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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and
...
comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
more
The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health
...
coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
more
A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these change
...
s vary substantially across countries, even at similar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected.
Methods
We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks.
Findings
Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending.
Interpretation
Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action.
Funding
Bill & Melinda Gates Foundation.
more
The 2019-2023 Strategy for UNU-IIGH, developed in
2018, built on UNU-IIGH’s strategic advantage and
position vis-à-vis the UN and global health ecosystem.
The Strategy set a goal to advance evidencebased policy on key issues related to sustain
...
able
development and health and shifted the Institute’s
body of work from investigator-driven global health
projects to three priority-driven, policy-relevant pillars
of work, each reflecting UNU-IIGH’s unique value
position.
When the COVID-19 pandemic hit in 2020, the
Institute adapted and reprioritised its areas of work
while continuing to deliver on the main strategic
objectives of translating evidence to policy, generating
policy-relevant analyses on gender and health, and
strengthening capacity for local decision making
especially in the Global South.
The new strategic plan encompasses four work packages:
1. Gender Equality and Intersectionality: through this work, we will aim to improve the quality of health care through a human-centred approach, by ensuring the health system is responsive to the needs of structurally excluded individuals and communities; and by advancing a positive and enabling environment for the frontline health workforce—e.g. addressing the experience of gender-based violence.
2. Power and Accountability: through this work, we will catalyse equitable shifts in power and address key accountability deficits that prevent the equitable and effective functioning of the global health system and prevent adequate responsiveness to the needs of states and populations in the Global South.
3. Digital Health Governance: through this work, we will address the colonial legacies and power asymmetries that negatively impact robust digital health governance, identify ways to strengthen health data governance with a particular focus on SRHR and promote diversity in technology design and development.
4. Climate Justice and Determinants of Health: through this work we will leverage UNU-IIGH's position within the UN and network of UNU institutes, network experts, practitioners, policy-makers, and academics to advance evidence-based policy on the different dimensions of the climate emergency and its impact on health.
more
The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child
...
health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing segments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompan
...
iment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
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
...
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.
more
In 2023, the World Health Organization was responding to 72 health emergencies, including 19 grade-3 emergencies which required the highest level of activation, reaching millions of people. The annu
...
al report on WHO’s response to health emergencies in 2023 outlines the increasingly critical role of WHO at global, regional and country levels, and across the key elements of effective emergency response, including emergency coordination and planning, operational and logistic support, and community engagement and protection. The huge scale and complexities of health emergencies in the 21st century require a strategic shift towards not only meeting the immediate needs of vulnerable communities, but also building community and health system resilience to all hazards – a challenge that both WHO and its partners must continue to meet.
more
This dataset contains data from WHO's data portal covering the following categories:
Air pollution, Antimicrobial resistance (AMR), Assistive technology, Child mortality, Dementia diagnosis, treatment and care, Dementia policy and legislation, Environment and
...
health, Foodborne Diseases Estimates, Global Dementia Observatory (GDO), Global Health Estimates: Life expectancy and leading causes of death and disability, Global Information System on Alcohol and Health, Global Patient Safety Observatory, HIV, Health financing, Health systems, Health taxes, Health workforce, Hepatitis, Immunization coverage and vaccine-preventable diseases, Malaria, Maternal and reproductive health, Mental health, Neglected tropical diseases, Noncommunicable diseases, Nutrition, Oral Health, Priority health technologies, Resources for Substance Use Disorders, Road Safety, SDG Target 3.8 | Achieve universal health coverage (UHC), Sexually Transmitted Infections, Tobacco control, Tuberculosis, Vaccine-preventable communicable diseases, Violence against women, Violence prevention, Water, sanitation and hygiene (WASH), World Health Statistics.
more
The objective of this project was to list the medical devices required to provide the essential reproductive, maternal, newborn and child health interventions defined by existing WHO guidelines and publications, in order to improve access to these d
...
evices in low- and middle-income countries, support quality of care, and strengthen health-care system. The medical devices are allocated across the reproductive, maternal, newborn and child health continuum of care according to the level of health-care delivery.
more
In this era, grand challenges lies in biodiversity loss, climate change, and global noncommunicable diseases signify that planet and humanity are in crisis. Scholarly evidence from human and animal kingdom suggest that there is an optimism in planetary hea
...
lth which can provide a unique and novel concept where efforts toward survival and remediation can be made. With accurate navigation, the current challenges can be mitigated leading to a new reality, one in which the core value is the well‐being of all. This paper discusses the drivers of planetary health and the role of community health workers (CHWs) in making health‐care system more resilient that can produce multiple benefits to community and overall planetary health. A web‐based international database such as Google, Google Scholar, SCOPUS/MEDLINE/PubMed, and JSTOR was searched relevant to a planetary health framework. The study findings suggest that CHWs can offer health care interventions through environmental health cobenefits across the spectrum of health effects of climate change cause and effects. These actions have been divided into four major categories (i. health care promotion and prevention, ii. health care strengthening, iii. advocacy, and iv. education and research) that CHWs perform through a variety of roles and functions they are engaged in protecting planetary health. CHWs contribute toward achieving sustainable development goals such as planetary health and focus on environment sustainability and well‐being of entire mankind.
