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Marco Schäferhoff and colleagues critique funding estimates for the maternal and child health Millennium Development Goals, and make recommendations for improving the tracking of financing flows and estimating the costs of scaling up interventions for mothers and children.
There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl
...
d Health Organization (WHO) Member States requested the WHO Director-General to provide an analysis across countries of successful approaches for the prevention and control of NCDs that used multisectoral action. This WebAnnex to the Global mapping report on multisectoral actions to strengthen the prevention and control of noncommunicable diseases and mental health conditions details experiences from around the world.
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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.
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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
This action plan is intended for senior-level decision-makers in ministries of health, malaria
programme managers, entomologists, and epidemiologists working on malaria and other vectorborne diseases programmes. It is also intended for decision-makers and technical and advocacy
staff at other orga
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nizations and stakeholders involved in public health, malaria control and
elimination, and urban and rural development.
more
This document seeks to help health communication professionals working on the topic of immunization more effectively communicate about Events Supposedly Attributed to Vaccination and Immunization (ESAVI) by building trust in National Immunization Programs, understanding risk perceptions related to v
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accination, and responding to false information related to vaccination. It includes practical dos and don’ts regarding risk communication and community engagement processes and principles, messaging, risk perceptions, handling false information, collaborating with partners, and pharmacovigilance, as well as real-world examples.
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“All sectors of humanitarian response are critical to providing an adequate and holistic response for children who have survived different types of violence, exploitation, abuse and neglect. Following the immediate humanitarian response, all humanitarian sectors have an important contribution to m
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ake to the effective rehabilitation and reintegration of child survivors. ‘Mainstreaming’ child protection, or ensuring that child protection considerations inform all aspects of humanitarian action, helps to maximize the child protection impacts of the work that all humanitarians do. ”
How to Use This briefing paper: This briefing paper is a quick reference for Plan International Child Protection in Emergencies (CPiE) staff on how to engage with other sectors operating in the emergency to ensure that child protection principles and considerations inform all aspects of humanitarian programming in other sectors. While there is child protection mainstreaming guidance for how to work with specific sectors (e.g. WASH, nutrition, distribution) this “All Sectors” briefing note can give CPiE staff the big picture of shared child protection mainstreaming messages that should be conveyed to all sectors. This briefing is aligned with the Minimum Standards for Child Protection in Humanitarian Action and the Sphere Standards, as well as Plan International staff feedback on what actions are the most vital for child protection mainstreaming in other sectors.
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This guide presents a basis for understanding how diarrhoeal diseases are currently influenced by climate and weather, and may be further exacerbated by climate change. It is a technical guide on how to conduct a Vulnerability & Adaptation assessment for diarrhoeal diseases and climate change, and p
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rovides guidance on how to:
identify populations and regions vulnerable to diarrhoeal diseases and the reasons for their vulnerability;
establish relevant baselines that can be analysed and monitored;
conduct analyses to project how diarrhoeal diseases may be impacted in the future due to climate change; and
identify appropriate responses to mitigate and monitor these risks over time.
more
In an ambitious new era for health development under the 2030 Agenda for Sustainable Development, WHO and
its partners have a solid foundation of success on which to build. Health plays a fundamental role in development
and is the central focus of Sustainable Development Goal 3, “Ensure healthy
...
lives and promote well-being for all
at all ages”. It is also relevant to all the Sustainable Development Goals. Understanding the significance of the
role of health is a prerequisite for successful collective action on the social, economic and environmental
determinants of health
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WHO-OHCHR launch new guidance to improve laws addressing human rights abuses in mental health care
Ahead of World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) are jointly launching a new guidance, entitled "Mental health, h
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uman rights and legislation: guidance and practice", to support countries to reform legislation in order to end human rights abuses and increase access to quality mental health care.
Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common. Involuntary hospitalization and treatment, unsanitary living conditions and physical, psychological, and emotional abuse characterize many mental health services across the world.
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Climate change is one of the most urgent challenges for people and ecosystems worldwide. The recently published sixth Assessment Report (AR6) of the Intergovernmental Panel on Climate Change (IPCC) stresses the occurrence of widespread adverse impacts of climate change. Increased frequency and inten
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sity of extreme weather events, as well as slow-onset processes cause enormous losses and damages to human and natural systems. Marginalized groups and people in vulnerable situations are often disproportionally affected. While the impacts of climate change already become more tangible and threatening, action for addressing them remains insufficient. Adaptation to climate change is, thus, becoming a necessity for governments, companies, and private citizens.
To provide practical and scientifically sound guidance on how to conduct vulnerability assessments, GIZ published its Vulnerability Sourcebook in 2014. The Vulnerability Sourcebook was used in over twenty different GIZ partner countries and provides a step-by-step guidance for designing and implementing a vulnerability assessment. It is also one of the methodological foundations for the ISO 14091:2021 standard on vulnerability, impacts and risk assessment for climate change adaptation.
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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
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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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In 2014, the World Heart Federation (WHF) launched
an initiative to develop a series of Roadmaps [1e6]. Their
aim is to identify potential roadblocks on the pathway to
effective prevention, detection, and management of cardiovascular disease (CVD), along with evidence-based
solutions to overcome
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them. The resulting documents
provide a framework to translate strategic intent into action
on integrating epidemiology, population, and cardiovascular outcome trial data into national plans for optimal
CVD management.
more
The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death
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and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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Vaccines are powerful weapons in the fight against pandemic viruses as shown by responses to both the 2009 H1N1 influenza and the COVID-19 pandemics. However, planning for accessing, allocating and deploying vaccines in a pandemic situation is a complex endeavour, beset with multiple challenges at a
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ll levels – local, regional and global. The World Health Organization (WHO) and its partners have prepared this revised guidance document to assist countries update their national deployment and vaccination plans (NDVPs) by leveraging global learnings from past pandemic responses, including the recent COVID-19 vaccination effort. The development and testing of a NDVP would not only advance pandemic preparedness efforts but would also have benefits in terms of increasing national capabilities to manage other health emergencies which require emergency vaccination campaigns.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to
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accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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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
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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.
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Guidelines for Management of ST-Elevated Myocardial Infarction
Directorate General of Health Services
Ministry of Health & Family Welfare Government of India
(2022)
CC
Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi
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on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
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t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall
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y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati
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ons.
These Guidelines, specifically tailored to small water supplies, build on over 60 years of guidance by the World Health Organization (WHO) on drinking-water quality and safety. They focus on establishing drinking-water quality regulations and standards that are health based and context appropriate; on proactively managing risks through water safety planning and sanitary inspections; and on carrying out independent surveillance. The guidance is intended primarily for decision-makers at national and subnational levels with responsibility for developing regulatory frameworks and support programmes related to these activities. Other stakeholders involved in water service provision will also benefit from the guidance in this document.
Designed to be practical and accessible, these Guidelines offer clear guidance that is rooted in the principle of progressive improvement. State-of-the-art recommendations and implementation guidance are provided, drawn from a comprehensive evidence review and established good practices. Additionally, case examples are provided from countries and areas around the world to demonstrate how the guidance in this publication has been implemented in practice in a wide variety of contexts.
Together with WHO’s 2024 Sanitary inspection packages – a supporting tool for the Guidelines for drinking-water quality: small water supplies, these Guidelines update and supersede WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. Key changes to this updated publication include a greater focus on preventive risk management and a broader range of small water supplies covered, including those managed by households, communities and professional entities.
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