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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The report is geared towards mayors, local government officials and city policy planners.It highlights key areas where city leaders can tackle the drivers of NCDs, including tobacco use, air pollution, poor diets and lack of exercise, and improve road safety.
From anti-tobacco actions in Beijing a...nd Bogor, to road safety initiatives in Accra and Bangkok, a bike sharing scheme in Fortaleza, and actions to create walkable streets for seniors that have reduced elderly pedestrian deaths by 16% in New York City, the report aims to share knowledge between urban policy planners.
Of the 19 case studies cited, 15 are from developing countries, where 85% of premature adult deaths through NCDs take place, and over 90% of road traffic fatalities are recorded. You can download the case studieson the website https://www.who.int/ncds/publications/tackling-ncds-in-cities/en/.
Over 90% of future urban population growth will be in low or middle-income countries, and seven of the world’s 10 largest cities are in developing countries.
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Evaluating the Return on Investment of Scaling Up Treatment for Depression, Anxiety, and Psychosis
These guidelines for the prevention and management of cardiovascular diseases are a critical ingredient for streamlining care across the entire health services provision continuum. They are a strategic component in achieving universal health coverage, securing affordable heal...th care and improving the livelihood of all Kenyans which in turn will guarantee a healthy nation working towards sustainable development and prosperity.These guidelines bring to the fore the need for availability of skilled human resource, sustained adequate funding and partnership building at all levels of governance. It provides clear roles for health workers at the different levels of our devolved system which will ensure a harmonized referral system with basic cardiovascular diseases treatment services available closest to the people while decongesting the county and national referral facilities.
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The menu was developed using the WHO-CHOICE methodology to prepare and update, as appropriate, WHO estimates of the cost-effectiveness of a range of mental health interventions, in line with the development of Appendix 3 to the global action plan fo...r the prevention and control of noncommunicable diseases 2013–2020.
WHO-CHOICE is a programme that helps countries to identify priorities based on health impact and cost-effectiveness. It can be applied to a wide range of strategies relevant to policies affecting health outcomes. All options are compared to a common comparator, a null scenario in which the impacts of currently implemented interventions are removed, thereby enabling comparison of interventions across geographical areas and aspects of health.
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- A Skills Building Program for Clinicians and Non-Clinicians. Adherence guidelines- slide deck- training course for health providers
Este informe es el primero de la serie «Intención de pasar a la acción» de la OMS, cuyo objetivo es mejorar la limitada base de evidencia sobre la repercusión de la participación constructiva y abordar la falta de enfoques normalizados sobre cómo hacer operativa dicha participación. La serie... «Intención de pasar a la acción» pretende conseguirlo proporcionando una plataforma desde la que personas con experiencias vividas, y defensores de organizaciones e instituciones, puedan compartir soluciones, dificultades y prácticas prometedoras relacionadas con esta agenda transversal. Esta serie también tiene como objetivo proporcionar poderosas historias, inspiración y evidencia de cara a la Cuarta Reunión de Alto Nivel de las Naciones Unidas sobre las ENT que se celebrará en 2025, así como lograr los Objetivos de Desarrollo Sostenible (ODS) de las Naciones Unidas para 2030.
Para ello, este informe incluye seis estudios de casos procedentes de 12 personas con experiencias vividas de diversas dolencias. Se analizan temas como la dinámica del poder y la reorientación del poder hacia las personas con experiencias vividas; la toma de decisiones informada y la alfabetización sanitaria; la implicación de la comunidad en redes sanitarias y sistemas de salud más amplios; la experiencia vivida como evidencia y conocimientos; la exclusión y la importancia de implicar a los grupos que están marginados; y la promoción y los derechos humanos
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The Second Economic Development and Poverty Reduction Strategy (EDPRS 2) is a launch into the home straight of our Vision 2020. We are faced with new challenges of ensuring greater self-reliance and developing global competitiveness. Conscious of these challenges, we forge ahead knowing that by work...ing together, we always overcome. The EDPRS 2 period is the time when our private sector is expected to take the driving seat in economic growth and poverty reduction. Through this strategy we will focus government efforts on transforming the economy, the private sector and alleviating constraints to growth of investment. We will develop the appropriate skills and competencies to allow our people particularly the youth to become more productive and competitive to support our ambitions. We will also strengthen the platform for communities to engage decisively and to continue to develop home grown solutions that have been the bedrock of our success. These are fundamental principles as we work to improve the lives of all Rwandans in the face of an uncertain global economic environment.
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The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate management of diabetes into primary health care. It ...will serve as basis for development of simple algorithms for use by health care staff in primary care in low-resource settings, to reduce the risk of acute and chronic complications of diabetes. The guideline was developed by a group of external and WHO experts, following the WHO process of guideline development. GRADE methodology was used to assess the quality of evidence and decide the strength of the recommendations.
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The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate management of diabetes into primary health care. It ...will serve as basis for development of simple algorithms for use by health care staff in primary care in low-resource settings, to reduce the risk of acute and chronic complications of diabetes. The guideline was developed by a group of external and WHO experts, following the WHO process of guideline development. GRADE methodology was used to assess the quality of evidence and decide the strength of the recommendations.
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People with diabetes mellitus are at an increased risk for foot ulcerations as a result of poorly controlled blood glucose which may lead to gangrene. These patients are at a high risk for lower limb amputations, higher healthcare costs, and lower quality of life. This course aims to cover the preve...ntion of foot ulcers in persons with diabetes, classification of diabetic foot ulcers, diagnosis and treatment of foot infection in people with diabetes and interventions to enhance healing of foot ulcers.
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This course aims to provide information on the basic understanding of palliative care and the elements of service program for delivering palliative care. The course contents will also include the considerations in managing signs, symptoms and assessing the patient as well as communicating with the p...atient, family, and care giver, and the principles and management of respiratory, gastrointestinal, urogenital, nervous systems’ symptoms and conditions in palliative care.
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This guideline provides evidence-informed guidance on the use of non-sugar sweeteners to reduce the risk of unhealthy weight gain and diet-related noncommunicable diseases in adults and children. The guidance in this guideline is not based on toxicological assessments of the safety of individual no...n-sugar sweeteners and is therefore not intended to update or replace guidance on safe or maximal levels of intake established by the Joint Food and Agriculture Organization of the United Nations (FAO)/WHO Expert Committee on Food Additives (JECFA) or other authoritative bodies.
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The document provides Information on alcohol use (risk factors, evaluation alcohol use etc.) in a descriptive way.
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 societies and contacted international organizations.
Co...untry-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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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetr...ation. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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Research globally has shown that metered dose inhaler (MDI) technique is poor,
with patient education and regular demonstration critical in maintaining correct use of
inhalers. Patient information containing pictorial aids improves understanding of medicine
usage; however, manufacturer leaflets i...llustrating MDI use may not be easily understood by
low-literacy asthma patients.
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Significant progress has been made in the eradication of three priority diseases in the African Region, as a result of extensive collaboration between the Regional Office, WHO country offices and countries. For example, in August 2020, the region was certified free of wild poliovirus. In the area of... neglected tropical diseases, Guinea worm disease is on the verge of eradication, and 12 member states are within reach of being certified as having eradicated yaws by the end of this year.
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