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...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.
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From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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The Republic of the Union of Myanmar’s National Strategic Plan on HIV/AIDS 2016–2020 is the strategic guide for the country’s response to HIV at national, state/regional and local levels. The framework describes the current dynamics of the HIV epidemic and articulates a strategy to optimize in...vestments through a fast track approach with the vision of ending HIV as a public health threat by 2030. Myanmar’s third National Strategic Plan (HIV NSP III) issues a call to all partners to front-load investments to close the testing gap and reach the 90–90–90 prevention and treatment targets to protect health for all.
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Background Paper prepared for the 2015 Global Assessment Report on Disaster Risk Reduction
The aim of this paper is to help bring voluntary standards into the toolbox of disaster risk reduction, including both by encouraging their use by business and by enhancing their role in legislation and ...regulatory practice.
- Authorities can build awareness for standards in Disaster Risk Reduction (DRR), by facilitating access to relevant standards, encouraging education on DRR-related standards and involving the standardization community.
- Standards need to be sustained by a powerful infrastructure that allows for reliable inspections, audits and precise measurements to be conducted by skilled professionals.
- Risk management best practice needs to embed, as emdodies in standards, more fully in regulatory frameworks in sectors that are relevant.
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Research results of sexual and gender-based violence (SGBV) prevention and response before, during and after disasters in Indonesia, Lao PDR and the Philippines
This report contributes new evidence on why and how sexual and gender-based violence (SGBV) risks increase during humanitarian disasters.... It details how humanitarian actors can better prevent and respond to such escalation of SGBV, and better meet the needs of affected women, girls, men and boys. This research is based on community views of disaster-affected women, adolescent girls, men and adolescent boys in three South-East Asian countries: Indonesia, Lao PDR and the Philippines.
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The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra...nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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Lao People’s Democratic Republic (Lao PDR), also referred to as Laos, or Lao, is exposed to natural disasters such as flooding, typhoons, cyclones, drought, and earthquakes. The country is vulnerable to recurrent, sudden-onset and slow onset natural disasters with flooding, storms and typhoons hav...ing a large effect on the population. The country remains highly vulnerable to agricultural shocks and natural disasters.
Lao has established Community Based Disaster Risk Reduction (CBDRR) practices as a result of the many natural disasters the country faces. CBDRR is implemented at the village level to enhance community preparedness and to decrease village vulnerabilities to disasters.
Lao established the National Disaster Management Committee (NDMC) as its national disaster management platform and the National Disaster Management Office (NDMO) to be responsible for DRM (Disaster Risk Management) and DRR activities in the country.
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The International Water Management Institute (IWMI) was commissioned to undertake a rapid review of access to and management of water resources in the Dry Zone, to assist LIFT and other potential donors and investors to identify the key issues and the priority actions for water management.
The ...study had three main components:
• A water resources assessment (surface and ground water) of availability, current use, and patterns, trends and variability at different spatial and temporal scales.
• Community survey to evaluate issues of water availability, access and management for different livelihood types in 24 local communities, including evaluation of institutional arrangements in relation to farming strategies and water management practices
• Review and analysis of existing program investments in water in the Dry Zone
Findings from the study are available in three reports (for details, see last page).
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic p...alliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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This training and guidance module addresses the use of coercive and violent practices in mental health and related services with a particular focus on seclusion and restraint. It aims to promote a greater understanding of why these practices are used and build practical skills to help end these prac...tices. While the module itself focuses on ending these practices in the health care setting, much of the content can also be applied in other settings where seclusion and restraint occur, for example in the home and in the wider community.
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Mental disorders impose an enormous burden on society, accounting for almost one in three years lived with disability globally. •In addition to their health impact, mental disorders cause a significant economic burden due to lost economic output and the link between mental disorders and costly, po...tentially fatal conditions including cancer, cardiovascular disease, diabetes, HIV, and obesity.•80% of the people likely to experience an episode of a mental disorder in their lifetime come from low- and middle-income countries.• Two of the most common forms of mental disorders, anxiety and depression, are prevalent, disabling, and respond to a range of treatments that are safe and effective. Yet, owing to stigma and inadequate funding, these disorders are not being treated in most primary care and community settings.
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This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of development assistance for health, domestic spending on health, health spending on two key infectious diseases – malaria and HIV/AIDS – and fut...ure scenarios of health spending. Several transitions in global health financing inform this report: the influence of economic development on the composition of health spending; the emergence of other sources of development assistance funds and initiatives; and the increased availability of disease-specific funding data for the global health community. For funders and policymakers with sights on achieving 2030 global health goals, these estimates are of critical importance. They can be used for identifying funding gaps, evaluating the allocation of scarce resources, and comparing funding across time and countries.
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The aim of the framework is to provide guidance to Member States and partners on region-specific priority actions towards the goals, targets and milestones of the GTS. The central pillar of the framework is the adoption of programme phasing and transitioning, aimed at facilitating a tailored ...lass="attribute-to-highlight medbox">approach to malaria control/elimination. This is in response to the increasing heterogeneity of malaria epidemiology among and within countries of the region.
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The Central African Republic is at a major turning point in its history. The country
is just emerging from a very violent conflict, during which thousands of human lives were lost and one-third of the population was displaced. After
a three-year transition, and with the support of the internationa...l community, authorities successfully created the conditions required to conduct credible presidential and legislative
elections. Central African citizens mobilized to express their desire for peace and to break
with the cycle of past violence. Their exemplary democratic maturity ensured the electoral
process was peaceful, despite palpable tensions. The welcome given Pope Francis in Bangui in
November 2015 and visible reconciliation efforts demonstrate the population wishes to turn
the page on this conflict.
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This Rapid Gender Analysis provides preliminary information and observations on the different needs, capacities and coping strategies of Venezuelan migrant and refugee women, men, boys, and girls in Colombia. It seeks to understand how gender roles and relations have changed as a result of the crisi...s and share recommendations for how the humanitarian community can more effectively consider these changing dynamics to better meet the different needs of women, men, boys and girls of different ages, abilities and other contextually relevant forms of diversity. The refugee and migrant crisis in Colombia is characterized by gendered dynamics and has taken a significant toll on the health and welfare on all those affected, but particularly on women and girls. Refugee and migrant women and girls face profound vulnerabilities as they leave Venezuela and either cross Colombia or stay in various locations across the country; this is even more the case for those at increased risk, such as indigenous populations, adolescent girls, etc.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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A healthcare worker manual. 2nd edition
The development of this National Manual for the Management of HIV-related Opportunistic Infections and Conditions for use by health care workers at the frontline of our fight against HIV/AIDS is intended to improve their understanding of the causes, preventio...n and appropriate management of opportunistic infections and conditions in adults and adolescents (OIs in children is covered effectively in the Integrated Management of Childhood Illnesses – IMCI – materials). It is also intended to be a practical guide at the clinic level, so as to improve quality of life, treatment outcomes and survival of PLHA. Crucially, this manual uses a “symptom-based” approach to support health care workers at the most basic primary level to be able to effectively initiate the care of PLHA with OIs and refer patients as appropriate (effective triage of patients at the primary care level). The result of this will be to move the management of OIs closer to the patient while ensuring that referral links with higher-level facilities and care is cultivated.
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The importance of fruits and vegetables in nutritious and healthy diets is well recognized, and in recent years consumers have been encouraged to eat more of these products. For many countries, particularly developing countries, these products have become a valuable ...ht medbox">commodity. At the same time, food safety problems linked to the consumption of fresh fruits and vegetables contaminated with microorganisms are increasing
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