countries that had responded to all rounds of the survey since 2010.
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he WHO global disability action plan 2014-2021 is a significant step towards achieving health and well-being and human rights for people with disabilities. The action plan was endorsed by WHO Member States in 2014 and calls for them to remove barriers and improve access to health services and progra
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mmes; strengthen and extend rehabilitation, assistive devices and support services, and community-based rehabilitation; and enhance collection of relevant and internationally comparable data on disability, and research on disability and related services. Achieving the objectives of the action plan better enables people with disabilities to fulfil their aspirations in all aspects of life.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem
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ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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In March 2020 the IASC Reference Group on Mental Health and Psychosocial Support uniting 57 humanitarian organizations as member issued the Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak. This document has proven to be very useful in the response and has
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till now been translated in 24 languages. It covers a set of recommended activities as well as messages for different target groups.
The current document is an annex to the Interim Briefing Note and is meant to support the MHPSS operational response within the various sectors of humanitarian work. Approaches and interventions to MHPSS are not confined to one sector, but need to be integrated within many existing sectors and clusters.This document contains a wealth of operational information and practical approaches that can be used for humanitarian programming in health, SGBV, community-based protection, nutrition, camp management and camp coordination.
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This guide provides an overview of the major elements that must be considered before, during and after the implementation of antigen-detecting rapid diagnostic tests (Ag-RDTs) for SARS-CoV-2. This guide is complementary to policy guidance issued by the World Health Organization (WHO). The guide may
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appeal to a range of audiences including Ministries of Health, donors, public and private organizations/agencies acting as implementing partners and community based and civil society organizations with experience working on health, especially organizations familiar with similar testing campaigns for other disease programmes like HIV and malaria
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This Course for Service Providers on how to give Vitamin A Supplementation and Deworming (VAS+D) uses both a Learner’sGuide and a Facilitator’s Guide. The Learner’s Guide is designed for participants in the course who are healthcare workers or trainers learning to deliver vitamin A and Albenda
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zole(for deworming) as part of regular activities associated with community or facility-based health care services, while the Facilitator’s Guide is designed for course facilitators who are planning and conducting courses .
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i
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n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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WHO recommendations on maternal and newborn care for a positive postnatal experience. Presentation
recommended
This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their n
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ewborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their n
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ewborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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The KMC implementation strategy targets a broad audience. These include policy-makers and programme managers at national, regional and local levels, government and nongovernmental organizations working in the area of maternal and newborn care, global and national professional associations, public an
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d private hospital management at all levels of care, and facility- and community-based maternal and infant care providers.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium
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term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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The ethical values and behaviors are not only abstract terms, but they are refined and conceptualized byreal-life experiences. The societal context where the actions of humans can be analyzed by ethicaldecision-making is entirely relevant to deliberate on what is the right thing to do and what the m
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oralagent should do, since the ethical values and principles response to the actual practices of life and to theneeds of humans in the society. This elaboration takes us to the realm of social ethics.This article reviews the definition and contextual meaning of social ethics at a broader level by givingspecial emphasis to the ethical theories and principles, focusing on the societal and public setting. Ethicswill be deliberated with social and community aspects. Based on the principle of justice and public healthethics, the concept of social ethics has been investigated concisely through the relationship between man,as a moral person, and the society in exemplification of the issues of healthcare ethics. It is argued that thetension between individualism and communitarian needs can be reconciled with the perspective of socialethics by respecting the individual autonomy without disregarding the common good and social justice.By promoting the values of social responsibility, solidarity, and social utility, social ethics has beenproposed as the basis of a rational, moral, egalitarian, pluralistic, democratic society rising on the pillars ofhuman rights and human dignity.
