Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WAS...H) services in all health care facilities. Such services are needed to provide quality care, ensure adherence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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Making the Case for Alcohol as a Public Health Threat in the Region. The purpose of this document is to explain the need for making alcohol a top public health priority in the region and the need fo...r national and regional action. Current evidence-based research shows that alcohol consumption and drinking patterns in the Americas are at damaging levels, with the region surpassing global averages for many alcohol related problems.
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Ce plan intégré de lutte contre les MNT au Burkina Faso tient compte dans une large mesure des résultats de cette enquête et des cibles principales du nouveau plan mondial de lutte contre les MN...T 2013-20201
. S’inscrivant dans la logique du PNDS, il s’est voulu multisectoriel et intègre trois principaux piliers de la stratégie mondiale de
lutte contre les maladies non transmissibles 2013-2020, à savoir la surveillance, la
prévention et la prestation de soins de santé dans le cadre de systèmes de santé.
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The availability of water, sanitation and hygiene (WASH) services in health care facilities, especially in maternity and primary-care settings where they are often absent, supports core aspects of quality, equity and dignity for all people. This doc...ument describes an approach for conducting a national situational analysis of water, sanitation and hygiene (WASH) as a basis for improving quality of care. This document describes the process from the initial preparatory stages, including triggers for action, through data collection and analysis to the dissemination of results. Each element of the approach is described and possible limitations and mechanisms to mitigate these are explored.
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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...an> average on all maternal health indicators in this 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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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and ...cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting.
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Current Environmental Health Reports volume 7, pages 363–370 (2020)
Climate change has direct impacts on human health, but those impacts vary widely by location. Local ...ighlight medbox">health impacts depend on a large number of factors including specific regional climate impacts, demographics and human vulnerabilities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches.
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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 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.
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This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards universal health coverage (UHC), ...o-highlight medbox">health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guidance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
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In many of Myanmar’s contested regions, healthcare services are provided through two parallel governance systems – by the government’s Ministry of Health, and by providers linked to ethnic armed organizations. Building upon efforts to build tr...ust between these two actors following ceasefires signed in 2011 and 2012, the new National League for Democracy-led government offers an unprecedented opportunity to increase cooperation between these systems and to ensure health services reach Myanmar’s most vulnerable populations.
The report provides an overview of existing health service arrangements in these areas, from both the Ministry of Health and from ethnic and community-based health organizations. It then unpacks the concept of “convergence”, highlighting key opportunities and policy recommendations for both government and non-government actors.
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The Venezuelan refugee and migrant crisis is one of the biggest external displacement crises in the world today. The COVID-19 pandemic has compounded an already desperate situation for many refugees and migrants, as well as their hosts, sorely testing heal...th and social welfare systems and the ability of countries to assist the vulnerable population.
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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors rema...in pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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Reducing the global suicide mortality rate by a third by 2030 is a target of both the UN Sustainable Development Goals and the WHO Global Mental Health Action Plan. However, an impediment to meeting... this goal is the fact that suicide and suicide attempts remain illegal in at least 23 countries worldwide. Decriminalization of suicide and suicide attempts represents one critical step governments can take in their efforts to prevent suicide. The WHO Policy Brief on the health aspects of decriminalization of suicide and suicide attempts cites data and research to make a case for decriminalizing suicide globally. It also includes case examples from countries that have recently decriminalized suicide and suicide attempts — Guyana and Pakistan, Singapore,— providing important insights to policy-makers, legislators, parliamentarians and other decision-makers.
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This document presents an integrated strategy for mental health system development that will lead to enhanced service delivery, improved outcomes, and improved human rights for people with mental disorders.
By using the practical guidance provid...ed in this document, countries can ensure that their mental health systems are not haphazard, but rather, the products of careful consideration and planning.
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Recommended actions at international and national levels
The health impact of radiological and nuclear emergencies can last for decades. Lessons learned from past radiological and nuclear accidents have demonstrated that the mental health and psychosocial... consequences can outweigh the direct physical health impacts of radiation exposure. International radiation emergency preparedness and response standards outline provisions for mitigating these effects. Yet, practical guidance for addressing the mental health and psychosocial aspects of radiation emergencies remains scarce.
This framework aims to promote integration between the MHPSS and radiation protection fields. It is intended for officials and specialists involved in radiation emergency planning and risk management as well as MHPSS experts working in health emergencies.
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This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) infants as the foundation for small and/or sick newborn care within maternal, newborn, and child ...ass="attribute-to-highlight medbox">health programmes, and spur collaborative global action. The document summarizes the background information, evidence, and rationale for making KMC available to every preterm or LBW newborn and seeks to galvanize the international maternal, newborn, and child health community and families to come together to support the implementation of KMC for all preterm or LBW infants to improve their and their mothers and families health and well-being.
This position paper is intended to be used by policy-makers (i.e. those responsible for national policy, guideline development and budget allocation), development partners, programme managers, health workforce leadership, practising clinicians, civil society leadership (e.g. parent and professional organizations) and researchers/research organizations involved in KMC implementation research.
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This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low- and middle-income countries, the report conclud...es that 38% lack access to even rudimentary levels of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
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The 2019 Humanitarian Response Plan (HRP) sets out the framework within which the humanitarian community will respond to the large-scale humanitarian and protection needs in Syria throughout 2019, on the basis of the prioritization undertaken across... and within sectors. The HRP, based on United Nations’ assessments and analysis, also presents urgent funding requirements to address these needs. It is anchored by three strategic objectives: saving lives and alleviating suffering, enhancing protection, and increasing resilience. These objectives are interlinked and achieving positive outcomes for affected people requires concerted action across all three.
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The Global Reference List of 100 Core Health Indicators is a standard set of core indicators prioritized by the global community to provide concise information on the health situation and trends, in...cluding responses at national and global levels.
This second (2018) edition builds on the previous work of the inter-agency working group that was commissioned by global health leaders to reduce reporting burden. The 2018 list of indicators contains modifications and additions to indicators and metadata elements to reflect the recommended health and health-related indicators of the Sustainable Development Goals, including universal health coverage.
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