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Current Environmental Health Reports volume 7, pages 363–370 (2020)
Climate change has direct impacts on human health, but those impacts vary widely by location. Local health impacts depend on a large number of factors including specific regional climate impacts, demographics and human vulnerabil
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ities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches.
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The main message emerging from this new comprehensive global assessment is that premature death and disease can be prevented through healthier environments – and to a significant degree. Analysing the latest data on the environment-disease nexus a
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nd the devastating impact of environmental hazards and risks on global health, backed up by expert opinion, this report covers more than 100 diseases and injuries.
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This volume contains monographs prepared at the ninety-first meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA), which met virtually online from 1 to 12 February 2021.
The detailed monographs in this volume summarize data on sp
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ecific contaminants in food. Individual monographs present the assessment of exposure to cadmium from all food sources, the technical, analytical, dietary exposure and toxicological data on ergot alkaloids, an assessment of five substances that may occur as previous cargoes, and a revision of the specifications for steviol glycosides. This volume and others in the WHO Food Additives series contain information that is useful to those who produce and use food additives and veterinary drugs and those involved with controlling contaminants in food, government and food regulatory officers, industrial testing laboratories, toxicological laboratories and universities.
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This report presents a framework to link science, policy and practice for a comprehensive assessment of climate mitigation and adaptation investments and their impact on human health.The framework proposes to use weather and climate data to forecast
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health impacts over time, as well as biophysical and economic models to quantify the outcomes of investments in climate change adaptation and mitigation for relevant sectoral indicators and health co-benefits. It provides guidance on the economic valuation of health co-benefits of climate action, for inclusion in sector-specific cost–benefit analysis (CBA), including the spatial allocation of such costs and benefits.
The framework developed and presented in this study is comprehensive, and provides various entry points for different audiences, including decision-makers in the public and private sectors, researchers and scientists, working in the health sector as well as in other thematic areas and related sectors affected by climate action.
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Past quantitative research on health financing has focused mostly on the level and distribution of total expenditure, with little emphasis on the specific role of public funds, despite their known importance for universal health coverage (UHC). Health Accounts
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data do not disaggregate public expenditure on health by source of funding. Achieving a better understanding of public financing for health in the context of the macro-fiscal and health financing environment is of fundamental importance to the development of future health financing policy, particularly in low- and middle-income countries (LMICs).
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The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respond to the health and well-being challenges, opportunities and needs of adolescents.
The guidance pro
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vides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
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The Food and Agriculture Organization of the United Nations has launched a new Compendium of forgotten foods in Africa which is a first-of-its-kind comprehensive collection of 100 African forgotten food crops.
Also referred to as neglected, under
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utilized or orphan crops, these species offer valuable benefits, including nutrition and diet diversification, while supporting resilient, climate-smart agriculture but they are at risk of being lost as foods such as maize, rice and wheat dominate African diets.
The compendium list includes details on each crop's botanical classification, agroecological suitability, agronomic requirements, traditional and medicinal uses, value-added prospects and nutritional content. Among the entries are: African locust beans, African nightshade, baobab, Bambara nut, bush mango, cassava, fonio, marula, moringa, teff and tigernut.
Produced by the Food and Agriculture Organization (FAO)'s Regional Office for Africa with the Forum for Agricultural Research in Africa (FARA), the Compendium is a direct response to the UN Food Systems Summit and the Call for Collective Action in the Global Manifesto on Forgotten Foods.
Embracing both agricultural heritage and innovation can transform agrifood systems across Africa. By cataloguing these forgotten or underutilized crops, traditional knowledge is being honoured in the push to unlock the potential for better nutrition, sustainable agriculture, and resilience against the climate crisis.
In a joint foreword to the publication, FAO Assistant Director-General and Regional Representative for Africa Abebe Haile-Gabriel and FARA Executive Director Aggrey Agumya urged the mainstreaming of forgotten foods into African agrifood systems.
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This is only the cover of the book. Download the whole Toolkit at: www.cdc.gov/reproductivehealth/Refugee/
Understanding the reproductive health needs of conflict-affected women will enable organizations to implement and enhance programs and services to improve the health of women and their fam
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ilies. The Reproductive Health Assessment Toolkit (RHA) for Conflict-Affected Women provides user-friendly tools to quantitatively assess the reproductive health needs of conflict-affected women aged 15–49 years. The RHA Toolkit enables field staff to collect data to inform program planning, monitoring, evaluation, and advocacy. It promotes using the collected data to enhance services and improve the reproductive health of women and their families.
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Surveillance tools for meningitis sentinel hospital surveillance: field guide to rapidly estimate the hospital catchment population (denominator) and the annual rate of hospitalisations
World Health Organization
(2015)
The document will provide information for Ministries of Health and hospital sentinel sites on why and how to determine the denominator of at-risk children <5 years of age and rate of meningitis hospitalizations for a sentinel hospital site conducting IB-VPD surveillance. Such a methodology is currently unavailable and this estimation is critical to enable interpretation of surveillance
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data, particularly pre- and post- vaccine introduction
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This implementation guide has been developed to help birth attendants and health-care leaders successfully launch and sustain use of the WHO Safe Childbirth Checklist. Development, use and implementation of the Checklist are described in this guide.
It covers how to introduce and ensure continuous
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use of the Checklist by engaging relevant stakeholders, how to launch the Checklist formally, and provides support for the process through coaching and data-sharing
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The Facilitator’s Guide for the basic-needs based Response Options Analysis and Planning (ROAP) is a step-by-step guide comprising tools and templates to carry out a multi-sectoral response analysis and planning of response options, in a sudden-onset or chronic crisis.
Being that so, the Guide i
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s conceived to be applied hand in hand with the BNA Guidance and Toolbox, and other assessments methodologies. It is expected to assist in analysing data from different sources - including humanitarian staff’ own
knowledge and experience on the sector, cash, protection matters - to come up with response decisions
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This study, and similar studies in Kenya, Mozambique, Swaziland, Uganda, and Zambia is the outcome of close collaborative by a team in Swaziland, with technical and financial support from the UNAIDS Regional Support Team for Eastern and Southern Africa, UNAIDS Geneva, and the World Bank's Global HIV
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/AIDS Program (Global AIDS Monitoring and Evaluation Team). The study entailed using existing data and collecting new data to better know the country's HIV epidemic, know the country HIV response and how funding was allocated, so as to improve the HIV response and strengthen prevention based on evidence on what works to prevent new infections.
