INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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L’un des principaux défis auxquels fait face le secteur de la santé au Togo est la mise à la disposition des décideurs, des partenaires et du public des données fiables, pertinentes et à temps opportun. Le présent annuaire des statistiques sanitaires a pour objectif, de contribuer à releve...r ce défi, en fournissant des informations de qualité sur le niveau de réalisation des plans d’action et des prestations de santé afin d’apprécier le niveau de performances de la mise en oeuvre des interventions à l’échelle du pays.
Cette publication retrace, sous forme de tableaux et de graphiques, les activités du département de la santé au Togo en 2016. Il s’agit : (i) des ressources en santé, (ii) de l’utilisation des services, (iii) des principales causes de morbidité et de mortalité, (iv) de la situation des maladies prioritaires et (v) des activités préventives et promotionnelles.
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A sanitary inspection is a simple, on-site evaluation (traditionally using a checklist) to help identify and support the management of priority risk factors that may lead to contamination of a drinking-water supply. Sanitary inspections are a well-established and widely-applied practice. They can su...pport water safety planning, and in some contexts, may be a simplified alternative to water safety plans.
This publication presents the World Health Organization’s (WHO’s) sanitary inspection packages. These packages update the sanitary inspection forms in WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. With more than 25 years of practical experience with the application of sanitary inspections, these packages have been developed from a comprehensive evidence review and established good practices.
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The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa...l health planning and the first point of reference for all actors working in the health sector. The overall aim of this policy is to ensure universal accessibility (in geographical and financial terms) of equitable and affordable quality health services (preventative, curative, rehabilitative and promotional services) for all Rwandans. It sets the health sector’s objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. A companion Health Sector Strategic Plan (HSSP) elaborates the strategic directions defined in the Health Sector Policy in order to support and achieve the implementation of the policy, and more detailed annual operational plans describe the activities under each strategy.
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Reflections and a call for action after a two-year exploration of emergency response in acute conflicts
There is general consensus that the humanitarian sector is failing to mount timely and adequate responses in the acute phase of conflict-related emergencies, according to the two-year Emergen...cy Gap Project by Médecins Sans Frontières (MSF).
The Project has explored what works for or against effective emergency responses. Its final report, Bridging the emergency gap, draws on the Project’s thematic papers and case studies, and consultations with more than 150 senior-level representatives from 60 key organisations across the humanitarian sector.
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Continuing a worrying decade-long rising trend, the number of people forced to flee due to persecution, conflict, violence, human rights violations and events seriously disturbing public order climbed to 89.3 million by the end of 2021. This is more than double the 42.7 million people who remained f...orcibly displaced at the end of 2012 and represents a sharp 8 per cent increase of almost 7 million people in the span of just 12 months. As a result, above one per cent of the world’s population – or 1 in 88 people – were forcibly displaced at the end of 2021. This compares with 1 in 167 at the end of 2012. During 2021, some 1.7 million people crossed international borders seeking protection and 14.4 million new displacements within their countries were reported. This is a dramatic increase from the combined 11.2 million a year earlier.
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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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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This paper was commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ) in 2015, and produced by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, in cooperation with German civil society actors and freelance psychologists working in the field... of Mental Health and Psychosocial Support (MHPSS) with refugees and internally displaced people (IDP) in both the Middle Eastern region and Germany. The commission arose from BMZ’s wish for guidance on the characteristics of good working practices in MHPSS and the desire expressed by GIZ’s civil society partners in the regional programme Psychosocial Support for Syrian and Iraqi Refugees and Internally Displaced People for more intensive dialogue to promote MHPSS in the context of the Syria and Iraq crises.
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Maternal and child malnutrition is a significant public health problem in South Sudan. Among children aged 6-59 months, 31% are stunted, 28% are underweight, and nearly 23% are acutely malnourished of which 13% are estimated to suffer from moderate acute malnutrition and 10% from severe acute malnut...rition.
Overall, South Sudan’s nutrition situation is worrisome, with GAM persistently above the emergency threshold in the Greater Upper Nile, Northern Bahr el Ghazal and Warrap states. Though data on micronutrient deficiencies is scanty, Vitamin A Supplementation (VAS) among children 6-59 months stood at only 2.6% in 2010, showing low uptake (SHHS, 2010). This is against a backdrop of high morbidity levels and a negligible proportion of children 6 to 23 months receiving at least the recommended minimum acceptable diet. In order to ensure optimal child growth, it is essential to ensure good nutrition and basic health care from pregnancy through two years of age (the first 1000 days).
