These guidelines form part of efforts to institutionalise the prevention and containment of antimicrobial resistance (AMR) in health care facilities in South Africa, as outlined in the Antimicrobial... Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interrelated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level.
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27 May 2021
All countries should increase their level of preparedness, alert and response to identify, manage and care for new cases of COVID-19. Countries should prepare to respond to different public he...alth scenarios, recognizing that there is no one-size-fits-all approach to managing cases and outbreaks of COVID-19. Each country should assess its risk and rapidly implement the necessary measures at the appropriate scale to reduce both COVID-19 transmission and economic, public and social impacts.
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Interium guidance, 25 June 2021Timely and accurate diagnostic testing is an essential tool in preventing and controlling the spread of COVID-19. This document describes recommendations for national testing strategies and the use of PCR and rapid antigen tests in different transmission scenarios of t...he COVID-19 outbreak, including how testing might be rationalized in low resource settings. All testing should be followed by a strong public health response including isolating those who test positive and providing them care, contact tracing and quarantine of contacts.
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People living with HIV depend on life-saving antiretroviral therapy (ART) and access to ART must be maintained during periods of travel restrictions and lockdowns resulting from the COVID-19 pandemic. The Information note on HIV and COVID-19 addresses common concerns people living with HIV have rega...rding the risks of COVID-19 and how to minimize them. For HIV programme managers and health facilities providing HIV services, it identifies key points related to ensuring uninterrupted provision of ART, while protecting clients and staff from the risk of infection with the SARS-CoV-2 virus.
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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis ...B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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Ethiopia GATS was implemented by Ethiopia Public Health Institute (EPHI) in collaboration with the Ethiopian Food, Medicine, Health ...Care Administration and Control Authority (FMHACA), CSA, FMOH and the World Health Organization (WHO)country office. Technical assistance for the implementation of the survey was provided by the WHO, the U.S. Centers for Disease Control and Prevention (CDC), and RTI International. Program support was provided by the CDC Foundation.Financial support for Ethiopia GATS was provided by the CDC Foundation with a grant from the Bill & Melinda Gates Foundation.GATS enhances countries’ capacity to design, implement and evaluate tobacco control programs. It also assistscountries to fulfill their obligations under the WHO FCTC to generate comparable data within and across countries. In addition,it allows countries to implement the WHO MPOWER policy package. WHO MPOWERisa technical packagedevelopedtoassist countries in implementing selected demand reduction measures contained in the WHO Framework Convention on Tobacco Control(FCTC)(5).The six MPOWER evidence-based measures contained in the FCTC;
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Enabling young children to achieve their full developmental potential is a human right and an essential requisite for sustainable development. Given the critical importance of enabling children to make the best start in life, the health sector, amon...g other sectors, has an important role and responsibility to support nurturing care for early childhood development. This guideline provides direction for strengthening policies and programmes to better address early childhood development.
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This is a guidance document for countries and implementing partners on the technical requirements for developing digital information systems for issuing standards-based interoperable digital certificates for COVID-19 vaccination status, and considerations for implementation of such systems, for the ...purposes of continuity of care, and proof of vaccination.
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This rapid communication outlines the main outcomes of a WHO convened Guideline Development Group (GDG) meeting, held in May-June 2021 on the topic of the management of TB in children and adolescents. The rapid communication aims to inform staff from ministries of ...t medbox">health and care providers across public and private sectors, technical partners and other stakeholders about the key findings, considerations and changes related to the diagnosis, treatment and care of TB for children and adolescents, in order to allow for planning at the country level ahead of the release of updated guidelines and an associated operational handbook. WHO will publish the guidelines and operational handbook in the coming months.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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Assessment of non-communicable diseases (NCDs) service disruptions during the COVID-19 pandemic. Preliminary results.
Guidance on how to provide continuity for NCD programmes:• How to include NCDs in public health emergencies protocols?• How to... develop national NCDs tool kits for use in emergencies?• How to provide ambulatory essential NCD services during lockdown?• How to provide medical care for NCDs through telemedicine and digital solutions?
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his Framework begins with a desired future scenario and considers actions and interventions necessary to get there. It advocates for holistic view to address tuberculosis. The Framework revisits challenges and actions in four layers: TB specific; challenges in ...box">health systems that influence TB care; challenges in sectors beyond health that determine TB; and overarching governance issues. Multisectoral action and accountability are embedded in the Framework. The Framework is based on the principles of people-centered care and system development.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama...nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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The leishmaniases are a group of diseases caused by Leishmania spp., which occur in cutaneous, mucocutaneous and visceral forms. They are neglected tropical diseases (NTDs), which disproportionately affect marginalized populations who have limited access to ...">health care. HIV co-infected patients with Leishmania infection are highly infectious to sandflies, and an increase in the coinfection rate in an endemic area is likely to increase the effective infective reservoir.
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Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB and comorbidities. The Framework for collaborative ...action on TB and comorbidities aims to support countries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions. It should be used in conjunction with relevant WHO guidelines. The Framework is intended for use by people working in ministries of health, other relevant line-ministries, policymakers, international technical and funding organizations, researchers, nongovernmental and civil society organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors.
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Promoting health and preventing disease is a critical component of the effort required to achieve Universal Health Coverage (UHC). to date, efforts to achieve UHC have focused mostly on strengthenin...g health systems and their capacities to provide curative care. However, experience from the COVID-19 pandemic has reaffirmed the need for resilient health systems, emphasizing primary health care, including preventive and promotive health and well-being.
Emerging from the eye of the storm as the global health lead agency during the pandemic, WHO is equipped with the required insights and actions for a holistic approach to “building back fairer and better” after COVID-19.
The Healthier Populations (UHP) Cluster in the African Region is designed to support Pillar 3 of WHO’s 13th Global Programme of Work (GPW13) which aims to make 1 billion people healthier by reducing health inequities, preventing diseases and injuries, addressing health determinants, and promoting partnerships for collaborative actions amongst all stakeholders.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP...C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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The WHO COVID-19 Clinical management: living guidance contains the most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients t...hroughout their entire illness is important.
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Developmental disabilities are common. Yet, children with developmental disabilities have been neglected in health systems planning and policy provisions for ...ox">health and continue to experience stigmatization, institutionalization, barriers to access health care and inequalities in health and education outcomes.
Using findings from research and practice and guided by the tenets of international human rights conventions, this WHO-UNICEF Global Report on children with developmental disabilities provides principles and approaches to intentionally include the needs and aspirations of children and young people with developmental disabilities in policy, programming and public health monitoring. It makes the case for greater accountability and proposes 10 priority actions to accelerate changes towards inclusive environments and responsive multisectoral care systems for children with developmental disabilities.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical socie...ties and contacted international organizations.
Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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