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The COVID-19 pandemic has had an unprecedented impact on health care systems that, in many instances, worsened the already existing assistance gaps. When it comes to Latin America and Central Americ
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a, this challenge adds to the consequences mass mobilizations have had in recent years, which have exceeded the national capacities to provide prompt assistance and social protection, particularly in the health care field. This pandemic has a direct impact on people on the move since the movement restriction policies and the lockdown and social distancing measures have reduced their ability to insert themselves into economic activities that were already precarious in many cases. Consequently, they have less access to food, housing, medicines and other essential consumer goods, and fewer possibilities of getting to their countries of destinati
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Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Understanding the magnitude of infertility is critical for developing
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appropriate interventions, for monitoring access to quality fertility care, and for mitigating risk factors for and consequences of infertility.
The objective of this report is to provide estimates of the global and regional prevalence of infertility by analyzing all relevant and representative studies from 1990 to 2021, taking into account different study approaches. This report also provides insight into how the estimation of infertility prevalence can be improved to obtain more reliable and actionable data. These estimates improve the understanding of the burden of infertility, and provide a basis for appropriate policies and services to achieve universal access to fertility care for all.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy
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2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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The 2022 report reviews the global malaria diagnostics market and technological landscape to support Unitaid’s 2023–2027 strategy for quality malaria case management. The report highlights the stalled progress of malaria control efforts, the gap
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s in access to diagnostics and the public health implications of P. falciparum HRP2/3 gene deletions, which compromise the accuracy of the widely used HRP2-detecting rapid diagnostic tests (RDTs). The report analyses the malaria RDT market, noting supplier diversification, price trends and production shifts resulting from the pandemic. It also addresses the emerging point-of-care G6PD testing market, which is required to ensure the safe radical cure of P. vivax infections. It surveys technological innovation, including digital microscopy, hemozoin tests, nucleic acid detection and biosensors, while emphasising that RDTs and microscopy will remain the mainstay of case management in the near term. The report identifies market shortcomings, access barriers and opportunities to improve malaria case management and diagnostic coverage.
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The Safe Delivery App is a smartphone application that provides skilled birth attendants with direct and instant access to evidence-based and up-to
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-date clinical guidelines on Basic Emergency Obstetric and Neonatal Care. The App leverages the growing ubiquity of mobile phones to provide life-saving information and guidance through easy-to-understand animated instruction videos, action cards and drug lists. It can serve as a training tool both in pre- and in-service training, and equips birth attendants even in the most remote areas with a powerful on-the-job reference tool.
Accessed 3rd April 2019
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Since the 1960s, the Tanzanian government has been striving to improve access to quality healthcare, including primary
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care. However, tuberculosis (TB) remains a significant public health concern, with an estimated prevalence rate of 528 cases per 100,000 people. However, currently, only 36% of TB cases are detected, leaving many undiagnosed within the community. Challenges include low community awareness, long distances to diagnostic centres and delayed health-seeking behaviour.
To address these issues, the Ministry of Health (MOHCDGEC) adopted the ENGAGE TB approach, involving NGOs, civil society organisations (CSOs) and other non-state actors in community-based TB activities. This has increased the number of active organisations from five to approximately twenty.
Building on this success, the Ministry has developed national operational guidelines for community-based TB, TB/HIV and drug-resistant TB interventions, with the aim of improving collaboration between communities and health facilities. These guidelines will be updated regularly, and stakeholders are urged to comply fully with them and support TB control efforts.
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The Knowledge Translation Unit is a group within the University of Cape Town’s Lung Institute and Department of Medicine who has worked on primary care programmes to strengthen provision of eviden
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ce-informed care in low-resources settings in South Africa, Ethiopia, Nigeria and Brazil for two decades. See here for more information. We are working around the clock to help health workers in these and similar settings to manage the COVID-19 pandemic. These can be accessed below. We are also working to expand these to support primary healthcare workers, patients and households. You can also access our free online training.
For purposes of assisting communities during the COVID-19 pandemic, we are making our COVID-19 and related materials freely available for others to use subject to some simple conditions.
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WASH FIT Digital is a free, open-access digital tool, based on the WASH FIT guide developed by WHO and UNICEF. WASH FIT is designed to help health care
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facilities improve quality of care through improved water, sanitation, and hygiene (WASH). Built on the mWater digital monitoring platform, WASH FIT Digital includes a set of forms for implementing a risk-based management approach developed by WHO and UNICEF. The site also includes a dashboard to visualize the process and keep track of progress
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Slum population in India is growing fast (25.1% decadal growth – Census 2011). Its health and nutrition indicators are worse than that of the non slum urban areas and comparable to that of rural India.
