1 June 2020
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidan
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ce for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges. This document expands on the content of pillar 9 of the COVID-19 strategic preparedness and response plan, supersedes the earlier Operational guidance for maintaining essential health services during an outbreak, and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. It is intended for decision-makers and managers at the national and subnational levels.
This is an update to COVID-19: Operational guidance for maintaining essential health services during an outbreak: Interim guidance, 25 March 2020
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The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributa
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ble to health system failures exceeded deaths from Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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To support countries’ preparedness effort on the COVID-19 outbreak, the Department of Health Security Preparedness at the WHO headquarters has de
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veloped various COVID-19 tabletop exercise (TTX) and Drills (DR) packages .
If you need technical support to implement any of the exercises listed on this page, please contact your WHO country office or regional office focal point.
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The primary focus of the plan continues to be prevention, preparedness and treatment of the the Novel Coronavirus (COVID-19) outbreak. Central to the plan are the following overall objectives:
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To prevent further transmission of COVID-19 in the oPt;
To provide adequate care for patients affected by COVID-19 and to support their families and close contacts; and
To mitigate the worst effects of the pandemic.
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Learn together. Managing transmission of viral haemmoraghic fever. Only available online!
This book is part of the Bettercare series which addresses the need for continuing education for health professionals. The book is produced under the auspices of the Infection Control Africa Network (ICAN), t
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o assist with training of healthcare workers during the Ebola virus disease outbreak of 2014-2015. However, the infection control principles discussed in the book are applicable to the management of other viral haemorrhagic fever outbreaks. The book should be used by healthcare workers, institutions and Ministries of Health dealing with the Ebola outbreak in West Africa. The book should also be of value to institutions wanting to increase their level of Ebola-preparedness.
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In Israel, as in other countries, the COVID-19 outbreak highlights existing structural inequities,which compromise the health of some migrant groups. The Israeli case also demonstrate show strong NGOs successfully advocate for the protection of migr
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ants‘health amidst the crisis, madepossible bya certain level ofcooperation withthe Israeli Ministry of Health.Hence,measures for COVID-19preparedness in Israel‘s marginalized migrant communities mostly result from pressure from civil society, against thebackdrop of a generally exclusionary approach toward migrants.4Over time, the Israeli Ministry of Health thus shifted from acknowledging the need to include migrants in preparedness measures toward the realization that particular needs and circumstances amongmigrant communities in some instances require special responses. Givena legacy of neglect and exclusion, this creates challenges for both the authorities and the migrant communities.
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Previous crises, such as the Ebola virus disease (EVD) in West Africa in 2014, indicate the direct impact movement restrictions and disease containment efforts have on food availability, access, utilization and violence – particularly gender-based violence (GBV). The importance of maintaining and
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upscaling food security interventions for the most vulnerable populations, alongside the health sector’s efforts to avert disease spread, is therefore undeniable. The COVID-19 outbreak in South Sudan threatens to paralyze an already fragile food system and negatively impact more than 6.5 million people in South Sudan who remain vulnerable. At the same time, the core national capacities for prevention, preparedness and response for public health events is limited, and the healthcare system has been weakened by years of conflict, poor governance and low investments.
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Bioethics 519 (online) doi:10.1111/bioe.12145 Volume 29 Number 8 2015 pp. 488–596;
Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreak, and are primarily aimed at preventing and mitigating human-to-human
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transmission. These plans carry presumptive weight and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization (WHO). The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, thisfocus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.
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The COVID-19 outbreak poses a significant challenge for all countries – creating an unprecedented need for international solidarity and a coordinated global response. This COVID-19 Partners Platform has launched anew landing platform to be an enab
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ling tool for all countries, implementing partners, donors and contributors to collaborate in the global COVID-19 response. The Partners Platform features real-time tracking to support the planning, implementation and resourcing of country preparedness and response activities.
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The cholera outbreak in the WHO African Region has affected 17 countries over the last two years. The are six countries categorised to be in acute crisis 1 (Democratic Republic of the Congo, Ethiopia, Mozambique, United Republic of Tanzania, Zambia
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and Zimbabwe). The southern region of the continent now in the rainy season with outbreaks now resurging. The increase in rainfall levels is now increasing floods in communities and landslides with increased for outbreaks in countries not reporting new confirmed cases. The seasonality of cholera outbreaks are issues for countries to consider and there is need to enhance preparedness and readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border transmission.
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The WHO Eastern Mediterranean Regional Office's webpage on cholera information resources provides a comprehensive collection of materials to support understanding and management of cholera outbreaks. It includes posters for public education, recent publications such as Global Defence Against the Inf
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ectious Disease Threat (with a chapter on cholera), Cholera Outbreak: Assessing the Outbreak Response and Improving Preparedness, and First Steps for Managing an Outbreak of Acute Diarrhoea. Additionally, it features policy documents like the WHO statement on international travel and trade during cholera outbreaks and the World Health Assembly resolution WHA 64.15 on cholera control and prevention. The page also links to the Global Task Force on Cholera Control and provides cholera country profiles, offering valuable insights into global and regional efforts to combat cholera.
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Rwanda first confirmed cases of coronavirus disease 2019 (COVID-19) in March 2020. Although the number of cases has been low, health system resources are being redirected to respond and an increasing number of children are affected by the socio-economic impacts of the pandemic, including disruptions
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to schooling and heightened protection risks.
