As of September 2022, just over one million forced
migrants from Ukraine have entered Germany, making Germany the third largest recipient of migrants
(Ukraine Refugee Situation, 2022).
As early as March 2022, several news outlets reported that accommodation centers were at or near
capacity in ma...ny German states and lacked the resources to quickly register new arrivals (Süddeutsche
Zeitung, 2022; Herz, 2022). Consequently, some states asked for the use of the Königstein Key —
an algorithm used to redistribute forced migrants to different states based on each state’s capacity.5
Depending on which state forced migrants arrive in or where they relocate to, their first stop is typically
a reception facility where they are able to register, begin the asylum application procedure, and access
support services
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The Quadripartite Organizations – the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Organisation for Animal Health (WOAH, founded as OIE), and the World Health Organization (WHO) – collaborate to drive the change and tra...nsformation required to mitigate the impact of current and future health challenges at the human–animal– plant–environment interface at global, regional and country level.
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This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A... comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain AMR. The system started with surveillance of AMR in bacteria causing common human infections and has expanded its scope to include surveillance... of antimicrobial consumption (AMC), invasive fungal infections, and a One Health surveillance model relevant to human health. To meet future challenges, it is in continuous evolution to enhance the quality and representativeness of data to inform the AMR burden accurately. As of the end of 2022, 127 countries, territories and areas participate in GLASS.
The fifth GLASS report, produced in collaboration with Member States, summarizes 2020 data on AMR rates in common bacteria from countries, territories, and areas. The report brings new features, including analyses of population testing coverage or AMR trends. For the first time, the report presents 2020 data on AMC at the national level. A new interactive dashboard allow users to explore AMR and AMC global data, country profiles and download the data.
This report marks the end of the early implementation phase of GLASS. In addition to presenting data collected through the latest data call, this report provides a summary of five years of national AMR surveillance data contributed to GLASS from its initiation, presents AMR findings in the context of progress of country participation in GLASS and in global AMR surveillance coverage and laboratory quality assurance systems at (sub)national level.
Patterns of antimicrobial consumption are presented by country with a particular focus on antibacterials. The report also presents the antimicrobial consumption according to the WHO AWaRe antibiotic classification, for penicillins and cephalosporines. From a One Health perspective, the report presents antimicrobial consumption data in the human sector expressed in tons to allow a comparison with antimicrobial consumption from other sectors (not included in this report).
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Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph ...of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
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WHO needs US$2.54 billion to provide life-saving assistance to millions of people around the world facing health emergencies. WHO’s Health Emergency Appeal is a consolidation of WHO’s priorities and financial requirements for 2023 to carry out health interventions in emergency and humanitarian r...esponses. The number of people in need of humanitarian relief has increased by almost a quarter compared to 2022, to a record 339 million. WHO is responding to an unprecedented number of intersecting health emergencies: climate change-related disasters such as flooding in Pakistan and food insecurity across the Sahel in the greater Horn of Africa; the war in Ukraine; and the health impact of conflict in Yemen, Afghanistan, Syria and north eastern Ethiopia – all of these emergencies overlapping with the health system disruptions caused by the COVID-19 pandemic and outbreaks of measles, cholera, and other killers. Contributions to the appeal can be fully flexible, flexible across a region, or flexible within a country appeal.
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Cholera which disproportionally impacts poor countries and the most vulnerable continues to affect at least 47 countries across the globe, resulting in an estimated 1.3 – 4 million cases, and 21,000 - 143,000 deaths per year worldwide. In Ethiopia, despite major improvements seen in the increasing... access to healthcare, clean water, and improvement in maternal and child health, the country continues to be significantly affected by cholera outbreaks. From 2015 – 2021 for example, several outbreaks of cholera have occurred in multiple parts of the country resulting in over 105,000 cases and thousands of deaths. Some of the risk factors associated with cholera in Ethiopia include inadequate access to clean water, practice of open defecation, poor household and environmental sanitation, unhygienic latrine and weak sanitation practise among communities.
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Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes.
Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by ...2030.
The United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) – comprising WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division (UNDESA/Population Division) has collaborated with external technical experts on a new round of estimates covering 2000 to 2020. The estimates represent the most up to date, internationally-comparable MMEIG estimates of maternal mortality, using refined input data and methods from previous rounds.
The report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
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An interregional meeting on leishmaniasis among neighbouring endemic
countries in the Eastern Mediterranean, African and European regions was organized by the World Health Organization (WHO) Regional Office for the Eastern
Mediterranean in Amman, Jordan, from 23 to 25 September 2018. The meeting w...as attended by representatives from the health ministries of Albania, Georgia, Greece, Iran (Islamic Republic of), Iraq, Jordan, Lebanon, Morocco, Pakistan, Saudi Arabia, Sudan, Syrian Arab Republic and Tunisia. Representatives from Afghanistan, Algeria and Libya were unable to attend. The Secretariat comprised staff from WHO headquarters, WHO regional offices in the Eastern Mediterranean, Africa and Europe, WHO country offices in Iraq, Pakistan, Syrian Arab Republic and Yemen, and WHO temporary advisors from Spain and Tunisia.
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Nigeria reported its first case of COVID-19 at the end of February 2020 and subsequently experienced
four waves, with peaks in June 2020 and January, August and December 2021. The COVID-19 pandemic
severely impacted the economy of Nigeria and caused disruption of health services nationwide. During... the crisis, many Nigerians failed to access routine health
services due to decreased income and lockdown
restrictions. The most significant service disruptions
were in maternal and newborn health, vaccination,
sick childcare, family planning and noncommunicable
disease treatment services (1). Pregnant women
were anxious about contracting COVID-19 during
2020, and as a result, many avoided attending health
facilities for antenatal (ANC) and postnatal care (PNC).