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Testimonies from Humanitarian Workers with Disabilities.
By reading the first-hand accounts, we hear how persons with disabilities, not through any particular talent or skill but from unique knowledge gained through life experience, are ideally placed to provide insights, ideas and leadership, to s
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upply essential data, and to fill the gaps in humanitarian response that cause this exclusion.
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Improving the quality of care for mothers and newborns in health facilities: learner's manual. Version 02.
World Health Organization (WHO), Regional Office for South-East Asia
WHOCC AIIMS, UNICEF, UNFPA and USAID
(2017)
C_WHO
A training package for building capacity of healthcare teams in health facilities for continous quality improvement of maternal and newborn healthcare. The focus is on the care of mothers and newborns at the time of child birth since a large proportion of maternal deaths, newborn deaths and stillbir
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ths happen around that time.
The 4-Step POCQI (Point of care Quality Improvement) package includes Coaching manual and Learner manual that present a demystified and simple model of quality improvement at the level of health facilities using local data to identify quality gaps, analyse underlying causes and improve health care practices in their own specific context without much additional resources.
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The National Institute for Transforming India (NITI) Aayog has developed the Composite Water Management Index (CWMI) to enable effective water management in Indian states in the face of extreme water stress. The Index and this associated report are expected to: (1) establish a clear baseline and ben
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chmark for state-level performance on key water indicators; (2) uncover and explain how states have progressed on water issues over time, including identifying high-performers and under-performers, thereby inculcating a culture of constructive competition among states; and, (3) identify areas for deeper engagement and investment on the part of the states. Eventually, NITI Aayog plans to develop the index into a composite, national-level data management platform for all water resources in India.
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The World Health Organization (WHO) endorses the use of population-based prevalence surveys for estimating the prevalence of trachoma. In general, the prevalence of TF in children aged 1–9 years and the prevalence of TT in adults aged ≥ 15 years are measured at the same time in any district bein
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g surveyed. This was the approach of the Global Trachoma Mapping Project, which undertook baseline surveys in > 1500 districts worldwide in order to provide the data required to start interventions where needed.
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined. more
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined. more
This report covers research conducted on HIV stigma and discrimination using the Stigma Index in the Papua New Guinea provinces of Western Highlands and Chimbu*. When Igat Hope began the project the aim was to conduct interviews in all regions of PNG. However, due to funding constraints and organis
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ational capacities, the Stigma Index has only been applied in one region, that is, the Highlands Region. In future, the hope is to gather comparable data from other regions in PNG. Despite the fact that the overall project aims have not yet been achieved, the data contained in this report provides useful information that can be considered as work continues in PNG on HIV-related stigma and discrimination and human rights.
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The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda’s 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In p
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roject districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery
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of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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This publication provides guidance to governments, civil society organizations (nongovernmental organizations and community-based organizations) and other partners implementing HIV prevention, care and treatment programs with key populations. This guide is designed to assist these programs in the de
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velopment of monitoring systems for frontline workers (such as peer outreach workers, staff outreach supervisors and program managers) to understand performance. It includes comprehensive tools and forms that various levels of staff can use to collect and analyze data to manage and improve a program.
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Punjab Province Report: Nutrition Political Economy, Pakistan
Zaidi, Shehla; Bhutta, Zulfiqar et al.
Institute of Development Studies, Aga Khan University
(2015)
C1
In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a
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nd grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
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The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load (VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. These guidelines include laboratory design considerat
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ions, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.
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This baseline survey and report examine the Durable Peace Programme (DPP) in Myanmar, which delivers a broad range of activities. The report provides an insight into the current situation facing both internally displaced persons (IDPs) and conflict-affected non-IDP communities in Kachin state, Myanm
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ar. It is based on a comprehensive and systematic research process involving just over 2,200 interviews conducted in 12 townships across Kachin. The research provides data and analysis on the socioeconomic situation, attitudes towards peace and conflict, gender dynamics, return and resettlement, among others. The Durable Peace Programme Consortium has decided to share the results of this baseline, as it provides insights into the Kachin context for interested stakeholders, and also to encourage cooperation and information sharing. The report adopts a highly visual approach to communicate the large amount of data collected.
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Flood Disaster Risk Management - Hydrological Forecasts: Requirements and Best Practices (Training Module)
Vogelbacher, A.
National Institute of Disaster Management (NIDM), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)
(2013)
C1
This Case Study explores flood forecasting systems from the perspective of its position within the flood warning process. A method for classifying the different approaches taken in flood forecasting is introduced before the elements of a present-day flood forecasting system are discussed in detail.
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Finally, the state of the art in developing flood forecasting systems is addressed including how to deal with specific challenges posed.
The target group of this case study are decision makers in disaster risk management and/or water management. The case study should help to understand some hydrologic basics of the flood forecast and assist in the administration and implementation of an appropriate flood warning system in a specific environment, to find the best solution for a region.
Best solutions depend mainly on quality and availability of data, the areas and/or points of interest, catchment properties, cross border catchments, and financial capabilities with special consideration of flood forecast. more
The target group of this case study are decision makers in disaster risk management and/or water management. The case study should help to understand some hydrologic basics of the flood forecast and assist in the administration and implementation of an appropriate flood warning system in a specific environment, to find the best solution for a region.
Best solutions depend mainly on quality and availability of data, the areas and/or points of interest, catchment properties, cross border catchments, and financial capabilities with special consideration of flood forecast. more
A recent survey of the literature and experience identified five broad actions that development institutions and governments, as well as their partners and stakeholders, can take to improve disability-inclusive disaster risk management. Those five actions are:
- Include persons with disabilitie ... s as valued stakeholders in disaster risk management activities
- Help remove barriers to the full participation of persons with disabilities
- Increase awareness among governments and their partners of the safety and security needs of persons with disabilities
- Collect data that is disaggregated by disability
- Ensure that new construction, rehabilitation and reconstruction are accessible to persons with disabilities more
- Include persons with disabilitie ... s as valued stakeholders in disaster risk management activities
- Help remove barriers to the full participation of persons with disabilities
- Increase awareness among governments and their partners of the safety and security needs of persons with disabilities
- Collect data that is disaggregated by disability
- Ensure that new construction, rehabilitation and reconstruction are accessible to persons with disabilities more
This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both inpatient and outpatient management of severe acute malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 i
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n the WHO Pocketbook for Hospital Care for Children, and the 2013 update on SAM (outpatient management). The global threat of increasing antimicrobial resistance and new data on efficacy and safety profiles requires a re-review of the current evidence to ensure recommendations are the most appropriate. The evidence base for the use of antibiotics in children presenting with uncomplicated SAM has been recently enlarged.