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"Achieving, maintaining and improving accuracy, timeliness and reliability are major challenges for health laboratories. Countries worldwide committed themselves to build national capacities for the detection of, and response to, public health events of international concern when they decided to eng
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age in the International Health Regulations implementation process. Only sound management of quality in health laboratories will enable countries to produce test results that the international community will trust in cases of international emergency. This handbook is intended to provide a comprehensive reference on Laboratory Quality Management System for all stakeholders in health laboratory processes, from management, to administration, to bench-work laboratorians. This handbook covers topics that are essential for quality management of a public health or clinical laboratory. They are based on both ISO 15189 and CLSI GP26-A3 documents"--Page 7.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery
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of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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A healthcare worker manual. 2nd edition
The development of this National Manual for the Management of HIV-related Opportunistic Infections and Conditions for use by health care workers at the frontline of our fight against HIV/AIDS is intended to improve their understanding of the causes, preventio
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n and appropriate management of opportunistic infections and conditions in adults and adolescents (OIs in children is covered effectively in the Integrated Management of Childhood Illnesses – IMCI – materials). It is also intended to be a practical guide at the clinic level, so as to improve quality of life, treatment outcomes and survival of PLHA. Crucially, this manual uses a “symptom-based” approach to support health care workers at the most basic primary level to be able to effectively initiate the care of PLHA with OIs and refer patients as appropriate (effective triage of patients at the primary care level). The result of this will be to move the management of OIs closer to the patient while ensuring that referral links with higher-level facilities and care is cultivated.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources
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and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit
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y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive
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predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
In March 2018, they convened a global meeting with the aim of establishing an action plan to develop new diagnostic solutions for Buruli ulcer and to create a framework of collaboration to address unmet needs in diagnostics for the disease. The participants agreed to develop a target product profile (TPP) to address the need for a rapid diagnostic test for use at the primary health-care level.
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Today, the World Health Organization (WHO) is advancing the global fight against acute malnutrition in children under 5 with the launch of its new guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition). This milestone is a crucial response to the persistent
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global issue of acute malnutrition, which affects millions of children worldwide.
In 2015, the world committed to achieving the Sustainable Development Goals (SDGs), including the ambitious target of eliminating malnutrition in all of its forms by 2030. However, despite these commitments, the proportion of children with acute malnutrition has persisted at a worrying level, affecting an estimated 45 million children under five worldwide in 2022.
In 2022, approximately 7.3 million children received treatment for severe acute malnutrition (SAM). Although treatment coverage has increased, children with SAM in many of the worst affected countries are still unable to access the full necessary care for them to recover.
The Global Action Plan (GAP) on child wasting recognized the need for updated normative guidance to support governments in the prevention and management of acute malnutrition. WHO answered this call to action and developed a comprehensive guideline that provides evidence-based recommendations and good practice statements and will be followed by guidance and tools for implementation.
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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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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 health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid
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e 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.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr
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ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
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sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati
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ons.
These Guidelines, specifically tailored to small water supplies, build on over 60 years of guidance by the World Health Organization (WHO) on drinking-water quality and safety. They focus on establishing drinking-water quality regulations and standards that are health based and context appropriate; on proactively managing risks through water safety planning and sanitary inspections; and on carrying out independent surveillance. The guidance is intended primarily for decision-makers at national and subnational levels with responsibility for developing regulatory frameworks and support programmes related to these activities. Other stakeholders involved in water service provision will also benefit from the guidance in this document.
Designed to be practical and accessible, these Guidelines offer clear guidance that is rooted in the principle of progressive improvement. State-of-the-art recommendations and implementation guidance are provided, drawn from a comprehensive evidence review and established good practices. Additionally, case examples are provided from countries and areas around the world to demonstrate how the guidance in this publication has been implemented in practice in a wide variety of contexts.
