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The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatmen
...
t of CVDs on national essential medicines lists (NEMLs) of LMICs and potential determinants for selection.
more
The epidemiology of adult-onset type 1 diabetes (T1D) incidence is not well-characterized due to the historic focus on T1D as a childhood-onset disease.
INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require substantial resources but little consideration has bee
...
n given to which treatments are appropriate for less advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
more
The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 680 102 adults 2021
Flood, D.; Seiglie, J.A.; Dunn, M.; et al.
The Lancet Healthy Longevity Volume 2, Issue 6e340-e351June 2021
(2021)
CC2
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nat
...
ionally representative data on the current patterns of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
more
The health of humans, animals and environment is vitally interlinked. A majority of emerging and endemic
human diseases have their origins in animals, be they transmitted directly, through food or the environment.
The World Health Organization (WHO), the World Organisation for Animal Health (WOAH,
...
founded as OIE) and
the Food and Agriculture Organization (FAO) of the United Nations are the main international organizations
responsible for proposing references and guidance for the public health, agriculture and animal health sectors
respectively. WHO, FAO, WOAH has been an active promoter and implementer of an intersectoral collaborative
approach between institutions and systems to prevent, detect, and control diseases among animals and
humans.
more
The document "Pocketbook for Management of Diabetes in Childhood and Adolescence in Under-Resourced Countries" (2nd Edition) provides practical guidelines for managing diabetes in children and adolescents, particularly in resource-limited settings.
...
It covers key topics like diagnosing and treating diabetes, managing diabetic ketoacidosis (DKA), insulin therapy, blood glucose monitoring, nutritional management, and dealing with complications. The pocketbook aims to support healthcare professionals in delivering effective diabetes care and improving outcomes for young patients in under-resourced areas.
more
Capacity-building for a strong public health nutrition workforce in low- resource countries
Delisle, H.; Shrimpton, R.; Blaney, S. et al.
Bulletin of the World Health Organization
(2017)
C_WHO
The document addresses the pressing issues of global malnutrition and the urgent need to build workforce capacity in public health nutrition, particularly in low- and middle-income countries. It highlights the dual burden of malnutrition, characteri
...
zed by the coexistence of undernutrition and overnutrition. While maternal and child undernutrition remain critical concerns, there is a growing prevalence of chronic diseases linked to overnutrition, even in resource-limited settings.
A significant gap exists in the availability of trained nutrition professionals. Many countries lack sufficient numbers of nutritionists, particularly at the undergraduate level, and existing training programs often focus on curative rather than preventive approaches. This leaves health workers inadequately prepared to address complex public health nutrition challenges.
To address these issues, the document recommends increasing the number of trained nutritionists, incorporating updated nutrition training into medical and nursing curricula, and developing competency frameworks and hybrid training programs. Accreditation systems for nutrition professionals are also proposed to ensure standardized and effective training.
Sustainability remains a challenge, with the need for long-term financing and better integration of nutrition programs into health systems. The document calls for systemic approaches to strengthen workforce capacity, enabling countries to effectively tackle the underlying causes of malnutrition.
more
Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co
...
ncept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
more
The article analyzes the prevalence and risk factors of chronic respiratory diseases, focusing on sub-Saharan Africa. It highlights that environmental exposures, such as biomass fuel usage and air pollution, significantly contribute to respiratory health issues in the region. The research underlines
...
the limited healthcare infrastructure, insufficient diagnostic tools, and the need for comprehensive data collection to better understand the burden of respiratory diseases. The authors advocate for targeted public health interventions, improved access to healthcare, and policies aimed at reducing exposure to risk factors to mitigate the prevalence of respiratory conditions.
more
WHO Interim Guidance for Internation al Meetings Attended by Individuals f rom Ebola Virus Disease - affected countries
World Health Organization
(2014)
This interim guidance is aimed at assisting organizers of international meetings attended by individuals from EVD-affected countries and individuals with a travel history to EVD-affected countries
...
within the previous 3 weeks.