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Despite improvements in recent years, the prevalence of undernutrition among women and children in Myanmar remains unacceptably high. One in three children are stunted and about 8% are acutely malnourished. Micronutrient deficiencies are common among infants, young children and pregnant women. In fa
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ct, more than 80% of children 6 to 23 months of age and 70% of pregnant women are anemic. To better understand the determinants of undernutrition and the linkages between food security, livelihoods and nutrition in Myanmar as a whole as well as in specific geographic areas where programs supported by the Livelihoods, Food Security Trust Fund (LIFT) are being implemented, the LEARN project has reviewed food and nutrition security data from the past five years and synthesized relevant findings into this report.
Following the Introduction, Section 2 presents national level data on the food and nutrition security situation in Myanmar in the past five years. Sections 3, 4 and 5 present data on food and nutrition security from the various agro-ecological zones that are of interest to LIFT, namely the Coastal/Delta, Dry, and Uplands. more
Following the Introduction, Section 2 presents national level data on the food and nutrition security situation in Myanmar in the past five years. Sections 3, 4 and 5 present data on food and nutrition security from the various agro-ecological zones that are of interest to LIFT, namely the Coastal/Delta, Dry, and Uplands. more
2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10–19 years, adolescents are both at risk of TB and
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represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
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This Community Health Systems (CHS) Catalog country profile is the 2016 update of a landscape
assessment that was originally conducted by the Advancing Partners & Communities (APC) project
in 2014. The CHS Catalog focuses on 25 countries deemed priority by the United States Agency for
Internation
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al Development’s (USAID) Office of Population and Reproductive Health, and includes
specific attention to family planning (FP), a core focus of the APC project.
The update comes as many countries are investing in efforts to support the Sustainable Development
Goals and to achieve universal health coverage while modifying policies and strategies to better align
and scale up their community health systems.
The purpose of the CHS Catalog is to provide the most up-to-date information available on community
health systems based on existing policies and related documentation in the 25 countries. Hence, it does
not necessarily capture the realities of policy implementation or service delivery on the ground. APC
has made efforts to standardize the information across country profiles, however, content between
countries may vary due to the availability and quality of the data obtained from policy documents.
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Follow-up and tracing of tuberculosis patients who fail to attend their scheduled appointments in Cotonou, Benin: a retrospective cohort study
Serge Ade1, Arnaud Trébucq, Anthony D. Harries, Gabriel Ade, Gildas Agodokpessi, Prudence Wachinou, Dissou Affolabi, Sévérin Anagonou
BMC Health Services Research
(2016)
C2
Ade et al. BMC Health Services Research (2016) 16:5
Background: In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about
the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the
possible b
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enefits on improving treatment outcomes. This study aimed to determine the contribution of tracing
activities for those who missed scheduled appointments towards a successful treatment outcome.
Methods: A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients
treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment
outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their
scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed
to explore factors associated with missing a scheduled appointment
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Tanzania: The National Action Plan on AMR 2017-2022
The United Republic of Tanzania - Ministry of Health Community Development Gender Elderly and Children
World Health Organization WHO
(2017)
C_WHO
This National Action Plan addresses actions needed to be taken in order to combat antimicrobial resistance (AMR) in the country. It is obligatory to raise awareness of antimicrobial resistance and promote behavioral change through public communication
programmes that targets human, animal and plant
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health. Inclusion of the use of antimicrobial agents and resistance in school curricula will further promote better understanding and awareness from an early age. Antimicrobial Resistance knowledge, surveillance and research will be strengthened through establishing a national surveillance system for antimicrobial resistance, establishing and building capacity for a national reference laboratory and designated laboratories for AMR surveillance, developing a national research agenda on AMR and establishing and supporting a coordinated mechanism that will ensure harmonized AMR guidelines, data management and sharing systems in human, animal and plant health settings.
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The issue of Antimicrobial resistance has become one of the most substantial health issues, prompting the World Health Assembly (WHA) to urge Member States to finalise tailor made national action plans by May 2017, aligning them with objectives of the Global Action Plan (GAP). These cover awareness,
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surveillance and research, hygiene infection prevention & control, optimal use of antimicrobial medicines and economic case for sustainable investment. Indonesia, by virtue of its geographical terrain and complex interactions with diverse stakeholders, indicates a higher burden of AMR. Most of the country’s data currently relies on local studies conducted by labs and universities. To get a more accurate estimate of the situation, one has to rely on results from the Regional Resistance Surveillance Programme. By undertaking such measure, Indonesia would acquire data to detect AMR trends at a national level.
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Internationally, there is a growing concern over antimicro-bial resistance (AMR) which is currently estimated to ac-count for more than 700,000 deaths per year worldwide. If no appropriate measures are taken to halt its pro-gress, AMR will cost approximately 10 million lives andabout US$100 trillion
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per year by 2050. In contrast tosome other health issues, AMR is a problem that con-cerns every country irrespective of its level of incomeand development as resistant pathogens do not respect borders.Despite the threat presented by AMR, the 2014 WorldHealth Organization (WHO) and the recent O’Neill re-port describe significant gaps in surveillance, standardmethodologies and data sharing. The 2014 WHOreport identified Africa and South East Asia as the regions without established AMR surveillance systems.
Tadesseet al. BMC Infectious Diseases (2017) 17:616 DOI 10.1186/s12879-017-2713-1
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The Global Antibiotic Resistance Partnership (GARP)-Mozambique team, in partnership with the Center for Disease Dynamics, Economics & Policy (CDDEP), has produced this report as part of a solid com-mitment to develop actionable policy proposals to tackle antibiotic resistance and improve appropriate
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antibiotic access. It is the result of a thorough review of published and unpublished data on antibiotic resistance and a long internal consultation effort that engaged academic scientists, health professionals and other stakeholders within Mozambique.