Together with WHO’s 2024 Sanitary inspection packages – a supporting tool for the Guidelines for drinking-water quality: small water supplies, these Guidelines update and supersede WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. Key changes to this updated publication include a greater focus on preventive risk management and a broader range of small water supplies covered, including those managed by households, communities and professional entities.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management
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and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc
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tion of safe and quality foods for our daily nourishment. Pests and disease epidemics negatively impact the quality, quantity and safety of our food sources, and cripple economic growth and efficiencies in production. Furthermore, the epidemic and endemic levels of the pathogens and disease vectors can be difficult to control. This is why FAO stresses and promotes the special efforts required for cost-effective preventive measures rather than the more expensive control, disinfestation, treatment and disposal measures. When preventive measures are late or difficult, preparedness and contingency plans must be in place to enable rapid response. Early warning systems, based on close monitoring, surveillance, and timely reporting are fundamental to warn and empower communities to safeguard their livelihoods and assets by enhancing disease and pest prevention measures and for government services to take immediate measures to protect communities and national economies.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca
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l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Information for policy-makers and planners on conducting deworming as part of an integrated
school health program
A national faecal examination of 27 729 schoolchildren from 395 schools carried out in
2008 indicated that intestinal parasitic worms affected an estimated five million (56.8%)
children in Kenya. Existing evidence shows that worm infections lead to reduced literacy
levels due to impaired growth a
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nd physical fitness.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge
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, on current best evidence and medical knowledge and practice at the date of publication. When assessing and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local and national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge
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, on current best evidence and medical knowledge and practice at the date of publication. When assessing and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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The HIV/AIDS Sustainability Index Dashboard is a tool completed every two years by President’s Emergency Plan for AIDS Relief (PEPFAR) teams, host government and partner stakeholders to sharpen the understanding of each country’s sustainability landscape and to assist PEPFAR and other donors in
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making informed HIV/AIDS investment decisions. Based on responses to more than 100 questions, the SID assesses the current state of sustainability of national HIV/AIDS responses across 17 critical elements. Scores for these elements are displayed on a color-coded dashboard, together with contextual charts and information. As the SID is completed over time,
it will allow stakeholders to track progress and gaps across these key components of financial and programmatic sustainability.
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The Country Cooperation Strategy is the World Health Organization (WHO)’s reference for country work guiding planning and resource allocation through alignment with national health priorities and harmonization with other development partners. It clarifies roles and functions of WHO in supporting t
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he national strategic plan for health through the Sector-Wide Approach and Malawi Growth and Development Strategy II. The Country Cooperation Strategy is based on a systematic assessment of the recent national achievements, emerging health needs,
challenges, government policies and expectations. An evaluation of the previous CCS was conducted and jointly discussed with the Ministry of Health as well as other key stakeholders. This process led to the identification of the, achievements, challenges and shortfalls of the previous CCS. Through this process the areas where WHO needed to focus on were also identified. The CCS development has also been done in parallel with the formulation of the new Health Sector Strategic Plan (HSSP) to ensure that there is a linkage between the two.
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The IDF Diabetes Atlas report highlights the disproportionate prevalence of type 2 diabetes (T2D) among Indigenous Peoples globally. It emphasizes the social and health disparities resulting from colonization, loss of traditional practices, and systemic inequities. The report includes prevalence dat
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a across various Indigenous populations, identifying significant variability and often higher rates among Indigenous women compared to men. The report calls for culturally responsive and community-driven interventions to address diabetes prevention and management while advocating for better data collection and representation to support Indigenous communities worldwide.
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Type 2 diabetes in adults
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2023)
CC2
The document provides the NICE Quality Standard for managing Type 2 diabetes in adults (QS209). It outlines evidence-based recommendations for preventing Type 2 diabetes, structured education, continuous glucose monitoring (CGM), medication such as
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SGLT2 inhibitors, and regular care processes to monitor complications. The guidelines emphasize individualized care, addressing health inequalities, and improving patient outcomes. They are intended to support healthcare professionals and services in delivering high-quality, equitable diabetes care.
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International Journal of Mental Health Systems December 2011, 5:3
Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs an
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d begin to assess the effectiveness of diverse service delivery models
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Documentation of Best Practices and Bottlenecks to Program Implementation in Senegal
SUMMARY REPORT
Accessed at March 2014
Lancet 2018; 391: 700–08
Violence Against Women and HIV/AIDS Prevention and Treatment
The primary audience for the guideline is policy makers and health programme managers of MNCH and immunization programmes in ministries of health where decisions are made and policies created on the use and implementation of homebased records.
The guideline is also aimed at health providers who use
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home-based records as a tool for recording information and providing health education or communicating key information. Development and international agencies and non-governmental organizations that support the implementation of home-based records will also find this guideline of use.
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Community health workers, recipients’ experiences and constraints to care in South Africa – a pathway to trust
Nonhlanhla Nxumalo, Jane Goudge & Lenore Manderson
AIDS Care Psychological and Socio-medical Aspects of AIDSHIV
(2016)
CC
