Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co...ncept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
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To understand the national situation, Ethiopia did a situation assessment, launched its first strategy in 2011, and took action to contain AMR, as detailed in the blue boxes found throughout this strategy. This updated version of the strategy was in response to the revised health and medicines polic...ies, health sector transformation plan, and the resolutions of the 68th World Health Assembly
of May 2015 and so that Ethiopia’s efforts could be coordinated with global initiatives in the prevention and containment of AMR.
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Together for One Health. Building on the momentum of increased collaboration, the WHO, FAO, OIE and UNEP have developed a Strategic Framework for collaboration on antimicrobial resistance (AMR). This Framework reflects the joint work of the four organizations to advance a One Health response to AMR ...at the global, regional and country level. It broadly supports the implementation of the five pillars of the Global Action Plan on AMR, as well as strengthening global AMR governance.
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The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respond to the health and well-being challenges, opportunities and needs of adolescents.
The guidance pro...vides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
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In 1998 the Swedish Veterinary Association decided to adopt a general policy for the use of antibiotics in animals. Since then specifi c policies for the use of antibiotics in dogs and cats have been adopted and in 2011 Guidelines for the use of Antibiotics in Production animals – Cattle and Pigs,... were accepted. By decision of the board of the Swedish Veterinary Society (SVS) these guidelines have been updated. Th e over-arching goal of SVS is to achieve a low and controlled use of antibiotics in Swedish animal production so that the fi rst-hand choices of treatment remain effi cient and that the spread of antimicrobial resistance – among animals and herds as well as in the food chain – is kept at a minimum. Keeping antimicrobial resistance in animals low is important also for human health, since we are all part of the same ecosystem. Th e authors of these guidelines hope that they may be useful for veteri-narians in clinical practice when deciding on treatments for common diseases and ailments caused by bacteria. Sometimes the decision may even be to refrain from use of antibiotics and chose other ways of improving herd health.
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7 June 2020 Version 1
Women in Myanmar have traditionally been underrepresented in public decision-making processes, a trend which is continuing in structures established to respond to COVID-19. This means that even as women are disproportionately affected by the crisis, they have less say in how t...heir communities and country respond to it, increasing the risk of a COVID-19 response that does not adequately address the needs and priorities of the most vulnerable women and girls.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Each unit builds on the one prior, and they all combine to provide key information for developing an SBCC strategy. It is not essential, however, to work through the I-Kit from start to finish. Users can choose to focus on specific aspects for which they need support in their emergency communication... response. The nine units and corresponding worksheets are outlined in the I-Kit Site Navigator.
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Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatment for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas..., the high burden of new N. gonorrhoeae infections (estimated at 11 million new cases a year), the complexity of the disease epidemiology, and in many countries the limited resources, make it difficult to fully understand the burden of disease and the burden of antimicrobial resistance (AMR) in N. gonorrhoeae.
PAHO has developed this document to facilitate the navigation of available guidance and recommendations for N. gonorrhoeae AMR surveillance by public health and health care professionals, at the national and subnational levels, involved in designing, implementing, and/or strengthening AMR surveillance of N. gonorrhoeae and overall surveillance of sexually transmitted infections.
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The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnan...cy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutrition in pregnancy.
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The risks of the use of nuclear, radiological, biological or chemical (NRBC) weapons are heterogeneous. Each risk has its own implications for developing and deploying any capacity to assist victims of an NRBC event and, in parallel, for the health and security of the people bringing this assistance.... At an international level, there are no plans for assisting the victims of an NRBC event which are both adequate and safe. Recognizing
the realities of the contexts associated with each risk throws up numerous challenges; such recognition is also a prerequisite for addressing these challenges. The realities that have to be considered relate to:
1. developing, acquiring, training for and planning an NRBC response capacity;
2. deploying a response capacity in an NRBC event;
3. the mandates and policies of international organizations pertaining to NRBC events. The challenges that will pose the greatest difficulty for a humanitarian organization are those for which the solutions are ‘non-buyable’ and which involve making extremely difficult decisions. Attempting to assist victims of an NRBC event without a reality-based approach might generate ineffective and unacceptably dangerous situations for those involved.