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The Feedback Starter-Kit responds to key questions ( ) and provides the most important tips ( ) for setting up and running a simple feedback mechanism. At the end of this document there is an overview of the templates needed to plan the mechanism and collect, answer, analyse and share community feed
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back data. These templates contain the necessary basic elements to implement and run a feedback mechanism.
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Migrants in Central Asia and the Russian Federation, have been among the most severely impacted by the COVID-19 pandemic.
In the short term, IOM aims at providing support to migrants who are stranded in countries of destination. In addition, IOM will focus its efforts on addressing
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data gaps, enhancing national and community preparedness, response and recovery efforts, ensuring that affected people have access to basic services, commodities and protection as well as mitigating the socioeconomic impact of COVID-19.
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This guidance note is meant to assist humanitarian actors, youth-led organizations, and young people themselves across sectors, working at local, country, regional, and global levels in their response to the novel coronavirus pandemic. It begins diagnostically, exploring the impacts of coronavirus d
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isease (COVID-19) on young people. It then proposes a series of actions that practitioners and young people can take to ensure that COVID-19 preparedness, response plans and actions, are youth-inclusive and youth-focused – with and for young people. Recommendations are structured around the five key actions of the Compact for Young People in Humanitarian Action: services, participation, capacity, resources, and data. Where available, the recommended actions are accompanied by resources and concrete examples, which can inform approaches and support implementation
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The Global Status Report on Preventing Violence Against Children 2020 - Executive Summary
recommended
The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violence against children. The report signals a clear need
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in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.
The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.
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The pandemic presents tough choices for governments, local communities, health and school systems, as well as families and businesses: How to re-open safely? How to safeguard people’s lives and protect their livelihoods? Where to allocate scarce resources? How to protect those unable to protect th
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emselves? Answers to questions like these will affect our short-term success in battling the spread of the virus and could have impacts for generations to come.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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BMJ Open2018;8:e020423. doi:10.1136/bmjopen-2017-02042
EC has been increasingly used in the evaluation of maternal and child health programmes.12–15 For instance, Nesbitt et al compared crude coverage and EC of pregnant women with facility-based obstetric services in Ghana and estimated that alth
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ough 68% of the women studied had service access only 18% received high-quality care provided by a skilled birth attendant.16 Similarly, by comparing EC of young children receiving Strengths and limitation of this study. Using multiple data sources (direct observation, vignettes, facility inventories) this study comprehensively assessed under 5-year-old child service
performance of first-line health facilities. We conducted this study in around 500 primary-level health facilities and within 7000 households
across six regions in Burkina Faso.
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This document, endorsed by the WHO Strategic Advisory Group of Experts on Immunization, provides guiding principles to support countries in their decision-making regarding provision or resumption of immunization services during severe disruptive events such as COVID-19, natural disasters or humanita
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rian emergencies. It incorporates the Immunization Agenda 2030 principles of being people-centred, country-owned, partnership-based and data-guided.
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The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach
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ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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This global guidance provided the framework for over 100 countries to develop their NDVPs. This updated (second) version supersedes the previous version published in 16 November 2020. New information has been added on the following areas:
the COVID-19 Partners Platform;
the use of COVID
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-19 simulation exercises to test deployment strategies;
the indemnity agreement and no-fault compensation programme for vaccines secured through the COVAX Facility in the Advance Market Commitment (AMC) eligible economies;
the availability and use of the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool;
the COVAX Facility’s humanitarian buffer that enables allocation of vaccine to cover high-risk populations in humanitarian settings;
recommendations for vaccination of pregnant and lactating women;
supplementary information on infection prevention and control (IPC) measures to be used to deliver COVID-19 vaccines safely;
the WHO licensed COVID-19 vaccines product-specific information;
use of geospatial data and digital micro plans for equitable access and delivery of COVID-19 vaccines;
lessons learned from the development of NDVPs and early experiences in COVID-19 vaccine deployment in countries; and
updated additional resources at the end of each chapter.
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9 June 2021
Since its launch, GLASS has expanded in scope and coverage and as of May 2021, 109 countries and territories worldwide have enrolled in GLASS. A key new component in GLASS is the inclusion of antimicrobial consumption (AMC) surveillance at the national level highlighted in this fourth G
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LASS report.
The fourth GLASS report summarizes the 2019 data reported to WHO in 2020. It includes data on AMC surveillance from 15 countries and AMR data on 3 106 602 laboratory-confirmed infections reported by 24 803 surveillance sites in 70 countries, compared to the 507 923 infections and 729 surveillance sites reporting to the first data call in 2017.
The report also describes developments over the past years of GLASS and other AMR surveillance programmes led by WHO, including resistance to anti-human immunodeficiency virus and anti-tuberculosis medicines, antimalarial drug efficacy.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the
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y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that l
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ack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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24 Nov. 2021
Action against gender-based violence being pushed to the outlying margins of the global COVID-19 response
A new Oxfam report shows an undeniable increase in gender-based violence (GBV) during the COVID-19 pandemic around the world to which too many governments and donors are not doi
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ng enough to tackle.
The report, The Ignored Pandemic: The Dual Crisis of Gender-Based Violence and COVID-19, showed the number of calls made by survivors to domestic violence hotlines in ten countries during the first months of lockdown. The data reveals a 25 – 111 percentage surge; in Argentina (25%), Colombia (79%), Tunisia (43%), China (50%), Somalia (50%), South Africa (69%), UK (25%), Cyprus (39%), Italy (73%) and the largest increase in Malaysia where calls surged by over 111%.
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The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria are part of a group of agencies working together to accelerate progress towards the health-related SDGs through the Global Action Plan for Healthy Lives and Well-being for All. Understanding patterns of inequal
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ities in these diseases is essential for taking strategic, evidence-informed action to realize our shared vision of ending the epidemics of HIV, TB and malaria.
This report presents the first comprehensive analysis of the magnitude and patterns of socioeconomic, demographic and geographic inequalities in disease burden and access to services for prevention and treatment.
The results confirm there have been improvements in service coverage and decreased disease burden at the national level over the past decade. But they also reveal an uncomfortable reality: unfair inequalities between population subgroups within countries are widespread and have remained largely unchanged over the past decade. For some disease indicators, inequalities are even worsening.
Moreover, the report points to the persistent lack of available data to fully understand inequality patterns in HIV, TB and malaria. Collecting data to improve the monitoring of inequalities in these diseases is vital to develop targeted responses for impact.
