Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. ...Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
more
DHS Working Papers No. 69
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant economic change in India. The main predictor is a new... measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level.
more
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
more
A key purpose of the Recovery Toolkit is to support countries in the reactivation of health services which may have suffered as a result of the emergency. These services include ongoing programmes such as immunization and vaccinations, maternal and child health services, and noncommunicable diseases....
more
Cases of monkeypox (MPX) acquired in the EU have recently been reported in nine EU Member States (Austria, Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the Netherlands).
Monkeypox (MPX) does not spread easily between people. Human-to-human transmission occurs through close contact ...with infectious material from skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites. The predominance, in the current outbreak, of diagnosed human MPX cases among men having sex with men (MSM), and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse
more
DHS Working Paper No. 136
A total of 1,222 children age 6-23 months were included in this analysis. Twenty percent of children were stunted and 43% were moderately anemic. Regarding IYCF practices, only 16% of children received a minimum acceptable diet, 25% received diverse food groups, 58% were... fed with minimum meal frequency, 85% currently breastfed, and 59% consumed iron-rich foods. Breastfeeding reduced the odds of being stunted. By background characteristics, male sex, perceived small birth size, children of short stature, and children of working mother were significant predictors of stunting. Iron-rich food consumption was inversely associated with moderate anemia. Among covariates, male sex and maternal anemia were also significant predictors of moderate anemia among children age 6-23 months.
The study concluded that stunting and anemia among young children in Myanmar are major public health challenges that need urgent action.
more
Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i...s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
more
Despite the significant role of vector control in national leishmaniasis control programmes, the programmatic community perceives vector control as the weakest component of leishmaniasis control strategies in terms of resources, scientific evidence of the usefulness of interventions and capacity for... quality-assured implementation. Therefore, the main objective of this manual is to provide practical tools, techniques and procedures to strengthen sand fly control and surveillance in order to improve implementation of leishmaniasis control programmes. The manual provides a rationale for programme managers in different geographical regions on the types of vector control interventions to be used in different epidemiological and environmental settings and also how to measure their impact.
more
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.
more
These consolidated guidelines on HIV testing services (HTS) bring together existing and new guidance on HTS across different settings and populations.
The World Health Organization (WHO) first released consolidated guidelines on HTS in 2015, in response to requests from Member States, national pr...ogramme managers and health workers for support to achieve the United Nations (UN) 90–90–90 global HIV targets – and specifically the first target of diagnosing 90% of all people with HIV. In 2016, based on new evidence, WHO released a supplement to address important new HIV testing approaches – HIV self-testing (HIVST) and provider-assisted referral.
Since the release of 2015 and 2016 HTS guidelines, new issues and more evidence have emerged. To address this, WHO has updated guidance on HIV testing services. In this guideline, WHO updates recommendation on HIVST and provides new recommendations on social network-based HIV testing approaches and western blotting (see box, next page). This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030.
These guidelines also provide operational guidance on HTS demand creation and messaging; implementation considerations for priority populations; HIV testing strategies for diagnosis HIV; optimizing the use of dual HIV/syphilis rapid diagnostic tests; and considerations for strategic planning and rationalizing resources such as optimal time points for maternal retesting
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
This Rapid Advice Guideline updates the Interim Guidance on the “Assessment of infants with microcephaly in the context of Zika virus” published in February 2016 (WHO/ZIKV/MOC/16.3). The recommendations provides guidance on the screening, clinical assessment, neuroimaging, laboratory investigati...on and follow-up of children born to women living in areas of Zika virus transmission. The Guideline summarises the evidence base and rationale in support of the recommendations and expands the scope to address complications beyond microcephaly and what is now referred to as the congenital Zika virus syndrome
more
Co-trimoxazole is a fixed-dose combination of two antimicrobial drugs (sulfamethoxazole and trimethoprim) that covers a variety of bacterial, fungal and protozoan infections. Co-trimoxazole preventive therapy is a feasible, well tolerated and inexpensive intervention for people living with HIV to re...duce HIV-related morbidity and mortality. Further, co-trimoxazole is an off-patent drug and widely available in resource-limited settings.
more
Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a...nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
more
The purpose of this manual is to provide a resource for training to increase understanding of Health in All Policies (HiAP) by health and other professionals. It is anticipated that the material in this manual will form the basis of two- or three-day workshops, which will:
• Bu...ild capacity to promote, implement and evaluate HiAP;
• Encourage engagement and collaboration across sectors;
• Facilitate the exchange of experiences and lessons learned;
• Promote regional and global collaboration on HiAP; and
• Promote dissemination of skills to develop training courses for trainers.
more
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.
more
Vitamin A supplementation (VAS) programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA) reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but a...midst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD) data.
Article published in: Nutrients, 2017, 9, 190
https://doi.org/10.3390/nu9030190
more
The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra...nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
more
The WHO Global Health Estimates show that nearly half a million deaths (493 471) occurred in the WHO European Region due to violence and injuries in 2016. This represents a decline of 29% from 2000. Injuries account for 5.3% of all deaths and 9.6 of all years of life lost. They are a leading cause o...f death in people aged 15–29 years and the second leading cause of death for young people aged 5–14. The three leading causes of injury deaths are self-directed violence (141 089), falls (83 325) and road-traffic injuries (78 198). Inequalities in injury deaths exist in the Region, with mortality rates 2.4 times higher in males than in females and 1.5 times higher in middle-income compared to high-income countries.
more
One of the many gender inequities in the health and care workforce that COVID-19 has exposed is around the fit and design of Personal Protective Equipment (PPE). The rapid onset and scale of COVID-19 led to shortages of PPE in most countries, causing preventable infection and mortality among healthc...are workers and others on the front lines. Even though most health workers are women, manufacturing specifications for medical PPE are usually drawn up based on the male body and there have been many reports of PPE not designed for women's bodies.
more