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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
...
patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
more
Global Development: Where Are We Now?
Today, we are facing a vital opportunity to change the profile of cardiovascular disease around the world.
The Millennium Development Goals (MDGs) are due to expire at the end of 2015, placing the cardiovascular heal
...
th community in a unique position to shape the priorities for the next development agenda, and save millions of lives.
Despite its devastating impact on people of all ages, genders and ethnicities, cardiovascular disease was excluded from the Millennium Development Goals (MDGs), which were announced by the United Nations in 2000. That oversight was far-reaching;
for well over a decade, non-communicable diseases were omitted from the global funding agenda and deprioritized by other mechanisms. During that period of muted government action, the prevalence and burden of non-communicable diseases increased in every region of the world.
Fifteen years later, as the successors to the MDGs are being negotiated, we are in a position to call for the prioritization of cardiovascular disease on the forthcoming global development agenda. Once we have ensured that CVD is recognised at the global policy level, our efforts will turn to encouraging governments to honour their commitments on
the prevention and control of CVD.
more
Clinical Spectrum of Schistosomiasis
Carbonell, C.; Rodríguz-Alonso, B.; López-Bernús, A.; et al.
MDPI Journal of Clinical Medicine
(2021)
CC
Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those wi
...
thin the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
more
BMJ Global Health2020;5:e002914. doi:10.1136/bmjgh-2020-002914
The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and in
...
fluenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider lessons for COVID-19. We show how models detach from their implementation contexts through their connections with global narratives of pandemic response, and how sociological and anthropological research can help to locate models differently. This potentiates multiple models of pandemic response attuned to their emerging situations in an iterative and adaptive science. We propose a more open approach to the modelling of pandemics which envisages the model as an intervention of deliberation in situations of evolving uncertainty. This challenges the ‘business-as-usual’ of evidence-based approaches in global health by accentuating all science, within and beyond pandemics, as ‘emergent’ and ‘adaptive’.
more
Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita
...
ble. We combined data from six Demographic and Health Surveys conducted in Senegal between 1992/93 and 2014. We examined FP trends over time among WRAU and subgroups, and trends in knowledge of FP and intention to use among women with unmet need for FP. Our results show that percent demand satisfied is lower among rural poor women and adolescents than WRAU, although higher among unmarried women. Marked recent increases have been observed in all subgroups, however fewer than 50% of women in need of FP use modern contraception in Senegal. Knowledge of FP has risen steadily among women with unmet need; however, intention to use FP has remained stable at around 40% since 2005 for all groups except unmarried women (75% of whom intend to use). Significant progress in meeting the need for FP has been achieved in Senegal, but more needs to be done particularly to improve acceptability of FP, and to strategically target interventions toward adolescents and rural poor women.
more
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
...
SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
more
(African Development Bank policy research document 1)
The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without ... health aid. It also presents a theoretical model of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
Between 2000 and 2014, malaria control efforts were scaled up and worldwide deaths were cut in half. But declining health aid and deprioritized vertical aid (as for malaria), despite its potentially great efficiency, have led to rising numbers of cases. In 2016, 216 million cases of malaria were reported, up from 211 million in 2015. Africa was home to 90% of all malaria cases and 91% of malaria deaths in 2016. Progress appears to have stalled in the global fight against the disease. more
The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without ... health aid. It also presents a theoretical model of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
Between 2000 and 2014, malaria control efforts were scaled up and worldwide deaths were cut in half. But declining health aid and deprioritized vertical aid (as for malaria), despite its potentially great efficiency, have led to rising numbers of cases. In 2016, 216 million cases of malaria were reported, up from 211 million in 2015. Africa was home to 90% of all malaria cases and 91% of malaria deaths in 2016. Progress appears to have stalled in the global fight against the disease. more
NUDOR’s first strategic plan (2010-2016) focused on establishing NUDOR as a viable, well-run organisation. Significant progress has been made towards these aims and therefore the strategy and has been reviewed by NUDOR board, secretariat and member organisations. The updated strategic plan now cov
...
ers the period 2015 – 2020 for which three strategic aims have been agreed.
1. Representation and accountability: NUDOR will be accountable to and effectively represent members’ interests through the delivery of projects and priorities agreed by member organisations, and by facilitating joint working amongst members.
2. Capacity building and resource mobilization: NUDOR and its member organisations are strengthened to fulfil its mandates by developing its technical skills, research and insight, sustainability and outreach.
3. Advocacy and influencing: NUDOR will work to ensure that the needs and rights of all persons with disabilities are recognised by all, mainstreamed in laws and policies at all levels of government, and in programmes of other institutions focusing on areas of education, health and poverty reduction.
more
This document presents the findings of the National Census of Persons with Disabilities in Rwanda. The preliminary result of this census has been used to produce a summary analysis of tables and figures. It shall be possible to derive basic socio-demographic indicators as well as to obtain the estim
...
ate of persons with disability in Rwanda, all of which shall serve as a reference to the categorization activity planned to be done in the near future by a medical committee from the Ministry of Health. The data of this report relate to (1) Persons with disability size for various administrative units (Districts and Provinces), (2) Distribution of Persons with disabilities by sex, age, marital status and type of disabilities.
more
Objective: The study aimed to describe the current epidemiological, clinical and immunological profile of newly
detected HIV - positive patients in Northern Benin by 2016. Methods: It was a prospective study conducted from May 2 to
October 31, 2016 on three main sites of
...
care of people living with HIV (PLHIV) in the department of Borgou in Benin. All
new cases of HIV infection have been systematically and comprehensively recruited. Initial epidemiological, clinical and
immunological data were collected using a questionnaire. These data were entered and analyzed using the Epi Info 7 software.