more
This publication presents a comprehensive methodology to support the Member States of the Pan American Health Organization (PAHO) in preparing for and responding to heat-health risks in the Region o
...
f the Americas. It builds on World Health Organization and the World Meteorological Organization global documents, as well as on the disaster preparedness methodologies employed throughout the countries of the Region. This publication is part of an effort coordinated by PAHO to support Member States in multihazard preparedness, and includes: early warning system strengthening; threat characterization; activation and deactivation procedure definition; and institutional coordination. It engages different disciplines and recognizes the importance of intersectoral collaboration to respond to heat-health risks. It aims to bring awareness of the impacts of heat on the health of people of the Americas to public health decisionmakers, and thereby strengthen health service provision.
more
These guidelines were written for anyone trying to meet and solve the challenges of operating a warehouse today. They are an important reference tool for managers and staff, whether they are constructing a new warehouse, implementing a new warehouse system
...
, or redesigning their current system.
Guidelines for Warehousing Health Commodities is for use by supply chain managers, logistics advisors, and warehouse managers who want to improve and increase efficiency in their current health commodity warehouse. more
Guidelines for Warehousing Health Commodities is for use by supply chain managers, logistics advisors, and warehouse managers who want to improve and increase efficiency in their current health commodity warehouse. more
OpenWHO is WHO’s new interactive, web-based, knowledge-transfer platform offering online courses to improve the response to health emergencies. OpenWHO enables the Organization and its key partners to transfer life-saving knowledge to large number
...
s of frontline responders.
On this platform you find online courses on: Pandemic and epidemic-prone diseases; Incident Management System; MERS; Ebola; Public Health Interventions; Risk communication; Predeployment training GO; ZIKA; Influenza
more
USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (P
...
HC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system through achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
more
Over the ages, human societies have altered local ecosystems and modified regional climates. Today the human influence has attained a global scale. This reflects the recent rapid increase in population size, energy consumption, intensity of land use, international trade and travel, and other human a
...
ctivities. These global changes have heightened awareness that the long-term good health of populations depends on the continued stability of biosphere's ecological, physical and socioeconomic systems.
The world's climate system is an integral part of the complex of life-supporting processes. Like other large systems, the global climate system is coming under pressure from human activities.
This book seeks to describe the context and process of global climate change, its actual or likely impacts on health, and how human societies and their governments should respond with particular focus on the health sector.
more
This draft Roadmap for the Global Health for Peace Initiative has been developed in response to decision WHA75(24) of the 75th World Health Assembly (2022), which requested that WHO develop, in full
...
consultation with Member States and Observers, and in full collaboration with other organizations of the United Nations system and relevant non-State actors in official relations with WHO, a Roadmap, if any, for the Global Health and Peace Initiative.
It incorporates feedback received from Member States through a first round of consultation carried out at the end of 2022. This (second) draft is being made available ahead of the 152nd session of the Executive Board, that will consider the draft Roadmap.
The Roadmap for the Global Health for Peace Initiative aims to provide a framework for the Initiative at global level, defining concepts, establishing principles, setting strategic goals and objectives as well as operational priorities. It also describes the “Health for Peace approach” to programming, which lies at the core of the Global Health for Peace Initiative (GHPI). The GHPI is a global initiative of WHO that aims to enhance the existing links between health (and health interventions) and peace
more
This handbook is intended primarily for front-line health care providers who are likely to see children (among other clients) in their day-to-day practice. These may include general practitioners, nurses, midwives, gynaecologists,
paediatricians, m
...
ental health professionals, first responders and staff in emergency care.
Other professionals who may find it useful include social workers, those working in social welfare institutions, providers of psychosocial support, and those working in child care facilities and the education system.
Further, the content will benefit the work of policy-makers and managers to enable and support provision of clinical care to children experiencing, or who have experienced, child maltreatment.
more
UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising
...
sessions on PSS in the community; and life skills & vocational training opportunities. The WFHS also facilitates referral to other services including Psychosocial Counseling Centers (PSCCs).
The aim of this guidance note is to provide an overview of approaches on how to successfully integrate adolescent and youth (A&Y) programming into the WFHSs. UNFPA activities for women’s and girl’s protection in health facilities aim to protect women and girls including child marriage. Given that vulnerable women and girls in Afghanistan continue to access health facilities, particularly for reproductive health and maternal health services, it is crucial to provide support for survivors in the same location to improve access to essential psychosocial and protection support for women and girls. To support the integration of A&Y in the WFHS programming each WFHS will be supported by two full time Youth Educators. A female Youth Educator who will be working within the WFHS and a male Youth Educator who will be working in the community. The role of the Youth educators is to increase A&Y awareness and knowledge on living healthy lifestyles and ensuring a referral system to services in existing facilities.
more
Background:Tracking aid fl ows helps to hold donors accountable and to compare the allocation of resources in relation to health need. With the use of data reported by donors in 2015, we provided estimates of offi cial development assistance and gr
...
