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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with ... more
In 2024, we need US$1.5 billion to provide live-saving health care to millions of people in emergencies. An alarming combination of conflict, clima... more
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 ... the absence of a CHW programme. In this study, we evaluated expanding 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. more
Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-...-human transmission of the disease, and reducing spillover of the virus from animals to humans. Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks. There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks. A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world. Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years. The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission. more
Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this ... more
This publication is designed to be used by programme planners and managers as a resource when designing interventions to integrate postpartum family planning into national and subnational strategies... more
The aim of this document is to provide interim guidance for interventions to reduce the risk of maternal Zika virus infection and to manage potenti... more
Each year, about 210 million women become pregnant and about 140 million newborn babies are delivered. The sheer scale of maternal health issues makes maternal well being and survival vital concerns. A decade after The Lancet published a Series on maternal survival, a new Series of six papers brings... more
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 barriers created by... more
Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan. Method: This was a mixed- methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) f... more
The COPSI project is divided into three phases: the first in which the intervention is developed, the second in which researchers evaluate the intervention in a randomised controlled trial, and the final one in which the results of the trial are analysed and disseminated. A COPSI resource kit has ... more
Nested case-control study of health workers exposed to confirmed COVID-19 patients. Similar objectives to the cohort study but case-control studies may be cheaper and provide robust evidence ... characterize and assess the risk factors for SARS-CoV-2 infection in health workers exposed to COVID-19 patients. Health workers with confirmed COVID-19 will be recruited as cases and other health workers in the same health care setting without infection will be recruited as controls (incidence density sampling). Secondary objectives are similar to the cohort study. more
Nutrition training of health and agriculture workers can help to reduce child undernutrition. Specifically, trained health extension workers cancontribute through frequent nutrition counselling of care... more
The purpose of the review was to assign a cause of death, to ascertain the fac-tors that contributed to the death and ... identify any systemic issues that could be addressed to prevent future similar deaths. The perinatal mortality audit process in 2019 provided important insights and evidence-based recommendations that can be used both to address system errors and barriers and to identify and praise points of strength. The aim is to pro-vide recommendations for better care for mothers and their infants during pregnancy, childbirth and the neonatal period and improve the quality of care provided throughout the health system. more