While Rwanda remained Ebola-free during the outbreak, it remains a priority country and continues to maintain its Ebola preparedness. Rwanda is also home to 147,000 refugees, half of whom are children, who require assistance in and outside of camps.1 In 2021, UNICEF will continue to deliver life-saving services to refugees and children and families affected by COVID-19 and its socio-economic impacts, and maintain its Ebola preparedness and contingency planning.
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Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations, refugees,
migrants, and minorities experience the highest degree
of socio-economic marginalization. Marginalized people
become even more vulnerable in emergencies.1 This is due
to factors su
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ch as their lack of access to effective surveillance
and early-warning systems, and health services. The
COVID-19 outbreak is predicted to have significant impacts
on various sectors.
The populations most at risk are those that:
• depend heavily on the informal economy;
• occupy areas prone to shocks;
• have inadequate access to social services or political
influence;
• have limited capacities and opportunities to cope and
adapt and;
• limited or no access to technologies.
By understanding these issues, we can support the capacity
of vulnerable populations in emergencies. We can give
them priority assistance, and engage them in decision-making
processes for response, recovery, preparedness, and
risk reduction.
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Accessed: 27.04.2020
Leaving no one behind in the Covid-19 Pandemic: a call for urgent global action to include migrants & refugees in the Covid-19 response
People on the move, whether they are economic migrants or forcibly displaced persons such asylum seekers, refugees, and internally displa
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ced persons (hereafter called migrants & refugees), should be explicitly included in the responses to the coronavirus disease 2019 pandemic. This global public health emergency brings into focus, and may exacerbate, the barriers to healthcare these populations face. Many migrant & refugee populations live in conditions where physical distancing and recommended hygiene measures are particularly challenging. The Covid-19 pandemic reveals the extent of marginalisation migrant & refugee populations face. From an enlightened self-interest perspective, the Covid-19 disease outbreak control measures will only be successful if all populations are included in the response. It is counter- productive to exclude migrant & refugee populations from the preparedness and response to the Covid-19 pandemic.
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For several years, agencies supporting preparedness and response to cholera outbreaks have supplied medicines and medical devices through the Interagency Diarrhoeal Disease Kits (IDDK).
In an effort to better align the presentation and content of
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the kits to field needs, the composition of the cholera kits has been reviewed by WHO and its partners in 2015 and again in 2020. The content of all modules have been slightly revised with no changes except for the cholera laboratory check list.
The revised cholera kits 2020 are designed to help prepare for a potential cholera outbreak and to support the first month of the initial response for 100 cases. The overall package consists of six different kits, each divided in several modules.
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Screening areas, treatment centres and community facilities are part of the strategic priorities for Severe Acute Respiratory Infection (SARI) outbreak preparedness, readiness and response. The SARI
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Facilities training package has been developed to meet the operational needs emerging with the COVID-19 pandemic.
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The slow global response to the Ebola crisis in west Africa suggests that important gaps exist in donor financing for key global functions, such as support for health research and development for diseases of poverty and strengthening of outbreak
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preparedness. In this Health Policy, we use the International Development Statistics databases to quantify donor support for such functions. We classify donor funding for health into aid for global functions (provision of global public goods, management of cross-border externalities, and fostering of leadership and stewardship) versus country-specific aid. We use a new measure of donor funding that combines official development assistance (ODA) for health with additional donor spending on research and development (R&D) for diseases of poverty.
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In 2016 WHO introduced the Cholera Kits. These kits replace the Interagency Diarrhoeal Disease Kit (IDDK) which had been used for many years. The Cholera Kit is designed to be flexible and adaptable for preparedness and
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outbreak response in different contexts. The overall Cholera Kit is made up of an Investigation Kit, Laboratory materials, 3 Treatment Kits (community, periphery and central) and a Hardware Kit. The Treatment and Hardware Kits are each composed of individual modules. Each of the kits and modules can be ordered independently based on field need. To support orders, a Cholera Kit Calculation Tool was developed.
The information note, packing lists and the Kit Calculation Tool are all available from the WHO website at: http://www.who.int/cholera/kit/en/
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The Africa Centres for Disease Control and Prevention (Africa CDC) was established in 2017, after the west Africa Ebola virus disease outbreak. Upon creation, the
role of Africa CDC was to mandate strengthening of the capacity of public health inst
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itutions in Africa to prevent, detect, and respond to disease threats, based on science, policy, and data-driven interventions and programmes, as envisaged by the Abuja Declaration. The inaugural strategic plan was focused on building health systems for emergency preparedness and response. However, from its inception, the organisation recognised the concomitant need to comprehensively strengthen systems to prevent and manage noncommunicable diseases (NCDs) and injuries, and to face the neglected issue of mental health disorders. The division dedicated to these issues was conceptualised, but operationalisation was deferred to a future date.
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The Global Health Network is an open source platform that provides trusted knowledge, guidance, tools and resources to support the generation of more and better health research data. During emerging outbreaks it is vital to learn as much as possible to generate evidence on best practice for preventi
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on, diagnosis and treatment and to facilitate effective preparedness and response for future outbreaks.
This pop-up space for 2019 Novel Coronavirus COVID-19 (formerly 2019-nCoV) supports evidence generation by pooling protocols, tools, guidance, templates, and research standards generated by researchers and networks working on the response to this outbreak. Findings from previous outbreaks, largely obtained during MERS and SARS, are also available. This all aims to make research faster and easier and to enable standardised, quality data to be collected and prepared for sharing.
Latest updates will be provided on transmission as well as recommendations for healthcare professionals on transmission, disease management, and care.
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