The first part is intended for organizers of international meetings, to safely plan and conduct these events. The second part is addressed to public health authorities directly involved in supporting such international meetings.
more
Handbook on Monitoring and Evaluation of Human Resources for Health with special applications for low- and middle-income countries
Mario R Dal Poz, Neeru Gupta, Estelle Quain and Agnes LB Soucat
World Health Organization (WHO); USAID; The World Bank
(2009)
Mass incarceration can explain population increases in TB and multidrug-resistant TB in European and central Asian countries
recommended
D. Stuckler, S. Basu, M. McKee, et al.
B. H. Singer (Princeton University); National Academy of Sciences of the USA
(2008)
C2
13280–13285 / PNAS / September 9, 2008 / vol. 105 / no. 36
Vitamin A deficiency is a risk factor for blindness and for mortality from measles and diarrhoea in children aged 6–59 months. We aimed to estimate trends in the prevalence of vitamin A defi ciency between 1991 and 2013 and its mortality burden in low-income and middle-income
...
countries.
more
Towards a Core Set of Clinical Skills for Health-Related Community Based Rehabilitation in Low and Middle Income Countries
Jessica O'Dowd, Malcolm MacLachlan, Chapel Khasnabis, Priscille Geiser
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2015)
CC
This research aims to identify a core set of clinical skills for working in
a Community Based Rehabilitation (CBR) setting, and to discuss whether they are appropriate for task shifting to a new or an alternative cadre of rehabilitation workers.
An Economist Intelligence Unit briefing paper | The Economist Intelligence Unit (EIU) undertook a study aimed at assessing the degree of commitment of 15 countries within the AsiaPacific region to integrating those with mental illness into their co
...
mmunities. The research was commissioned and funded by Janssen Asia Pacific, a division of Johnson & Johnson Pte. Ltd. This report focuses on the results of this benchmarking study, called the Asia-Pacific Mental Health Integration Index. Drawing on lessons from the EIU’s 2014 European Mental Health Integration Index, this edition index compares the level of effort in each of the countries on indicators associated with integrating individuals suffering from mental illness into society. Data for the Index was collected between March and May 2016. The set of 18 indicators were grouped into four categories.
more
Depress Anxiety. 2018 March ; 35(3): 195–208. doi:10.1002/da.22711.
The aim of this paper is to investigate how doctors working in primary health care in Latin American address patients with common mental disorders and to investigate how stigma can affect their clinical decisions
PLoSONE 13(11):e0206440.https://doi.org/10.1371/journal.pone.0206440
The seven essential features of practice for scaling up are described with great clarity. They are practical and universal, and encourage local innovation. They include policy, funding and local management structure, as well as working with all possible partners and developing local context adaptati
...
ons. The case studies give ideas and inspiration to develop new programmes and find ways around obstacles in existing programmes, especially through involving those with most at stake including users and their families and local community leaders
more
National HIV, Hepatitis and STI programme managers meeting for selected asian and pacific island countries
World Health Organization (Western Pacific Region)
(2018)
C_WHO
Meeting Report
27–30 June 2017 Manila, Philippines
A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal health system evaluations continue to identify major gaps in capacity
...
to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
more
Meeting of national HIV programme managers of Eastern European, Central Asian and non-EU/EEA countries
World Health Organization (Europe)
(2018)
C_WHO
Meeting report, 25-26 September 2017 Copenhagen, Denmark
Incidence and Prevalence of Opportunistic and Other Infections and the Impact of Antiretroviral Therapy Among HIV-infected Children in Low- and Middle- income Countries: A Systematic Review and Meta-a
M.-R. B-Lajoie; O. Drouin; G. Bartlett; et al.
Clinical Infectious Diseases; Infectious Diseases Society of America (IDSA); hivma; Oxford; WHO
(2016)
C2
Clinical Infectious Diseases
1586 - 1594 • CID 2016:62 (15 June) • HIV/AIDS
Revised working paper following AVAREF meeting February 2019.