Disruptions in the medical supply chain and diversion
of resources to COVID-19 management impacted on
essential health services. Health workers were often
unable to go to work because of transport disruptions
or illness
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Since the beginning of the Ukraine crisis on 24 February 2022, WHO has supported Government-led efforts and initiatives alongside key partners on the ground. Building on efforts to date, and working alongside Bulgaria’s health authorities to bring added value to existing mechanisms, the WHO ...class="attribute-to-highlight medbox">Country Office Bulgaria, the WHO Regional Office for Europe and the WHO Health and Migration Programme, in close collaboration with the Ministry of Health of Bulgaria and key partners, undertook a joint review mission to support Bulgaria, with a focus on addressing the health system needs of refugees, migrants, asylum seekers and vulnerable host populations in Bulgaria.
The assessment team developed this report on the key findings and a package of potential interventions based on the opportunities identified and the need for technical support and assistance. The report summarizes concrete areas of work for which collaborations can be further strengthened. The joint review team identified key recommendations for consideration across 8 priority areas. The report and the outcomes of the review mission serve as a basis for future technical collaboration in the area of refugee health, to address the health needs of refugees and third-country nationals fleeing from Ukraine.
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The NDMS&IP focuses on mainstreaming disability to promote equitable access to services in the six thematic areas of health, education, livelihoods, empowerment, and social inclusion and cross-cutting issues.
The first part of the NDMS&IP outlines incongruences between national and sectoral policie...s and pieces of legislation on one hand, and practice on the other and identifies key priority areas/themes of the strategy,
medium-term outcomes and strategies for each identified priority area/ theme. This process is largely informed by key findings and recommendations from a study on the Situation of Persons with Disabilities
in Malawi (CBMM/NAD, 2011). The study provides background descriptive information on existing national and sectoral policy and legal framework, level of access by children, adult women and males with disabilities to services in the areas of education, health, livelihoods and other social services as well as of participation by persons with disabilities through self-representation in development activities at various levels. A review of relevant documents at the international level further describes the disability situation in Malawi in the global context.
The second part of the NDMS&IP consists of the operational matrix, (Annex 1), a monitoring and evaluation framework (Annex 2) and budget estimates (Annex 3). This part outlines specific actions by various actors both in the public, private and civil society sectors to prioritise disability in their routine policy, programming, resource mobilisation and allocation, monitoring, evaluation and reporting routines. The action plan lays out priority sectors and concrete actions by setting out implementation schedules, defining targets, assigning responsibility to key duty bearers and rights holders for coordination, decision-making, monitoring and reporting, mobilisation and allocation and control of resources.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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Glaucoma is a leading cause of irreversible blindness globally. In Malawi, glaucoma accounts for 15.8% of the blindness among people aged 50 years and above. Blindness from glaucoma is preventable with early detection and timely treatment. However, glaucoma management remains a challenge to eye care... providers due to its asymptomatic progression.
These guidelines inform eye care providers about the requirements for early detection of glaucoma, and the appropriate assessment and management of glaucoma patients. The guidelines also demonstrate the need for ophthalmologists to work with secondary-level eye care providers. With
glaucoma being a permanently blinding condition, it is vital to ensure that all eye care providers are adequately equipped with skills and resources for the early detection and management of glaucoma.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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It is impossible to address the many complex needs of respiratory virus surveillance with a single surveillance system. Multiple systems, investigations and studies must each be fit-for-purpose to specific priority surveillance objectives, and only together can they provide essential information to ...policy-makers. In essence, each surveillance approach fit together as “tiles in a mosaic” that provides a complete picture of respiratory viruses and the impact of associated illnesses and interventions at the country level. This mosaic framework demonstrates how surveillance approaches may be implemented as coordinated and collaborative systems, well-matched to specific priority objectives.
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Hand hygiene is vital for safe health care delivery, yet practices at the point of care remain suboptimal worldwide. A comprehensive research agenda is therefore necessary to improve our understanding of factors influencing hand hygiene behaviour and to strengthen appropriate interventions. This age...nda will provide insightful ideas for researchers to focus their projects and funding proposals and will direct donors towards the areas of hand hygiene evidence that require urgent support and innovation. It will also guide decision-makers and stakeholders at the national and international level and support country efforts in updating and strengthening hand hygiene promotion programmes. Global collaboration and investment in hand hygiene research remain essential to promote safe and effective care worldwide.
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The recurrence of severe climate events combined with economic, social, and institutional fragilities leave El Salvador in an utterly critical humanitarian situation and highly vulnerable. Located in a disaster-prone subregion, El Salvador is among the 20 countries at the highest risk of disasters w...orldwide. The successive hydrometeorological hazards that impacted El Salvador over the past two years include tropical storms Amanda and Cristóbal and hurricanes Eta, Iota, and,
more recently, Julia. These storms profoundly affected the lives and livelihoods of almost 900 000 people and significantly disrupted health services, especially at the first level of care. In addition, the country’s exposure to earthquakes, floods, and droughts is also constant. Infrastructural and institutional limitations to deal with emergencies and
low capacity to respond to adverse events are an additional challenge, which leaves the population—particularly the most vulnerable—at even higher risk.
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This topic brief highlights how nutrition and healthy diets support the achievement of education and learning objectives, and explains how intervention benefits can be amplified with a whole-school and systems approach. The recommended actions are informed by the Global Standards for health-promotin...g schools. This evidence-informed resource is intended for national education, health and associated sectors to support the strengthening of national school health programmes.
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