ants from the Bill & Melinda Gates Foundation (collectively termed ODA+) to reproductive, maternal, newborn, and child health for 2013 and complete trends in reproductive, maternal, newborn, and child health support for the period 2003–13. Methods: We coded and analysed fi nancial disbursements to reproductive, maternal, newborn, and child health to all recipient countries from all donors reporting to the creditor reporting system database for the year 2013. We also revisited disbursement records for the years 2003–08 and coded disbursements relating to reproductive and sexual health activities resulting in the Countdown dataset for 2003–13. We matched this dataset to the 2015 creditor reporting system dataset and coded any unmatched creditor reporting system records. We analysed trends in ODA+ to reproductive, maternal, newborn, and child health for the period 2003–13, trends in donor contributions, disbursements to recipient countries, and targeting to need.
more
Background: Mental health has recently gained increasing attention on global health and development agendas, including calls for an increase in international funding. Few studies have previously cha
...
racterized official development assistance for mental health (DAMH) in a nuanced and differentiated manner in order to support future funding efforts. Methods: Data from the Organisation for Economic Cooperation and Development Creditor Reporting System were obtained through keyword searches. Projects were manually reviewed and categorized into projects dedicated entirely to mental health and projects that mention mental health (as one of many aims). Analysis of donor, recipient, and sector characteristics within and between categories was undertaken cumulatively and yearly.
more
Background: Tracking of aid resources to reproductive, maternal, newborn, and child health (RMNCH) provides timely and crucial information to hold donors accountable. For the first time, we examine flows in official development assistance (ODA) and
...
grants from the Bill & Melinda Gates Foundation (collectively termed ODA+) in relation to the continuum of care for RMNCH and assess progress since 2003. Methods: We coded and analysed financial disbursements for maternal, newborn, and child health (MNCH) and for reproductive health (R*) to all recipient countries worldwide from all donors reporting to the creditor reporting system database for the years 2011–12. We also included grants from the Bill & Melinda Gates Foundation. We analysed trends for MNCH for the period 2003–12 and for R* for the period 2009–12.
more
We created a dataset to generate estimates of donor-reported ‘official development assistance’ and private grants (ODA+) to reproductive, maternal, newborn and child health (RMNCH) by donor, recipient country and activity type over the period 20
...
03–2013. We collected disbursement information from the Organisation for Economic Co-operation and Development Creditor Reporting System (CRS) in January 2015. All 2.1 million records across all sectors were coded based on donor name, project title, short and long descriptions, and CRS code describing the purpose of the disbursement. We classified records according to the degree to which they would promote attainment of Millennium Development Goals 4 and 5 (reproductive and sexual health, maternal and newborn health, and child health). We also classified records according to whether they supported prenatal and neonatal health (PNH). The dataset includes project funding as well as allocating shares of general budget support, health sector support and basket funding. The data can be used to analyse resource flows to RMNCH or to other purposes or beneficiaries of ODA+.
more
Background
Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictab
...
le, transparent, and up-to-date estimates that could be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017.
Methods
Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators.
Findings
After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million).
Interpretation
Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention.
Funding
Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health.
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In this quality improvement study, data from the Creditor Reporting System were used to estimate flows of total DAAH and per-adolescent DAAH and to assess its distribution by donors, regions, and countries and the leading causes of burden of disease
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(ie,
disability-adjusted life-years) in 132 developing countries between January 1, 2003, and December 31, 2015. Through use of a key word search and various funding allocation methods, 2 sets of estimates were produced: adolescent-targeted DAAH that included disbursements to projects with a primary adolescent health target and adolescent-inclusive DAAH that included disbursements to
projects with either a primary or partial adolescent health target, as well as projects that could benefit adolescent health but did not include age-related key words.
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In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors
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ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
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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
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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
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Human Resource Capacity Development in Public Health Supply Chain Management: Assessment Guide and Tool
USAID; Deliver Project
(2013)
this toolkit presents a structured, rating-based methodology designed to provide a rapid, comprehensive assessment of the capacity of the human resource support system for a country’s supply chain. Data are gathered from a document review, focus g
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roup discussions, and in-country stakeholder interviews to identify the strengths, areas for improvement, opportunities, and challenges for a wide range of human resource inputs and components. The findings are transformed into specific recommendations and strategies for action based on an understanding of country priorities and programming gaps. It includes Word templates; PowerPoint templates and Exce-based Diagnostic Dashboard
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This Policy for community-based health insurance answers the will of the Rwandan government to popularize the fundamental aces of the current policy. This document serves as an update to the first policy that was elaborated and published in 2004, an
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d integrates all the changes that have occurred in the process since then. This new version of the policy for community based health insurance contributes to the fulfillment of the same objectives as the EDPRS and the Millennium Development Goals (MDG). It integrates system experiences but more especially the devices adapted to the challenges with which community base health insurance are confronted at present.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited peopl
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e's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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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
A cross-sectional descriptive study design covering all states and regions was undertaken to:
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of ... health facilities,
2) To assess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of ... health facilities,
2) To assess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
Observatory report by Médecins du Monde/Doctors of the World Germany:“Deprived of the right to health. Sick and without medical care in Germany” gives a rare insight into the situation of those who have no or only limited access to the German
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health system.
more
A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal
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health system evaluations continue to identify major gaps in capacity to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
...