WHO has published a roadmap aiming to coordinate partners’ actions and contributions to the licensing and roll-out of Merck’s Ebola vaccine (VSV-ZEBOV) in African countries. The vac
...
cine was developed during the West Africa Ebola epidemic of 2014-2016, during which more than 11 000 people lost their lives to the disease. The vaccine was tested in European and African countries at the time and is currently used under an “expanded access” protocol in the Democratic Republic of Congo.
WHO will expedite prequalification and licensing of the vaccine for use in countries at risk of Ebola outbreaks and will coordinate work between those countries’ regulatory authorities and the European Medicines Agency and the US Food and Drug Administration.
more
Prevention and Treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries
World Health Organization; UNFPA; UNAIDS; etc al.d
(2012)
C_WHO
HIV/AIDS Programme
Policy Brief
Blueprint for the provision of comprehensive care for trans persons and their communities in the Caribbean and other anglophone countries
John Snow, Inc.; PAHO; World Health Organization; et al.
(2019)
C2
Accessed: 06.11.2019
A Systematic Review and Meta-analysis
Clinical Infectious Diseases® 2016;62(12):1586–94
Timely detection of novel coronavirus (2019-nCoV) infection cases is crucial to interrupt the spread of this virus. We assessed the required expertise and capacity for molecular detection of 2019-nCoV in specialised laboratories in 30 European Union/European Economic Area (EU/EEA)
...
countries. Thirty-eight laboratories in 24 EU/EEA countries had diagnostic tests available by 29 January 2020. A coverage of all EU/EEA countries was expected by mid-February. Availability of primers/probes, positive controls and personnel were main implementation barriers.
more
Massoda Tonye et al. Malar J (2018) 17:156
https://doi.org/10.1186/s12936-018-2284-7
Background: In 2011, the demographic and health survey (DHS) in Cameroon was combined with the multiple indicator
cluster survey. Malaria parasitological data were collected, but the survey period did not overl
...
ap with the high
malaria transmission season. A malaria indicator survey (MIS) was also conducted during the same year, within the
malaria peak transmission season. This study compares estimates of the geographical distribution of malaria parasite
risk and of the effects of interventions obtained from the DHS and MIS survey data.
more
The Lancet Global Health Published:May 12, 2020DOI:https://doi.org/10.1016/S2214-109X(20)30229-1
Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including
...
disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
more
This updated step by step guide aims to assist the ministries of health (MoHs) in developing the national action plans for noma prevention and control, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national heal
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th planning, strengthening of primary health care (PHC) and attainment of universal health coverage (UHC).
more
تحمل العبء الأكبر على كبار السن في الدول ذات الدخل 19تأثير جائحة الكوفيد-2020المتدني والمتوسط - رؤى من عام
The report shows that older people are not getting the healthcare treatments they desperately need. The COVID-1
...
9 response has disrupted services for non-communicable diseases such as cancer and diabetes, communicable diseases such as malaria, and much-needed services for mental health. Combined with a loss of income, many older people are unable to get the medicines they need.
A Summary is available in Russian and Arabic
more
Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environme
...
ntal factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
more
39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response. The report shows that deliberate and proactive action is required to ensure that persons with disabilities from all constituencies are systemat
...
ically included and meaningfully participate in DRR and humanitarian preparedness, response and recovery. It draws lessons from field practices, but does not provide technical guidance. The newly published IASC Guidelines are the reference document to seek in-depth theoretical and technical information.
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This document presents an evidence-informed Checklist for implementing rural pathways to train and support the rural
health workforce in low and middle income countries (LMIC). Rural areas are the most underserviced around the world.
A report demonstrating the urgent need to support groups at the local level if COVID-19 misinformation and mistrust is to be tackled effectively.
7 April 2022. Aimed at national policymakers, public health and healthcare planners, staff working in reception centres, and healthcare staff caring for displaced persons, the information note concludes that universal testing of incoming refugees from Ukraine for tuberculosis (TB) infection is not r
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ecommended. Specific groups, such as household contacts of bacteriologically confirmed pulmonary cases, or those who are immunocompromised should however be considered for TB infection testing.
