Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majorit
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y, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally known as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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Gender-based violence is a life-threatening, global health and human rights issue that violates international human rights law and principles of ge
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nder equality. It is also a threat to lasting peace and an affront to our common humanity. United Nations Member States have called for urgent action to end GBV in emergencies, recognizing that in crises, the risk of GBV is heightened, particularly for women and adolescent girls.
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As part of our commitment to the fight against NCDs, Nigeria was signatory to the political declaration at the UN General Assembly High Level Meeting on NCDs in September 2011. Thus, the purpose of this document is to deve
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lop and ensure the implementation of policies and programmes that will engender and guarantee a healthy lifestyle and quality health for all Nigerians. The core sections include background, scope of the policy, policy goal, strategic thrusts for implementation, programme management and coordination, roles of stakeholders and partnership coordination. It is expected that with the adoption of this policy, the control and prevention of NCDs and their associated risk factors will be well integrated at all levels of government and health care delivery system in Nigeria. This policy document is therefore a stepping stone towards the development of guidelines for the prevention and management of NCDs.
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This article examines the activities of national and international actors in Pharmaceutical Services (PS) in Mozambique from 2007 to 2012, focusing on the public provision of HIV/Aids, malaria
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and tuberculosis medicines. It describes how PS functions in the country, what actors are involved in this area and the relations among them, pursuing salient issues in the modus operandi of partners in cooperation.
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Early detection, assessment and response to acute public health events:
The WHO Global Health Estimates show that nearly half a million deaths (493 471) occurred in the WHO European Region due to violence and injuries in 2016. This represents a decline of 29% from 2000. Injuries account for 5.3% of all deaths
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and 9.6 of all years of life lost. They are a leading cause of death in people aged 15–29 years and the second leading cause of death for young people aged 5–14. The three leading causes of injury deaths are self-directed violence (141 089), falls (83 325) and road-traffic injuries (78 198). Inequalities in injury deaths exist in the Region, with mortality rates 2.4 times higher in males than in females and 1.5 times higher in middle-income compared to high-income countries.
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ISN Public Affairs Kidney International Supplements (2020) 10, e19–e23
More than 700 000 people lose their life to suicide every year. A core foundation of suicide prevention is the timely registration and regular monitoring of suicide
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and self-harm. Surveillance data can be used to show important progress towards reaching global targets, such as reducing the suicide rate by one third by 2030 as articulated in the UN SDGs and in the WHO Mental Health Action Plan 2013-2030. However, there are considerable discrepancies in the quality of data on suicide and self-harm globally. The aim of this training manual is to equip fieldworkers and supervisors with the skills to collect and manage data on suicide and self-harm in the community via key informants, health-care facilities and police records. In doing so, the value and overall goal is to strengthen the surveillance of suicide and self-harm in communities, particularly in LMICs and hard-to-reach communities where CRVS systems are weak or absent.
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive prote
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ction for individuals across the lifespan. By adopting a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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Areas for action include: increasing prioritisation and awareness of dementia; reducing the risk of dementia; diagnosis, treatment and care; support for dementia carers; strengthening information sy
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stems for dementia; and research and innovation.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant b
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arriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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The COVID-19 pandemic has exposed the inadequacy of investments in public health, the persistence of profound economic and social inequalities and
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the fragility of many key global systems and approaches.
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In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twent
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y-one in-depth interviews with key stakeholders were also conducted along with a review of published and grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
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Policy Note: Thailand Health Systems in Transition
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the Civil Servant Medical Benefit Scheme (CSMBS) for civil servants
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and their dependents, Social Health Insurance (SHI) for formal sector employees, and the Universal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing.
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A framework to implement the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030
This guideline provides health policy-makers and decision-makers in health professional training institutions with advice on the rationale for health-care providers’ use of counselling skills to address sexual health concerns in a primary health c
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are setting
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The purpose of this interim guidance is to provide information and insight to assist public policy and
health system leaders in preparing for
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and responding to an MCE caused by terrorist use of explosives
(TUE). This document provides practical information to promote comprehensive mass casualty care
in the event of a TUE event and focuses on two areas:
1. leadership in preparing for and responding to a TUE event, and
2. effective care of patients in the prehospital and hospital environments during a TUE event.
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This Strategy and Plan of Action on Health Promotion within the Context of the Sustainable Development
Goals 2019-2030 seeks to renew health promotion (HP) through social, political,
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and technical actions,
addressing the social determinants of health (SDH), he conditions in which people are born, grow, live,
work, and age (1). It seeks to improve health and reduce health inequities within the framework of
the 2030 Agenda for Sustainable Development.
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Technical guidance.
This technical guidance aims to inform policy and practice development specifically related to improving the health of older refugees and migrants within the European Union
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and the larger WHO European Region. Both ageing and migration are in themselves complex multidimensional processes shaped by a range of factors at the micro, meso and macro levels over the life-course of the individual, but also with intertwined trajectories. Relevant areas for policy-making include healthy ageing over the life-course, supportive environments, people-centred health and long-term care services, and strengthening the evidence base and research
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Globally, it is estimated that 128.6 million people are currently in need of humanitarian assistance. Of these individuals, approximately one-fourth are women and girls of reproductive age. Although family planning is one of the most
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life-saving, empowering, and cost-effective interventions for women and girls, it remains an overwhelming gap in emergency responses due to a lack of prioritisation and funding. Consequently, many women and girls are forced to contend with an unmet need for family planning and unplanned pregnancies in addition to the traumas of conflict, disaster, and displacement.
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