This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th...e health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
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Antimicrobial resistance (AMR) has emerged as a major public health problem all over the world. Infections caused by resistant microbes fail to respond to treatment, resulting in prolonged illness and greater risk of death. This document focuses on the mechanism to develop a practically applicable h...ospital antibiotic policy and standard treatment guidelines (STG). In addition, the document contains information on various effective strategies for implementation of STG. It also discusses various activities and information required for the development of the antibiogram, antibiotic policy and standard treatment guidelines, such as surveillance programmes, the cause and controlling strategies for AMR and HAI; performance measures of antibiogram, antibiotic policy and standard treatment guidelines. A model hospital STG for community-acquired pneumonia in adults is included.
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BMC Infectious Diseases (2019) 19:832
Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using
praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children
and does not include neither adult individuals nor... other public health measures. The Ijinga schistosomiasis project
examines the impact of an intensified treatment protocol with praziquantel MDA in combination with additional
public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly
endemic African setting using an integrated community-based approach.
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Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc...ular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to tho...se directly providing care to pregnant women and preterm infants, such as obstetricians, paediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth.
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Les conflits et les guerres ont des effets catastrophiques sur la santé et le bien-être des nations, et ils ont considérablement évolué au cours des dernières décennies. Avec la forte augmentation des crises humanitaires, y compris de la violence urbaine, de plus en plus de gens sont touchés... pendant des périodes plus longues par des interruptions des services élémentaires, devenues une triste réalité.
Les interventions sanitaires et les approches novatrices face aux défis que posent les
crises humanitaires peuvent sauver des vies et atténuer les conséquences des conflits
pour les civils.
Les équipes médicales qui interviennent lors de conflits armés et dans d’autres
environnements dangereux sont fréquemment confrontées à de graves menaces pour
leur sécurité et leur sûreté. Elles doivent surmonter ces difficultés pour avoir accès
aux patients, d’autant plus qu’elles se heurtent parfois à la réticence des populations
auprès desquelles elles interviennent et qui sont parties au conflit.
Une riposte médicale fondée sur des principes se compose d’interventions cliniques
et opérationnelles inspirées et respectueuses de normes fondamentales, qui mettent
l’accent sur la qualité, la sécurité et la protection dans l’intérêt des patients.
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UNCTAD has prepared a rapid assessment of the impact of war in Ukraine on trade and development, and interrelated issues in the areas of finance, technology, investment and sustainable development.
The results confirm a rapidly worsening outlook for the world economy, underpinned by rising food, fu...el and fertilizer prices, heightened financial volatility, sustainable development divestment, complex global supply chain reconfigurations and mounting trade costs.
This rapidly evolving situation is alarming for developing countries, and especially for African and least developed countries, some of which are particularly exposed to the war in Ukraine and its effect on trade costs, commodity prices and financial markets.
The risk of civil unrest, food shortages and inflation-induced recessions cannot be discounted, particularly given the fragile state of the global economy and the developing world as a result of the COVID-19 (coronavirus disease) pandemic.
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This publication describes an arduous campaign to tackle the use of antimicrobials - specifically antibiotics - in the Danish swine-producing sector thanks to the collaboration between the regulatory sector within the Ministry of Environment and Food, private veterinary practitioners and swine produ...cers. The document is a retrospective tribute to all those who had the foresight to make significant changes to ensure consumer protection - improving hygiene at primary sites, developing options for intervention, identifying sites for intervention, setting targets, restructuring the relationship between the veterinary services and farmers, and implementing changes in behaviour for greatest impact
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Ce document fournit des orientations provisoires sur la qualité, les caractéristiques de performance et les normes connexes des équipements de protection individuelle (EPI) à utiliser dans le contexte de COVID-19. Il s'agit notamment des dispositifs médicaux prioritaires de l'OMS, à savoir : l...es masques chirurgicaux, les masques non chirurgicaux, les gants, les lunettes de protection, les écrans faciaux, les blouses et les masques N95. Il est destiné aux organismes d'approvisionnement, aux services de santé au travail, aux services ou points focaux de prévention et de contrôle des infections, aux administrateurs d'établissements de santé, aux ingénieurs biomédicaux et des matériaux, aux fabricants d'EPI et aux autorités de santé publique, tant au niveau national qu'au niveau des établissements.
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August 2020.
In December 2018, the President launched the UHC pilot covering four strategically selected counties-Isiolo, Kisumu, Machakos and Nyeri. It isplanned that by the year 2022, all persons in Kenya will be able to use the essential services they need for their health... and wellbeing through a single unified benefit package, without the risk of financial catastrophe. Essential health products are considered an integral part of UHC andare an indispensable element for delivery ofservices andare also a requirement for qualitycare. Despite this realization, a review of the UHC pilot in September 2019 established that whereas the Kenya Medical Supplies Authority (KEMSA) was able to fill up to 80% of pharmaceutical items, the order fill rate for medical supplies was less than 50%for level 2 and 3 facilities and as low as 30%for level 4 and 5 facilities.
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Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States dollars (USD) 12.7 billion, representing 108% of the ...country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
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Le développement des peuples, tout particulièrement de ceux qui s'efforcent d'échapper à la faim, a la misère, auxmaladie endémiques, à l'ignorance; qui cherchent une participation plus large aux fruits de la civilisation, une mise envaleur plus active de leurs qualités humaines; qui s'orien...tent avec décision vers leur plein épanouissement, est considéréavec attention par l'Eglise. Au lendemain du deuxième Concile œcuménique du Vatican, une prise de consciencerenouvelée des exigences du message évangélique lui fait un devoir de se mettre au service des hommes pour les aiderà saisir toutes les dimensions de ce grave problème et pour les convaincre de l'urgence d'une action solidaire en cetournant décisif de l'histoire de l'humanité.
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These guidelines were written for anyone trying to meet and solve the challenges of operating a warehouse today. They are an important reference tool for managers and staff, whether they are constructing a new warehouse, implementing a new warehouse system, or redesigning their current system.
G...uidelines for Warehousing Health Commodities is for use by supply chain managers, logistics advisors, and warehouse managers who want to improve and increase efficiency in their current health commodity warehouse.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov...ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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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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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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Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak health systems and poor infrastructure. Low-carbon appro...ach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons ...in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change. ...Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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