Available in Czech, Hungarian, Polish, Romanian, Slovakian, Ukranian
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It explains the importance of faecal sludge management in urban areas in which many people rely on on-site and decentralized sanitation facilities and emphasizes the place of treatment in the overall sanitation service chain. It defines terms used throughout the book, explains why faecal sludge and
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septage treatment is important, and identifies broad treatment objectives.
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Surveillance, prevention and control of leishmaniases in the European Union and its neighbouring countries
European Centre for disease prevention and control (ECDC)
European Centre for disease prevention and control (ECDC)
(2022)
C_CDC
This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countr
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ies of southern Europe, northern Africa, and the Middle East and that there is a need to improve leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
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Rabies is a neglected zoonotic disease with a global burden of approximately 59,000 human deaths a year. Once clinical symptoms appear, rabies is almost invariably fatal; however, with timely and appropriate post-exposure prophylaxis (PEP) consisting of wound washing, vaccine, and in some cases rabi
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es immunoglobulin (RIG), the disease is almost entirely preventable. Access to PEP is limited in many countries, and when available, is often very expensive.
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Those who clean are the first line of defense against health care-associated infections (HAIs), and support efforts to reduce antimicrobial resistance (AMR).
Strengthening the training of this important group can contribute to resolving many of today’s public health challenges. This is importan
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t given that cleaning both surfaces and hands is vital to control the transmission of a number of HAIs.
This two-part training package targets those who clean heath care facilities.
The Trainer’s Guide takes the user through how to prepare, deliver and sustain an effective training for those who clean. The Modules and Resources provides instructions, definitions, photographs, posters and specific illustrations of recommended practices
The package can be used by those who deliver environmental cleaning training programmes and/or those with a background in IPC including ministries of health, nongovernmental organizations, academic institutions, experts working in Quality of care, IPC and environmental cleaning/ Water, sanitation and Hygiene (WASH) and Health facility IPC focal points and onsite cleaning supervisors
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Childhood immunisation is one of the most cost-effective health interventions. However, despite its known value, global access to vaccines remains far from complete. Although supply-side constraints lead to inadequate vaccine coverage in many health systems, there is no comprehensive analysis of the
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funding for immunisation. We aimed to fill this gap by generating estimates of funding for immunisation disaggregated by the source of funding and the type of activities in order to highlight the funding landscape for immunisation and inform policy making.
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Estimates of government spending and development assistance for tuberculosis exist, but less is known
about out-of-pocket and prepaid private spending. We aimed to provide comprehensive estimates of total spending on
tuberculosis in low-income and middle-income
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countries for 2000–17.
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Background: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards
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UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country’s UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios.
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Background: Primary health care (PHC) is a driving force for advancing towards universal health coverage (UHC). PHC-oriented health systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments and project the associated resource
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needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs.
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This report analyses the intersection of HIV, COVID-19 and public debt in developing countries. The collision between COVID-19 and a crippling debt crisis have reversed decades of progress - putting present and future investments in health and HIV a
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t risk. Pragmatic options to address the pandemic triad are proposed.
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Introduction
In 2017, development assistance for health (DAH) comprised 5.3% of total health spending in lowincome countries. Despite the key role DAH plays in global health-spending, little is known about the characteristics of assistance that ma
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y be associated with committed assistance that is actually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.
Methods
We extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.
Results
Factors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).
Conclusion
Substantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.
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Background
In the prevention of cardiovascular disease, a WHO target is that at least 50% of eligible people use statins. Robust evidence is needed to monitor progress towards this target in low-income and middle-income countries (LMICs), where mos
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t cardiovascular disease deaths occur. The objectives of this study were to benchmark statin use in LMICs and to investigate country-level and individual-level characteristics associated with statin use.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known
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about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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The report provides an overview of alcohol consumption, related health harm, and policy responses in 30 European countries (EU Member States, Norway, and Switzerland). It highlights the high levels of alcohol consumption in the WHO European Region,
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which contribute to a significant disease burden compared to other regions. The report covers trends in alcohol consumption and harm between 2010 and 2016, noting some progress in reducing alcohol-attributable mortality but stagnation in consumption reduction and heavy episodic drinking.
