Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Update - 27 June 2018
During the reporting week, the monsoon rains brought 252 mm of rainfall compared to 95 mm during the previous week. The downpour caused 65% of the week’s weather-related incidents (i.e. landslides, wind-storms and floods). Three rain gauges were installed in Chakmarkul (...near Camp 21), Camp 16 and Kutupalong, complementing existing rain gauges in Cox’s Bazar and Teknaf, as well as the Meteorological Station installed by Samaritan Purse in Camp 12. This network of rain gauges provides localized rainfall data at regular intervals throughout the day, which will allow the humanitarian community to better monitor, anticipate and respond to developments within the camps. Relocation of families at risk of landslides and flooding continued; a total of some 200 families have already moved to Camp 20 Extension and more than 100 families to Camp Extension 4. Repair of access roads, culverts, bridges and infrastructure is ongoing with continued attention to preparing for further heavy rains.
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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around t...he hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644
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Based on the Vulnerability Index developed in this review, an estimated 22.7 million persons in Myanmar, or 44% of the population, were found to have some form of vulnerability related to human development and/or exposure to active conflict/violence. These people experience varying combinations of p...oor housing, lack of education, poor educational attainment, lack of access to safe sanitation and improved drinking water, and direct exposure to conflict.
Shan and Ayeyarwady have the largest populations of vulnerable persons, a function of both their size and relative vulnerability in comparison to other States and Regions. Yangon and Shan show the widest variation in vulnerability across townships (in terms of the number of vulnerable persons and their level of vulnerability), followed by Mandalay, Chin and Rakhine.
Original file: 15 MB
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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How the Greek reception system is failing to protect the most vulnerable people seeking asylum.
Greece and its EU partners are failing pregnant women, unaccompanied children, victims of torture or sexual violence and other vulnerable people who seek protection in Europe. These people are being put ...at risk by flawed processes and chronic understaffing in EU ‘hotspot’ camps on the Greek islands. They do not receive adequate support from the authorities that are legally responsible for protecting them and are being abandoned in overcrowded camps in squalid conditions. Many people live in unheated tents and do not have sufficient access to washing facilities and toilets, and winter is only making their situation worse
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The report focuses on several key areas where health outcomes are falling short, and provides insight into ways in which countries can improve the situation for their children and adolescents. Areas in focus include mental health, overweight/obesity and adolescent risk-taking behaviour.
The report ...shows, for example, that:
- mental health remains a neglected subject – only one quarter of countries are collecting data on the number of children treated by a mental health professional;
- half of countries do not regulate the marketing of food to children, despite the fact that childhood obesity rates are high across the Region and physical activity rates are low;
- almost half of countries have no policy that affects the availability of unhealthy foods at school;
- 2 in 5 girls and 1 in 3 boys who are having sex do not protect themselves; and
one third of countries do not offer legal access to contraception without parental consent for those under 18 years of age.
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In an environment of stagnant donor funding and increasing private sector investment in low- and middle-income countries, actors in both the public and private sectors are increasingly interested in using blended finance approaches to catalyze new funding for global health and achieve health outcome...s. As USAID moves towards greater engagement with the private sector, blended finance will be an important component to help achieve development objectives.
Accessed 19th May 2019.
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As part of the new strategy preparation, USAID/Senegal requested assistance with a gender assessment. This study was conducted from March 20 to April 11, 2010. It was supported jointly by the Women in Development Indefinite Quantity Contract (WID IQC) Task Order 1 ShortTerm Technical Assistance and ...Training (STTA&T) and the USAID/Senegal mission. In addition to conducting a literature review, the team made site visits in the cities and towns of Dakar, Thiès, Kaolack, and Tambacounda and villages near each of them. These offered examples of key gender issues in Senegal, including gender disparities in access to education, unequal allocation of land and other productive resources, and gender-based violence (such as domestic violence, female genital cutting [FGC], and rape), as well as examples of USAID/Senegal‟s programming to address these problems.
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The present Community Empowerment Manual draws upon the lessons learned of the Community Protection Approach implementation in Lebanon, the occupied Palestinian territory and Central America during the period 2015-2020 by WeWorld – GVC and its partners.
