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Publication Years
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Reliable cause specic mortality statistics are the cornerstone of national health information
systems. They are essential for evidence-based decision making for monitoring
...
health of
populations, health services planning and delivery, programme implementation, policy development
and epidemiological research.
more
Diabetes in pregnancy
National Institute for Health and Care Excellence (NICE)
National Institute for Health and Care Excellence (NICE)
(2016)
CC2
The document "Diabetes in Pregnancy" by NICE (National Institute for Health and Care Excellence) outlines quality standards for managing diabetes in women during pregnancy, with a focus on five key
...
areas. First, it emphasizes the importance of preconception planning for women of childbearing age with diabetes. These women should receive guidance on optimizing their health before pregnancy, including achieving target HbA1c levels and taking high-dose folic acid to minimize risks. Second, joint diabetes and antenatal care is recommended for pregnant women with pre-existing diabetes, who should be seen early in pregnancy (ideally by 10 weeks gestation) by a combined diabetes and antenatal team to ensure optimal care throughout their pregnancy.
The third focus area is continuous glucose monitoring (CGM), which should be offered to pregnant women with type 1 diabetes. This includes either real-time CGM or flash monitoring to help improve blood glucose control and reduce complications during pregnancy. Fourth, postnatal testing and referral are essential for women diagnosed with gestational diabetes, who should receive glucose testing after birth to detect any persistent diabetes. Those eligible are referred to the National Diabetes Prevention Programme to lower their risk of developing type 2 diabetes. Lastly, the document recommends annual HbA1c testing for women with a history of gestational diabetes to monitor for type 2 diabetes development.
These standards aim to improve pregnancy outcomes for women with diabetes by providing individualized, accessible, and culturally appropriate care.
more
The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way towards Universal Health Coverage (UHC),choosing a
...
path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population by 2020 while increasing financial protection.
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
...
services, following the conduct of a comprehensive assessment using the WHO QualityRights assessment toolkit.
more
There has been important progress for the rights of adolescent girls and women in recent decades, yet millions still struggle to
access the nutritious diets, essential nutrition services and nutrit
...
ion and care practices they need to prevent malnutrition.
Undernutrition, micronutrient deficiencies and anaemia amplify gender inequalities by lowering learning potential, wages and life opportunities for adolescent girls and women, weakening their immunity to infections, and increasing their risk of lifethreatening complications during pregnancy and childbirth.
more
There is a crucial need to initiate and sustain fistula programs that increase access and strengthen the capacity of the health care system to provide high quality
...
services for repair and care of women living with female genital fistula. Therefore, it is important to pay particular attention to the quality of training, and to proactively determine how this training fits into the health care system. Furthermore, the quality of training is improved by committing adequate resources to ensure competent trainers, able to train and follow-up their trainees. Women with genital fistulae, their families and the community need to have confidence in the health care system. It is therefore necessary to have pro-active discussions about the quality of training with relevant stakeholders. These fistula training guidelines and standards go towards harmonizing the training approach and to improving the quality of training and hence, service delivery.
more
Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar ... eas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis. more
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar ... eas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis. more
Despite the continuing war in Ukraine, the Government is preparing for the country’s recovery and reconstruction. Given the magnitude of the attacks on the health infrastructure and consequent disruption to
...
health system functioning, reconstruction of the health system is integral to the country’s recovery. The immediate priorities are to restore essential services, respond to new physical and mental health needs, protect public health, and provide a secure and attractive environment for the return of both health professionals and the general population. This policy note identifies strategic directions for post-war health system recovery in the short and longer terms, while sustaining essential health services during the ongoing invasion
more
Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030 ... . In practice, this means that over the next 15 years the aim is to progressively ensure that all people in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC. more
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030 ... . In practice, this means that over the next 15 years the aim is to progressively ensure that all people in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC. more
Objectives of the Study:
To understand the community needs, behaviors and perception for MNH in urban poor settings.
To explore various factors (both demand and supply side) affecting care seeking for MNH.
To assess the preparedness of the urban
...
health system for providing MNH services at various levels of care in terms of infrastructures at various levels of care, HR availability and capacity, logistics, drugs & equipment, referral, recording & reporting, supervision, governance and financial modalities.
more
UNAIDS is calling on governments to ensure that the right to health is realized by all by prioritizing public investments in health. At least half of the world’s population cannot access
...
essential health services. Every two minutes a woman dies while giving birth. Among the people being left behind are women, adolescents, people living with HIV, gay men and other men who have sex with men, sex workers, people who inject drugs, transgender people, migrants, refugees and poor people.
more
WHO-OHCHR launch new guidance to improve laws addressing human rights abuses in mental health care
Ahead of World Mental Health Day, the World
...
Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) are jointly launching a new guidance, entitled "Mental health, human rights and legislation: guidance and practice", to support countries to reform legislation in order to end human rights abuses and increase access to quality mental health care.
Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common. Involuntary hospitalization and treatment, unsanitary living conditions and physical, psychological, and emotional abuse characterize many mental health services across the world.
more
This manual describes some of the strategic, managerial, financial, technical and scientific aspects to be considered in establishing a national EQA programme for clinical laboratories and other testing services at all
...
health care levels
more
The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Essential
...
Care and Practice that includes general guidelines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
more
Consistent, current and complete documentation in the medical record is an essential component of quality patient care. The following 21 elements reflect a set of commonly accepted standards for med
...
ical record documentation. An organization may use these elements to develop standards for medical record documentation. NCQA considers 6 of the 21 elements as core components to medical record documentation. Core elements are indicated by an asterisk (*).
more
In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts to transform the health system. These changes should foster equi
...
table and efficient expenditures and create or strengthen comprehensive integrated health systems with a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
more
The recurrence of severe climate events combined with economic, social, and institutional fragilities leave El Salvador in an utterly critical humanitarian situation and highly vulnerable. Located in a disaster-prone subregion, El Salvador is among the 20 countries at the highest risk of disasters w
...
orldwide. The successive hydrometeorological hazards that impacted El Salvador over the past two years include tropical storms Amanda and Cristóbal and hurricanes Eta, Iota, and,
more recently, Julia. These storms profoundly affected the lives and livelihoods of almost 900 000 people and significantly disrupted health services, especially at the first level of care. In addition, the country’s exposure to earthquakes, floods, and droughts is also constant. Infrastructural and institutional limitations to deal with emergencies and
low capacity to respond to adverse events are an additional challenge, which leaves the population—particularly the most vulnerable—at even higher risk.
more
An estimated 1.3 billion people globally experience significant disability. This figure has grown over the last decade and will continue to rise due to demographic and epidemiological changes. In 2022, the World Health Organization launched the Glob
...
al report on health equity for persons with disabilities. This report demonstrated that many persons with disabilities are still being left behind. Experiencing persistent health inequities, persons with disabilities die earlier, they have poorer health and functioning, and they are more affected by health emergencies than the general population. These differences are largely associated with unjust factors both inside and beyond the health sector and are avoidable. The Global Report called upon Member States to take actions to make health sector more inclusive for persons with disabilities through the primary health care approach. This will be essential for countries to make health coverage truly universal and to progress towards other health-related targets in the sustainable development goals.
more
The Federal Ministry of Health (FMOH) has been coordinating sector wide reforms that aim to improve equity and quality of maternal and child health
...
services. As part of these efforts, the ministry is also exerting concerted efforts to improve availability and use of quality RMNCH pharmaceuticals. Management of RMNCH pharmaceuticals has had significant challenges such as poor availability of essential pharmaceuticals and wastages of valuable resources as pharmacy professionals were not demonstrating the required knowledge, skill and attitude towards availing the pharmaceuticals and ensuring their rational medicine use.
more
The world faces grave consequences from the lack of available mental health services and treatment. Mental illness impacts every country, culture and community, with the World
...
Health Organization (WHO) stating that 10% of the global burden of disease is related to mental, neurological and substance use disorders. In low-and middle-income countries, more than 75% of people with mental disorders receive no treatment at all for their disorder. During 2020, as a result of the global pandemic, 93% of countries reported their mental health services were either halted or interrupted (WHO, 2020e). WHO reported a 25% increase in depression and anxiety alone during the pandemic. The Organisation for Economic Co-operation and Development estimates depression and anxiety cost the global economy US $1 trillion dollars a year. All nurses have a health care role in mental health and substance use. ICN strongly advocates for the investment of further education and professional development in this area in order to support individuals and communities achieve the highest attainable standard of health which includes
physical, mental and social wellbeing.
more
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 Europ
...
e and neighbouring countries (D5.1)
Contract 2015 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
more
This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services
...
for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
more
This training and guidance module addresses the use of coercive and violent practices in mental health and related services with a particular focus on seclusion and restraint. It aims to promote a g
...
reater understanding of why these practices are used and build practical skills to help end these practices. While the module itself focuses on ending these practices in the health care setting, much of the content can also be applied in other settings where seclusion and restraint occur, for example in the home and in the wider community.
more
Haiti's Health Emergency Appeal 2023
recommended
For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the
...
