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To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities
...
in Germany with fictitious appointment requests and randomized patients’
characteristics. We find that patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
more
Pandemic Influenza Risk Management
recommended
A WHO guide to inform & harmonize national & international pandemic preparedness and response
The main updates from the 2013 interim guidance are:
Alignment with other relevant United Nations policies for crisis and emergency management, and
...
Inclusion of the significant development in recent years of the strategies for pandemic vaccine response during the start of a pandemic.
The guide is available in English, Arabic, Chinese, French, Spanish and Russian
more
This report situates disability and inclusion within the broader context of sustainable development, with a particular focus on the Sustainable Development Goals (SDGs). The paper provides background on the historical role of the UN in promoting
...
inclusion and outlines the current trends and challenges facing people with disabilities globally. The following section presents these challenges within the context of the SDGs, showing that disability needs to be tackled if the SDGs are to be achieved. It concludes with a number of recommendations for a disability-inclusive 2030 agenda for sustainable development
more
This assessment is the first of its kind to be conducted in the south-eastern region of Myanmar. It is an important contribution to ensuring the full incl
...
usion of women and children in Myanmar’s political, social, and cultural systems, with a specific focus on the issue of gender-based violence (GBV) and its impact on these groups in south-eastern Myanmar. The United Nations Population Fund (UNFPA) is grateful for the participation of women, men, boys and girls from Mon, Kayin and Kayah States for sharing their views and experiences during the study.
more
DR-TB drugs under the microscope: Sources and prices for drug-resistant tuberculosis medicines
recommended
4th edition.
This report – now in its fourth edition – analyses the barriers and factors affecting access to treatment regimens for drug-resistant tuberculosis (DR-TB), including new and repurp
...
osed drugs. We provide detailed pricing profiles of key DR-TB drugs, using manufacturer responses to standardised questionnaires and the Global TB Drug Facility website.
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A wide range of potential enablers and barriers were identified for influencing progress for the scale-up of severe wasting services within national health systems. Findings were categorised according to
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the six pillars of WHO’s health system strengthening framework.
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Strategic communication is used to raise awareness of issues among specific target populations. It aims to provide timely, evidence-based, authoritative information and
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guidance needed for public health action. Proper implementation of strategic communication leads to sustained behaviour change and is essential in overcoming barriers to access to services or generating demand for such services.
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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.
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To achieve tuberculosis control in these communities, it is necessary to respond to 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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Children with disabilities in South Africa: The hidden reality is part of a multiple-country study conducted by ACPF. The study seeks to analyse how cultural, social, physical and other societal barriers
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prevent children with disabilities from enjoying their constitutional rights to equality, freedom and human dignity. It also seeks to establish opportunities and practices that could be used to address these barriers to enhance disabled children’s participation in society.
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The study analyses the current situation of children with disabilities in relation to realizing their rights and accessing basic services, as well as their life experiences in their communities. It also focuses on identifying the
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barriers created by society that prevent children with disabilities from enjoying their human rights. This includes identifying negative attitudes; environmental and communication barriers; gaps in policies or their effective implementation.
The report reveals that children with disabilities in Myanmar are less likely to access services in health or education; rarely have their voices heard in society; and face daily discrimination as objects of pity. It also highlights how inadequate policies and legislation contribute to the challenges these children face.
The information available in this publication should be useful for policy makers, development partners and Disabled Persons Organisations to promote the realization of the rights of all children with disabilities. more
The report reveals that children with disabilities in Myanmar are less likely to access services in health or education; rarely have their voices heard in society; and face daily discrimination as objects of pity. It also highlights how inadequate policies and legislation contribute to the challenges these children face.
The information available in this publication should be useful for policy makers, development partners and Disabled Persons Organisations to promote the realization of the rights of all children with disabilities. more
This article looks at the Baseline Standards developed by the International Society for Paediatric
Oncology (SIOP) for paediatric oncology nursing care in low- and middle-income countries. The
Baseline Standards lay the foundation for effective care and address
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barriers such as inadequate
staffing levels, lack of support, limited access to nurse education and unsafe nursing environments.
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Each humanitarian setting provides distinct opportunities and challenges for actors to coordinate and collaborate at strategic and operational levels. The Health and Protection Joint Operational Framework has been developed
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to ensure that the health and protection response during humanitarian emergencies can adapt to each environment and is adequately coordinated to ensure high-quality services to meet the needs of affected individuals and at-risk groups based on their situation or vulnerabilities.
The Health and Protection JOF was conceived in 2019 as a collaboration between the Global Health Cluster (GHC), the Global Protection Cluster (GPC) and its Areas of Responsibility (AoRs), the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG), and the Inter-Agency Working Group for Reproductive Health in Crisis (IAWG), in addition to key technical experts.
A Steering Group (SG) comprised of representatives from each of these entities guided the framework through a joint global analysis of good practices, gaps, and barriers to integrated and inter-sectoral response coordination. This included a mixed methods review of policy and practice, a survey of humanitarian experts, multiple case studies, structured stakeholder interviews, and field visits. This exercise produced a zero-draft which was then reviewed by field practitioners in three operational contexts to clarify and fully coordinate its operationally focused lens. Finally, the JOF was reviewed by the SG including via a series of consultations in early 2023 to consolidate the current framework.
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Non-pharmaceutical interventions (NPI) are public health measures that aim to prevent and/or control SARS-CoV-2 transmission in the community. As long as there is no effective and safe vaccine to pr
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otect those at risk of severe COVID-19, NPI are the most effective public health interventions against COVID-19. These ECDC guidelines detail available options for NPI in various epidemiologic scenarios, assess the evidence for their effectiveness and address implementation issues, including potential barriers and facilitators.
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The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at
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high-level United Nations meetings. It highlights the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
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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 t
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hey do. However, few have examined their experiences and identity and how that might influence how they 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 full-scale invasion of Ukraine has caused a deterioration in the level of access to health-care services and medicines in the country, particularly for people living in regions close to the fron
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t line and areas that are not partially or fully controlled by the Government of Ukraine, and for people who have been internally displaced. Cost and time constraints involved in getting to and from health facilities, as well as limited transportation options were the main barriers to accessing essential health-care services. At the same time, the findings show that the country’s health system remains resilient and that overall access to health services is fairly high.This report is based on data collected through a quantitative cross-sectional survey of self-reported health needs of the general population in Ukraine. It presents results of the first round survey conducted in September 2022 and could help to address the specific health-care needs of the population groups concerned.
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The main objectives of these guidelines are:
A. To create awareness among the CBM family (International Office, Member Associations, Regional Offices, Country Offices and partners) on the opportunity savings groups create
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to attain socio-economic empowerment of a significantly larger number of persons with disabilities particularly among the poorest of the poor.
B. Lobbying mainstream savings group providers and donors to promote the inclusion of persons with disabilities in their programmes as a right as a catalyst of inclusive development.
C. To highlight and illustrate the key steps and procedures that are required to link persons with disabilities through CBR programmes with existing mainstream savings groups and/or promote development of disability specific savings groups.
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The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by hi
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gh level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and pr
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ovide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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he WHO global disability action plan 2014-2021 is a significant step towards achieving health and well-being and human rights for people with disabilities. The action plan was endorsed by WHO Member States in 2014 and calls for them to remove
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barriers and improve access to health services and programmes; strengthen and extend rehabilitation, assistive devices and support services, and community-based rehabilitation; and enhance collection of relevant and internationally comparable data on disability, and research on disability and related services. Achieving the objectives of the action plan better enables people with disabilities to fulfil their aspirations in all aspects of life.
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