The 2020 recommendations for the programmatic management of TB preventive treatment are the first to be released under the rubric of WHO consolidated TB guidelines (Module 1 – Prevention). The WHO consolidated TB guidelines will gradually group all TB recommendations and will be complemented by ma...tching modules of a consolidated operational handbook. [1] The handbook will provide practical advice on how to put in place the recommendations at the scale needed to achieve national and global impact. The first handbook module in the series will be on the programmatic management of TB preventive treatment and will accompany the 2020 guidelines.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based ...approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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The Compendium of data and evidence-related tools for use in TB planning and programming was developed as a companion document to the People-centred framework for tuberculosis programme planning and prioritization – user guide, published by the World Health Organization (WHO)... in 2019. The compendium is intended to support implementation of the people-centred framework user guide. It can also be used independently to inform decisions taken by national tuberculosis (TB) programmes about the implementation of the tools included in this document.
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The marathon to eradicate polio is on its final lap: the world is more than 99% of the way to success. After millennia of living with poliovirus and suffering the paralysis it causes, today nearly all the world’s people live in polio-free countries; two of the three strains of wild poliovirus (WPV...) have been eradicated. Some 20 million people are walking who would have been paralysed had it not been for the efforts of national governments and health workers. If eradicating polio has been a marathon, the finishing line is in sight.
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Plus de 700 000 personnes perdent la vie par suicide chaque année. La réduction d’un tiers du taux mondial de mortalité par suicide d’ici à 2030 est à la fois un indicateur et une cible (la seule pour la santé mentale) dans les objectifs de développement durable des Nations Unies et dans ...le Plan d’action global de l’OMS pour la santé mentale 2013–2030. Le treizième programme général de travail 2019–2023 de l’OMS comprend le même indicateur avec une réduction de 15 % à l’horizon 2023.
Le monde n’est pas sur la bonne voie pour atteindre les cibles de la réduction du suicide fixées pour 2030. L’OMS encourage les pays à prendre des mesures pour prévenir le suicide, idéalement par le biais d’une stratégie nationale intégrée de prévention du suicide. Les gouvernements et les communautés peuvent contribuer à la prévention du suicide en mettant en œuvre l’approche LIVE LIFE de l’OMS, dont le but est de servir de base pour commencer la prévention du suicide, et dont ils peuvent s’inspirer pour élaborer une stratégie nationale intégrée de prévention du suicide. Le présent guide s’adresse à tous les pays, qu’ils disposent actuellement ou non d’une stratégie nationale de prévention du suicide.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –... are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi...ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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Las infecciones del sitio quirúrgico (ISQ) constituyen una de las Infecciones Asociadas al Cuidado de la Salud (IACS) más frecuentes que ponen en riesgo a los pacientes llevando muchas veces al fracaso del procedimiento quirúrgico. Con una incidencia mucho mayor en países de medianos y bajos ing...resos, representa un desafío de la práctica médica cotidiana que compromete la salud y la seguridad de los pacientes. La indicación de profilaxis primaria con antibióticos en relación a los procedimientos invasivos, tiene como objetivo disminuir la incidencia de infecciones con la consecuente disminución de la morbimortalidad debiendo utilizarse únicamente en aquellos procedimientos en los que hay evidencia de efectividad. Cabe destacar que la indicación inadecuada, tiene potenciales efectos adversos tales como infecciones por Clostridium difficile, emergencia de resistencia
bacteriana, reacciones adversas a drogas e incremento de los costos en salud.
La profilaxis antibiótica como complemento de una buena técnica quirúrgica, es una medida costo efectiva de prevención de las ISQ representando alrededor del 30% de la indicación de antibióticos entre los pacientes hospitalizados. Dado que en algunos estudios el uso inapropiado de antibióticos se ve reflejado en el 40 al
80% de las indicaciones médicas, desde la Comisión de Infecciones Asociadas al Cuidado de la Salud y Seguridad del Paciente de SADI hemos realizado una actualización de la evidencia disponible. Este documento es una acción complementaria al consenso “Prevención de Infección del Sitio Quirúrgico” realizado entre SADI y el Instituto Nacional de Epidemiología “J. Jara” durante el Congreso de SADI 2015.
La posibilidad de contar con una guía actualizada de profilaxis quirúrgica adaptada a nuestro medio, constituye una herramienta de uso cotidiano por parte de los profesionales del equipo quirúrgico que permite la optimización de la utilización de fármacos restringiendo así la emergencia y diseminación de la resistencia bacteriana. Sin duda esperamos que pueda ser de utilidad para el equipo de salud.