country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
more
Mental Health Atlas 2020
recommended
The Mental Health Atlas, released every three years, is a compilation of data provided by countries around the world on mental health policies, legislation, financing, human resources, availability
...
and utilization of services and data collection systems. It serves as a guide for countries for the development and planning of mental health services. The Mental Health Atlas 2020 includes information and data on the progress made towards achieving mental health targets for 2020 set by the global health community and included in WHO’s Comprehensive Mental Health Action Plan. It includes data on newly-added indicators on service coverage, mental health integration into primary health care, preparedness for the provision of mental health and psychosocial support in emergencies and research on mental health. It also includes new targets for 2030.
more
Food security, human health and wellbeing largely depend on biodiversity. Biodiversity supports agriculture through ecosystem services such as pollination and water purification, and provides access
...
to natural medicines,
which are the primary source of health care for 4 billion people worldwide
more
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 Ethiopia 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.
more
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 those 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
more
This guide is available in English, French, Spanish, Russian, Arabic and Chinese
This guide consolidates COVID-19 guidance for human resources for health managers and policy-makers at national, subnational and facility levels to design, manage and
...
preserve the workforce necessary to manage the COVID-19 pandemic and maintain essential health services.
The guide identifies recommendations to protect, support and empower health workers at individual, management, organizational and system levels.
more
The European Mental Health Action Plan 2013–2020
recommended
Mental disorders are one of the top public health challenges in the WHO European Region, affecting about 25% of the population every year. In all countries, mental health problems are much more prev
...
alent among the people who are most deprived. The WHO European Region therefore faces diverse challenges affecting both the mental well-being of the population and the provision and quality of care for people with mental health problems.
The European Mental Health Action Plan focuses on seven interlinked objectives and proposes effective action to strengthen mental health and well-being. Investing in mental health is essential for the sustainability of health and socioeconomic policies in the European Region. The Action Plan corresponds to the four priority areas of the European policy framework for health and wellbeing, Health 2020, and will contribute directly to its implementation.
more
A manual intended for medical and other personnel responsible for humanitarian activities in armed conflicts. It covers the following topics: setting up a health-care system that meets the
...
essential needs of war victims, particularly of displaced persons; public health tools most frequently used for evaluation, establishment of priorities, analysis of possible activities and their follow-up; protecting war victims and aspects of humanitarian law related to health; and lastly, ethical problems
more
The study sought to understand the factors that facilitate women to adhere to treatment and return to health facilities for routine care from their own perspective. The researchers focused on Malawi
...
, Uganda and Zambia, early adopters of the global guidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment. more
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment. more
Estimating Cost of National Strategic Plan for Newborn and Child Health Development (2015-2018)
The Republic of the Union of Myanmar, Ministry of Health, Department of Health, Child Health Division
World Health Organization (WHO), Country Office for Myanmar
(2015)
C1
No publication year indicated
The cost of newborn and child health interventions were estimated considering several different angles. At the first attempt, the cost of implementing all newborn and child ... health interventions packaged as antenatal, Intra natal, Essential newborn care, Care of sick newborn, Care of premature & LBW, Nutrition, Immunization, Care of sick infants and newborns, ECCD and WASH was estimated. This estimate reflects the cost of entire newborn and child care program thrust in the country. Costs of different intervention sub packages were also determined. more
The cost of newborn and child health interventions were estimated considering several different angles. At the first attempt, the cost of implementing all newborn and child ... health interventions packaged as antenatal, Intra natal, Essential newborn care, Care of sick newborn, Care of premature & LBW, Nutrition, Immunization, Care of sick infants and newborns, ECCD and WASH was estimated. This estimate reflects the cost of entire newborn and child care program thrust in the country. Costs of different intervention sub packages were also determined. more
Technical guidance.
This technical guidance aims to inform policy and practice development specifically related to improving the health of older refugees and migrants within the European Union and the larger WHO European Region. Both ageing and mig
...
ration are in themselves complex multidimensional processes shaped by a range of factors at the micro, meso and macro levels over the life-course of the individual, but also with intertwined trajectories. Relevant areas for policy-making include healthy ageing over the life-course, supportive environments, people-centred health and long-term care services, and strengthening the evidence base and research
more
o support and guide countries and partners to strengthen a health systems response to address violence against women, WHO has produced several tools, including:
• clinical and policy guidelines;
• implementation handbooks and manuals;
...
training curriculum;
• evidence-based policy, prevention and intervention strategy packages.
The resource package consolidates these documents to support countries to develop or update their national or subnational guidelines, protocols, standard operating procedures, health provider training materials, and multisectoral action plans to prevent and respond to violence against women.