Monitoring is the on-going collection, management and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the diseasehave wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergenc
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y departments(EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight frommultidisciplinary frontline staff to understand the changes in paediatric emergency healthcare utilization duringCOVID-19 the experiences of working within the restructured health system.
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In the wake of the Covid‑19 Pandemic, parts of the public health system at increased risk of reduced efficiency include healthcare services for women and children. This in turn
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could reverse all the progress achieved over the years in reducing maternal and child mortality. In this study, an attempt has been made to assess the indirect effect of the pandemic on maternal and child health services in public health facilities.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c
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ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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As the world population is growing and health care resources are in high demand the pressure on medical services is becoming higher. Developing countries are already at a crisis point in health care
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provision, and time demands a new approach in structuring medical resources. Primary care is the vital pillar for fundamental health care at community level and has been deemed as a cost-effective modality. In the West the primary care physician manages chronic medical conditions in communities and therefore reduces unnecessary hospital admissions. In the West, the primary care system is extremely well organised. Low-income countries must improve teaching, training and funding in primary care. In this article the urgent need for primary care is discussed in developing countries, and ways to minimise costs and improve clinical outcomes at community level.
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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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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, healthcare workforce constraints, financing, availability
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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.
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Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent measles outbreaks which started in August 2021, and t
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he highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
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Translation of the 1st ed., 2003
These guidelines were written for anyone trying to meet and solve the challenges of operating a warehouse today. They are an important reference tool for managers and staff, whether they are constructing a new warehouse, implementing a new warehouse ... system, or redesigning their current system.
Guidelines for Warehousing Health Commodities is for use by supply chain managers, logistics advisors, and warehouse managers who want to improve and increase efficiency in their current health commodity warehouse. more
These guidelines were written for anyone trying to meet and solve the challenges of operating a warehouse today. They are an important reference tool for managers and staff, whether they are constructing a new warehouse, implementing a new warehouse ... system, or redesigning their current system.
Guidelines for Warehousing Health Commodities is for use by supply chain managers, logistics advisors, and warehouse managers who want to improve and increase efficiency in their current health commodity warehouse. more
Nota Informativa - Gestire la salute mentale e gli aspetti psicosociali dell'epidemia di COVID-19 - Versione 1.5
IASC Reference Group on Mental Health and Psychosocial Support in Emergency Settings; OCCHA Services; System Socio Sanitario Regione Lombardia ATS Milano Città Metropolitana; Servizio Sanitario Regionale Emilia-Romagna
IASC Reference Group on Mental Health and Psychosocial Support in Emergency Settings; OCCHA Services; System Socio Sanitario Regione Lombardia ATS Milano Città Metropolitana; Servizio Sanitario Regionale Emilia-Romagna
(2020)
C2
17 Marzo 2020
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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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an
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d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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Classical rabies caused by RABV occurs worldwide besides some isolated countries and Western Europe that are regarded rabies free. Carnivores, especially of the canidae family represent the principal reservoir species and are responsible for the maintenance of the infectious cycle and hence for the
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presence of the disease (see Epidemiology of rabies). While wildlife rabies maintained by different reservoirs hosts predominantly occurs in the Northern hemisphere, canine rabies is by far more important for public health in the developing world.
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All lyssaviruses have evolved closely with distinct natural reservoir hosts. The latter are animals species in which a pathogen of an infectious disease are maintained independently. For lyssaviruses, these are a wide range of mammalian species within the Carnivora and Chiroptera (bats) orders with
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a global distribution.
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The incubation period (the time the virus spreads from the peripheral nerves near the site of the bite via the spinal cord to the brain – see transmission and pathogenesis) ranges in general between 2 and 3 month (2 weeks to 6 years are reported) depending on the site of infliction, the amount of
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virus and the virus strain. Due to its neurotropism all known lyssaviruses cause severe neurological symptoms as a result of an acute encephalitis. Therefore, clinical signs in humans and animals are very similar.
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Background: Investing in the health workforce is key to achieving the health-related Sustainable Development Goals. However, achieving these Goals requires addressing a projected global shortage of
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18 million health workers (mostly in low- and middle-income countries). Within that context, in 2016, the World Health Assembly adopted the WHO Global Strategy on Human Resources for Health: Workforce 2030. In the Strategy, the role of official development assistance to support the health workforce is an area of interest. The objective of this study is to examine progress on implementing the Global Strategy by updating previous analyses that estimated and examined official development assistance targeted towards human resources for health. Methods: We leveraged data from IHME’s Development Assistance for Health database, COVID development assistance database and the OECD’s Creditor Reporting System online database. We utilized an updated keyword list to identify the relevant human resources for health-related activities from the project databases. When possible, we also estimated the fraction of human resources for health projects that considered and/or focused on gender as a key factor. We described trends, examined changes in the availability of human resources for health-related development assistance since the adoption of the Global Strategy and compared disease burden and availability of donor resources.
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Introduction
In 2017, development assistance for health (DAH) comprised 5.3% of total health spending in lowincome countries. Despite the key role DAH plays in global
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health-spending, little is known about the characteristics of assistance that may be associated with committed assistance that is actually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.