The assessment of alcohol policies shows variability in implementation across countries, particularly in areas like pricing and reducing the negative consequences of drinking. It emphasizes the need for stronger evidence-based policies, such as better regulation, taxation, and accessibility restrictions, to further reduce alcohol-related harm and achieve health-related Sustainable Development Goals.
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With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across coun
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tries by development level. Using internationally comparable data on disability inequalities in 40 countries, we assess disability inequalities through the use of regression analyses with a variety of development measures. Results support the hypothesis only partially: disability inequalities related to education, employment, and multidimensional poverty are found to be significantly larger in countries at higher levels of development. However, this is not the case for rates of access to water, sanitation, clean fuel, electricity, housing, and assets. These results, overall, hold when using different development and
outcome indicators, and when focusing on specific subgroups of the population. The potential implications of these findings are discussed. Further research is needed to understand, for education and employment, the factors and processes that contribute to larger disability inequalities in countries at higher levels of development and what strategies might be pursued to reduce them.
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Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity
and mortality in low-income and middle-income countries (LMICs). Access to safe, effective, quality-assured, and
affordable essential medi
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cines is variable. We aimed to review the existing literature relating to the availability, cost,
and affordability of WHO’s essential medicines for asthma and COPD in LMICs.
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Health-care waste management is a critical aspect of health-care systems, crucial for public health and environmental sustainability. This report provides valuable insights into the existing health-care waste management frameworks across 16 countries
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in the Western Pacific Region. It provides an overview of essential components of the legal framework and best practices, including adoption of environmental friendly technologies in policies and highlights both strengths and areas in need of improvement. The report provides recommendations to enhance the effectiveness and sustainability of future health-care waste management policies in the Region.
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The Global Status Report on Noncommunicable Diseases (NCDs) 2014 by the World Health Organization outlines the global impact of NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are responsible for a significant portion of global mortality, particular
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ly in low- and middle-income countries.
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The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate he
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althcare access, limited diagnostic tools like spirometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
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The monkeypox virus (MPXV) clade I epidemic that has been affecting the Democratic Republic of the Congo
(DRC) since November 2023 has recently spread to several other African countries including Burundi, Rwanda,
Uganda and Kenya. The size of thes
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e outbreaks could be larger than reported due to under-ascertainment and
under-reporting.
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Asthma is the commonest chronic respiratory tract disease in children. In low-income countries, challenges exist in asthma diagnosis. In surveys done in children, the prevalence of ‘asthma’ defined by symptoms is high compared to ‘doctor diagn
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osed asthma’. The questions answered by this review are What challenges have been experienced in the diagnosis of asthma in children? What solutions will address these challenges?
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Asthma, hay fever and eczema are three common chronic conditions. There have been no recent multi-country data on the burden of these three conditions in adults; the aims of this study are to fill this evidence gap.
The Global Asthma Network Phase I is a multi-country cross-sectional population-bas
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ed study using the same core methodology as the International Study of Asthma and Allergies in Childhood Phase III. It provides data on the burden of asthma, hay fever and eczema in children and adolescents, and, for the first time, in their parents/guardians.
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Demographic and epidemiological transitions are changing the age structure of the population and the most common diseases. Non-communicable respiratory diseases are an increasing problem at both ends of the age range in low-income and middle-income countri
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es. In children, who represent a large proportion of the total population, the increasing problem of asthma is a strain on health services. Improved survival of the older population is increasing the proportion of morbidity and mortality attributable to chronic lung diseases. Health services in low-resource countries are poorly adapted to treating chronic diseases. Designed to respond episodically to acute disease, almost all historical investment has focused on infectious diseases. Crucial to the successful management of chronic diseases is an infrastructure designed to support pro-active management, providing not only an accurate diagnosis, but also a secure supply of cost effective drugs at an affordable price. The absence of such an infrastructure in many countries and the market failure that makes drugs generally more expensive in low-resource regions means that many people with chronic non-communicable lung diseases are not given effective treatment. This has damaging economic consequences. The common causes of poor lung health in lowincome countries are not the same as those in richer countries, and there is a need to study why they are so common and how best to manage them.