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In view of the ongoing political, peace and reconciliation, administrative and economic reforms as well as plans to establish the United Nations Development Assistance Framework (UNDAF) in 2018, WFP extended the current Protracted Relief and Recovery Operation (PRRO 200299), launched in January 2...013, by two years to include 2016 and 2017, with approved budget USD 343 million. To echo this extension and provide a more appropriate response to the country's rapid and multi-pronged transition, WFP adopted a transition strategy with gradually reduced emphasis on humanitarian assistance and greater focus on early recovery and development interventions. WFP's strategic engagement in-country was driven by the overarching goal to assist Myanmar to achieve the national Zero Hunger Challenge by 2025, and was guided by three priorities: emergency preparedness and response; nutrition; and provision of social safety nets.
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In the last five years, i.e. how old turned the Campaign “Indifesa” (Defenceless) in 2016, that was launched by Terre des Hommes in 2012, the world has become smaller. One can actually say that the derangements following the Arab Spring in 2011 reshuffled what is stable and what produces instabi...lity; between those, who live in a peaceful world, and those, who try to survive in areas affected by violence. All that significantly reduced the distance between those, who live there, along the Mediterranean cost, and those, who live here. Such deep disorder made even more acute, visible and tangible also for the so called developed world all the serious violations of the human rights suffered by little girls and girls: on the one hand the widespread political instability and violence made even more precarious the little girls and young women’s conditions on the Mediterranean southern coast, where they were already fragile; and on the other hand the migration flows further worsened them, matching at the same time the conditions of those young and very young migrants to those of the European girls of the same age.
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PEN-Plus is an integrated care delivery strategy focused on alleviating the noncommunicable disease (NCD) burden among the poorest children and young adults by increasing the accessibility and quality of chronic care services for severe NCDs—such as type 1 diabetes, rheumatic heart disease, and si...ckle cell disease—in the rural areas of low- and lower-middle-income countries, where more than 90 percent of the world’s poorest people live.
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Currently, Mauritius and Seychelles have 85 and 82 percent vaccination rates, respectively, surpassing the 70 percent target set by the WHO in 2021. Countries that have attained vaccination rates of between 50 and 70 percent include Liberia
at 67 percent, Rwanda at 66 percent, Morocco at 62 percent..., and Tunisia at 53 percent. Meanwhile, about 25.3 percent of the continent's population is fully vaccinated.
Africa has registered over 12 million COVID-19 cases since the beginning of the pandemic. The following countries have recorded the highest number of cases: Egypt, Ethiopia, Libya, Morocco, South Africa, and Tunisia
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DIAGNOSING PTSD IN CHILDHOOD | The following literature review addresses the developmental and domain-specific consequences of previous and current diagnostic criteria for posttraumatic stress disorder (PTSD) in pre-adolescent children. PTSD was introduced in 1980 to capture extreme responses follow...ing a traumatic event. I analyze the evolution of the disorder’s diagnostic criteria toward a more developmentally conscious structure. I also examine instances in which these criteria lack developmental consistency: (1) preschool PTSD is the only diagnostic subtype despite the fact that childhood development also differentiates traumatic expressions in older children from adolescents and adults; and (2) many of the PTSD epidemiological data that have been reanalyzed under the most recent (DSM-5) typology only refer to adolescent and adult samples although many researchers have
demonstrated that developmental alterations to DSM-IV and DSM-IV-TR criteria produce significantly higher prevalence rates in children.
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This course has two main goals. The first is to provide an introduction to key sexual and reproductive health issues of youth, including the relationship between gender norms and health. The second is to present an overview of the best programmatic approaches for improving young people’s sexual an...d reproductive health - See more at: http://www.globalhealthlearning.org/course/youth-sexual-and-reproductive-health-update#sthash.hWLzTUQt.dpuf
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A National Service Programme for All Children with Special Needs and their Families
In Myanmar, we estimate that at least 40% of children require ECI services for short to longer periods of time. At present, 35.1% of Myanmar children are moderately to severely stunted; all of these children are l...ikely to have one or more developmental delays. In addition, at least 5% to 12% of the nation’s children will be identified to have disabilities, chronic diseases or atypical behaviours.
Over time, approximately 70% of the children who will be served will improve in their development, attain expected levels of development for their age, and will consolidate their gains within one to two years. Other children, approximately 30%, will have lifelong disabilities or other conditions, and ECI services usually greatly improve their development and help them to achieve their full potential.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou...gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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The document contains a set of indicators that can be used for monitoring traditional and complementary medicine (T&CM) systems in a country.
The core indicator set consists of 16 indicators that were considered essential and collectively able to provide information on T&CM inputs, processes and ou...tputs. A longer list of reference indicators is also available for countries that wish to monitor more indicators or that want to consider alternative metrics that would better suit each country’s T&CM situation, priorities and monitoring capacities.
Each core and reference indicator is accompanied by a set of metadata. This provides information on the indicator rationale, definitions, data elements (numerator, denominator and data disaggregation), frequency of measurement, and data sources. It is a guide towards more standardized data measurement as well as data interpretation.
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—and over 2.7 million deaths attrib...uted to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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