Methods
We extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.
Results
Factors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).
Conclusion
Substantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.
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Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026
Global Burden of Disease 2021 Health Financing Collaborator Network
The Lancet Glob Health
(2023)
C2
The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national
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health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness.
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The guidance aspires
• To emphasize the 'need' to mainstream disaster risk reduction (DRR) in the health sector initiatives.
• To identify key approaches for mainstreaming DRR in the health ... sector in Myanmar, particularly in rural areas, based on the good practices, innovative approaches and lessons learned of Government, UN agencies, NGOs and others involved in the Cyclone Nargis recovery.
• Identify key ‘vulnerabilities and opportunities’ for creating a ‘safer health system’ in Myanmar.
No publication year indicated. more
• To emphasize the 'need' to mainstream disaster risk reduction (DRR) in the health sector initiatives.
• To identify key approaches for mainstreaming DRR in the health ... sector in Myanmar, particularly in rural areas, based on the good practices, innovative approaches and lessons learned of Government, UN agencies, NGOs and others involved in the Cyclone Nargis recovery.
• Identify key ‘vulnerabilities and opportunities’ for creating a ‘safer health system’ in Myanmar.
No publication year indicated. more
Policy Guidance Brief 2
• The potential health risks from climate change include: increase of waterborne and vector-borne diseases, heat-related illnesses, injuries and deaths, food insecurity and increased malnutrition. The poor, women, chil ... dren and the elderly, as well as communities living in remote high-risk areas are most vulnerable.
• The expected results to achieve this outcome are: (i) climate risk management system is well-established, robust and nationally integrated to respond efectively to increased intensity and impact of risks and hazards on people’s health and wellbeing; (ii) improved social protection, gender consideration and risk finance capacity to prepare for and recover from potential loss and damage resulting from climate change; (iii) Myanmar’s health system is improved and can deal with climate-induced health hazards and support climate-vulnerable communities to respond effectively to disaster and health hazards from climate change. more
• The potential health risks from climate change include: increase of waterborne and vector-borne diseases, heat-related illnesses, injuries and deaths, food insecurity and increased malnutrition. The poor, women, chil ... dren and the elderly, as well as communities living in remote high-risk areas are most vulnerable.
• The expected results to achieve this outcome are: (i) climate risk management system is well-established, robust and nationally integrated to respond efectively to increased intensity and impact of risks and hazards on people’s health and wellbeing; (ii) improved social protection, gender consideration and risk finance capacity to prepare for and recover from potential loss and damage resulting from climate change; (iii) Myanmar’s health system is improved and can deal with climate-induced health hazards and support climate-vulnerable communities to respond effectively to disaster and health hazards from climate change. more
What recommendations did the assessment produce?
• Developing guidelines and plans to further the process of SRH and Hiv integration.
• Training stakeholders at different levels of the health sys
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tem on how to integrate activities.
• Establishing mechanisms for collaboration/coordination on SRH and Hiv at different levels.
• Developing plans for SRH and Hiv integration that include: situation analysis; feasibility studies; assessment of needs for reorganizing and reorienting services towards better integration; necessary tools (e.g. job descriptions, work plans); and tools to evaluate service quality and user satisfaction in relation to integration.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for h
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ealth professionals. It requires early recognition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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A key component of achieving control and elimination of neglected tropical diseases (NTDs) is effective supply chain management of preventive chemotherapy drugs for Mass Drug Administration (MDA) for trachoma, river blindness, lymphatic filariasis, soil-transmitted helminthiasis and schistosomiasis.
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This course explains the end-to-end process from planning and submitting donated drug requests through to waste management of expired and unserviceable stock and reverse logistics of unused tablets. It is essential knowledge for all levels of the health system that must work together to implement MDA.
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Background: Disbursements of development assistance for health (DAH) have risen substantially during the past several decades. More recently, the international community's attention has turned to other international challenges, introducing uncertain
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ty about the future of disbursements for DAH.