The resource package is also intended to be used for training and sensitization of policy-makers, advocates, health care providers and managers of services and programmes to address violence against women.
more
Recovery from COVID-19 has been challenging in Guatemala. As a result of the prolonged socio-economic impact of the pandemic, the average poverty rate nationwide has increased by almost 5%. This rise in the poverty level further exacerbates preexisting vulnerabilities and erodes the limited safety n
...
ets available to vulnerable populations. Year after year, recurrent disasters and humanitarian crises aggravate the historic social gaps that result in high levels of vulnerability, multidimensional poverty, and overall deprivation of essential services among hundreds of thousands of Guatemalans. According to the World Risk Report 2020, Guatemala is the tenth country with the highest level of exposure to disaster worldwide. Globally, it ranks 28th regarding vulnerability according to the 2021 INFORM’s risk index and 62nd in the Global Climate Risk Index 2021.
In 2020, Guatemala faced a record-breaking and devastating hurricane season with extreme rainfall, catastrophic winds, and deadly landslides, from which the country has not yet recovered. Unfortunately, recurrent extreme weather events, such as Hurricane Julia that hit Central America in early October 2022, progressively but deeply eroded a weak health infrastructure and local health systems.
more
A System of Health Accounts 2011: Revised edition
Organisation for Economic Co-operation and Development (OECD), Eurostat and World Health Organization (WHO)
OECD Publishing, Paris
(2017)
CC
A System of Health Accounts 2011: Revised Edition provides an updated and systematic description of the financial flows related to the consumption of health
...
care goods and services. As demands for information increase and more countries implement and institutionalise health accounts according to the system, the data produced are expected to be more comparable, more detailed and more policy relevant. It builds on the original OECD Manual, published in 2000, and the Guide to Producing National Health Accounts to create a single global framework for producing health expenditure accounts that can help track resource flows from sources to uses. It is the result of a collaborative effort between the OECD, WHO and the European Commission, and sets out in more detail the boundaries, the definitions and the concepts – responding to health care systems around the globe – from the simplest to the more complicated.
more
ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, health
...
care workforce constraints, financing, availability and affordability of CVD medicine, and service delivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
more
In Kenya, 12.7 percent of sick Kenyans do not seek health care when they are ill with high cost of services being one of the major barriers that ac
...
counted for upto 21 percent of those who did not seek care in 2013. Further, 2.6 million Kenyans (6.2 percent) of households were at risk of impoverishment as a consequence of expenditure on health care depleting household savings and were at a risk of falling into poverty (Republic of Kenya 2015b).
more
The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume series entitled Managing Hazardous Material Incidents. The series is designed to help emergency response and health
...
care professionals plan for and respond to hazardous material emergencies.
- Volume I Emergency Medical Services: A Planning Guide for the Management of Contaminated Patients
- Volume II Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients
- Volume III Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to hazardous materials.
more
This document presents a brief overview of how UNHCR adapts its activities for mental health and psychosocial support (MHPSS) to the changing context of the pandemic. Staff of UNHCR and partners, in country offices in all regions of the world, have
...
developed innovative field practices to continue providing essential MHPSS services to refugees. The examples in this document are testimony to the commitment and creativity of our staff and can serve as inspiration and encouragement for others to continue integrating MHPSS in the humanitarian work during and after the COVID-19 pandemic.
more
Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper
...
health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
more
Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul
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nerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
more
Every year, nearly 250 million people move across borders temporarily or permanently for a job opportunity, studying, to flee a crisis back home, or for other reasons. Another 750 million move for similar reasons within the borders of their countries. With the understanding that human mobility affec
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ts public health, and health affects human mobility and migrants, for decades, IOM has been providing critical health services to women, children and men on the move, while standing by governments for technical and operational support as needed. In 2019, in lower-income settings and in complex emergencies, along the world’s most perilous migration routes, in the aftermath of natural disasters or in response to disease outbreaks, IOM’s health teams have provided hundreds of thousands with primary health-care consultations, mental health and psychosocial support, sexual and reproductive health care, pre-migration health services, and much more.
This year, more than ever before, as the world reels from the socioeconomic impact of COVID-19, we have experienced that health is a cross-cutting component of overall human development and well-being.
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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-exist
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ing mental health conditions, health workers, and persons 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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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on
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health at all country income levels underpinned the rise in health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NC
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Ds) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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This integrated operational framework provides an overview of the connections between mental health, neurological and substance use (MNS) conditions, and their links to health, well-being and the br
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oader public health and sustainable development agenda. The need for integrated approaches is increasingly recognized as critical to address the complex interactions between mental health, brain health, substance use, and physical health, particularly in light of global threats such as the COVID-19 pandemic. The framework also provides a series of actions for governments and health service planners and advisors to achieve integration across four domains: leadership and governance; care services; promotion and prevention; and health information systems, evidence generation and research.
