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Integrated community case management (ICCM) – an approach where community-based health workers are trained to identify, treat and refer children under-five with pneumonia, diarrhoea and malaria – is increasingly being used across sub-Saharan Africa to supplement the gaps in basic healthcare prov
...
ision. ICCM programmes have been endorsed by major international organisations and donors, and many African Ministries of Health as a key strategy for reducing child mortality.
This learning paper describes Malaria Consortium’s approach to and experience of engaging local communities in integrated community case management (ICCM) in Uganda, Zambia and Mozambique.
more
The WHO Guide on Cholera Control in Complex Emergencies provides key steps for preparedness, prevention, and response to cholera and other diarrheal diseases in crisis situations. It highlights the importance of early warning systems, rapid response, and coordination among health agencies. The guide
...
outlines measures for case management, water sanitation, hygiene promotion, and outbreak containment, particularly in refugee camps and disaster-affected areas. It emphasizes community involvement, surveillance, and proper health infrastructure to reduce mortality and control disease spread in vulnerable populations.
more
Integrated Response Plan: Yemen Cholera Outbreak
recommended
The plan outlines emergency health, WASH and communications interventions to contain and prevent further spread of the outbreak in the 227 high risk districts, where suspected cholera cases were reported during the period October 2016 to May 2017. Health and WASH clusters will continually identify p
...
riority districts from at
high risk districts, by considering the number of caseload and attack rate. As of 15 May, 30 priority high risk districts (10 Governorates) that report over 100 or more suspected cholera cases have been identified.
more
The WHO Cholera Vaccine Position Paper (August 2017) highlights the importance of oral cholera vaccines (OCVs) as a key tool in outbreak response and prevention, alongside water, sanitation, and hygiene (WASH) measures. It recommends OCVs for high-risk populations, endemic areas, and humanitarian cr
...
ises, emphasizing their effectiveness in reducing cases and mortality. The paper discusses two types of OCVs (Dukoral®, Shanchol™, Euvichol®) and supports the WHO-managed vaccine stockpile for rapid deployment in cholera-prone regions.
more
The WHO South-East Asia (SEA) Region bears a high burden of tuberculosis (TB) and MDR-TB. In 2015, the Region accounted for nearly 200 000 or 35% of the global estimated new RR/MDR-TB cases eligible for treatment. Extensively drug-resistant TB (XDRTB) has also been reported from s
...
ix countries of the SEA Region. MDR-TB could potentially replace drug-susceptible TB, and constitutes a threat to global public health security. The South- East Asia Regional Response Framework for DR-TB 2017–2021 complements the Ending TB in the South-East Asia Region: Regional Strategic Plan 2016–2020” and outlines key strategies for reducing morbidity, mortality and transmission of DR-TB.
more
Blueprint for a Public Health and Safety Approach to Drug Policy
Tracy Pugh, Julie Netherland, Ruth Finkelstein
The New York Academy of Medicine, Drug Policy Alliance
(2013)
C2
"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re
...
lapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing."
more
The global burden of disease due to mental disorders continues to rise, especially in low- and middle-income countries (LMIC). In addition to causing a large proportion of morbidity, mental disorders – especially severe mental disorders (SMD) – are linked with poorer health outcomes and increase
...
d mortality. SMD are defined as a group of conditions that include moderate to severe depression, bipolar disorder, and schizophrenia and other psychotic disorders. People with SMD have a two to three times higher average mortality compared to the general population, which translates to a 10-20 year reduction in life expectancy. While people with SMD do have higher rates of death due to unnatural causes (accidents, homicide, or suicide) than the general population, the
majority of deaths amongst people with SMD are attributable to physical health conditions, both
non-communicable and communicable.
more
The Global Burden of Disease (GBD) study, a collaborative endeavour of the World
Health Organization (WHO), the World Bank and the Harvard School of Public Health,
drew the attention of the international health community to the burden of neurological
disorders and many other chronic conditions. T
...
his study found that the burden of neurological
disorders was seriously underestimated by traditional epidemiological and health
statistical methods that take into account only mortality rates but not disability rates. The
GBD study showed that over the years the global health impact of neurological disorders
had been underestimated.
more
This report aims to improve the assessment of mental health needs in the Americas by providing an updated and nuanced picture of: (a) the disability resulting from mental, substance use, and specific neurological disorders, plus self-harm, alone and in combination with premature
...
mortality; (b) the imbalance between mental health spending and its related disease burden; and (c) the inadequate allocation of the meager mental health spending by countries of the Region
more
As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In ad
...
dition, there is compelling evidence that antimicrobial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
more
Financing Global Health 2017: Funding Universal Health Coverage and the Unfinished HIV/AIDS Agenda
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2018)
C2
In 2017, $37.4 billion of development assistance was provided to low- and middleincome countries to maintain or improve health. This amount is down slightly compared to 2016, and since 2010, development assistance for health (DAH) has grown at an annualized
...