Methods: We collected audited budget statements, annual reports, and project-level records from the main international agencies that disbursed DAH from 1990 to the end of 2015. We standardised and combined records to provide a comprehensive set of annual disbursements. We tracked each dollar of DAH back to the source and forward to the recipient. We removed transfers between agencies to avoid double-counting and adjusted for inflation. We classified assistance into nine primary health focus areas: HIV/AIDS, tuberculosis, malaria, maternal health, newborn and child health, other infectious diseases, non-communicable diseases, Ebola, and sector-wide approaches and health system strengthening. For our statistical analysis, we grouped these health focus areas into two categories: MDG-related focus areas (HIV/AIDS, tuberculosis, malaria, child and newborn health, and maternal health) and non-MDG-related focus areas (other infectious diseases, non-communicable diseases, sector-wide approaches, and other). We used linear regression to test for structural shifts in disbursement patterns at the onset of the Millennium Development Goals (MDGs; ie, from 2000) and the global financial crisis (impact estimated to occur in 2010). We built on past trends and associations with an ensemble model to estimate DAH through the end of 2040.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essentia
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l for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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The primary role of Benin’s Department of Pharmacy and Medicines (DPMED) is to develop and apply the national pharmaceutical policy. The main objective of this policy is to ensure the availability and accessibility of quality medicines for the population. To fulfill its mandate, DPMED aims to stre
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ngthen its regulatory capacity, including the issuance of licenses to pharmaceutical establishments and the registration of pharmaceutical products. Benin’s current registration system shares core concerns that are common to most developing countries, notably the capacity to evaluate and monitor the security, efficacy, and quality of medicines and other health products. It is currently characterized by 1) poor or inadequate traceability of records or regulations (example: a product’s marketing authorization [MA] is often hard to find); 2) lack of evidence used in the regulatory decision-making process (reasons behind special import authorization, i.e., products without valid MAs); 3) inconsistent and unsecured archiving system; 4) limited human resources; and 5) an inefficient information management system
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World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting community awareness about mental illness to increase levels
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of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
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According to WHO, infection prevention and control (IPC) is a scientific approach and practical solution designed to prevent harm caused by infection to patients and health workers. It is grounded in infectious diseases, epidemiology, social science
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and health system strengthening. IPC occupies a unique position in the field of patient safety and quality universal health coverage since it is relevant to health workers and patients at every single health-care encounter. Poor WASH and IPC lead to health acquired infections, transmission of diseases from health facilities to communities and increased use of antibiotics and exacerbate outbreak and spread of infections- in this case- COVID- 19. On the contrary, effective IPC reduces hospital-acquired infections by at least 30% (WHO 2016).
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Bangladesh has been going through incremental trend of GDP growth rates for a long time. The GDP is the key aspect to measure the economic growth of a country. But the current world wide pandemic due to the COVID-19 hardly affects the world’s economy as well as Bangladesh. The present
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lockdown make the wheel of the industries uncertain. The main source of the GDP of this country is ready made garment sector which has been shut down since mid of March 2020. Already 20 billion of cancellation of foreign order makes the situation worse. Also, the foreign remittance has been decline dramatically due to the loss of jobs of Bangladeshi workers in foreign countries. The overall economic situation declines in this country due to the COVID-19 which has huge impact on the health care system especially in maternal and child health. In this paper, the economic situation of Bangladesh before and during the COVID-19 has been shown. Also, how the COVID-19 would affect the condition
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Existing data on chronic obstructive pulmonary disease (COPD) prevalence are irregularly distributed around the world, and in many geographic regions data are scarce or even nonexistent. This fact hinders the implementation of adequate preventive and therapeutic interventions to reduce the high burd
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en and costs of COPD. In the current study, we have used the Geographic Information System (GIS) inverse distance weighted (IDW) interpolation technique with the objective of visualising spatial data of COPD prevalence in the world and obtaining a visual impression of the magnitude of this global health problem. GIS has been recognised as an effective tool to display the geographical distribution of data, even when they are few and widely separated, as is the case with the prevalence of COPD.
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Evolution of Ebola Virus Disease from Exotic Infection to Global Health Priority, Liberia
M. Allison Arwady, Luke Bawo, Jennifer C. Hunter et al
Centers for Disease Control and Prevention CDC
(2015)
Emerg Infect Dis. April 2015
Read online at: http://wwwnc.cdc.gov/eid/article/21/4/14-1940_article
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global
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health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. The authors outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country’s health care system, such as infections among health care workers
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In order to maintain daily operations and patient care services, health care facilities need to develop an Emergency Water Supply Plan (EWSP) to prepare for, respond to, and recover from a total or partial interruption of the facilities’ normal wa
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ter supply. Water supply interruption can be caused by several types of events such as natural disaster, a failure of the community water system, construction damage or even an act of terrorism.
The planning guide provides a four step process for the development of an EWSP:
1. Assemble the appropriate EWSP Team and the necessary background documents for your facility;
2. Understand your water usage by performing a water use audit;
3. Analyze your emergency water supply alternatives; and
4. Develop and exercise your EWSP more
The planning guide provides a four step process for the development of an EWSP:
1. Assemble the appropriate EWSP Team and the necessary background documents for your facility;
2. Understand your water usage by performing a water use audit;
3. Analyze your emergency water supply alternatives; and
4. Develop and exercise your EWSP more
This checklist is intended to heighten the awareness and sensitivity of personnel to the importance of cultural diversity and cultural competence in human service settings. It provides concrete examples to demonstrate values and engage in practices that promote a culturally diverse and culturally co
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mpetent service delivery system fo rchildren with disabilities or special health care needs and their families.
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Improving health systems and services for mental health: mental health policy and service guidance package
This document presents an integrated st
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rategy for mental health system development that will lead to enhanced service delivery, improved outcomes, and improved human rights for people with mental disorders.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig
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h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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Reporting system for the general public - This document aims to provide practical guidelines on how to set up national systems for consumers to report adverse reactions to medicines. The purpose is to help countries set up a well-organized and effec
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tive consumer reporting system within their pharmacovigilance centre. Throughout this document, the phrase “consumer reporting” is used to refer to reporting of adverse drug reactions (ADRs) by the general public.
