The Lancet Published Online
October 8, 2021 https://doi.org/10.1016/ S0140-6736(21)02143-7
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... 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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Healthy people, healthy animals and a healthy environment worldwide with the One Health approach.
The COVID-19 pandemic has drastically demonstrated just how close the link is between humans, animals, and the environment, and has highlighted and aggravated existing challenges. The destruction of na...tural habitats and displacement of species, trade in wild animals, resource-intensive lifestyles and conditions, non-sustainable food systems and, in particular, industrial agriculture and intensive livestock farming are the causes of the emergence of zoonoses as well as numerous other communicable and non-communicable, chronic diseases.
The One Health approach focuses precisely on such interaction between humans, animals, and the environment.
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This report is the first of its kind. It brings together various data sets to present the current status of hand hygiene, highlight lagging progress, and call governments and supporting agencies to action, offering numerous inspiring examples of change.
During the COVID-19 pandemic, hand hygiene ...received unprecedented attention and became a central pillar in national COVID prevention strategies. However, concern with hand hygiene should not only be as temporary public health measure in times of crisis, but as a vital everyday behaviour that contributes to health and economic resilience. Hand hygiene is a highly cost-effective investment, providing outsized health benefits for relatively little cost.
Despite efforts to promote hand hygiene, the rates of access to hand hygiene facilities remain stubbornly low. If current rates of progress continue, by the end of the SDG era in 2030, 1.9 billion people will still lack facilities to wash their hands at home.
This report presents a compelling case for investment in five key ‘accelerators’ as a pathway towards achieving hand hygiene for all – governance, financing, capacity development, data and information, and innovation. These accelerators are identified under the UN-Water SDG 6 Global Acceleration Framework.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness,... equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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Multizentrische Analyse des Erkrankungsspektrums und der Versorgungsqualität anhand dezentralisierter Routinedaten des Verbunds PriCarenet
Health Equity Studies & Migration Report Series 2021-03
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 ...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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Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to... ambient temperature.
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As pandemias virais costumam representar sérias ameaças ao equilíbrio dos sistemas de saúde, ao impor-lhes demandas extraor-dinárias e sustentadas, que podem ultrapassar a capacidade de atendimento, no que diz respeito tanto aos insumos e às tecnologias disponíveis, quanto aos recurs...os humanos/profissionais capacitados. Trazem o enorme desafio de equilibrar igualdade entre as pessoas e equidade na distribuição de riscos e benefícios entre elas.
Diante desse cenário de casos cada vez mais frequentes de COVID-19 na
população, surge a premente necessidade de se avaliarem as melhores práticas para a otimização da utilização dos meios e recursos disponíveis. Dessa forma, considerando o iminente risco de indisponibilidade de leitos de terapia intensiva e respiradores para todos os indivíduos, acometidos ou não pela doença, torna-se fundamental estabelecer critérios clínicos, técnicos e éticos, para a melhor utilização dos mesmos, para se conseguir otimizar resultado e gerar o maior benefício possível.
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This toolkit is designed to help you plan and implement a Patient Navigation program with the best chance of reducing health disparities and improving health outcomes for your patients. It contains evidence-based and experience-based examples, case studies, practical tools, and resources to help you...:
1. Establish an evidence-based patient navigation program tailored to reduce barriers for your patients
2. Incorporate best practices to enhance current patient navigation programs or services
3. Implement a patient navigation model to address any targeted medical condition
where disparities exist
4. Hire, prepare, supervise, support and retain effective Patient Navigators
5. Navigate patients who experience health disparities
6. Evaluate patient navigation programs with the aim of continuous quality
improvement
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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...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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The COVID-19 pandemic led to school closures around the world, affecting almost 1.6 billion students. The effects of even short disruptions in a child’s schooling on their learning and well-being have been shown to be acute and long lasting. The capacities of education systems to respond to the cr...isis by delivering remote learning and support to children and families have been diverse yet uneven.
This report reviews the emerging evidence on remote learning throughout the global school closures during the COVID-19 pandemic to help guide decision-makers to build more effective, sustainable, and resilient education systems for current and future crises.
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Food environments are usually defined as the settings with all the different types of
food made available and accessible to people as they go about their daily lives.
That is, the range of food in supermarkets, small retail outlets, wet markets, street
food stalls, coffee shops, tea houses, s...chool canteens, restaurants, and all the other
venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing,
marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate
quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems
and food environments are challenged in supporting consumer choices that are
consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges.
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En el presente informe se señalan las principales deficiencias que padecen los servicios WASH nivel mundial: un tercio de los establecimientos de salud no disponen de los elementos necesarios para limpiarse las manos en los lugares donde se presta atención; uno de cada cuatro establecimientos care...ce de servicios básicos de agua, y uno de cada diez no cuenta con servicios de saneamiento. Esto significa que 1800 millones de personas son usuarias de unos establecimientos que carecen de servicios básicos de agua, y que 800 millones de personas acuden a centros que no disponen de aseos. Este problema es aún mayor en los 47 países menos adelantados del mundo, donde la mitad de los establecimientos de salud carecen de servicios básicos de agua. Por otro lado, la magnitud del problema sigue siendo una incógnita, ya que continúa habiendo importantes deficiencias de datos, sobre todo en materia de limpieza del entorno.
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AJOL, Vol.92 No.2; There is a low bed capacity in ICUs compounded by a universal deficit in human resource capacity and support infrastructure for the critical care services. Regionalisation, increased funding and more training opportunities for critical are
services by the regional and central go...vernments will go a long way in alleviating these challenges
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me...thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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Development of one or more vaccines for Neisseria gonorrhoeae is an important objective for sexual and reproductive health worldwide, and for the fight against antimicrobial resistance.
WHO preferred product characteristics (PPCs) provide strategic guidance as to WHO’s preferences for new vacci...nes in priority disease areas. PPCs are intended to encourage innovation and development of vaccines for use in settings most relevant to the global unmet public health need.
Gonococcal vaccine PPCs describe global public health goals for gonococcal vaccines and preferred parameters pertaining to vaccine indications and target populations, safety and efficacy considerations, and immunization strategies.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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