There are, encouragingly, isolated successes in reducing inequities. Change is possible when deliberate action is taken to reach disadvantaged populations.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov
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ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin
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shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological age
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nts of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks.
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Cancer in sub-Saharan Africa
recommended
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data
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estimates show a major increase in cancer mortality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
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An overview of validation structures and responsibilities at national, regional and global levels.
This governance document supplements the global guidance document. Validation of elimination requires rigorous assessment at the national, regional and global levels of the impact and process indicato
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rs and the fulfilment of the four foundational requirements for (1) data quality, (2) strong programmes, (3) laboratory quality and (4) human rights, gender equality and community engagement.
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The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain AMR. The system started with surveillance of AMR in bacteria causing common human infections and has expanded its scope to include surveillance
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of antimicrobial consumption (AMC), invasive fungal infections, and a One Health surveillance model relevant to human health. To meet future challenges, it is in continuous evolution to enhance the quality and representativeness of data to inform the AMR burden accurately. As of the end of 2022, 127 countries, territories and areas participate in GLASS.
The fifth GLASS report, produced in collaboration with Member States, summarizes 2020 data on AMR rates in common bacteria from countries, territories, and areas. The report brings new features, including analyses of population testing coverage or AMR trends. For the first time, the report presents 2020 data on AMC at the national level. A new interactive dashboard allow users to explore AMR and AMC global data, country profiles and download the data.
This report marks the end of the early implementation phase of GLASS. In addition to presenting data collected through the latest data call, this report provides a summary of five years of national AMR surveillance data contributed to GLASS from its initiation, presents AMR findings in the context of progress of country participation in GLASS and in global AMR surveillance coverage and laboratory quality assurance systems at (sub)national level.
Patterns of antimicrobial consumption are presented by country with a particular focus on antibacterials. The report also presents the antimicrobial consumption according to the WHO AWaRe antibiotic classification, for penicillins and cephalosporines. From a One Health perspective, the report presents antimicrobial consumption data in the human sector expressed in tons to allow a comparison with antimicrobial consumption from other sectors (not included in this report).
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Atlas of African Health Statistics 2022: Health situation analysis of the WHO African Region
Since 2019, we have been implementing Phase 2 of the regional Transformation Agenda, which informs and aligns with the global WHO Transformation, to ensure WHO is accountable, driven by re- sults and provid
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ing value for money in the pursuit of better health. Our global priority in this period is to contribute to delivering on the triple billion targets of expanding universal health coverage, protecting people from emergencies, and promoting health and well-being for people across the Region.
This year’s Atlas of African Health Statistics is being produced in the context of the COVID-19 pandemic that we have been expe- riencing for over two years. The ongoing coronavirus pandemic, together with other health emergencies in the WHO African Re- gion, is yet again testing the strength and resilience of our health systems. Indeed, the impact of COVID-19 is visible in the disruption of services. The report also presents the latest data for more than 50 health-related indicators of the Sustainable Development Goals and WHO’s “triple billion” targets and provides comprehensive country-level statistics using the results chain of the AFRO frame- work of actions for strengthening health systems to achieve UHC and the health-related SDGs.
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Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes.
Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by
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2030.
The United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) – comprising WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division (UNDESA/Population Division) has collaborated with external technical experts on a new round of estimates covering 2000 to 2020. The estimates represent the most up to date, internationally-comparable MMEIG estimates of maternal mortality, using refined input data and methods from previous rounds.
The report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc
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e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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This report presents the results of the official United Nations estimates and projections of urban and rural populations for 233 countries and areas of the world and for close to 1,900 urban settlements with 300,000 inhabitants or more in 2018, as published in World Urbanization Prospects: The 2018
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Revision. The data in this revision are consistent with the total populations estimated and projected according to the medium variant of the 2017 Revision of the United Nations global population estimates and projections, published in World Population Prospects: The 2017 Revision. This revision updates and supersedes previous estimates and projections published by the United Nations.
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There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting
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and suggest improvements. Methods: Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation’s Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant
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imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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The guide to implementing the One Health Joint Plan of Action (OH JPA) at national level provides practical guidance on how countries can adopt and adapt the OH JPA to strengthen and support national One Health action.
Building on the OH JPA theory of change, this guide describes three pathways a
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nd five key steps to implement the OH JPA at national level:
Pathway 1 -- Governance, policy, legislation, financing and advocacy
Pathway 2 -- Organizational and institutional development, implementation and sectoral integration
Pathway 3 -- Data, evidence, information systems and knowledge exchange.
The stepwise approach comprises:
Situation analysis including stakeholder mapping and review of existing assessment results
Set-up/strengthening of a multisectoral, One Health coordination mechanism
Planning for implementation, including activity prioritization and leveraging of resources
Implementation of national One Health action plans
Review, sharing and incorporation of lessons learned.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t
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hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to
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accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
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t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases
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, injuries and risk factors in more than 200 countries and territories and at the subnational level in more than 20 countries. The GBD is now produced by an active collaboration of over 8,000 scientists and analysts from more than 150 countries. With each GBD iteration, the data, data processing and methods used for data synthesis have evolved, with the goal of enhancing transparency and comparability of measurements and communicating various sources of uncertainty. The GBD has many limitations, but it remains a dynamic, iterative and rigorous attempt to provide meaningful health measurement to a wide range of stakeholders.
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Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.
Metho
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ds: A cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.
Results: 3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.
Conclusions: In three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.
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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 accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta
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in 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.
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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
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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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The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportionally on low- and middle-income countries. Injury Pr
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evention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year
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India contributes to 16% of the global maternal deaths and around 27% of global newborn deaths. Reducing the burden of maternal and newborn mortality and morbidity in urban poor settings today requires an expansion of effective Maternal and Newborn Health (MNH) care services and lowering the barrier
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s to the use of such services, especially availability and accessibility.
For designing sensitive, responsive and relevant urban health policy and action, it is important for planners and programme managers to understand the context with regard to current systems and mechanisms, potential organisations and best practices.
In order to adres this need, Save the Children’s Saving Newborn Lives programme commissioned a study that reviewed the literature and looked at available secondary data on MNH in urban poor settings.
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Vitamin A supplementation (VAS) programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA) reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but a
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midst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD) data.