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El documento "Lista de productos sanitarios prioritarios para la respuesta a COVID-19 y especificaciones técnicas asociadas" complementa esta directriz.
Este documento proporciona una orientación provisional sobre la calidad, las características de rendimiento y las normas conexas de los equi...pos de protección personal (EPP) que se utilizarán en el contexto de COVID-19. Esto incluye los productos sanitarios prioritarios de la OMS, concretamente: mascarillas quirúrgicas, mascarillas no quirúrgicas, guantes, gafas, protectores faciales, batas y mascarillas N95. Está dirigido a los organismos de adquisición, los departamentos de salud laboral, los departamentos o puntos focales de prevención y control de infecciones, los administradores de los centros de salud, la ingeniería biomédica y de materiales, los fabricantes de EPI y las autoridades de salud pública, tanto a nivel nacional como de los centros.
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La presente guía tiene además como objetivo, ser un respaldo y no una camisa de fuerza para los médicos, pues pretendemos con ella proveer evidencia sólida respecto a los riesgos, beneficios o consecuencias que puede generar la toma de una decisión en pacientes con tuberculosis. Como lo propone... el Ministerio Nacional de Salud en sus normas técnicas, se busca un manejo integral del niño con tuberculosis pulmonar, asegurando la oportunidad, la eficiencia y la calidad de la atención.
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Las enfermedades no transmisibles (ENT) suelen ser condiciones de salud de larga duración, resultado de determinantes sociales, factores genéticos, fisiológicos, ambientales y conductuales. Debido a la adquisición de hábitos poco saludables y al importante cambio demográfico, que evidencia un ...incremento de la proporción de personas mayores, ha aumentado la prevalencia de ENT y el número de muertes que generan. Por esto, constituyen uno de los principales desafíos sanitarios
del siglo XXI, tanto en los países de mayores ingresos como en aquellos en vías de desarrollo, por su gran impacto a nivel individual, en los sistemas de salud y en la economía nacional.
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El resumen ejecutivo del Informe de la OMS sobre la situación mundial de la salud bucodental presenta una instantánea de los datos más recientes sobre las principales enfermedades bucodentales, los factores de riesgo, los retos para los sistemas de salud y las oportunidades de reforma. La clara c...onclusión del informe es que la situación de la salud bucodental a nivel mundial es alarmante y requiere una acción urgente. El informe servirá de referencia para los responsables de la formulación de políticas y permitirá a un amplio abanico de partes interesadas de diferentes sectores orientar su labor de promoción hacia una mejor priorización de la salud bucodental en los contextos mundial, regional y nacional. Además, el informe proporciona, como un recurso en línea separado, los primeros perfiles nacionales de salud bucodental para los 194 Estados Miembros de la OMS, lo que da una visión única de las áreas y los marcadores clave de la salud bucodental que son relevantes para los responsables de la adopción de decisiones.
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El proyecto “Abordar las Enfermedades Infecciosas Desatendidas (EID) y las arbovirosis en el Chaco Paraguayo” ejecutado en el period 2017-2018 en el Chaco paraguayo por el Ministerio de Salud Pública y Bienestar Social de Paraguay (MSPyBS) con la cooperación técnica de la Representación en e...l Paraguay de la Organización Panamericana de la Salud/ Organización Mundial de la Salud (OPS/OMS) tiene como propósito generar evidencias sobre la capacidad de respuesta del país en esta zona geográfica, a fin de que permita establecer estrategias e intervenciones para fortalecer las capacidades existentes y facilite la toma de acciones oportunas para la prevención, el control y/o eliminación de este conjunto de enfermedades a la luz de los compromisos enmarcados en los Objetivos de Desarrollo Sostenible 2030, la Política Nacional de Salud 2030 y el Plan Estratégico de la OPS/OMS 2014-2019. El proyecto pretende lograr la implementación de un ambicioso sistema de vigilancia integrada (vigilancia epidemiológica, vigilancia de laboratorio y vigilancia entomológica) que proporcione datos de manera oportuna y eficaz para hacer frente a las arbovirosis y a las EID endémicas, como son en Paraguay la enfermedad de Chagas, leishmaniosis, helmintiasis transmitidas por el suelo, teniasis/cisticercosis, la lepra y de forma estratégica se ha incluido al dengue.
