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...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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Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA <...span class="attribute-to-highlight medbox">report was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.
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Despite high regional demand for vaccines valued at over US$ 1 billion annually, Africa’s vaccine industry provides only 0.1% of global supply. Vaccine inequity and hoarding at the start of the pandemic, which resulted in delays in obtaining COVID-19 doses, stimulated new resolve to address future... supply security. In 2021, the AU set a target to produce and supply more than 60% of the vaccine doses on the continent by 2040.
In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040*, demonstrating the potential for a thriving regional industry to emerge.
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The IMCI model handbook provides a detailed explanation of the IMCI case management guidelines. It is organized into seven main parts: overview of the IMCI process; assess and classify the sick child age 2 months up to 5 years; assess and classify t...he sick young infant age 1 week up to 2 months; identify treatment; treat the sick child or the sick young infant; communicate and counsel; and give follow-up care.
Teaching institutions are advised to adapt the handbook in two ways:
to ensure that all text, charts and illustrations are consistent with nationally-adapted IMCI clinical guidelines, and
to ensure that its content and format corresponds to the teaching approach used by the institution.
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Effective risk communication requires the alignment of complex factors including trust between the communicator and the audience(s), audience involvement, and emotional responses to risk. Risk communication is especially challenging now as new media changes the landscape for both
communicators and... their audiences. Viewed as a discussion of the most important findings for risk communicators and managers, this report delves into research-driven recommendations for effective risk communication practices.
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Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal health indicators in th...is study, while other highpriority counties consistently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care.
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Reflections and a call for action after a two-year exploration of emergency response in acute conflicts
There is general consensus that the humanitarian sector is failing to mount timely and adequate responses in the acute phase of conflict-related emergencies, according to the two-year Emergen...cy Gap Project by Médecins Sans Frontières (MSF).
The Project has explored what works for or against effective emergency responses. Its final report, Bridging the emergency gap, draws on the Project’s thematic papers and case studies, and consultations with more than 150 senior-level representatives from 60 key organisations across the humanitarian sector.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile popul...ations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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The CBDRR Manual is a practical ‘how-to’ guide on community-based disaster risk reduction for government and non-government agencies in Lao PDR. It is a commonly agreed document to be referred to by agencies working on CBDRR in Lao PDR. It provides guidance and support for systematic implementat...ion of CBDRR programs by explaining each of the steps as well as tools used.
The manual will also support the Government of Lao PDR (GoL) to monitor CBDRR activities, oversee progress of activities implemented by different actors and locations, provide necessary support on CBDRR technical knowledge as well as provide a reference point for replication of initiatives for local government and implementing agencies.
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Over 244,000 displaced people remain in camps or camp-like situations in Kachin, Shan, Rakhine
and Kayin states. Children make up at least 50 per cent of this population, while women and„Myanmar: 2019 Humanitarian Needs Overview - Myanmar“. ReliefWeb. Zugegriffen 4. Januar 2019. https://reliefw...eb.int/report/myanmar/myanmar-2019-humanitarian-needs-overview.
children together make up about 77 per cent. This includes approximately 97,000 people in
Kachin, 8,800 in Shan and 10,300 in Kayin who remain displaced as a result of the armed conflict.
It also includes about 128,000 people in Rakhine, the vast majority of whom are stateless, who
were displaced as a result of the violence in 2012.
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Adolescence is a critical stage in life for physical, cognitive and emotional development, shaping future health and well-being. Comprehensive measurement of adolescent health is essential to prioritize health issues, guide interventions and track progress.... However, global, regional and national adolescent health measurement has historically been inconsistent and incomplete.
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The HIV/AIDS Sustainability Index Dashboard is a tool completed every two years by President’s Emergency Plan for AIDS Relief (PEPFAR) teams, host government and partner stakeholders to sharpen the understanding of each country’s sustainability landscape and to assist PEPFAR and other donors in ...making informed HIV/AIDS investment decisions. Based on responses to more than 100 questions, the SID assesses the current state of sustainability of national HIV/AIDS responses across 17 critical elements. Scores for these elements are displayed on a color-coded dashboard, together with contextual charts and information. As the SID is completed over time,
it will allow stakeholders to track progress and gaps across these key components of financial and programmatic sustainability.