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The aim of this brief is to ensure that the COVID-19 pandemic does not disrupt the supply of and demand generation for condoms. Sexual relations may be transformed in the new context of the pandemic, but they have not stopped. While access to male and female condoms has been critical in the global r
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esponse to reduce HIV, sexually transmitted infections (STIs) and unintended pregnancies over the past three decades, these gains can be lost if condoms are not included in the essential commodities that are freely available to populations during the lockdown of countries. This brief for country condom programme managers and experts provides a summary of relevant actions to sustain supplies of male condoms, female condoms and lubricants, and to adjust approaches for condom promotion during the time of COVID-19
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Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries
Tol, Wietse A. , Song, Suzan, Jordans, Mark J. D.
The Journal of Child Psychology and Psychiatry
(2018)
C1
Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions
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.
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Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middle-income countries
I. Petersen; , S. Evans‐Lacko; M. Semrau; et al.
International Journal of Mental Health Systems; BioMed Central
(2016)
CC
Petersen et al. Int J Ment Health Syst (2016) 10:30 DOI 10.1186/s13033-016-0060-z
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe & neighbouring countries
C. Folch; P. Fernández-Dávila; J. Palacio-Vieira; et al.
European Commission; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT); European AIDS Treatment Group
(2020)
C2
Accessed: 07.03.2020
A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe and neighbouring countries (D5.1)
Contract 201
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5 71 01 A behavioural survey for HIV/AIDS and associated infections and a survey and tailored training for community based health workers to facilitate access and improve the quality of prevention, diagnosis of HIV/AIDS, STI and viral hepatitis and health care services for men who have sex with men (MSM).
Pubic Health
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Improving the quality of hospital antibiotic use is a major goal of WHO’s global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally.
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We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions.
www.thelancet.com/lancetgh Vol 7 July 2019
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The objective of this report is to assess the situational landscape during mid-May 2020 surrounding the value chain of the production and distribution of generic antiretroviral medicines in low- and-middle-income countries and to provide recommendat
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ions on mitigating the risks of potential disruptions.
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin
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g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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Int J Hyg Environ Health. 2019 Jun; 222(5): 765–777. doi: 10.1016/j.ijheh.2019.05.004;
To develop updated estimates in response to new exposure and exposure-response data of the
burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth
infec
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tions and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours
(WASH) with a focus on low- and middle-income countries.
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Front. Public Health, 30 April 2021 | https://doi.org/10.3389/fpubh.2021.628744
The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed,
especially during public health emergencies. Development assistance is an important source of health financing in
many low-income countries, yet li
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ttle is known about how much of this funding was disbursed for COVID-19. We
aimed to put development assistance for health for COVID-19 in the context of broader trends in global health
financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery to
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wards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spendi
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ng can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods: We extracted GDP, government spending in 184 countries from 1980–2015, and health spend data from 1995–2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted.
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Comprehensive and comparable estimates of health spending in each country are a key input for health
policy and planning, and are necessary to support the achievement of national and international health goals. Previous
studies have tracked past and projected future health spending until 2040 and
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shown that, with economic development,
countries tend to spend more on health per capita, with a decreasing share of spending from development assistance
and out-of-pocket sources. We aimed to characterise the past, p
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An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we furth
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er explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends.