Article published in: Nutrients, 2017, 9, 190
https://doi.org/10.3390/nu9030190 more
Article published in: Nutrients, 2017, 9, 190
https://doi.org/10.3390/nu9030190 more
A guidance document in simple language for health personnel, setting out their rights and responsibilities in conflict and other situations of violence. It explains how responsibilities and rights for health personnel can be derived from international humanitarian law, human rights law and medical e
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thics.The document gives practical guidance on:
- The protection of health personnel, the sick and the wounded; - Standards of practice; - The health needs of particularly vulnerable people; - Health records and transmission of medical records; - "Imported" health care (including military health care);
- Data gathering and health personnel as witnesses to violations of international law; - Working with the media
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West: Drada & Nagar Haveli, Daman & Diu, Goa, Gujarat, Maharashtra
South: Andhra Pradesh & Telangana, Karnataka, Kerala, Puducherry, Tamil Nadu
This technical document consists of epidemiological profiles (fact-sheets) for States and districts based on information available from multiple ... data sources including the HIV Sentinel Surveillance (HSS) and the Integrated Biological and Behavioural Surveillance (IBBS). Given the need for focussed prevention efforts in low/high prevalence and vulnerable States/districts, the information presented will be useful for policy makers, program planners at national/State/ district level, researchers, and academicians in identification of areas for priority attention and also to derive meaningful conclusions for programme planning, implementation, monitoring and scale-up. This document will be a quick reference for the HIV/AIDS situation in a State/district, risk and safe behaviour of the high risk groups, their level of knowledge about STIs and HIV/AIDS, experience of violence, HIV testing and ART awareness and exposure to HIV/AIDS prevention. more
South: Andhra Pradesh & Telangana, Karnataka, Kerala, Puducherry, Tamil Nadu
This technical document consists of epidemiological profiles (fact-sheets) for States and districts based on information available from multiple ... data sources including the HIV Sentinel Surveillance (HSS) and the Integrated Biological and Behavioural Surveillance (IBBS). Given the need for focussed prevention efforts in low/high prevalence and vulnerable States/districts, the information presented will be useful for policy makers, program planners at national/State/ district level, researchers, and academicians in identification of areas for priority attention and also to derive meaningful conclusions for programme planning, implementation, monitoring and scale-up. This document will be a quick reference for the HIV/AIDS situation in a State/district, risk and safe behaviour of the high risk groups, their level of knowledge about STIs and HIV/AIDS, experience of violence, HIV testing and ART awareness and exposure to HIV/AIDS prevention. more
Northern: Chandigarh, Delhi, Haryana, Himachal Pradesh, Jammu & Kashmir, Punjab, Rajasthan, and Uttarakhand
Central: Chhattisgarh, Madhya Pradesh and Uttar Pradesh
Eastern: Andaman & Nicobar, Bihar, Jharkhand, Odisha and West Bengal
This technical document consists of epidemiological ... profiles (fact-sheets) for States and districts based on information available from multiple data sources including the HIV Sentinel Surveillance (HSS) and the Integrated Biological and Behavioural Surveillance (IBBS). Given the need for focussed prevention efforts in low/high prevalence and vulnerable States/districts, the information presented will be useful for policy makers, program planners at national/State/ district level, researchers, and academicians in identification of areas for priority attention and also to derive meaningful conclusions for programme planning, implementation, monitoring and scale-up. This document will be a quick reference for the HIV/AIDS situation in a State/district, risk and safe behaviour of the high risk groups, their level of knowledge about STIs and HIV/AIDS, experience of violence, HIV testing and ART awareness and exposure to HIV/AIDS prevention. more
Central: Chhattisgarh, Madhya Pradesh and Uttar Pradesh
Eastern: Andaman & Nicobar, Bihar, Jharkhand, Odisha and West Bengal
This technical document consists of epidemiological ... profiles (fact-sheets) for States and districts based on information available from multiple data sources including the HIV Sentinel Surveillance (HSS) and the Integrated Biological and Behavioural Surveillance (IBBS). Given the need for focussed prevention efforts in low/high prevalence and vulnerable States/districts, the information presented will be useful for policy makers, program planners at national/State/ district level, researchers, and academicians in identification of areas for priority attention and also to derive meaningful conclusions for programme planning, implementation, monitoring and scale-up. This document will be a quick reference for the HIV/AIDS situation in a State/district, risk and safe behaviour of the high risk groups, their level of knowledge about STIs and HIV/AIDS, experience of violence, HIV testing and ART awareness and exposure to HIV/AIDS prevention. more
A comprehensive compilation is provided of the medicinal plants of the Southeast Asian country of Myanmar (formerly Burma). This contribution, containing 123 families, 367 genera, and 472 species, was compiled from earlier treatments, monographs, books, and pamphlets, with some medicinal uses and pr
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eparations translated from Burmese to English. The entry for each species includes the Latin binomial, author(s), common Myanmar and English names, range, medicinal uses and preparations, and additional notes. Of the 472 species, 63 or 13% of them have been assessed for conservation status and are listed in the IUCN Red List of Threatened Species (IUCN 2017). Two species are listed as Extinct in the Wild, four as Threatened (two Endangered, two Vulnerable), two as Near Threatened, 48 Least Concerned, and seven Data Deficient. Botanic gardens worldwide hold 444 species (94%) within their living collections, while 28 species (6%) are not found any botanic garden. Preserving the traditional knowledge of Myanmar healers contributes to Target 13 of the Global Strategy for Plant Conservation
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Int J Bipolar Disord (2018) 6:6 https://doi.org/10.1186/s40345‑017‑0110‑8
In 2001, the WHO stated that: "The use of mobile and wireless technologies to support the achievement of health objectives (mHealth) has the potential to transform the face of health service delivery across the globe"
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. Within mental health, interventions and monitoring systems for depression, anxiety, substance abuse, eating disorder, schizophrenia and bipolar disorder have been developed and used. The present paper presents the status and findings from studies using automatically generated objective smartphone data in the monitoring of bipolar disorder, and addresses considerations on the current literature and methodological as well as clinical aspects to consider in the future studies.
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New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, s
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carce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people’s mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice.
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This guide is a revised edition to the previous version published in 2017.