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Combination file of all the documents related to the national guidelines for accreditation, supervision and regulation of ART clinics in India. Documents included:
National Guidelines for Accreditation, Supervision & Regulation of ART Clinics in India | Preliminary Pages | Corrigendum | Chapter 1 ...- Introduction, Brief history of ART and Requirement of ART Clinics | Chapter 2 - Screening of Patients for ART - Selection Criteria and Possible Complications | Chapter 3 - Code of Practice, Ethical Considerations and Legal Issues | Chapter 4 - Sample Consent Forms | Chapter 5 - Training | Chapter 6 - Future Research Prospects | Chapter 7 - Providing ART Services to the Economically Weaker Sections of the Society | Chapter 8 - Establishing a National Database for Human Infertility | Chapter 9 - Composition of the National Accreditation Committee | Bibliography
| Members of the Expert Group for Formulating the National Guidelines for Accredation, Supervision and Regulation of ART Clinics
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Based on WHO South-East Asia Regional Strategy on Autism Spectrum Disorder
The collaborative framework for implementation of the “WHO South-East Asia Regional Strategy on Autism Spectrum Disorders” articulates to Member States: the nature of autism spectrum disorder and the issues faced by ...PwASD and their caregivers; the foundation on which the Regional Strategy and the collaborative framework is based; desired outcomes against each objective of the ASD Regional Strategy; recommended actions to fulfill each objective; requisite parameters that should govern the recommended actions; and suggested guidelines for monitoring, evaluating and reporting a Member State’s progress towards fulfilling the objectives. It encourages Member States to share best practices and information for promoting cooperation and partnerships for development of effective and sustainable programmes.
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Annex I to: To stay and deliver, good practice for humanitarians in complex security environments
The principal findings of the report include that despite overall improvements in aid agencies’ security risk management, national aid worke...rs perceive continued inequities in security support compared with their international counterparts. National aid workers, while less subject to major attacks per capita than international aid workers, nevertheless form the majority of victims, and their specific security needs require more attention.
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The World Health Organization (WHO) and United NationsHuman Settlements Programme (UN-HABITAT) joint globalreport, Hidden cities: unmasking and overcoming healthinequities in urban settings, exposes the extent to whichcertain city dwellers suffer disproportionately from a wide range of diseases and ...health problems. This report provides information and tools to helpgovernments and local leaders reduce health inequities in their cities. The objective of the report is not tocompare rural and urban health inequities. Urban healthinequities need to be addressed specifically for they aredifferent in their magnitude and in their distribution.
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The aim of the people-centred framework is to help countries to develop fully prioritized and budgeted NSPs based on a culture of making full use of the available data, which are aligned with national planning cycles and which provide the basis for a robust national response that can accelerate ...n class="attribute-to-highlight medbox">progress towards the goal of ending TB. In addition, applying the framework for other possible applications according to the country’s planning and policy cycle encourages the culture of data utilization and evidence translation into decision making and planning.
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Part 2: Part 2 Beyond the evidence: Implications for innovation and practice
Part 2 of the Gap Analysis presents the insights from individuals working in humanitarian response, disability inclusion and older age inclusion. This report begins by lo...oking at how an agenda for the inclusion of people with disability and older people in humanitarian response has been established. The report then considers the ways in which standards and guidance inform humanitarian practice and the challenges associated with translating commitments into practice. Finally, the report identifies seven areas where there are key gaps and opportunities presenting the potential for innovation in research and practice.
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Health is routinely considered in strategic environmental assessment (SEA) and environmental impact assessment (EIA), following requirements of European Union directives and the Protocol on Strategic Environmental Assessment to the Convention on Environmental Impact Assessment in a Trans...boundary Context (Espoo Convention). Policy-makers and other sources report that these assessments mostly adopt a biophysical perspective and that few cases consider or define health in a manner which is consistent with the WHO Constitution, by considering the wider social, economic, behavioural and institutional aspects of health. This systematically conducted review of over 333 SEA and EIA cases in the WHO European Region shows that while about 80% of assessments pursue a narrow, biophysical interpretation of health, around 10% consider wider determinants when defining health, and another 10% consider wider determinants of health in the actual assessment. Twelve case studies are presented, literature is reviewed and implications for practice are considered.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t...o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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