A total of 18 laboratories from 13 countries participated in the four rounds of EQA: 10 laboratories from eight African endemic countries, four of which participated in all four rounds and three in three rounds. The overall results showed that the median performance of these laboratories improved ov...er the four rounds. However, the proportion of laboratories reporting false–positive cases remains high and indicates a problem of specificity probably due to contamination. The proportion of laboratories reporting both false–positive and false–negative results raises the issue of the quality of the data reported by WHO in Africa as well as the results of the studies carried out in these different laboratories in various countries.
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This document provides countries with recommendations for structuring a public health entomology laboratory ...box">network. The document will help countries to identify their areas of need and determine how the entomology network can be strengthened, especially in the context of a decentralized health system. The recommendations also consider the different degrees of development and different entomological research needed to support disease prevention and control activities.
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Due to the anticipated significant rise in VL testing occasioned by Ghana’s adaptation of 2016 ART guidelines, it has become necessary to develop this VL scale-up and operational plan to assure complete client access to laboratory monitoring towar...ds the achievement of the third 90 of the HIV care cascade. The plan will enhance VL testing, monitoring whilst improving the clinical and laboratory interface for improved client care.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia... is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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Policy Brief. 24 June 2022. This policy brief, one of two on the updated hepatitis C (HCV) guidelines, focuses on the new recommendations on simplified service delivery for a public ...ribute-to-highlight medbox">health approach to HCV testing, care and treatment. These recommendations include decentralization, integration and task-sharing, in addition to the use of point-of-care (POC) HCV viral load assays and reflex viral load testing.
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July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public ...ighlight medbox">health, rights-based and person-centred approach.
These guidelines bring in the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the method...s used, the context and policy motivations for developing EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced.
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This document aims to provide global guidance on poliomyelitis (polio) surveillance in the context of the COVID-19 pandemic. It comes as a technical complement to Polio eradication programme continuity, Immunization in the context of COVID-19 pandemic frequently asked questions, and is aligned with ...the Global Polio Eradication Initiative (GPEI) commitment to support the COVID-19 pandemic response.
It highlights the decision making framework to guide the level of polio surveillance activities at country level including; the measures to put in place to ensure a minimum level of polio surveillance in the field and in the laboratory, and the trigger to return to normal polio function.
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The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load (VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. Th...ese guidelines include laboratory design considerations, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.
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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing ...countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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The classification of digital health interventions (DHIs) categorizes the different ways in which digital and mobile technologies are being used to support health system needs. Historically, the di...verse communities working in digital health—including government stakeholders, technologists, clinicians, implementers, network operators, researchers, donors— have lacked a mutually understandable language with which to assess and articulate functionality. A shared and standardized vocabulary was recognized as necessary to identify gaps and duplication, evaluate effectiveness, and facilitate alignment across different digital health implementations. Targeted primarily at public health audiences, this Classification framework aims to promote an accessible and bridging language for health program planners to articulate functionalities of digital health implementations.
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Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent measles outbreaks which started in August 2021, and t...he highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
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This policy brief describes key HIV viral load thresholds and the available viral load testing approaches for monitoring how well antiretroviral therapy is working for people living with HIV. It provides clarification for and elaborates upon the current treatment monitoring algorithm from the Consol...idated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach.
This information can help people living with HIV to live healthy lives, ensure that HIV is not transmitted to other people and support policy-makers in determining the optimal allocation of resources for viral load testing and communicating the results.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and contro...l. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health...an> issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwide represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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