The National Urban Health Mission (HUHM), la
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unched in 2013, focuses on improving the health of urban slum population through a needs based, city-specific urban health care system that includes a revamped primary care system, targeted outreach, equitable access, and involvement of the community and urban local bodies (ULBs).
The HUHM recognizes that lack of disaggregated data collected at local and/or city level impedes efficient planning with focus on the urban poor, and that data availability is a critical need.
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The main objective of the health systems is to meet the health needs of the population in general, but for this the system must have adequate financing and supply support to cover the entire populat
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ion in question and check quality, efficiency, equity services, safety and sustainability. However, considering the segmented Peruvian health system, this makes it more deficient in comprehensive care for the population due to the duplication of functions, misuse of its resources, absence of complementary services. Due to the COVID-19 pandemic, this deficiency in the Peruvian health system became more evident owing to the high number of
deaths and its state of collapse, combining these factors this scope review aims to map the current state of the Peruvian health system, its structure, synthesize data on the performance of the health system (in terms of access, coverage and quality of health services) and identify the main public health policies available
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In 2018, approximately 60,000 Ugandans were estimated to be suffering from cancer. It was also reported that only 5% of cancer patients access cancer care
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and 77% present with late-stage cancer coupled with low level of cancer health literacy in the population despite a wide coverage of primary healthcare facilities in Uganda. We aimed to contribute to reducing the unmet needs of cancer prevention and early detection services in Uganda through capacity building.
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The ASEAN Mental Health Systems Report
catalogues the situation of mental health in ASEAN
Member States. This report provides comprehensive
information on the progress made so far by AMS in
integrating mental health into national health systems,
increasing
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access to care as well as challenges faced.
It also offers recommendations on how to improve the mental health system in
respective ASEAN Member States.
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his course provides an overview of the basic information relevant to FP programs and services, including rationale for voluntary FP, contraceptive method considerations, contraceptive options (including short-acting, long-acting, and permanent metho
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ds), and FP for clients with special needs. It also addresses quality of services and access to care, as well as contraceptive security. Finally, the course highlights key tools to facilitate service delivery, client counseling, and provider training.
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There are indigenous communities at high risk in every country of the region. At stake are the lives of 45 million people who belong to more than 800 indigenous peoples. Of these, some 100 are spread across several countries, around 200 maintain vol
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untary isolation or are in initial contact, and nearly 500 are at risk of disappearing due to their reduced numbers. Due to their lower immune resistance, their lack of access to hospital care and the increasing penetration of extractive activities in their territories, indigenous communities in voluntary isolation or in initial contact are cause for particular concern.
Far from hospitals and the news cameras, indigenous people in Latin American become ill and die without access to the means needed to protect themselves. They face the pandemic in conditions of social exclusion, racism and discrimination, which highlights historical inequalities and extreme precariousness in basic and health services.
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Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health
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care for all conditions. Maintaining essential health services: operational guidance for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges.
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Revised COVID-19 Testing Strategy
recommended
Second edition. June 2022. This revised guidance recommends that access to COVID-19 testing is decentralized as far as possible and made available at health facilities, and through the use of self t
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ests to enable access to care and the mitigation of transmission. Testing should be prioritized for high-risk and vulnerable individuals presenting with acute onset of respiratory illness so that those found to be infected can benefit from clinical care and access to COVID-19 therapeutics and vaccines
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Prompt, effective antimalarial treatment, and supportive care can substantially reduce the rate of mortality from severe malaria. However, many children in malaria-endemic countries do not have access
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to health facilities or a qualified health care provider and do not receive the necessary care in a timely fashion. Without rapid detection of danger signs and access to effective treatment, including pre-referral treatment that can be administered in the community level, many of these children with severe malaria die.
In situations where there is no immediate access to a health care facility, WHO recommends the administration of a standard dose of an effective antimalarial medicine as pre-referral treatment before referral to a facility at which complete treatment can be administered.
Rectal artesunate is the WHO-recommended pre-referral intervention in situations where artesunate injection are not feasible for children under the age of 6 years with suspected severe malaria. The intervention reduces the risk of death or permanent disability by up to 50% provided the child is referred to a health facility at which complete treatment can be administered.
This field guide is aimed at supporting the effective deployment of RAS as pre-referral treatment of suspected severe malaria in line with the WHO malaria guidelines.
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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Com
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plex emergencies are combinations of both manmade and natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues
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to be an important public health problem worldwide, particularly in poorly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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