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The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the s
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ituation of health and well-being of older persons in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the
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health, nutrition and other sectors, to:
Consider the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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UNHCR’s Public Health Strategy 2021-2025 is based on the lessons learnt, and builds on the achievements, of the Global Strategy for Public Health 2014-2018.
Progress was made on policies favourin
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g inclusion and integration into national systems3 with 92% of 48 operations surveyed reporting refugees having access to national primary health care facilities under the same conditions as nationals and 96% reporting refugees having access to all relevant vaccines under the same conditions as nationals. While many refugee hosting countries have policies that allow refugees to access national health services, many face partial access, prohibitive out-of-pocket expenditures and other barriers including distance to facilities, language and provider acceptance. Furthermore, more work is needed on strengthening these systems to be able to meet the needs of both host communities and refugees.
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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
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child mortality. The Government of Nepal has implemented 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 1964 medical mission was challenged and called to define its distinctiveness and its special role in the context of that particular time. The consultation "Tuebingen I" clearly stated: "The Christian church has a specific task in the field of
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health and healing"1, and developed a concept of wholeness and of the role of the congregation in health provision. 50 years later, the question of the proprium of Christian health services is again a very important one. At a time when governments, international non-governmental organizations and other philanthropic organizations participate in health care, the question has to be asked: What is the specific contribution of a Christian health service or ministry of healing? At a time when chronic disease challenges not only rich but now also poor countries, when infections like Ebola that for years were hidden in Africa pose a threat to the global situation, Christians have to reflect on the question of the proprium of Christian health care.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
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3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential
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health services, including those that address sexual and reproductive health and rights (SRHR), gender-based violence (GBV) and preventing harmful practices such as child marriage and female genital mutilation.
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Bolkan HA, Bash-Taqi DA, Samai M, Gerdin M, von Schreeb J. Ebola and Indirect Effects on Health Service Function in Sierra Leone. PLOS Currents Outbreaks. 2014 Dec 19. Edition 1. doi: 10.1371/currents.outbreaks.0307d588df619f9c9447f8ead5b72b2d.
I
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npatient health services have been severely affected by the Ebola outbreak. The dramatic documented decline in facility inpatient admissions and major surgery is likely to be an underestimation. Reestablishing such care is urgent and must be a priority.
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Women and Health Initiative Working Paper No. 1. Women and Health Initiative
Improving maternal health in the context of the sub-Saharan African ... HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Improving maternal health in the context of the sub-Saharan African ... HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Best practice guidelines are systematically developed statements designed to assist nurses working in partnership with persons and their families to make decisions about health care and
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services (Field & Lohr, 1990). This nursing Best Practice Guideline (BPG) is intended to replace the RNAO BPGs Screening for Delirium, Dementia and Depression in Older Adults (2010b) and Caregiving Strategies for Older Adults with Delirium, Dementia and Depression (2010a).
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Peru − Progress in health and sciences in 200 years of independence
Carrillo-Larco; R.M.; Guzman-Vilca, W. C.; Leon-Velarde, F.; et al.
The Lancet Regional Health - Americas
(2021)
CC
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and
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population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also
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the importance of basing the response on existing structures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study
The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere
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. Before the government implements a payment policy in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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The purpose of this interim guidance is to provide information and insight to assist public policy and
health system leaders in preparing for and responding to an MCE caused by terrorist use of explosives
(TUE). This document provides practical in
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formation to promote comprehensive mass casualty care
in the event of a TUE event and focuses on two areas:
1. leadership in preparing for and responding to a TUE event, and
2. effective care of patients in the prehospital and hospital environments during a TUE event.
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The volume presents data on the surgical burden of disease, disability, congenital anomalies, and trauma, along with health impact and economic analyses of procedures, platforms, and packages to improve ca
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re in settings with severe budget limitations. Essential Surgery identifies 44 surgical procedures that meet the following criteria: they address substantial needs, are cost effective, and are feasible to implement in low- and middle-income countries. If made universally available, the provision of these 44 procedures would avert 1.5 million deaths a year and rank among the most cost effective of all health interventions.
Entire Volume large file: 19 MB!!!