This updated publication provides programme managers with a user-friendly tool that can: (i) analyse and draw conclusions from historic dengue datasets; (ii) identify appropriate alarm indicators that can predict forthcoming
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outbreaks at smaller spatial scales; and (iii) use these results and analyses to build an early warning system to detect dengue outbreaks in real time and respond accordingly. This web-based tool can ensure enhanced, fast and secured communication between national and subnational levels, and standardized utilization of surveillance data.
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More time or more money to improve nutrition in Benin Republic?
M. C. D. N. Vodouhe, L. Fakambi
Institut National des Recherches Agricoles du Bénin (INRAB)
(2015)
C2
Children malnutrition eradication in developing countries is a real challenge, especially among
vulnerable population. There are so many effort towards women (who are the main care providers)
socio-economic situation in order to improve their children nutrition. This article aims to identify the
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impact of mothers’ activities on child nutrition and care. Interviews were used to collect data from
mothers of children less than 5 years old. Pearson correlation test and regression models were
performed to highlight relation and to identify the main factors that affect child nutrition and care. The
nutritional statuses of children show a high prevalence of underweight (38.46%), emaciation (25.17%)
and stunting (23.77%). Statistic results show that a child whose mother has food processing as main
activity has 2,322 more times to not suffer from emaciation malnutrition compared to a child whose
mother has trade as main activity. A child whose mother has high revenue has 1.463 more times to
not be suffering from stunting malnutrition compared to a child whose mother has lower revenue. A
child whose father has fishing as main activity has 8,4 more chance to not be suffering from stunting
malnutrition compared to a child whose father has another activity as main activity. A child whose
father is present in the household has 8.11 more chance to not suffer from stunting malnutrition
compared to a child whose father is absent. A child from mother who has food processing as main
activity is 2,464 more times preserved from fever compared to a child from mother whose main activity
is trade. Moreover child position, child feeding with porridge, child nursing are correlated with mother
activity. This situation is justified by the fact that mother need money to improve child nutrition and
health but they are also confronted to the fact that those activity that provide significant money are
sometime time consuming and not permit to take care of children in term of feeding practices, hygiene
control etc. Therefore it is important that intervention towards women take in consideration those
factors (money and time) but also the family in the whole.
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Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita
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ble. We combined data from six Demographic and Health Surveys conducted in Senegal between 1992/93 and 2014. We examined FP trends over time among WRAU and subgroups, and trends in knowledge of FP and intention to use among women with unmet need for FP. Our results show that percent demand satisfied is lower among rural poor women and adolescents than WRAU, although higher among unmarried women. Marked recent increases have been observed in all subgroups, however fewer than 50% of women in need of FP use modern contraception in Senegal. Knowledge of FP has risen steadily among women with unmet need; however, intention to use FP has remained stable at around 40% since 2005 for all groups except unmarried women (75% of whom intend to use). Significant progress in meeting the need for FP has been achieved in Senegal, but more needs to be done particularly to improve acceptability of FP, and to strategically target interventions toward adolescents and rural poor women.
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A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance
Patricia M.C. Huijbers, Carl-Fredrik Flach, D.G. Joakim Larsson
Centre for Antibiotic Resistance Research (CARe), University of Gothenburg
(2019)
C2
The systematic surveillance of antibiotic use and antibiotic re-sistance prevalence in humans and animals is imperative for managingbacterial infectious disease (JPIAMR, 2019;WHO, 2015). Many low-income countries currently face substantial challenges in building national surveillance systems due to
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a lack of infrastructure and resources,resulting in a shortage of systematic data (FAO/OIE/WHO, 2018)
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High levels of storage iron may increase malaria susceptibility. This risk has not been investigated in semi-immune adolescents. We investigated whether baseline iron status of nonpregnant adolescent girls living in a high malaria transmission area in Burkina Faso affected malaria risk during the fo
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llowing rainy season. For this prospective study, we analysed data from an interim safety survey, conducted six months into a randomised iron supplementation trial. We used logistic regression to model the risk of P. falciparum infection prevalence by microscopy, the pre-specified interim safety outcome, in relation to iron status, nutritional indicators and menarche assessed at recruitment.
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Asia is home to more than half of the world’s 1.1 billion girls. Gender inequality in many parts of the region means that girls are often systematically disadvantaged and oppressed by poverty, violence, exclusion and discrimination. Girls’ development is hampered by child, early and forced marri
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age and high adolescent pregnancy rates. Across the region, genderbased violence against girls and women constitutes a serious and widespread rights violation, particularly with regard to domestic violence, marital rape, and trafficking in women and girls.
Emerging data shows that since the outbreak of COVID-19, violence against girls and women, particularly domestic violence, has intensified
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Excessive consumption of salt (more than 5 g per day) raises blood pressure, a major risk factor for cardiovascular diseases such as heart disease and stroke, and is the leading cause of death in the WHO European Region. Many countries in the Region have initiated national salt reduction strategies,
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including public awareness campaigns, reformulation, and front-of-pack nutrition labelling. However, despite ongoing efforts, surveillance data indicate that salt intake still far exceeds the limits recommended by WHO to protect health.
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The WHO COVID-19 LENS (Living Evidence Synthesis) working group consolidated available evidence, based on rapid reviews of the literature and results of a living systematic review on pregnancy and COVID-19 (up to October 7, 2020), on potential mechanisms of vertical transmission of infectious pathog
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ens, feasibility of vertical transmission of SARS-CoV-2, data related to interpretation of positive SARS-CoV-2 virologic and serologic neonatal tests, lessons from diagnosis of other congenital infections, and existing proposed definitions to classify timing of vertical transmission of SARS-CoV-2.
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This publication provides recommendations for the management of critically ill adult patients with COVID-19 being treated in intensive care units (ICUs) in the Americas. These clinical practice guidelines provide evidence-informed recommendations for identifying markers and mortality risk factors in
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critically ill patients, as well as infection control, sample collection, supportive care (respiratory and hemodynamic), pharmacological treatment, early rehabilitation, diagnostic imaging use, prevention of complications, and discharge requirements. The recommendations are for all health care staff caring for patients in emergency departments and ICUs. These guidelines are also intended for use by decisionmakers and government entities involved in the management of patients with COVID-19 in ICUs in the Region of the Americas.
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Ghana's attempt to regulate health care waste management started in 2002 with the development of guidelines on health care waste manage-ment by the Environmental Protection Agency (EPA). In 2006, the Ghana Health Service (GHS) also developed the Health Care Waste Management Policy and Guidelines as
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a single document.