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To help health- and social-system leaders as they respond to unprecedented challenges related to the COVID-19 pandemic, teams from the McMaster Health
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Forum and Ottawa Hospital Research Institute – as part of their contribution to RISE – and the Africa Centre for Evidence have compiled a list of evidence sources.
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Welcome to the Global Information System on Resources for the Prevention and Treatment of Substance Use Disorders. These pages present data collected from WHO Member States in broad categories: governance, policy and financing, service organization
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and delivery, human resources and national information systems. The latest data were collected in 2014 with the WHO Global Survey on Resources for Prevention and Treatment of Substance Use Disorders (ATLAS-SU survey). The global information system presents all available data to monitor the progress in advancing treatment coverage for substance use disorders (health target 3.5 of the Sustainable Development Goals 2030)
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The assistive technology capacity assessment (ATA-C) is a system-level tool to evaluate a country’s capacity to finance, regulate, procure and provide assistive technology. It can be used for awareness raising, policy and programme design, and ong
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oing monitoring and evaluation. This manual provides guidance and practical information on the ATA-C implementation process. The ATA-C is intended to be implemented by an experienced team, in collaboration with relevant ministries and users’ organizations.
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Effective infection prevention and control (IPC) is the cornerstone of every health system. As of 2023, 17 Member States have a functioning IPC programme; 19 countries have developed national IPC gu
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idelines; and 13 countries have adopted multimodel intervention strategies to improve th
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This protocol establishes the principles and definitions of a surveillance system devised by the WHO Health in Prisons Programme (HIPP) to monitor the evolution of COVID-19-related epidemiolog
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ical data in prisons and other places of detention and to report the main measures adopted to prevent, control and manage the spread of the disease.
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Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Understanding the magnitude of infertility is critical for developing
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appropriate interventions, for monitoring access to quality fertility care, and for mitigating risk factors for and consequences of infertility.
The objective of this report is to provide estimates of the global and regional prevalence of infertility by analyzing all relevant and representative studies from 1990 to 2021, taking into account different study approaches. This report also provides insight into how the estimation of infertility prevalence can be improved to obtain more reliable and actionable data. These estimates improve the understanding of the burden of infertility, and provide a basis for appropriate policies and services to achieve universal access to fertility care for all.
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Guideline ‒ Alternative mass drug administration regimens to eliminate lymphatic filariasis
recommended
Lymphatic filariasis is a vector-borne neglected tropical disease that causes damage of the lymphatic system and can lead to lymphoedema (elephantiasis) and hydrocele in infected individuals. The global baseline estimate of persons affected by lymph
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atic filariasis is 25 million men with hydrocele and over 15 million people with lymphoedema. At least 36 million persons remain with these chronic disease manifestations. The disease is endemic in 72 countries. In 2016, an estimated total population of 856 million were living in areas with ongoing transmission of the causative filarial parasites and requiring mass drug administration (MDA). Lymphatic filariasis disfigures and disables, and often leads to stigmatization and poverty. Hundreds of millions of dollars are lost annually due to reduced productivity of affected patients. WHO has ranked the disease as one of the world’s leading causes of permanent and long-term disability.
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The strategic priorities of the CCS 2014–2018 are:
(1) Strengthening the health system.
(2) Enhancing the achievement of communicable disease control targets.
(3) Controlling the gr ... owth of the noncommunicable disease burden.
(4) Promoting health throughout the life course.
(5) Strengthening capacity for emergency risk management and surveillance systems for various health threats. more
(1) Strengthening the health system.
(2) Enhancing the achievement of communicable disease control targets.
(3) Controlling the gr ... owth of the noncommunicable disease burden.
(4) Promoting health throughout the life course.
(5) Strengthening capacity for emergency risk management and surveillance systems for various health threats. more
An in-depth analysis of the health-seeking behaviour of patients and health system response in seven countries of the Eastern Mediterranean Region
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Oxygen is an essential medicine required at all levels of the health care system; only high quality, medical-grade oxygen should be given to patients. Pressure swing adsorption (PSA) oxygen generat
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ing plants are a source of medical-grade oxygen. This document provides technical specifications as the minimum requirements that a PSA Oxygen Plant must meet for use for the administration of medical-grade oxygen.
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These guidelines for the National Pharmacovigilance and Medicine Information System in Rwanda have been developed to ensure that safe, efficacious and quality medicines are made available to all Rwandans.
Rabies is a virus (Lyssavirus) that infects cells in the central nervous
system, causing disease in the brain and, ultimately, death. Any animal
with rabies has the ability to transmit the disease to humans or other
animals.
There is no cure for
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rabies, but it is 100 percent preventable through
prompt, appropriate medical care.
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The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a bio
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logical process related to virus and host interactions.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the pres
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ence (or likely presence) of the full life cycle of Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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Burden of T. solium: Neurocysticercosis is a disease induced by T. solium larvae penetrating human tissues, especially the nervous system. Neurocysticercosis burdens economies, societies and individuals because of the impact of epilepsy on wages,
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health costs and social stigmatization of sufferers. Health systems are also burdened as treatments must be tailored to individual needs.
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In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population.