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The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed,
especially during public health emergencies. Development assistance is an important source of health financing in
many low-income countries, yet li
...
ttle is known about how much of this funding was disbursed for COVID-19. We
aimed to put development assistance for health for COVID-19 in the context of broader trends in global health
financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.
more
Little is known about the patterns of development assistance (DA) for each component of reproductive, maternal, newborn, child and adolescent health (RMNCAH) in conflict-affected countries nor about the DA allocation in relation to the burden of dis
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ease
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Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among
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high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
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Diabetes mellitus is a leading cause of mortality and reduced life expectancy. We aim to estimate the burden of diabetes by type, year, regions, and socioeconomic status in 195 countries and territories over the past 28 years, which provide informat
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ion to achieve the goal of World Health Organization Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2025. Data were obtained from the Global Burden of Disease Study 2017. Overall, the global burden of diabetes had increased significantly since 1990. Both the trend and magnitude of diabetes related diseases burden varied substantially across regions and countries. In 2017, global incidence, prevalence, death, and disability-adjusted life-years (DALYs) associated with diabetes were 22.9 million, 476.0 million, 1.37 million, and 67.9 million, with a projection to 26.6 million, 570.9 million, 1.59 million, and 79.3 million in 2025, respectively. The trend of global type 2 diabetes burden was similar to that of total diabetes (including type 1 diabetes and type 2 diabetes), while global age-standardized rate of mortality and DALYs for type 1 diabetes declined. Globally, metabolic risks (high BMI) and behavioral factors (inappropriate diet, smoking, and low physical activity) contributed the most attributable death and DALYs of diabetes. These estimations could be useful in policy-making, priority setting, and resource allocation in diabetes prevention and treatment.
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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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Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study
García-Marcos, L.; Chiang, C. Y.; Asher, I.; et al.
The Lancet Global Health Volume 11, Issue 2e218-e228February 2023
(2023)
CC2
Asthma is one of the most common non-communicable diseases globally. This study aimed to assess asthma medicine use, management plan availability, and disease control in childhood, adolescence, and adulthood across different country settings.
The roadmap describes the actions needed to
achieve the three development goals for TB
vaccines set by the WHO:
1. A safe, effective and affordable TB vaccine
for adolescents and adults.
2. An affordable TB vaccine for neonates and
infants with improved safety and efficacy.
3. A therapeutic v
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accine to improve TB
treatment outcomes
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Advocacy in Action - A Toolkit to support NGOs and COBs responding to HIV/AIDS
International HIVAIDS Alliance (Supporting Community Action on AIDS in Developing Countries); ICASO (International Council of AIDS Service Organizations); USAID; et al.
(2003)
C2
Developed in collaboration with the International Council of AIDS Service Organizations (ICASO)
Developmental Disabilities
Institute of Medicine (US); Committee on Nervous System Disorders in Developing Countries; National Academy of Sciences
(2001)
C2
Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World
Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries.
Washington (DC): National Academies Press (US); 2001.
...
more
Countries with free access to BNF and BNF for Children on MedicinesComplete via HINARI
Registered users of the BNF website are allowed free access to the core content of the latest edition of the BNF and BNF for Children on the MedicinesComplete we
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bsite if they reside in England, Scotland, Wales, Northern Ireland, the Channel Islands, the Isle of Man or any of the countries in the HINARI list of countries managed by the World Health Organisation WHO (see www.who.int/hinari for details).
more
A chronological map of the presence of Zika only in those countries for which there is evidence of indigenous transmission by mosquitos, excluding the many countries that have notified imported Zika
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infections.
more
The "Global NCD action plan" provides a road map and a menu of policy options for countries to take in order to attain the 9 voluntary global targets, including that of a 25% relative reduction in premature mortality from cardiovascular diseases, ca
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ncer, diabetes or chronic respiratory diseases by 2025. The main focus of this action plan is on 4 types of NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes) which make the largest contribution to morbidity and mortality due to NCDs, and on 4 shared behavioural risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol).
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TNew data from the World Health Organization reveal that the COVID-19 pandemic has disrupted malaria services, leading to a marked increase in cases and deaths.
According to WHO’s latest World malaria report, there were an estimated 241 million malaria cases and 627 000 malaria deaths worldwide i
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n 2020. This represents about 14 million more cases in 2020 compared to 2019, and 69 000 more deaths. Approximately two-thirds of these additional deaths (47 000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment during the pandemic.
