Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
more
Case Studies on Building Resilience in the Horn of Africa
The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term...ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
more
PERC produces regional and member state situation analyses, updated regularly.
The joys and the hopes, the griefs and the anxieties of the men of this age are the joys and hopes, the griefs and anxieties of the followers of Christ. As a community composed of men, united in Christ, they are led by the Holy Spirit toward the Kingdom of their Father. They have welcome...d the news of salvation, meant for every man. This community realizes its link with mankindand its history by the deepest of bonds
more
The following technical report outlines the rationale, process and results of a joint research study, coordinated by the World Health Organization (WHO) and the Pan-American Health Organization (PAHO), co-chaired by the Ministry of Health and Social Protection and the Ministry of Environment and Sus...tainable Development in collaboration with the Climate and Climate Air Coalition, the Stockholm Environment Institute, the Clean Air Institute and leading international and national experts. A rationale section describes the links between greenhouse gas (GHG) emissions, short-lived climate pollutants, air pollution and adverse health outcomes. A summary of the research study describes how scenarios were modelled to examine the health and economic implications of raising ambition in Colombia’s Nationally Determined Contribution (NDC) to the United Nations Framework Convention on Climate Change (UNFCCC)
more
This note sets out actions to be undertaken throughout the humanitarian programme cycle (HPC) to fulfill commitments on Accountability to Affected Populations (AAP) and to ensure that protection is central to humanitarian response. It sets out the fundamental link between accountability systems and ...protection in humanitarian action, and then describes, for each stage of the HPC, the accountability mechanisms that should be established and actions required at country-level.
more
Disability at a Glance 2015 focuses on barriers to the employment of persons with disabilities in the Asia-Pacific region, and offers solutions to strengthen their employment prospects. Employment is not only the primary means of livelihood generation; it also provides individuals with the purpose a...nd meaning of playing a productive role in society. Equal access to employment is therefore vital, and barriers to work faced by persons with disabilities must be removed.
more
Participatory Learning and Action Planning; A Facilitator's Guide
abridged version, March 2021
he study highlights the impacts of COVID-19 on women and men as gleaned from research conducted during 2020, as well as the Computer Assisted Telephonic Interviews (CATI) Rapid Gender Assessments (RGAs) executed by UN Women, UNFPA and partners in seven countries in the ...East and Southern Africa region.
more
Working towards better COVID-19 outcomes in the WHO European Region.From the first COVID-19 cases in Europe reported on
24 January 2020, the pandemic reached 1 million cases
within 3 months, 10 million cases within 8 months, and
100 million cases in Europe alone within 2 years. Over
the course o...f its two years, COVID-19 has claimed over
1.6 million lives across Europe and Central Asia. The
World Health Organization (WHO) European Region has
accounted for close to a third of the cumulative global
COVID-19 cases and deaths.
more
In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a...nd grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
more
Le Burkina Faso est un pays sahélien sans littoral d’une superficie de 274 000 km2 et une
population estimée à 17,4 millions d’habitants en 2013 avec une croissance démographique de
3,1%. C’est l’un des pays les plus pauvres du monde avec un Produit intérieur brut par tête de
684 US...$ (Banque Mondiale, 2013), un indice de développement humain (IDH) de 0,388 et une
incidence de la pauvreté de 46,7% (INSD, 2009). Environ 80% de la population vit directement
ou indirectement de l’agriculture de subsistance au gré des aléas climatiques.
more