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Guidelines for essential trauma care. Russian Version
30 April 2020
| COVID-19: Essential health services
STGs are designed to assist health care professionals in making decisions about appropriate, effective patient care. However,
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health managers often have trouble setting and meeting the high standards required of modern, developed health care systems. With stakeholders expressing concern over issues such as strength of evidence, transparency, conflicts of interest, and effective implementation, it is clear that many health care professionals need further guidance in developing and making use of STGs.
This manual guides health professionals through the process of establishing and implementing STGs, placing special emphasis on the low- and middle-income country (LMIC) context. By including tools, templates, and success stories as well as hyperlinks to useful resources, the manual helps health practitioners understand not only important concepts of treatment guidelines, but also how they can best be used in practice.
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Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencie
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s for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice
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Recovery partnership preparation package: Building capacity to reactivate safe essential health services and sustain
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health service resilience.
In the aftermath of an emergency, the recovery partnership preparation package supports the establishment and implementation of institutional health partnerships, or ‘twinning partnerships’. These partnerships focus on shared learning and improvement in the services that are being delivered. The Twinning Partnerships for Improvement (TPI) approach supports capacity-building, the re-establishment of safe essential health services and encourages joint long term efforts on service delivery strengthening
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Strengthening competency based training of health care providers for Reproductive Maternal Newborn Child & Adolescenct Health (RMNCH + A)
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services
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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%
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of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disability 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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Summary of National Priorities - Malawi
Community Health Roadmap
United States Agency for International Development; Bill & Melinda Gates Foundation; The Rockefeller Foundation; World Bank Group; community health acceleration partnership; unicef
(2021)
CC
Malawi’s first National Community Health Strategy (NCHS, 2017-2022) defines a new community health system in which community health cadres, both
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formal and non-formal, deliver services of the Essential Health Package, with a focus on child and maternal health. It envisages an integrated approach to service delivery and is embedded in Malawi’s Health Sector Strategic Plan (HSSPII).
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No country can claim to be free from health-care associated infections, therefore, improvement of infection prevention and control (IPC) strategies is ess
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ential. WHO recommends the use of multimodal improvement strategies to implement IPC interventions. These include each item of standard and transmission-based precautions according to national guidelines or standard operating procedures and under the coordination of the national IPC focal point (or team, if existing). This publication consists of three focused improvement tools, called “aide-memoires”, which focus on 1) respiratory and hand hygiene, 2) personal protective equipment, and 3) environmental cleaning, waste and linen management, all elements of standard, droplet/contact and airborne precautions.
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The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Heal
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th Sector Transformation Plan (HSTP). The EHSTG, which is consistent with the national focus on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
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The availability of controlled medicines is crucial for patients requiring palliative care, pain relief and symptom management. Many individuals worldwide, especially in low- and middle-income countries, continue to experience limited access to thes
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e essential medicines. Enhancing access to controlled medicines is paramount in promoting universal health coverage. This report offers a detailed situational analysis of policies and programmes aimed at improving access to affordable, high-quality controlled medicines for pain management in the WHO South-East Asia Region. The report identifies the existing barriers, challenges and possible solutions to facilitate access to such medicines across all Member States.
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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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Throughout the Americas, populations are aging and the Region is undergoing a rapid demographic transition. The aging index, which reflects the size of the older age groups per 100 compared to children under age 15, clearly demonstrates the increase in people aged 60 and older. Compared to global tr
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ends, the Region of the Americas will have a larger number of people aged 60 and older than children under 15 by 2030, which is approximately 25 years before the global average. The COVID-19 pandemic has presented an unparalleled health crisis around the world. The impact on older persons and those with underlying health conditions has highlighted the challenges of addressing the needs of older populations during a public health emergency. Given this demographic transition it is essential to think about preparedness of systems and services to address this population’s needs, including an increase in emergency planning and protection of older populations.
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WHO published guidance for clinicians and health care decision-makers on the use of corticosteroids in patients with COVID-19.
We recommend systemic corticosteroids for the treatment of patients
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with severe and critical COVID-19. We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful. Treatment should be under supervision of a clinician.
Corticosteroids are listed in the WHO model list of essential medicines, readily available globally at a low cost. WHO encourages countries to maintain sufficient stocks of corticosteroids to treat COVID-19 and the other disease for which they are effective, while not maintaining excessive stocks which could deny other countries access.