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As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc...tion of safe and quality foods for our daily nourishment. Pests and disease epidemics negatively impact the quality, quantity and safety of our food sources, and cripple economic growth and efficiencies in production. Furthermore, the epidemic and endemic levels of the pathogens and disease vectors can be difficult to control. This is why FAO stresses and promotes the special efforts required for cost-effective preventive measures rather than the more expensive control, disinfestation, treatment and disposal measures. When preventive measures are late or difficult, preparedness and contingency plans must be in place to enable rapid response. Early warning systems, based on close monitoring, surveillance, and timely reporting are fundamental to warn and empower communities to safeguard their livelihoods and assets by enhancing disease and pest prevention measures and for government services to take immediate measures to protect communities and national economies.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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Atlas of African Health Statistics 2022: Health situation analysis of the WHO African Region
Since 2019, we have been implementing Phase 2 of the regional Transformation Agenda, which informs and aligns with the global WHO Transformation, to ensure WHO is accountable, driven by re- sults and provid...ing value for money in the pursuit of better health. Our global priority in this period is to contribute to delivering on the triple billion targets of expanding universal health coverage, protecting people from emergencies, and promoting health and well-being for people across the Region.
This year’s Atlas of African Health Statistics is being produced in the context of the COVID-19 pandemic that we have been expe- riencing for over two years. The ongoing coronavirus pandemic, together with other health emergencies in the WHO African Re- gion, is yet again testing the strength and resilience of our health systems. Indeed, the impact of COVID-19 is visible in the disruption of services. The report also presents the latest data for more than 50 health-related indicators of the Sustainable Development Goals and WHO’s “triple billion” targets and provides comprehensive country-level statistics using the results chain of the AFRO frame- work of actions for strengthening health systems to achieve UHC and the health-related SDGs.
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April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t...he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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This report seeks to uncover the extent to which global goals crowd in international financing, inform domestic policy priorities, and navigate progress toward development outcomes in low- and middle-income countries (LICs and MICs). Our report:
Provides a historical perspective on how ODA financin...g was aligned with the MDGs, and the perceived influence of global goals in shaping domestic priorities
Offers a baseline of ODA financing to the SDGs and a forward-looking perspective in translating past lessons learned from the MDGs era into actionable insights
Using a pilot methodology developed by AidData, we analyze ODA flows during the MDGs era (2000-2013) and approximate baseline financing for each goal prior to the adoption of Agenda 2030 in September 2015. The dataset used in the report, Financing to the SDGs, Version 1.0, provides project-level data on estimated Official Development Assistance (ODA) commitments to the 17 Sustainable Development Goals (SDGs) from 2000 to 2013. In this report, we also draw upon the responses of nearly 7,000 public, private, and civil society leaders from AidData’s novel 2014 Reform Efforts Survey to assess how national-level policymakers perceive the MDGs in light of their domestic reform priorities, and what this may mean for the SDGs.
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WHO/Europe has launched a new guide, providing support to countries on how to apply behavioural and cultural insights (BCI) for health. It presents a simple step-wise approach, complemented by a rich collection of detailed considerations, tools and exercises. The guide is the first of its kind, spec...ifically developed for use by public health professionals developing policies, services and communications informed by BCI across health topics.
Some of the most persistent public health challenges involve human behaviour. Using a BCI lens means that health policies, services and communications can be tailored to the needs and circumstances of people and communities, and thereby help combat these challenges. The new Tailoring Health Programmes (THP) guide describes how this can be done.
Building on several topic-specific guides that focused on applying BCI to routine and influenza vaccination and tackling antimicrobial resistance, as well as external evaluations and a rigorous peer-review process, this guide is the result of over a decade of work by WHO/Europe. The THP approach has already been adopted in over 20 countries and has received positive feedback from public health agencies.
“This guide is the culmination of a decade of work involving many colleagues at country, regional and global levels. The guide is our “BCI bible”, guiding our work with and in countries to help tackle persistent health challenges,” said Katrine Bach Habersaat, Regional Advisor for BCI at WHO/Europe.
Karina Godoy, Senior Analyst and National Focal Point for Behavioural Insights at the Public Health Agency of Sweden, who is employing the approach described in the guide across several health projects, comments: “The THP guide is easy to use and at the same time provides detailed guidance and inspiration where needed. We have decided to translate the document into Swedish and use the approach widely”.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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