Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t...he design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
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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.
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Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa...nded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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The document describes the use of strategic information at various stages of the response in the context of strengthening broader health information systems. Strategic information can be defined as data collected at all service delivery and administrative levels to inform policy and programme decisi...ons.
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Supplement
HIV testing services
December 2016
The Ministry of Health conducted STEPS surveys on adult risk factors surveillance in Myanmar in 2003, 2009 and 2014. Amongst these three surveys, the 2014 one is the most comprehensive, providing an analysis of all States and Regions within Myanmar through not only questionnaires and physical measur...ements – STEPs 1 and 2 of the survey – but also with data obtained through biochemical measurements (STEP 3).
The STEPS survey was initiated by the Ministry of Health in December 2014 with the technical support of WHO Headquarters, regional and country offices.
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The WHO Guidelines on physical activity and sedentary behaviour provide evidence-based public health recommendations for children, adolescents, adults and older adults on the amount of physical activity (frequency, intensity and duration) required to offer significant health benefits and mitigate he...alth risks. For the first time, recommendations are provided on the associations between sedentary behaviour and health outcomes, as well as for subpopulations, such as pregnant and postpartum women, and people living with chronic conditions or disability.
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The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly ... certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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The Polio Transition1
Monitoring and Evaluation (M&E) Framework was designed to monitor progress towards achieving the strategic and operational outcomes of the post-2023 Strategic Action Plan on Polio Transition (2018– 2023), as outlined in the Global Vision to use polio investments to build st...rong, resilient and equitable health systems (the Global Vision), and regional strategic plans for the WHO African, Eastern Mediterranean and SouthEast Asia Regions. It aims to support an efficient and effective polio transition process through both process and outcome-based monitoring. The M&E Framework promotes accountability and strives for a harmonized approach to monitoring and evaluating the polio transition at the country, regional and global levels
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The standards of care cover the routine care and management of complications occurring for women and their babies during labour, childbirth and the early postnatal period, including those of small babies during the first week of life. They define priorities for improving the quality of maternal and ...newborn care for use by planners, managers and health care providers
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African Journal of Laboratory Medicine | Vol 7, No 2 | a770 | 06 December 2018
The new WHO guidelines recommend that people living with HIV be started on antiretrovirals (ARVs) as soon as possible after being diagnosed. Currently, many people living with the virus globally must wait until their CD4 counts fall to 500 to start treatment. According to the WHO, the move to early ...treatment –or what some have dubbed the “test and treat” model –is backed by the latest research.
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For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max...imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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It highlights the numerous challenges to quality service provision, along with the organisation’s response to mental health needs, and recommendations for international and regional decision-makers including:
- Advocating and working towards mental health policies that support adequate funding f...or mental health care and government suppor
- Legislation to protect the rights of people with mental disorders and vulnerable communities
- Advocating for multi-year funding to support the sustainability of MHPSS programs
- Creating capacity building opportunities consistent with the IASC guidelines and supported with continuous supervision
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Rev Saude Publica. 2022; 56: 22.
Published online 2022 Apr 11. doi: 10.11606/s1518-8787.2022056004040
The aim of this guidance is to enhance the capacity of health care facilities to protect and improve the health of their target communities in an unstable and changing climate; and to empower health care facilities to be environmentally sustainable, by optimizing the use of resources and minimizing ...the release of waste into the environment. Climate resilient and environmentally sustainable health care facilities contribute to high quality of care and accessibility of services, and by helping reduce facility costs also ensure better affordability. They are, therefore, an important component of universal health coverage (UHC).
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Interim Guidance October 2022. This addendum addresses some of the methodological aspects of VE evaluations that have been learned during the past year, as well as those that have become relevant in the current epidemiological setting of the COVID-19 pandemic. For some of the COVID-19 vaccine method...ology issues there are still insufficient data to make a recommendation, in which case different options for approaching VE evaluations are presented.
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