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Guidelines for the Clinical Management of HIV Infection in Myanmar, 5th ed.
recommended
The Republic of the Union of Myanmar, Ministry of Health, Department of Health, National AIDS Programme
World Health Organization (WHO), Country Office for Myanmar
(2017)
C1
These guidelines aim to guide all health care providers in Myanmar, accommodating the situation of different settings in the context of progressive decentralization of HIV
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services. Notable changes from the previous edition include:
• diagnosis of HIV
• update on the initiation of ART
• new ARV drugs and regimens
• new recommendation on infant prophylaxis
• PrEP and PEP updates
• updates on co-infections and comorbidities management
It should be noted that these guidelines are meant for the operational level and are adapted and adopted in line with existing Myanmar context. more
• diagnosis of HIV
• update on the initiation of ART
• new ARV drugs and regimens
• new recommendation on infant prophylaxis
• PrEP and PEP updates
• updates on co-infections and comorbidities management
It should be noted that these guidelines are meant for the operational level and are adapted and adopted in line with existing Myanmar context. more
The aims of these guidelines are to provide guidance to health-care providers (i.e. the end-users of these guidelines: physicians, nurses, pharmacists and caregivers) on the adequate relief of pain
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associated with cancer. They also assist policy-makers, programme managers and public health personnel to create and facilitate appropriately balanced policies on opioids and prescribing regulations for effective and safe cancer pain management. Proper and effective stewardship of opioid analgesics in the cancer treatment setting is essential to ensure the safety of patients and to reduce the risk of diversion of medicine into society.
The goal of cancer pain management is to relieve pain to a level that allows for an acceptable quality of life.
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Laboratory diagnosis of Buruli ulcer
recommended
A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulceran
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s. Aimed at laboratory technicians and scientists working on this disease, the manual details the exact procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the he
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alth-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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A module from the suite of health service capacity assessments in the context of the COVID-19 pandemicINTERIM GUIDANCE5 February2021
The Community needs, perceptions and demand: community assessment toolcan be used by countries to conduct a rapid p
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ulse survey of community health needs and perceptions around effective use of essential health services during the COVID-19 outbreak. The assessment helps to establish an early warning system on the need to implement coping strategies to continue to respond to communities’ health needs throughout the course of the pandemic. This assessment tool is informed by WHO and partner tools and guidance on community health needs, continuity of essential health services and readiness planning for COVID-19
more
A module from the suite of health service capacity assessments in the context of the COVID-19 pandemicINTERIM GUIDANCE5 February2021
The Community needs, perceptions and demand: community assessment toolcan be used by countries to conduct a rapid p
...
ulse survey of community health needs and perceptions around effective use of essential health services during the COVID-19 outbreak. The assessment helps to establish an early warning system on the need to implement coping strategies to continue to respond to communities’ health needs throughout the course of the pandemic. This assessment tool is informed by WHO and partner tools and guidance on community health needs, continuity of essential health services and readiness planning for COVID-19
more
Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charit
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ies such as nongovernmental organizations (NGOs), armies, and international organizations such as the International Red Cross/Red Crescent movement. They comply with the classification and minimum standards set by the World Health Organization (WHO) and its partners and bring to an emergency their training and self-sufficiency so as not to burden the national health system. EMT initiatives strengthen national surge capacities and facilitate the deployment of internationally classified teams of health- care professionals to countries and territories during emergencies, particularly during disease outbreaks and natural disasters, providing immediate assistance when national health systems are overwhelmed . Considering that they aim to support the provision of quality clinical care services to populations affected by public health emergencies, the expectation is that financial resources and equipment will be available to enable the performance of the requested task.
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Community pharmacists are the health professionals most accessible to the public and are a cornerstone of primary health care. The role of communit
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y pharmacists is expanding globally. This report provides an overview of existing components and provisions of the legal and regulatory framework for community pharmacies and their activities in Europe. It presents the diverse approaches to community pharmacy licenses and to establishment of new pharmacies and their ownership. It also details the framework for community pharmacy operating requirements (including opening hours, workforce, premises and equipment, services provided and identification of a community pharmacy) and the types of activity undertaken. Provisions associated with possible alternative forms of dispensing medicines (over-the-counter medicines, prescription-only medicines, dispensing by medical doctors and online medicine sales) are also described
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The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South Africa.
The NCS de
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fine fundamentals for quality of care based on six dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
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The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering
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quality care services to patients over a long time. The new National Guidelines for Prevention and Management of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
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This guide is intended to promote a global health sector response to FGM for the provision of high-quality prevention and care services to women an
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d girls at risk of FGM or living with the consequences of FGM. It also aims to support the systematic development of pre-service and in-service FGM content for midwifery and nursing education curricula which are relevant to context and need. This document could also be used for training materials of other cadres of health-care providers.
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The Ideal Clinic Realisation and Maintenance (ICRM) programme was initiated by the National Department of Health in July 2013 in order to systematically improve primary health
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care (PHC) facilities and the quality of care they provide. The Ideal Clinic framework/dashboard sets out the standards for PHC facilities to provide good-quality health services. An Ideal Clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicines and supplies, good administrative processes, and sufficient adequate bulk supplies. Applicable clinical policies, protocols and guidelines are adhered to, and it harnesses partner and stakeholder support.