Although awareness on Health Care Waste Management (HCWM) has improved in recent years, there is the need for a systematic approach to improve on effective segregation, safe collection, and storage, as well as ultimate treatment before disposal.
This guideline seeks to ensure that HCW is managed effectively in compliance with existing International Conventions that Ghana is a signatory to, national laws and regulations, and others to be passed in future.
Recommendations for better management of HCW in the nation's health care facilities have been presented in this document. Also, standard operating procedures (SOPs) have been developed to provide
guidance to various levels of the health facilities.
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This document shall serve as the most comprehensive set of guidelines on the safe management of waste generated from heath care activities in the country. It incorporates the requirements of all Philippine laws and regulations governing HCWM and is designed for the use of individuals, public and pri
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vate establishments, and other entities involved in segregation, collection, handling, storage, treatment,and disposal of waste generated from heath care activities.
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Health Care Facilities (HCFs) are primarily responsible for management of the healthcare waste generated within the facilities, including activities undertaken by them in the community. The health care facilities, while generating the waste are responsible for segregation,
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collection, in-house transportation, pre-treatment of waste and storage of waste, before such waste is collected by Common Bio-medical Waste Treatment Facility(CBWTF) Operator. Thus, for proper management of the waste in the healthcare facilities the technical requirements of waste handling are needed to be understood and practiced by each category of the staff in accordance with the BMWM.
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The frequency of infectious disease epidemics is increasing, and the role of the health sector in the management of epidemics is crucial in terms of response. In the context of infectious disease epidemics, the use of climate-informed early warning systems (EWS) has the potential to increase the eff
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ectiveness of disease control by intervening before or at the beginning of the epidemic curve, instead of during the downward slope.
Currently, the initiation of interventions is heavily reliant on routine disease surveillance systems – data that often arrive too late for preventative response. However, forecasting of disease outbreaks using surveillance and weather information shows promising potential – there also remains further scope to examine seasonal climate forecasts. By combining these elements in new EWS based on computational models, it will be possible to improve both the timeliness and impact of disease control. The World Health Organization (WHO) is strengthening existing surveillance systems for infectious diseases to enable the development of more robust and timely EWS, which has resulted in the rapid development and innovation of EWS for disease outbreaks.
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This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to
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air pollution.
Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines (see the full report, Air pollution and child health: prescribing clean air. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under the age of 5 years in 2016.
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The objective of Health in the Americas: Overview of the Region of the Americas in the Context of the COVID-19 Pandemic is to respond to the need to address important public health issues in an increasingly timely manner, while serving as a platform with a close focus on specific issues of regional
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importance. This 2022 edition is the second in its new format, providing an overview of the analysis, as well as an in-depth description of the key issues related to COVID-19 in the Region of the Americas. This overview is supported by the Health in the Americas+ virtual platform, which offers interactive resources for data analysis and allows for the comparison of information disaggregated by subregions and countries.
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These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C infection and the 2017 WHO Guidelines on hepatitis B and C testing. These priority areas are:
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direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
simplified HCV service delivery (decentralization, integration and task sharing)
HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing.
These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.
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Cities are uniquely positioned to understand local needs and respond rapidly to changing conditions to safeguard health. These changes require strong city leadership to implement multisectoral, health-relevant policies and public services that engage communities. The response to malaria must be an i
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ntegral part of such policies and processes.
This framework supports the control and elimination of malaria in urban environments. It provides guidance for city leaders, health programmes and urban planners as they respond to the challenges of rapid urbanization in a targeted way. For each urban context, the strategic use of data can inform effective, tailored responses and help build resilience against the threat of malaria and other vector-borne diseases.
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Reducing the global suicide mortality rate by a third by 2030 is a target of both the UN Sustainable Development Goals and the WHO Global Mental Health Action Plan. However, an impediment to meeting this goal is the fact that suicide and suicide attempts remain illegal in at least 23 countries world
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wide. Decriminalization of suicide and suicide attempts represents one critical step governments can take in their efforts to prevent suicide. The WHO Policy Brief on the health aspects of decriminalization of suicide and suicide attempts cites data and research to make a case for decriminalizing suicide globally. It also includes case examples from countries that have recently decriminalized suicide and suicide attempts — Guyana and Pakistan, Singapore,— providing important insights to policy-makers, legislators, parliamentarians and other decision-makers.
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The road map 2030 was developed by WHO through an extensive global consultation, with indicators set for measuring progress against targets and milestones. This compendium of indicators provides a comprehensive and standardized listing of recommended indicators, including the 70 core indicators pres
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ented in the M&E framework. These indicators will also support reporting on strategies described in other road map companion documents to guide action against neglected tropical diseases include the sustainability framework, the global strategy on water, sanitation and hygiene, the One Health approach and the strategic framework for integrated control and elimination of skin-related neglected tropical diseases.
The purpose of this compendium is to guide monitoring and evaluation of programmes and thereby to improve their quality and effectiveness in alignment with the road map goals. It provides a standardized listing of the most widely used indicators relevant to countries, with uniformity in defining indicators to allow comparisons over time and among different programmes. Detailed metadata are provided for each of these indicators to facilitate validity, internal consistency, standardized measurement, estimation methods and comparability of data across countries.
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This report aims to outline the current available knowledge on the health and wellbeing of older persons in the Region of the Americas during the United Nations Decade of Healthy Ageing (2021-2030). It also seeks to guide political actions towards ensuring the human rights of older persons, and desc
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ribes the negotiation and drafting process behind the Inter-American Convention on Protecting the Human Rights of Older Persons. It reports on the doctrinal and legal developments that led the Region of the Americas to draft the Convention and describes its action areas and guaranteed rights, as well as the obligations assumed by the States Parties. The Convention is an essential tool to advance the strategies of the Decade of Healthy Ageing. This publication reflects on the importance of having a major legal instrument for this purpose at the international level. The demographic transition in Latin America and the Caribbean will continue to shape the ability of countries and health systems to respond to the needs of the population. Given this reality, international instruments will be needed to guarantee the full enjoyment of the human rights of older persons. In order to design inclusive and sustainable systems, accurate, updated, and effective information is required. The Decade of Healthy Ageing––the initiative that constitutes the framework for this document––is a strategic period in which to focus on data generation and monitoring.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid
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e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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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 sustainable
development and health and shifted the Instit
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ute’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.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan
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ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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