Health facilities in the Region of the Americas frequently suffer the effects of health emergencies and disasters, which jeopardize their ability to provide services to the population. The STAR-H methodology helps staff responsible for health emergency and disaster risk management to identify and as...sess risks as part of strategic planning to improve facility preparedness. It is intended to help them develop, with a multi-hazard approach, a response framework with operating procedures to deal with hazards of any type, scale, or frequency; determine roles and responsibilities; facilitate the effective use of resources; undertake strategic planning exercises, and improve the preparedness of facilities to effectively respond to and recover from impacts. This methodology is designed for use in health facilities of any size and capacity, and makes it possible to generate historical reports and national or subnational risk profiles. This information can be used to develop an effective health emergency and disaster risk management program.
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Sound periodic programme reviews provide opportunities for countries to objectively assess progress and take corrective action to sustain or get back on track towards achieving their medium and long-term programme goals. It reflects people’s diverse needs, enables efficient use of health system re...sources and improves the predictability, sustainability and transparency of the programmes.
This publication provides guidance to countries on how to perform programme reviews for HIV, viral hepatitis and sexually transmitted infections in this dynamic health sector context. The guidance encourages integrated reviews across health programmes for more efficient use of health system resources. The welfare of populations to be served must be at the centre of health programme reviews, with the overarching resolve to protect and promote health as a human right.
This guidance is intended for use by all national partners, including health ministries, related ministries, civil society, affected communities and other stakeholders, for participatory and evidence-informed programme reviews.
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Today, the World Health Organization (WHO) is advancing the global fight against acute malnutrition in children under 5 with the launch of its new guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition). This milestone is a crucial response to the persistent... global issue of acute malnutrition, which affects millions of children worldwide.
In 2015, the world committed to achieving the Sustainable Development Goals (SDGs), including the ambitious target of eliminating malnutrition in all of its forms by 2030. However, despite these commitments, the proportion of children with acute malnutrition has persisted at a worrying level, affecting an estimated 45 million children under five worldwide in 2022.
In 2022, approximately 7.3 million children received treatment for severe acute malnutrition (SAM). Although treatment coverage has increased, children with SAM in many of the worst affected countries are still unable to access the full necessary care for them to recover.
The Global Action Plan (GAP) on child wasting recognized the need for updated normative guidance to support governments in the prevention and management of acute malnutrition. WHO answered this call to action and developed a comprehensive guideline that provides evidence-based recommendations and good practice statements and will be followed by guidance and tools for implementation.
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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be...come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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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.
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Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr...oteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.
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ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del...ivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi...on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases..., injuries and risk factors in more than 200 countries and territories and at the subnational level in more than 20 countries. The GBD is now produced by an active collaboration of over 8,000 scientists and analysts from more than 150 countries. With each GBD iteration, the data, data processing and methods used for data synthesis have evolved, with the goal of enhancing transparency and comparability of measurements and communicating various sources of uncertainty. The GBD has many limitations, but it remains a dynamic, iterative and rigorous attempt to provide meaningful health measurement to a wide range of stakeholders.
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom...ote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID...-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
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Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a...ge of the population, an increase in obesity and also perhaps to increasing survival of those with diabetes.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca...ncer care services through regional collaboration and integrating NCD services in when responding to emergencies.
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The Global Status Report on Noncommunicable Diseases (NCDs) 2014 by the World Health Organization outlines the global impact of NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are responsible for a significant portion of global mortality, particular...ly in low- and middle-income countries.
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For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source... of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
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To maintain a structured and well-organized implementation plan it is important to have a lead agency or sector. The ministry of health or a similar authority in government will be critical in facilitating development and implementation of the multisectoral action plan.
This study compared clinical and autopsy findings for three asbestos-related diseases (asbestosis, mesothelioma and lung cancer) in former asbestos mineworkers, and explored factors that influenced agreement between clinical and autopsy findings using data from two compensation systems. In South Afr...ica, statutory compensation for occupational lung diseases in mineworkers makes provisions for autopsy examinations of the cardio-respiratory organs at the National Institute for Occupational Health (NIOH) in Johannesburg. In addition, the Johannesburg-based Asbestos Relief Trust and Kgalagadi Relief Trust (the “Trusts”) compensate individuals with defined asbestos-related diseases who worked in or lived near qualifying asbestos mining or processing operations. The Trusts also compensate dependents of deceased qualifying mineworkers and therefore encourage statutory autopsies for the detection of previously undiagnosed asbestos-related disease or disease that may have progressed to higher compensation grades.
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