En el análisis demográfico se calcularon tasas específicas por sexo y edad para el período respecto al cual se dispone de datos oficiales (1950-2013), de donde se derivó la estimación del índice de sobremortalidad
masculina, la importancia relativa de las defunciones causadas por accidentes... de tráfico con respecto al total de fallecimientos, las variaciones de cambio porcentual en el tiempo, los coeficientes de correlación de Pearson y las estimaciones a futuro (2017) de la tasa de mortalidad por accidentes de tráfico terrestre, así como una descripción y análisis detallado de gráficos que ilustran las variaciones temporales.
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La segunda década de la vida es un periodo de rápido desarrollo y cambio biológico, cognitivo, emocional y social. Durante la adolescencia, los individuos adquieren muchos de los recursos para mantener su salud y bienestar a lo largo de su vida. Invertir en la salud y el bienestar de los y las ad...olescentes ofrece tres ventajas: 1) adolescentes sanos hoy; 2) adultos sanos en el futuro; y 3) próximas generaciones saludables.
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Se espera que el Panorama 2020 ayude a visibilizar los desafíos de los territorios con peores indicadores en términos de alimentación y nutrición, y que sirva para movilizar el compromiso político y la atención pública en los lugares que sufren mayores rezagos respecto a los promedios naciona...les. Al igual que en ediciones anteriores, también se proporciona información sobre las políticas y los programas que los países están desarrollando para enfrentar todas las formas de malnutrición.
El año 2020 se recordará durante muchas décadas por la pandemia provocada por la COVID-19. Los indicadores de la Agenda 2030 que se utilizan en esta publicación aún no recogen los distintos impactos del nuevo coronavirus. Pero en cada uno de los capítulos y secciones que siguen se hace referencia a algunas de las posibles implicaciones de la pandemia para el futuro.
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El libro de cuentos, una secuela del inmensamente exitoso "Mi héroe eres tú: ¡cómo pueden los niños luchar contra el COVID-19!", Se lanzará en el segundo año de la pandemia del COVID-19. La nueva historia, dirigida principalmente a niños de 6 a 11 años, ve el regreso de Ario, una criatura d...e fantasía que viaja por el mundo ayudando a los niños a encontrar esperanza en el futuro y alegría en placeres simples. Junto con viejos y nuevos amigos, Ario aborda los miedos, frustraciones y preocupaciones que enfrentan los niños durante esta fase de la pandemia y explora con ellos los diversos mecanismos de afrontamiento que pueden utilizar cuando se enfrentan a emociones difíciles como el miedo, el dolor, la ira y la tristeza. A través de las voces de los niños que Ario conoce en sus viajes, el libro proporciona una ilustración vívida del impacto de COVID-19 en la salud mental y el bienestar de los niños.
El contenido del libro se basó en las respuestas de la encuesta de más de 5000 niños, padres, cuidadores y maestros de todo el mundo sobre los desafíos que continúan enfrentando en el segundo año de la pandemia.
Disponible en más idiomas
El libro -dirigido principalmente a niños de 6 a 11 años- es un proyecto del Grupo de Referencia del Comité Permanente entre Organismos sobre Salud Mental y Apoyo Psicosocial en Situaciones de Emergencia, una colaboración única de organismos de las Naciones Unidas, organizaciones no gubernamentales nacionales e internacionales y organismos internacionales que prestan servicios de salud mental y apoyo psicosocial en situaciones de emergencia.
Disponible en varios idiomas
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La Gobernabilidad/Gobernanza en Derechos de la Niñez (CRG) es una de cinco áreas temáticas
establecidas como tema global para implementar la estrategia hacia el 2030 de Save the Children.
El trabajo de CRG busca ayudar a construir sociedades donde una gobernanza atenta, inclusiva y que
rinda c...uentas, garantice los derechos de cada niña y niño y donde cada niña y niño pueda tener una
voz en las decisiones que les afectan. Es una estrategia para apoyar los estados en la implementación
efectiva de la Convención de los Derechos del Niño y otras obligaciones relacionadas a los Derechos
de la Niñez (DDNN). Se trata de apoyar y trabajar junto a una activa sociedad civil, incluyendo a niñas
y niños en el monitoreo de la situación de los DDNN en su país, y levantando alto en la agenda política
los temas de niñez. Integrar los DDNN en leyes, políticas y presupuestos es una etrategia efectiva para
lograr cambios sistemáticos y positivos en la vida de niñas, niños y adolescentes, hoy y en el futuro.
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O currículo irá ajudá-lo, a si e à sua comunidade, a compreender a ciência do vírus que causa a COVID-19 e outros vírus como este. Ajudá-lo-á a descobrir como este vírus o está a afectar ou a afectar ou poderá vir a afectá-lo no futuro. Ajudá-lo-á a compreender as acções que pode to...mar para se manter a si e à sua comunidade em segurança.