Results: In total, 185 adults (68 male and 117 female) newly screened HIV positive were included in this study. The middle age
was 36.2 ± 10.9 years and the sex ratio was 0.6 One hundred and thirty-five patients (73%) were between 25 and 50 years old.
In terms of the profession, 132 patients (71.3%) were engaged in liberal activities (craftmen, traders and retailers). The
majority was schooled (113 or 61.1%) and resided in urban areas (146 or 79%). One hundred and sixteen patients lived in
couple (62.7%) with an average monthly income estimated at 70 US Dollars. Clinically, 123 patients (66.5%) were in WHO
stage III. The body mass index was over 18.5 kg/m2 in 124 patients (67%). The median number of TCD4 lymphocytes was
254.5 cells/ml and 25 patients (13.5%) had a number of CD4 over 500 cells/ml. HIV1 was really predominant (97.8%). Most
patients (152 or 82.2%) had been screened for clinical suspicion. Conclusion: HIV infection in Benin remains the prerogative
of young, female, educated and poor people. Screening is delayed and hence the need to develop innovative strategies for early
more
In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
...
miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
more
Climate change presents the single biggest threat to human development, and its widespread impacts disproportionately burden the poorest and most vulnerable households in fragile and rural developing contexts – particularly women and children.
According to the Intergovernmental Panel on Climate C
...
hange’s (IPCC) latest report, ‘between 2010 and 2020, droughts, floods and storms killed 15 times as many people in highly vulnerable countries, particularly in Africa — which is responsible for less than 3 percent of global emissions – than in the wealthiest countries’.
Recognising environmental degradation and climate change are key accelerators of extreme child vulnerability, World Vision (WV) approved the Environmental Stewardship Management Policy (‘the Policy’) and Guidelines (‘the Guidelines’) in 2021.
To support the implementation of the Policy and Guidelines, WV has developed this Environmental Stewardship and Climate Action Handbook (‘the Handbook’) to help offices across the WV Partnership implement best practice environmental management strategies both in the field and in our operations and facilities.
Integrating environmental stewardship and climate action into all our work – whether that be in our Area Programmes, grant projects, responses to disasters or advocacy – is critical to achieving WV’s strategy.
As a Christian organisation we are compelled to follow the ways of Jesus Christ, calling us to care for the ‘least of these’ (Matthew 25:40) – the vulnerable children who are disproportionately impacted by climate change. Our response to the degradation of the environment is not motivated by political expediency or funding – but because we are called to steward God’s creation (Genesis 1:28).
more
Zero Draft for Consultation, 3rd Version, November 2015
In response to the urgent need for trained health professionals to assist in the efforts to contain the Ebola outbreak in West Africa, Médecins Sans Frontières has been running training sessions i
...
n Brussels for international aid workers before they depart for the field. Below are videos used to accompany the training sessions, helping to demonstrate infection control measures.
All videos are without sound to avoid language barriers. All videos are intended to be viewed in training sessions with an experienced Médecins Sans Frontières trainer
A free registration at vimeo is requested
more
In response to the urgent need for trained health professionals to assist in the efforts to contain the Ebola outbreak in West Africa, Médecins Sans Frontières has been running training sessions i
...
n Brussels for international aid workers before they depart for the field. Below are videos used to accompany the training sessions, helping to demonstrate infection control measures.All videos are without sound to avoid language barriers. All videos are intended to be viewed in training sessions with an experienced Médecins Sans Frontières trainer
more
Mental wellbeing does not mean being happy all the time and it does not mean you won’t experience negative or painful emotions, such as grief, loss, or failure, which are a part of normal life. However, whatever your age, mindfulness can help
you
...
lead a mentally healthier life and improve your wellbeing.
more
The Contingency Fund for Emergencies (CFE) provides WHO with rapid and flexible resources to respond to disease outbreaks and other health emergencies. The annual report provides an overview of the
...
use and impact of the Fund over the previous year.
more
Draft May 2011
The first ever nursing and midwifery services policy document in the history of MoPH was developed with the following aims:
1. Create a positive environment for Nursing and Midwifery Policy and Practice
2. Promote educa ... tion, training and career development for nurses and midwives.
3. Contribute to the strengthening of health systems and services
4. Monitor the development of nursing and midwifery professions and ensure their quality
5. Streamline Nursing and Midwifery Workforce Management
6. Develop Partnerships for Nursing and Midwifery Services more
The first ever nursing and midwifery services policy document in the history of MoPH was developed with the following aims:
1. Create a positive environment for Nursing and Midwifery Policy and Practice
2. Promote educa ... tion, training and career development for nurses and midwives.
3. Contribute to the strengthening of health systems and services
4. Monitor the development of nursing and midwifery professions and ensure their quality
5. Streamline Nursing and Midwifery Workforce Management
6. Develop Partnerships for Nursing and Midwifery Services more