BMJ Global Health https://gh.bmj.com/content/6/9/e007004
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
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e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising
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poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
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The EAPC White Paper addresses the issue of spiritual care education for all palliative care
professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and educati
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on; as well as national and local curricula development groups.
The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care. The revised spiritual care education competencies for all palliative care providers are accompanied by the best practice models and research evidence, at the same time being sensitive towards different develop-ment stages of the palliative care services across the European region.
Conclusions: Better education can help the healthcare practitioner to avoid being distracted by their own fears, prejudices, and restraints and attend to the patient and his/her family. This EAPC white paper encourages and facilitates high quality, multi-disciplinary, academically and financially accessible spiritual care education to all
palliative care staff.
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A United Nations System Commitment for
Action to assist Member States delivering on
the post-2020 global biodiversity framework
At a time when the world is reeling from the deepest global disruption and health crisis of a lifetime, this year’s Living Planet
report provides unequivocal and alarming evidence that nature is unraveling and that our planet is flashing red warning signs of
vital natural systems failure. The
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Living Planet Report 2020 clearly outlines how humanity’s increasing destruction of nature is having
catastrophic impacts not only on wildlife populations but also on human health and all aspects of our lives.
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This Study presents the key results of a research that analyses the implications of an ambitious agroecological transition across Europe, following the TYFA scenario. Published in 2018, what it proposes by 2050 is fully aligned with the objectives that the European Farm to Fork and Biodiversity stra
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tegies aim to achieve by 2030, in particular regarding the decrease in pesticides, nitrogen, and antibiotics on the supply side, and the transition towards more plant-based diets on the demand side. Using a world biomass balance model (GlobAgri-AgT), the impact of the TYFA scenario in the EU on world land use, the EU physical trade balance, the provision of calories and global food security is analysed in addition to key policy levers to spur the transition.
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Agriculture is highly exposed to climate change, as farming activities directly depend on climatic conditions. Agriculture also contributes to climate change through the release of greenhouse gases into the atmosphere. Two powerful greenhouse gases are by-products of agricultural activity:
Methan
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e (CH4) – from livestock digestion processes and stored animal manure;
Nitrous oxide (N2O) – from organic and mineral nitrogen fertilisers.
However, agriculture can also contribute to climate change mitigation by reducing greenhouse gas emissions and by sequestering carbon while maintaining food production.
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Unhealthy diets and excess body weight are leading risk factors for death and disability in the WHO European Region. Addressing malnutrition in all its forms is essential to ensure health and well-being for all and, consequently, sustainable development. It requires coherent and innovative actions c
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overing the entire food system and across other sectors to ensure access to a diversified, balanced and healthy diet for all.
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This guideline aims to improve the quality of donations and the management thereof and serve as the basis for policies of the State and other organizations in the giving and receiving of donations of medicines, medical devices and IVDs.
Over the last three or four decades, there has been an enorm
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ous increase in scientific knowledge about the mode of action, effects and side effects of medicines, medical devices and IVDs. It is important for all
stakeholders to understand that these products have both benefits and risks, that they have to be used carefully and appropriately and that some can do more harm than good.
There are many different scenarios for the donation of medicines, medical devices and IVDs. Donations may take place in acute emergencies or as part of development aid in non-emergency situations. They may involve donations (i.e. direct or through private voluntary organizations), aid by governments or persons authorized to sell medicines, medical devices and/or IVDs.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha
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llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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5 April 2022, Addendum. This policy brief confirms WHO guidance and policy on injection safety in the context of the extraordinary increase in global injections resulting from COVID-19 immunization campaigns. It also calls attention to information on specialized syringes for COVID-19 vaccines and br
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oad short-term and long-term solutions to address and alleviate supply shortages related to vaccine products with non-standard dose volumes.
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Brazilian media and science communicators must understand the main characteristics of misinformation in social media about COVID-19, so that they can develop attractive, up-to-date and evidence-based content that helps to increase health literacy and counteract the spread of false information.
Global and Regional Data 1 December 2021; The 90–90–90 targets were missed, but not by much. At the end of 2020, 84% of people living with HIV knew their HIV status, 87% of people living with HIV who knew their HIV status were accessing antiretroviral therapy, and 90% of people on treatment were
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virally suppressed.
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Joint actions by the Global Fund and UNAIDS are guided by a strong alignment of strategies, goals and targets. UNAIDS has worked with all stakeholders to set a common agenda and targets within the Global AIDS Strategy 2021–2026, and the United Nations General Assembly confirmed this strategy and i
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ts ambitious targets within its 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030.
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MEDBOX Issue Brief no.18.
The MEDBOX team has compiled a new issue brief on the impact of COVID-19 on PLHIV HIV prevention programmes and treatment for this year's World AIDS Day on 1 December 2021.
To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries—the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV
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expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
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