The Manual means to accompany Field Staff i...n devising the most appropriate strategy to engage with communities, given the conditions of access, security and time of the specific context in which a project is implemented. Even though the steps described proceed alongside the implementation of the Community Protection Approach, the manual has different sections providing guidance for the definition of engagement strategies in any context or project in question.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of... 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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Cholera which disproportionally impacts poor countries and the most vulnerable continues to affect at least 47 countries across the globe, resulting in an estimated 1.3 – 4 million cases, and 21,000 - 143,000 deaths per year worldwide. In Ethiopia, despite major improvements seen in the increasing... access to healthcare, clean water, and improvement in maternal and child health, the country continues to be significantly affected by cholera outbreaks. From 2015 – 2021 for example, several outbreaks of cholera have occurred in multiple parts of the country resulting in over 105,000 cases and thousands of deaths. Some of the risk factors associated with cholera in Ethiopia include inadequate access to clean water, practice of open defecation, poor household and environmental sanitation, unhygienic latrine and weak sanitation practise among communities.
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This report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of power dynamics and power reorientation towards individuals with lived experience; informed decision-making and health literacy; community engagement ...across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights.
It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives,inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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https://doi.org/10.1371/journal.pntd.0002439
South Sudan has a high burden – among the highest in sub-Saharan Africa – of neglected tropical diseases (NTDs). This adversely affects the health and social and economic well-being of people in the country. The prevention, control and eventual elim...ination of many NTDs depend heavily on improved access to water, sanitation and hygiene (WASH) and, once there is access, on sound sanitation and hygiene practices. This is especially the case in NTD endemic communities.
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The Country Cooperation Strategy is the World Health Organization’s corporate framework developed in response to a country’s needs and priorities. The 2022–2025 CCS is the fourth for WHO in Sierra Leone. It is a medium-term strategic document that defines a broad framework for WHO’s work, at... all levels, with the Government of Sierra Leone and all health partners for the next four years. This document is guided by the country’s major policy and strategy documents including the 2020 National Health and Sanitation Policy (NHSP); the 2021–2025 National Health Sector Strategic Plan (NHSSP); and the 2019–2023 National Medium-term Development Plan (NMTDP). The current CCS also reflects the broad priorities of WHO as outlined in its Thirteenth General Programme of Work (2019–2023, extended to 2025) with a focus on improving access to universal health coverage, protecting people from health emergencies, and improving people’s health and well-being. The CCS priorities are also in alignment with the United Nations Sustainable Development Cooperation Framework (UNSDCF) in Sierra Leone and will contribute to attaining the country's SDG targets
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are ...attribute-to-highlight medbox">limited studies on the epidemiology and management of cardiac arrhythmias in LMICs. This review will highlight the unique challenges and opportunities that these countries face when managing cardiac arrhythmias.
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UNFPA supports the Youth Health Line (YHL), launched in 2012, as a nationwide, youth friendly health service to provide information and counseling for adolescents and youth on issues related to their health and reproductive health. The YHL is providing a vital service to young people around the coun...try who are dialing the toll-free number ‘120’ from any phone to speak to a professionally trained youth health counselor. These conversations are confidential, free of judgment, and do not require parental consent. The average reach of the YHL per year is 120,000 adolescents and youth served by full-time male and female counselors.
This Standard Operating Procedure for YHL provides a critical resource for the administration and day-to-day management. The SOP is designed to provide direction to all staff responsible for carrying out the administrative and managerial functions of the YHL. The SOP is intended to guide UNFPA Implementing Partners in running the YHL with a consistent approach to ensure improved access and quality of services provided to adolescents and youth in Afghanistan.
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299 deaths have been recorded and 329 people are still missing, according to the Government.
• Latest assessments indicate that the homes of some tens of thousands of people have been destroyed or damaged beyond habitability. Most of these people are staying with hosts in the extended community.
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• Revised Flash Appeal requires US$294 million to respond to the drought and Cyclone Idai.
• Food Cluster partners have so far assisted an estimated 30,000 people in the worst-affected areas of Chimanimani and Chipinge.
• Access to a sufficient quantity of water for drinking, cooking and personal hygiene has been restored for 43,000 people.
• Eight clusters have been activated to bolster the humanitarian response effort in support to the Government of Zimbabwe,
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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