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This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five mortality, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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It is impossible to address the many complex needs of respiratory virus surveillance with a single surveillance system. Multiple systems, investigations and studies must each be fit-for-purpose to specific priority surveillance objectives, and only
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together can they provide essential information to policy-makers. In essence, each surveillance approach fit together as “tiles in a mosaic” that provides a complete picture of respiratory viruses and the impact of associated illnesses and interventions at the country level. This mosaic framework demonstrates how surveillance approaches may be implemented as coordinated and collaborative systems, well-matched to specific priority objectives.
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A lot has happened this year. While we continued to tackle the COVID-19 pandemic, we were hit by disease outbreaks and
humanitarian crises. Yet, despite these challenges, we marched on, resolute in resolving critical health systems issues to increa
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se
access to quality healthcare services. To further our vision and bring concrete actions to reality, under
the leadership of the Government of South Sudan, we developed the Health Sector Strategic Plan to define the strategic
approaches, key interventions, mapping resource needs, and the implementation framework to strengthen the health system
to deliver essential quality health services equitably for 2023 to 2027. For WHO, this Plan will usher in a new reality -- access
to lifesaving or health-promoting interventions is doable and possible, making the health sector fairer, especially for those
unable to pay
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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
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health cadres, both 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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A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children’s Fund
This document provides guidelines on the establisment of early surveillance actions to be carried out in countries where no case of Ebola virus disease has been reported.
An alert system should be in place at the following sites: major land border
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crossing with already affected countries; capital cities, including at airports, seaports, and health-care facilities, especially in major hospitals.
The alert system (staff trained in case definitions and able to detect signs and symptoms of disease) should report sick persons coming from country that has reported cases of Ebola virus disease (EVD) and possibly meeting the definition of a case under investigation
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Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA)
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of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.
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This manual provides guidance for policymakers on the issue of prehospital trauma care systems. The main areas covered include the organisation of the prehospital trauma care system, capacity development, data collection, transportation and communic
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ation, as well as ethical and legal considerations
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This handbook was designed primarily as a tool for district clinical specialist teams (DCSTs), and for the provincial specialists who will guide and support their work. This handbook will also be useful to managers of health facilities, heads of cli
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nical units and nurses, doctors and allied health workers at the coalface of clinical care. This handbook will be of interest to district managers and other members of the district management team who are dedicated to developing the capacity of the district health system to respond
effectively to the health needs of the population they serve. It will help them understand the role of the DCSTs and the type of
activities they need to engage in to improve the quality of care
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Fact Book on WHO Level I and Level II monitoring indicators - To monitor the progress of efforts to improve the global medicines situation, WHO has developed a system of indicators that measure important aspects of a country’s pharmaceutical situa
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tion. Level 1 indicators measure the existence and performance of key national pharmaceutical structures and processes. Level II indicators measure key outcomes of these structures and processes in the areas of access, product quality and rational use. These indicators can be used to assess progress over time; to compare situations between countries; and to reassess and prioritize efforts based on the results.
This Fact Book gives the results of the assessment of Level I indicators conducted in 2003 and of Level II indicator surveys conducted between 2002 and 2004
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Good primary care may lead to fewer avoidable hospitalizations, but unsafe primary care can cause avoidable illness and injury, leading to unnecessary hospitalizations, and in some cases, disability and even death.Implementing system changes and pra
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ctices are crucial to improve safety at all levels of health care. Recognizing the paucity of accessible information on primary care, World Health Organization (WHO) set up a Safer Primary Care Expert Working Group. The Working Group reviewed the literature, prioritized areas in need of further research and compiled a set of nine monographs which cover selected priority technical topics. WHO is publishing this technical series to make the work of these distinguished experts available to everyone with an interest in Safer Primary Care.The aim of this technical series is to provide a compendium of information on key issues that can impact safety in the provision of primary health care.
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A guide to monitoring and evaluation for collaborative TB/HIV activities
A. Kanchar; H.Getahun; P. Glaziou; et al.
World Health Organization (WHO); PEPFAR; UNAIDS; et al.
(2015)
C_WHO
Monitoring of implementation of collaborative TB/HIV activities and evaluation of impact is critically important. This requires efficient monitoring and evaluation system so as to establish accountability mechanisms between programmes, the populatio
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n they serve, and donors. The Guide to monitoring and evaluation for collaborative TB/HIV activities will facilitate this process. The first version of the guide was developed in 2004 placing collaborative TB/HIV activities as integral part of national TB/HIV response. It was revised in 2009 to harmonize the approaches and indicators for monitoring and evaluation across key stakeholders. The current revision builds upon remarkable progress in implementation of collaborative TB/HIV activities and aims to strengthen the implementation further through improved quality of data.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of
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Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health services closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35000 Nepali children die before their fifth birt
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hday, with almost two-thirds of these deaths occurring in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.
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The purpose of the review was to assign a cause of death, to ascertain the fac-tors that contributed to the death and to identify any systemic issues that could be addressed to prevent future similar deaths. The perinatal mortality audit process in 2019 provided important insights and evidence-based
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recommendations that can be used both to address system errors and barriers and to identify and praise points of strength. The aim is to pro-vide recommendations for better care for mothers and their infants during pregnancy, childbirth and the neonatal period and improve the quality of care provided throughout the health system.
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