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. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a
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nd 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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Antimicrobial agents play an indispensable role in animal health and welfare management. At the same time, the need for prudent use is obvious to ensure good food safety outcomes and to manage the potential risk of antimicrobial resistance. The emergence of multi-resistant bacteria is posing challen
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ges to health professionals and communities around the world for both human and animal health. These bacteria are not destroyed by the common antimicrobial agents and so pose a risk to people, particularly children, the elderly and those with poorly functioning immune systems, as well as to animals.
Throughout the years, the dairy sector has been very much aware of the need for responsible use and has, in many countries, implemented adequate measures throughout the dairy supply chain.
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The active participation and engagement of health and care workers (HCWs) in health emergency preparedness, readiness and response is crucial to support risk communication, community engagement and infodemic management (RCCE-IM) interventions during emergencies. HCWs hold unique position
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s in society – repeatedly being identified among the main influencers of people’s behaviours: they are one of the most trusted sources of health information and advice in communities and role models for the acceptance and uptake of protective measures during health emergencies. On the frontline, HCWs have valuable insights and knowledge that can be harnessed to support health emergencies across the entire emergency cycle. Between October and December 2023, the WHO Regional Office for Europe interviewed key informants on strategies and experiences to meaningfully engage HCWs during emergencies
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Traditional food markets play important economic, cultural, and social role and are sources of livelihood for millions of people in urban and rural areas. The manual Five keys for safer traditional food markets: risk mitigation in traditional food markets in the Asia-Pacific Region aims to support a
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nd guide local authorities, market community, and consumers to transform these markets into safer and healthier places through practical risk mitigation measures and community engagement strategies. The manual provides guidance on the implementation of five keys to promote public health and safety, particularly, in the context of food safety, zoonoses diseases, and infectious respiratory diseases.
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A practical handbook. This Health Cluster Guide (2nd edition, 2020) provides practical advice on how WHO, Health Cluster Coordinators and partners can work together during a humanitarian crisis to achieve the aims of reducing avoidable mortality, morbidity and disability, and restoring the delivery
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of and equitable access to preventive and curative health care.
It highlights key principles of humanitarian health action and how coordination and joint efforts among health and other sector actors can increase the effectiveness and efficiency of health interventions and promote better health outcomes. It draws on Inter-Agency Standing Committee and other expert guidance and includes lessons from field experience in acute and protracted crises.
The coordination principles and practice presented in Health Cluster Guide are equally valid for coordinators and members of health sector groups that seek to achieve effective health action in countries where the cluster approach has not been formally adopted.
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Antimicrobial resistance (AMR) has emerged as a major public health problem all over the world. Infections caused by resistant microbes fail to respond to treatment, resulting in prolonged illness and greater risk of death. This document focuses on the mechanism to develop a practically applicable h
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ospital antibiotic policy and standard treatment guidelines (STG). In addition, the document contains information on various effective strategies for implementation of STG. It also discusses various activities and information required for the development of the antibiogram, antibiotic policy and standard treatment guidelines, such as surveillance programmes, the cause and controlling strategies for AMR and HAI; performance measures of antibiogram, antibiotic policy and standard treatment guidelines. A model hospital STG for community-acquired pneumonia in adults is included.
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4th edition
The WHO Laboratory Biosafety Manual (LBM) has been in broad use at all levels of clinical and public health laboratories, and other biomedical sectors globally, serving as a de facto global standard that presents best practices and sets trends in biosafety.
LBM encouraged countries t
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o accept and implement basic concepts in biological safety and to develop national codes of practice for the safe handling of biological agents in laboratories within their geographical borders.
This fourth edition of the manual builds on the risk assessment framework introduced in the third edition. A thorough, evidence-based and transparent assessment of the risks allows safety measures to be balanced with the actual risk of working with biological agents on a case-by-case basis.
This novel evidence- and risk-based approach will allow optimised resource use and sustainable laboratory biosafety and biosecurity policies and practices that are relevant to their individual circumstances and priorities, enabling equitable access to clinical and public health laboratory tests and biomedical research opportunities without compromising safety.
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The Policy Guidelines and Service Standards for National Sexual and Reproductive Health Programme document outlines the steps on how to offer and deliver services. Improving quality of care is critical to improving clients' health status as well as increasing access to, and utilization of Sexual and
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Reproductive Health services. Service Standards and Guidelines are intended to be used by programme managers, implementers, trainers, surpervisors, and service providers as a tool for delivering quality care measures.
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The intent of these guidelines is to develop a holistic, coordinated, proactive and technology driven strategy for management of biological disasters through a culture of prevention, mitigation and preparedness to generate a prompt and effective response in the event of an emergency. Th
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e document contains comprehensive guidelines for preparedness activities, biosafety and biosecurity measures, capacity development, specialised health care and laboratory facilities, strengthening of the existing legislative/
regulatory framework, mental health support, response, rehabilitation and recovery, etc. It specifically lays down the approach for implementation of the guidelines by the central ministries/departments, states, districts and other stakeholders, in a time bound manner.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery
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of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop
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le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC.
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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the
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township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis.
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Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ
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ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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People living with HIV who have a low CD4 count are at a much higher risk of falling ill from TB infection than HIV negative people.
It is important to offer both HIV testing to TB patients and TB diagnosis in HIV patients. Early detection and effective treatment are essential to preventing TB
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-associated deaths.
WHO and UNAIDS have strongly advised countries to ensure that HIV programmes integrate regular TB screening, preventive therapy and early treatment.
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The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care services and systems to deliver integrated care in community settings and support the development of ICOPE implementation action plans. There are 19 actions needed to implement ICOP
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E on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state that efficiency measurement can be a substantial contribution to saving lives. Therefore we analyse the performance of health centres in rural Burkina F
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aso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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Coronavirus Disease-19 (COVID-19) was declared a global pandemic on 11 March 2020, and Malawi declared its first case on 2 April. As of 30 April, there were 36 confirmed positive cases of COVID-19 and 3 deaths. A State of Disaster was declared by President Arthur Peter Mutharika on 20 March and a 21
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-day lockdown was implemented from 18 April to 9 May. The lockdown measures include: bans on public gatherings; closure of schools; and bans on international flights and cross-border passenger buses.
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa
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cerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
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This manual presents a compelling case for action on carbapenem-resistant organisms (CROs) and describes the linkages between the prevention and control of CROs and the Global Action Plan on Antimicrobial Resistance (AMR). It describes how the eight recommendations contained within the World Health
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Organization (WHO) guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities relate to general measures (that is, the core components of infection prevention and control [IPC] programmes) that need to be in place in all countries and health care facilities to prevent and control health care-associated infections (HAIs). The use of a stepwise approach is proposed to support implementation and improvement, based on the evidence and experience of what has worked in several health care settings worldwide. The focus is on adoptable and adaptable information.
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Interim guidance. 12 May 2021. The Continuity of essential health services: Facility Assessment Tool can be used by countries to rapidly assess the capacity of health facilities to maintain the provision of essential health services during the COVID-19 pandemic. It can help to alert the authorities
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and other stakeholders about where service delivery and utilization may require modification and/or investment. This assessment tool covers the following aspects of essential health services:
health workforce (numbers, absences, COVID-19 infections, health workforce management, training and support);
financial management and barriers;
service delivery and utilization (facility closures, changes in service delivery, community communication campaigns, changes in service utilization and catch-up strategies);
IPC capacities (protocols, safety measures, guidelines and the availability of personal protective equipment (PPE) for staff);
availability of therapeutics, diagnostics and supplies, and vaccine readiness; and
provision of COVID-19 primary care services.
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