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The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way towards Universal Health Coverage (UHC),choosing a
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path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population by 2020 while increasing financial protection.
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The new guidelines provide public health guidance on pharmacological agents for managing hyperglycaemia in type 1 and type 2 diabetes for use in primary health-
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care in low-resource settings. These guidelines update the recommendations for managing hyperglycaemia in the WHO Package of Essential NCD Interventions (WHO PEN) for primary care in low-resources settings, reviewing several newer oral agents as second- and third-line treatment: dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and thiazolidinediones. The guidelines also present recommendations on the selection of type of insulin (analogue versus human insulin) for adults with type 1 and type 2 diabetes.
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HIV-1 drug resistance (HIVDR) genotyping is an essential component of the WHO global HIVDR surveillance strategy. Plasma “gold standard” specimen type for HIVDR genotyping, but its use may not be feasible in rural, remote areas in low- and middl
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e-income countries, since preparing and storing it require personnel and laboratory infrastructure that are often lacking. An alternative specimen type is dried blood spots (DBS), which can be made without special laboratory processing. DBS are more easily transported than plasma because they can be shipped at ambient temperature as non-hazardous materials using regular mail or courier services.
3rd edition
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These guidelines for the prevention and management of cardiovascular diseases are a critical ingredient for streamlining care across the entire health
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services provision continuum. They are a strategic component in achieving universal health coverage, securing affordable health care and improving the livelihood of all Kenyans which in turn will guarantee a healthy nation working towards sustainable development and prosperity.These guidelines bring to the fore the need for availability of skilled human resource, sustained adequate funding and partnership building at all levels of governance. It provides clear roles for health workers at the different levels of our devolved system which will ensure a harmonized referral system with basic cardiovascular diseases treatment services available closest to the people while decongesting the county and national referral facilities.
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Enabling young children to achieve their full developmental potential is a human right and an essential requisite for sustainable development. Given the critical importance of enabling children to make the best start in life, the
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health sector, among other sectors, has an important role and responsibility to support nurturing care for early childhood development. This guideline provides direction for strengthening policies and programmes to better address early childhood development.
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Saving lives is the priority of WHO’s response in Ukraine. WHO works to ensure time-critical, lifesaving multisectoral assistance, non-discriminatory access to emergency and essential health
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services and priority prevention programmes, and laying the foundation for longer-term health systems recovery and strengthening.
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Since 24 February 2022, the war in Ukraine has caused widespread suffering to its people and serious damage
to the country’s infrastructure. Attacks on the country’s health system and its power network threaten people, compromise the provision
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of health care, and complicate the distribution of essential medicines and equipment.
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Programming strategies for Postpartum Family Planning
World Health Organization; USAID; MCHIP
(2013)
This publication is designed to be used by programme planners and managers as a resource when designing interventions to integrate postpartum family planning into national and subnational strategies. Postpartum family planning should not be considered a ‘vertical’ programme, but rather as an int
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egrated part of existing maternal and child health and family planning efforts. Successful interventions for postpartum family planning require holistic and evidence-based programme strategies that contribute to strengthened health systems and sustained improvements in high-quality services that put people at the centre of health care
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The meningitis road map has been designated as a flagship global strategy of the WHO’s Thirteenth General Programme of Work, 2019–2023 and is an essential component in achieving universal health
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coverage.
The road map will reinforce and combine with wider initiatives, such as those aimed at strengthening primary health care and health systems, increasing immunization coverage, improving global health security, fighting antimicrobial resistance and advocating for the rights of persons with disabilities. It will complement other global control strategies, such as those addressing sepsis, pneumonia, tuberculosis and HIV. Implementation will be a challenge for all countries across the world, but especially in resource-poor settings where the burden of meningitis is greatest. The targets for the visionary and strategic goals will be adapted to regional and local contexts.
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2nd. edition
The new edition has been developed to make widely available to programme managers, health care workers in endemic settings, academic researchers, and other key partners, a concise sour
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ce of information on strategies for MMDP for LF. It is a product of efforts to elaborate and concepts and approaches introduced in the previous edition, with a focus on ensuring that countries have the tools necessary to provide the essential package of care for LF.
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The Toolkit is a library of technical tools and resources that have been constructed to support the implementation of national health plans during the recovery phase in the context of the Ebola outbreak. It brings together technical expertise and re
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sources on safe essential services into a single source
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