Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i
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n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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This report has been developed, based on data provided by the TB & ORD surveillance system from across Rwanda. It provides a comprehensive picture of the occurrence and management of TB & ORD and Leprosy in Rwanda. It is structured based on the 2013-2018 Rwanda TB national strategic plan (2013-2018
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TB NSP) and on the 2014-2018 Rwanda Leprosy national strategic plan (2014-2018 Leprosy NSP).
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This report has been developed, based on data provided by the TB & ORD surveillance system from across Rwanda. It provides a comprehensive picture of the occurrence and management of TB & ORD and Leprosy in Rwanda. It is structured based on the 2013-2018 Rwanda TB national strategic plan (2013-2018
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TB NSP) and on the 2014-2018 Rwanda Leprosy national strategic plan (2014-2018 Leprosy NSP).
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For the Fiscal Year 2015-2016, the Health Sector continued to implement actions meant to improve the availability, and access to quality healthcare. The following report highlights achievements registered by the health sector for the fiscal 2015-2016 in different health programs, as well as in the a
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rea of health system strengthening.
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This report highlights key achievements registered by the Ministry of Health, affiliated institutions, implementing agencies both at central and decentralized levels in 2013-2014. Generally, the Health Sector accomplishments and programs routine data for 2013-2014 confirm that Rwanda maintains its p
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rogress towards the realization of health-related MDGs and national health targets as well.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem
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ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurr
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ing in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.
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The Newborn Situational Analysis reports of 2009 and 2011, as well as the “Bottleneck analysis on neonatal health” of 2013, culminated in the Nigeria launch of “Call to action on Newborn health” at the first National Newborn Health Conference in 2014. This call to action provided the framewo
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rk for the development of the Nigeria Every Newborn Action
Plan (NiENAP). The NiENAP lays out a vision to end preventable stillbirths and newborn deaths by accelerating progress and scaling up evidence- based high-impact and cost effective interventions. The plan is guided by the principles of country-leadership, integration, accountability, equity, human rights, innovation and research. This blue print outlines our commitment as government and stakeholders to repositioning newborn health as we implement approaches that impact on the lives of newborns for improved health outcome.
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The current SEARVAP (South-East Asia regional vaccine action plan) describes a set of regional goals and objectives for immunization and control of vaccine-preventable diseases for 2016 – 2020 and highlights priority actions, targets and indicators that address the specific needs and challenges of
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countries in the Region.
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The report aims to help policy-makers and programme managers identify the areas that need attention and to work towards effective implementation and enforcement of policies and legislations. The need for alcohol policy-specific infrastructures to support the alcohol policy process, including designa
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ted responsible agency, policy and strategy, and law and regulation, is also required at the country level.
The report is presented in three sections. Section 1 gives an insight to the alcohol consumption situation in the WHO South-East Asia Region and cites the alcohol-related problems that the Region is facing. Section 2 illustrates the policy situation in the 10 areas of national action identified in the Global Strategy to Reduce the Harmful Use of Alcohol and gives specific recommendations pertaining to these areas. Section 3 provides overall recommendations.
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The Asia Pacific Observatory on Health Systems and Policies is a collaborative partnership which supports and promotes evidence-based health policy making in the Asia Pacific Region. Based in WHO’s Regional Office for South-East Asia, it brings together governments, international agencies, foundat
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ions, civil society and the research community with the aim of linking systematic and scientific analysis of health systems in the Asia Pacific Region with the decision-makers who shape policy and practice.
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Polymerase Chain Reaction (PCR) has significantly helped in early diagnosis and commencement of specific interventions for diseases control. It also plays a critical role in understanding the disease epidemiology and unraveling the transmission dynamics of the disease. This manual intends to p
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rovide primary guidelines to assist health lab personnel in developing countries to establish a PCR diagnostic facility for efficient support to patient care as well as public health actions.
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The WHO South-East Asia (SEA) Region bears a high burden of tuberculosis (TB) and MDR-TB. In 2015, the Region accounted for nearly 200 000 or 35% of the global estimated new RR/MDR-TB cases eligible for treatment. Extensively drug-resistant TB (XDRTB) has also been reported from s
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ix countries of the SEA Region. MDR-TB could potentially replace drug-susceptible TB, and constitutes a threat to global public health security. The South- East Asia Regional Response Framework for DR-TB 2017–2021 complements the Ending TB in the South-East Asia Region: Regional Strategic Plan 2016–2020” and outlines key strategies for reducing morbidity, mortality and transmission of DR-TB.
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Report of a regional workshop, New Delhi, India, 29–30 September 2014
To reduce the burden of cardiovascular disease and its subsequent problems, the WHO Regional Office for South-East Asia organized a regional workshop on sodium intake and iodized salt for Member States in the South-East Asi
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a Region. The general objective of the workshop was to strengthen an integrated approach for sodium reduction and salt iodization programmes in the Member States of the Region. The specific objectives included reviewing the current sodium reduction and salt iodization strategies in the Member States of South-East Asia, provide training to the participants in standardized approaches for dietary estimation of salt/sodium and urinary iodine estimation.
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The purpose of this handbook is to provide guidance to Member States on the practical aspects of maintaining sanitary standards at international borders at ports, airports, and ground crossings (points of entry) as set out in the International Health Regulations (2005). It provides technical advice
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for developing a comprehensive programme for systematic monitoring of disease vectors and integrated vector control at points of entry. This includes standardizing procedures at points of entry and ensuring a sufficient monitoring and response capacity with the necessary infrastructure for surveillance and control of vectors. In addition, this handbook to serves as reference material for port health officers, regulators, port operators, and other competent authorities in charge of implementing the IHR (2005) at points of entry and on conveyances.
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This toolkit for integrated vector management (IVM) is designed to help national and regional programme managers coordinate across sectors to design and run large IVM programmes.
The toolkit provides the technical detail required to plan, implement, monitor and evaluate an IVM approach. IVM can
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be used when the aim is to control or eliminate vector-borne diseases and can also contribute to insecticide resistance management. This toolkit provides information on where vector-borne diseases are endemic and what interventions should be used, presenting case studies on IVM as well as relevant guidance documents for reference.
The diseases that are the focus of this toolkit are malaria, lymphatic filariasis, dengue, leishmaniasis, onchocerciasis, human African trypanosomiasis and schistosomiasis. It also includes information on other viral diseases (Rift Valley fever, West Nile fever, Chikungunya, yellow fever) and trachoma. If other vector-borne diseases appear in a country or area, vector control with an IVM approach should be adopted, as per national priorities.
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This year marked the beginning of the WHO biennium 2016-2017 action plan; this annual report highlights WHO’s key achievements in 2016
It also documents the extraordinary efforts by a broad coalition of government ministries, municipalities, international agencies, community groups, women’s or
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ganizations, religious and traditional leaders, media, private sector and donors towards restoration and improving health indicators.
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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
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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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