Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. ...hlight medbox">Countries have a legal obligation to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
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Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries ove...r the last 30 or so years. LA is a highly diverse region in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disp...roportionately high asthma-related mortality relative to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and ...that of their families. Health facilities have been redesigned to care for patients with COVID-19, posing challenges to other services. Governments and civil society organizations have redirected scarce resources and shifted programming priorities to respond to the pandemic. Several countries have reported intermittent declines in HIV testing and diagnosis, antenatal care visits, collection of antiretroviral medicines (ARVs) by people living with HIV, and attendance at clinic appointments. Community-based education and support programmes have had to rapidly adapt to restrictions on movement and public gatherings. Children, adolescents, and women have experienced multiple deprivations due to the adverse impact of the pandemic.
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This purpose of this guide is to inform robust evaluations of the WHO training package – a package aimed at personnel whose primary role in health-care facilities is environmental cleaning, hereafter referred to as cleaners.
The WHO training package – Environmental cleaning and infection prev...ention and control in health-care facilities in low- and middle-income countries – was designed to improve the competencies of cleaners through a practical, educational approach for adult learners in low- and middle-income countries and comprises two volumes: trainer’s guide and modules and resources (1,2). An associated OpenWHO online course describes the essential preparations for trainers to deliver the WHO training package.
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Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi... (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania.
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For the first time WHO and UNICEF bring together the data on sanitation coverage and investment, and how it impacts health, economies, and the environment. Citing evidence on what works from successful countries and global guidelines, WHO and UNICEF... call for strong government leadership and investment in resilient sanitation services. The report charts an ambitious way forward following the SDG6 global acceleration framework themes of governance, financing, capacity development, data and information, and innovation to achieve universal access to safe sanitation.
Read the full publication report here: https://www.who.int/publications/i/item/9789240014473.
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This report presents the key findings of the end-of-project assessment of households and
community health volunteers, conducted in 2017 in the Kamukunji and Embakasi sub-counties
of Nairobi, Kenya, for a Community Health Volunteers’ Decision Sup...port System (CHV DSS)
intervention project. The report was prepared by the African Population and Health Research
Center (APHRC). The end-line survey was implemented by APHRC. Implementation of the CHV
DSS project is a joint collaboration among several partners, including APHRC, the City County
of Nairobi, sub-county health management teams (Kamukunji and Embakasi), and community
health volunteers. The opinions expressed in this report are those of the authors and do not
necessarily reflect the views of the donor organization, the County Innovation Challenge Fund
for Kenya.
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Trachoma is an eye infection that for thousands of years caused many people to go blind across all continents. As the result of development and targeted interventions, trachoma is now limited to an estimated 57 countries, often affecting the poorest...
populations of the world. Today, more than 2 million people are either blind or suffer from a very painful disability as the result of trachoma.
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It is estimated that more than 311 000 women die of cervical
cancer each year. Of these deaths, 91% occur in low- and
middle-income countries. Demographic changes and a lack of
action mean that the number of deaths per year is projected
to reach... 460 000 by 2040.
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This report compiles data for the first time on the far-reaching consequences of uncontrolled hypertension, including heart attacks, strokes and premature death, along with substantial economic losses for communities and countries. It also contains ...information on the global, regional and country-level burden of hypertension and progress of control efforts.
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Significant progress has been made in the eradication of three priority diseases in the African Region, as a result of extensive collaboration between the Regional Office, WHO country offices and countries. For example, in August 2020, the region wa...s certified free of wild poliovirus. In the area of neglected tropical diseases, Guinea worm disease is on the verge of eradication, and 12 member states are within reach of being certified as having eradicated yaws by the end of this year.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal h...ealth systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there... is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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This book is aimed at policymakers in ministries of agriculture and national agricultural research institutes, as well as multilateral development banks and the private sector and provides guidance on various technology strategies and which to pursue as competition grows for land, water, and energy ...across productive sectors and even increasingly across borders. Climate change, population, and income growth will drive food demand in the coming decades. Food prices are also expected to significantly increase between 2005 and 2050 and the number of people at risk of hunger in the developing world would grow from 881 million in 2005 to more than a billion people by 2050. This book endeavors to respond to the challenge of growing food sustainably without degrading our natural resource bas
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The main aim of these guidelines is to enable the central units of national TB and HIV/AIDS programmes to support districts to plan, coordinate and implement collaborative TB/HIV activities. These guidelines reinforce current medical understanding, that highly active antiretroviral treatment (HAART)... has decreased TB incidence of people living with HIV/AIDS. They are comprehensive, giving an overview of the range of activities that could be undertaken in high burden TB/HIV countries or where a rising prevalence of HIV might fuel TB. Activities highlight the need for comprehensive care, prevention and support for adults living with HIV/AIDS. Comprehensive TB and HIV care and prevention rely on full implementation of the DOTS strategy as part of a wide ranging HIV/AIDS care and prevention programme as well as collaborative TB and HIV programme activities.
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To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
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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 clinical units and nurses, doctors and allied health w...orkers 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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Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combi-
nations of DAAs can cure infection with HCV in 12 weeks, are highly effective and
have limited side-effects. Affordability of DAAs has improved significantly, but access remains lim-
i...ted. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-
income countries alike. Now there is a divide between those countries where, because of intellectual
property barriers, prices have remained (very) high and other countries where generics are, or can be,
available at much lower prices. The result is a dual market
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Experience from Save the Children and partners globally
demonstrates that improvements in education quality go hand-in-hand
with inclusion and access, Flexible, quality, responsive learning
environments will benefit all children and are fundamental to including
marginalised groups like disabled ...children in education.
These guidelines are primarily aimed at education staff trying to
develop inclusive education practices, focussing on including disabled
children in schools.While this book focuses on disabled children, we
hope it will be useful for developing general inclusive education
practices. Community groups and non-governmental organisations, as
well as people working in community-based rehabilitation(CBR) and
the wider disability context, could also use these guidelines to provide
input into inclusive education work.
While the guidelines focus primarily on schools, much of the
information is still relevant to readers working in out-of-school
situations.
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