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Las necesidades de salud mental insatisfechas en la Región de las Américas son una de las principales causas de morbimortalidad, y tienen enormes consecuencias sociales, económicas y para la salud. La pandemia de COVID-19 ha exacerbado la crisis de la salud mental en la Región, por lo que se nec...esita una acción urgente en los niveles más altos del gobierno y en todos los sectores con el propósito de reconstruir para mejorar los sistemas y servicios de salud mental ahora y en el futuro. En este histórico informe, elaborado por la Comisión de Alto Nivel de la OPS sobre Salud Mental y COVID-19, se presenta un análisis de la situación de la salud mental en las Américas, seguido de una serie de recomendaciones y sus puntos de acción correspondientes, a fin de ayudar a los países a priorizar y promover la salud mental con enfoques basados en los derechos humanos y la equidad.
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El paquete de capacitación de nivel básico fue pensado para apoyar la capacitación del personal o los voluntarios, para que suministren sillas de ruedas manuales y cojines apropiados a los niños, niñas, hombres y mujeres que tienen problemas de movilidad pero pueden sentarse erguidos sin apoyo ...postural adicional. El propósito del Cuaderno del participante es desarrollar las habilidades y los conocimientos del personal que presta servicios de sillas de ruedas. El Cuaderno del participante contiene ejercicios que ayudarán a los participantes a practicar y desarrollar sus habilidades y conocimientos. El Cuaderno del participante contiene material de las lecciones, las presentaciones de diapositivas y el manual de referencia. Se recomienda a los participantes que conserven su cuaderno para usar como referencia futura.
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O pacote de treinamento de Nível Básico é desenvolvido para dar suporte ao treinamento da equipe de atendimento ou dos voluntários para fornecer uma cadeira de rodas manual e almofadas apropriados para meninas, meninos, mulheres e homens que possuem mobilidade reduzida, mas que podem sentar eret...os sem suporte adicional para a
postura. O objetivo da Apostila do Participante é desenvolver as habilidades e conhecimentos das pessoas envolvidas na prestação de serviços para cadeira de rodas. A Apostila do Participante contém exercícios que ajudarão a testar e desenvolver o conhecimento e as habilidades do participante. A Apostila do Participante contém material das palestras, apresentações de slides e do manual de referência. O participante deve manter sua cópia da apostila consigo para consultas futuras, se necessário.
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Proporciona herramientas para ayudar a organizar un día para el diálogo comunitario acerca de la salud mental. Habla sobre la logística de encontrar un lugar, formar una red de socios; reclutar participantes y facilitadores, organizar la reunión e identificar las medidas de seguimiento. Nota: Ha...brá copias impresas de este documento disponibles en el futuro cercano.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence...-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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This handbook offers a simple framework of action for actors in local government, and in particular, health leaders such as Civil Surgeons (CSs) and Upazila Health and Family Planning Officers (UHFPQOs), to take ownership and leadership to combat COVID-19 at each district and upazila respectively, w...ith support and guidance from elected representatives and local administration, and through effective engagement of various segments of society including informal health care providers, religious leaders, journalists, police and law enforcement agencies, etc. The toolkit draws extensively from the experiences in Chapainawabganj, Savar and other areas and contains relevant best practises that have already proven effective in these places, which should be readily adaptable to various contexts.
It is important to note that while this framework has been developed in the context of COVID-19 and with related best practises, it is by no means limited to COVID-19 response. Indeed, the experience from Savar shows that the same approach has proven extremely effective in combating the dengue outbreak and the severe floods in 2020, and hence can be used to combat future public health emergencies in Bangladesh and other countries having similar contexts.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy ...2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the na...tional demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
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Since the beginning of the Ukraine crisis on 24 February 2022, WHO has supported Government-led efforts and initiatives alongside key partners on the ground. Building on efforts to date, and working alongside Bulgaria’s health authorities to bring added value to existing mechanisms, the WHO Countr...y Office Bulgaria, the WHO Regional Office for Europe and the WHO Health and Migration Programme, in close collaboration with the Ministry of Health of Bulgaria and key partners, undertook a joint review mission to support Bulgaria, with a focus on addressing the health system needs of refugees, migrants, asylum seekers and vulnerable host populations in Bulgaria.
The assessment team developed this report on the key findings and a package of potential interventions based on the opportunities identified and the need for technical support and assistance. The report summarizes concrete areas of work for which collaborations can be further strengthened. The joint review team identified key recommendations for consideration across 8 priority areas. The report and the outcomes of the review mission serve as a basis for future technical collaboration in the area of refugee health, to address the health needs of refugees and third-country nationals fleeing from Ukraine.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources... and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Dengue is the fastest spreading, mosquito-borne viral infectious disease worldwide, with remarkable morbidity and mortality. In the past decades, profound contributions have been made towards understanding its epidemiology, including disease burden and distributions, risk factors, and control and pr...evention practices. Dengue continues to disseminate to new areas, including high latitude regions, and a new serotype (dengue virus serotype 5) has been identified. Vaccine research has made new progress, in which the licensed yellow fever and dengue virus quadrivalent chimeric vaccine is now under further safety assessment. In disease surveillance, because of its operational simplicity, rapidity, capability, and utility as an indicator of disease severity, dengue virus NS1 antigen detection has great promotion and application value among primary health care institutions. Vector control progress has driven new breakthroughs in biotechnology, including Wolbachia-infected Aedes and genetically modified Aedes. Both Aedes variants have been used to block transmission of the dengue virus through population replacement and suppression. In the future, vector control should still be pursued as a key measure to prevent transmission, along with anti-viral drug and vaccine research.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant ...asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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