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical... conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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The National Strategic Plan is based on the following guiding principles:
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recognizes the cross cutting health and development needs o...f young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare.
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Mosby’s Pocket Guide to Nursing Skills and Procedures, eighth edition, is
a practical, portable reference for students and practitioners in the
clinical setting. Grouped alphabetically, 85 commonly performed skills
are presented in a clear, step-by-step format that includes:
■ Purpose for pe...rforming each skill
■ Guidelines to help students in delegating tasks to assistive
personnel
■ List of equipment required
■ Rationales to explain why specific techniques are used
■ Full-color photographs and drawings to provide visual
reinforcement
In addition, Safety Alerts are included in the skills to highlight important
information about patient safety and effective performance.
Current Standard Precautions guidelines from the Centers for Disease
Control and Prevention are incorporated throughout. Preprocedure
and postprocedure protocols are conveniently located on the inside
back cover.
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Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d...evelopment needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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Study Report August 2014
Curatio International Foundation (CIF) and the Association Tanadgoma would like to acknowledge the financial support provided by GFATM under the project “Establishment of evidence base for national HIV/AIDS program by strengthening of HIV/AIDS surveillance system in t...he country” (GEO-H-GPIC), which made this study possible.
The report was prepared by Dr. Ivdity Chikovani, Dr. Natia Shengelia, Lela Sulaberidze (CIF) and Nino Tsereteli (Tanadgoma).
Special thanks are extended to international consultants – Ali Mirzazadeh (MD, MPH, PhD Postdoctoral Scholar, University of California, San Francisco Institute for Health Policy Studies & Global Health Sciences) for his significant contribution in study preparation, protocol and questionnaire design and data analysis and Abu S. Abdul-Quader (PhD, Epidemiologist, Global AIDS Program Centers for Disease Control and Prevention) for his valuable input in refining methodology and overall guidance during the study implementation.
Special thanks are extended to international consultants – Abu S. Abdul-Quader (PhD, Epidemiologist, Global AIDS Program, Centers for Disease Control and Prevention) for his valuable input in refining methodology and overall guidance during the study implementation and Ali Mirzazadeh (MD, MPH, PhD Postdoctoral Scholar, University of California, San Francisco Institute for Health Policy Studies & Global Health Sciences) for his significant contribution in the NSU study preparation, protocol and questionnaire design and data analysis.
Authors appreciate a highly professional work of Tanadgoma staff: the survey coordinator KhatunaKhazhomia; the interviewers: Ketevan Tchelidze, Nino Kipiani, Koba Bitsadze, Kakhaber Akhvlediani, ZazaBabunashvili, Rati Tsintsadze and the social workers: Archil Rekhviashvili, Tea Chakhrakia, Irina Bregvadze, Kakhaber Kepuladze, Ketevan Jibladze and Shota Makharadze for their input in the recruitment process.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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This document outlines the working structure and guiding principles for collaboration of COVAX, the Vaccines pillar of the Access to COVID-19 Tools Accelerator (ACT-A). The working structure of COVAX continues to adapt to emerging needs and the changing trajectory of the pandemic. Some components of... the pandemic response capabilities united under COVAX may eventually be integrated into regional, national and sub national health systems, routine immunization programmes and future global pandemic preparedness and response (PPR) structures. Therefore, the working structures outlined in this document continue to evolve and the document provides a snapshot of the COVAX ways of working in the first half of 2022.
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From the start of the COVID-19 pandemic until August 2021, extreme weather events have affected at least 139.2 million people and killed at least 17,242 people in at least 433 unique events. These figures are certainly an underestimate, as they do not include estimates of numbers of people affected ...by extreme temperatures, or mortality during drought events.
One dimension of the compound risk of COVID-19 and climate extremes was the additional challenge of preparing for and responding to disasters during the pandemic, such as the constraints of physical distancing during evacuations and response operations.
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In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts to transform the health system. These changes should foster equitable and efficient expenditures and create or strengthen comprehensive integrated health systems with... a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
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