As in past years, the report provides an up-to-date assessment of the burden of malaria at global, regional and country levels. It tracks investments in malaria programmes and research as well as progress across all intervention areas. This latest report draws on data from 87 countries and territories with ongoing malaria transmission.
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Countries experiencing concentrated epidemics of HIV need the size of key populations (KPs) to guide the national response on HIV and AIDS. Conducting a robust method to estimate the size of KPs is quite challenging as most of them are hidden and do
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not want to disclose theiridentity due to stigma and discrimination associated with their behaviour. KPs in Bangladesh include female sex workers (FSW), people who inject drugs (PWID), men who have sex with men (MSM) including transgender (TG)/Hijra and sex workers, and clients of sex workers in the country or abroad.
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The SAARC Member States have more than an estimated 2.0 million TB cases accounting for close to one-third of the total cases of TB in the world. India alone had almost one-fifth of the global disease burden due to TB. India, Pakistan and Bangladesh followed by Afghanistan are the major contributors
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of disease burden of TB in the SAARC Region. They are countries that have a dubious distinction of being on the list of 22 TB High Disease Countries in the world.
more
Recent efforts to fight malaria in the Greater Mekong Subregion (GMS) have yielded impressive results. According to the latest WHO estimates, the six GMS countries cut their malaria case incidence by an estimated 54% between 2012 and 2015. Malaria d
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eath rates fell by 84% over the same period.
In May 2015, GMS Ministers of Health adopted the WHO Strategy for malaria elimination in the Greater Mekong Subregion 2015-2030. Urging immediate action, the plan aims to eliminate P. falciparum malaria from the subregion by 2025 and all species of human malaria by 2030. more
In May 2015, GMS Ministers of Health adopted the WHO Strategy for malaria elimination in the Greater Mekong Subregion 2015-2030. Urging immediate action, the plan aims to eliminate P. falciparum malaria from the subregion by 2025 and all species of human malaria by 2030. more
State of Health in the WHO African Region
recommended
This report is not a country scorecard. Rather, its purpose is to act as a compass to guide progress towards health in the SDGs.
There has been a significant improvement in the state of health in the region with healthy life expectancy - time spent in full health - in the region increasing from 50
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.9 years to 53.8 between 2012 and 2015 - the most marked increase of any region in the world.
What is making Africans sick is changing. The top killers are still lower respiratory infections, HIV and diarrhoeal disease and countries have routinely focused on preventing and treating this trio, often through specialized programmes. The payoff has been significant declines in deaths due to these diseases. There has been a 50% reduction in the burden of disease caused by what have been the top 10 killers since 2000 and death rates have dropped from 87.7 to 51.1 deaths per 100,000 persons between 2000 and 2015...
Chronic diseases like heart disease and cancer are now claiming more lives with a person aged 30 to 70 in the region having a one in five chance of dying from a noncommunicable disease (NCDs).
Countries are specifically failing to provide essential services to two critical age groups – adolescents and the elderly...
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Crisis Group’s Watch List identifies ten countries or regions at risk of deadly conflict or escalation thereof in 2021. In these places, early action, driven or supported by the EU and its member states, could enhance prospects for peace and stabi
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lity.
Crisis Group’s early-warning Watch List identifies up to ten countries and regions at risk of conflict or escalation of violence. In these situations, early action, driven or supported by the EU and its member states, could generate stronger prospects for peace. The Watch List 2021 includes an Introduction, detailed conflict analyses and EU-targeted recommendations on Central African Republic, Democratic Republic of Congo, Ethiopia, Iran & the Gulf, Libya, Mexico & Central America, Nagorno-Karabakh, Somalia, Thailand and Venezuela.
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For the 24th consecutive year, PAHO has published the report Health Situation in the Americas: Core Indicators featuring the latest information on key indicators for the Region of the Americas. This 2018 edition includes data on the 82 core indicators for the
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countries, territories, and sub regions of the Americas, grouped into the following categories: demographic-socioeconomic, health status, risk factors, service coverage, and health systems. Information is also presented on 22 indicators of the Sustainable Development Goals (SDGs).
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