rate of 1.0%. While global development assistance for health has seemingly leveled off, global health spending continues to climb, outpacing economic growth in many countries. Total health spending for 2015, the most recent year for which data are available, was estimated to be $9.7 trillion (95% uncertainty interval: 9.7–9.8)*, up 4.7% (3.9–5.6) from the prior year, and accounted for 10% of the world’s total economy. With some sources of health spending growing and other types remaining steady, and with major variations in spending from country to country, it is more important than ever to understand where resources for health come from, where they go, and how they align with health needs. This information is critical for planning and is a necessary catalyst for change as we aim to close the gap on the unfinished agenda of the Millennium Development Goals (MDGs) and move forward toward universal health coverage (UHC) in the Sustainable Development Goals (SDGs) era.
more
Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f
...
or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
more
Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201
...
6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
more
This year’s MPI results show that more than two-thirds of the multidimensionally poor—886 millionpeople—live in middle-income countries. A further 440 million live in low-income countries. In both groups, data show, simple national averagescan hide enormous inequality inpatterns of povertywith
...
in countries. For instance, in Uganda 55 percentof the population experience multidimensional poverty—similartotheaverage in Sub-Saharan Africa. But Kampala, the capital city, has an MPI rate of sixpercent, whileinthe Karamojaregion, the MPI soars to 96 percent—meaningthat partsof Ugandaspan the extremes of Sub-Saharan Africa.There is even inequality under the same roof. In South Asia, for example, almost a quarter ofchildren under five live in households where at least one child in the household is malnourished but at least one child is not.
There is also inequality among the poor. Findings of the2019 global MPI paint a detailed picture of the many differences in how-and how deeply -people experience poverty. Deprivationsamong the poor varyenormously: in general, higher MPI valuesgo hand in hand with greater variationin the intensity of poverty. Results also show that children suffer poverty more intensely than adults and are more likely to be deprived in all 10 of the MPI indicators, lackingessentialssuch as clean water, sanitation, adequate nutrition or primary education
more
Zambia has about 1.2 physicians, nurses, and midwives per 1000 population while the minimum acceptable density threshold is 2.3 per 1000 population. The estimated shortage of doctors, nurses and midwives in Zambia is about 14,960. However, with the projected population growth the deficit more than d
...
oubles disproportionately to, 25,849 in 2020, and 46,549 in 2035, at the current rate of HRH production. Worryingly, the human resources for health crisis has persisted for over 20 years. The efforts before and leading up to the development and implementation of the 2013 – 2016 National Training Operational Plan (NTOP) and the National Human Resources for Health Strategic Plan (2011 – 2016) yielded certain achievements, however, the HRH numbers and skill-mix gap remained disturbingly enormous.
more
Maternal Mental Health and child health and development in low and middle income countries
recommended
The impact of maternal mental health problems on infants in high income countries has been identified mostly in terms of psychosocial and emotional development, thanks to the groundbreaking early work of Spitz (2) and of Bowlby (3), who studied the emotional needs of infants and mother-child attachm
...
ent. Subsequently, a large body of literature, also from HICs, documented the effects of maternal mental health on the child's psychological development (4), intellectual competence(5), psychosocial functioning (6) and rate of psychiatric morbidity (7, 8).
more
Needs and barriers for mental health and psychosocial support among syrian refugees in lebanon: perspectives for future interventions
European Union Civil protection and Humanitarian Aid
European Union Civil protection and Humanitarian Aid
(2018)
CC
Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ
...
ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
...
terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
Antibiotics have been useful in fighting infectious diseases in our country for decades, but because of the overuse and misuse of these agents, an increasing number of organisms are now resistant to them. The Philippines, like other Southeast Asian countries, has already been encountering the many c
...
hallenges of antimicrobial resistance (AMR) which include increasing social and economic costs and rising patient mortality. Although considered a global threat, it is already an emerging local health concern which calls for an urgent collaboration among different sectors to provide solutions addressing this growing problem.
more
Nearly 800 women die every day from preventable maternal causes, and in 2022 alone, an estimated 2.3 million newborns died. For every maternal death, countless more women endure life-altering injuries, infections, and disabilities related to childbirth.
Maternal deaths are concentrated in the poo
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rest regions and conflict-affected areas. In 2020, sub-Saharan Africa accounted for nearly 70% of all maternal deaths, with just 22 countries responsible for 81% of the global total. Humanitarian crises and fragile health systems exacerbate these challenges, with maternal mortality rates in crisis-affected areas often double the global average. The barriers to progress are multifaceted, including inadequate funding, poor-quality healthcare, harmful gender and social norms, and critical gaps in data and accountability.
more
