Azraq refugee camp located in Zarqa governorate was established in April 2014. As of June 2023, the camp continues to hosts 40,600 Syrian refugees, with 61% of the population children, and 25% of all households female-headed (UNHCR, 2023).
The water supply system in Azraq has been operational sin...ce 2017 across the four villages of the camp and consists of 300 tap stands, two boreholes and two storage locations (each with 16 T-95 steel tanks).
Based on data from UNICEF (2022), the community is provided on average 2100 cubic meters of safe, treated water a day, which is distributed across the camp via a gravity flow system. A distribution schedule is in place, with water pumped during two shift times each day in the morning and evening. Monthly data reported through ActivityInfo (2023) shows a range 53.5-76.3 million liters per month provided through the network in 2022 for an average of 57 liters/person/day – well above the locally agreed minimum standard of 35 liters/person/day and the SPHERE standard of 15 liters/person/day.
Latrine and shower facilities in the camp are organized through communal WASH blocks shared typically between three households and connected to water and greywater networks. However, based on an ACF and World Vision assessment (2022), 60% of the surveyed households are using private latrines (50% self-constructed latrines, and 10% constructed by WASH actors), 24% of households used communal latrines as private latrines not shared with other families, and 16% reported the use of communal latrines shared with other families.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Prioritise education in conflict-affected areas:
Across the world 28 million1 primary school-age children living in conflict-affected countries are
out-of-school, and they form half of the world’s total out-of-school population. During conflict,
infrastructure assets such as schools are damaged... or completely destroyed during fighting. Children
may choose to stay away from school due to their and their family’s safety fears in the midst of
conflict, or the need to supplement their family’s income amidst conflict-related financial loss.
Children who are internally displaced by conflict face a particularly challenging task accessing
education due to the specific conditions created by their displacement, such as loss of livelihoods
making school fees hard to find, and discrimination from host communities. Children caught in
conflict are being deprived of their right to education2 and denied the opportunity to benefit from the
protective and life-sustaining mechanisms of education.
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This report, written in partnership with various Royal Medical Colleges and Public Health England, sets out the essential actions to improve the physical health of adults with severe mental illness (SMI) across the NHS. The report makes practical recommendations for changes that will help adults wit...h SMI to receive the same standards of physical healthcare as the general population and reduce the risk of premature death.
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This Community Health Systems (CHS) Catalog country profile is the 2016 update of a landscape
assessment that was originally conducted by the Advancing Partners & Communities (APC) project
in 2014. The CHS Catalog focuses on 25 countries deemed priority by the United States Agency for
Internation...al Development’s (USAID) Office of Population and Reproductive Health, and includes
specific attention to family planning (FP), a core focus of the APC project.
The update comes as many countries are investing in efforts to support the Sustainable Development
Goals and to achieve universal health coverage while modifying policies and strategies to better align
and scale up their community health systems.
The purpose of the CHS Catalog is to provide the most up-to-date information available on community
health systems based on existing policies and related documentation in the 25 countries. Hence, it does
not necessarily capture the realities of policy implementation or service delivery on the ground. APC
has made efforts to standardize the information across country profiles, however, content between
countries may vary due to the availability and quality of the data obtained from policy documents.
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The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic
has disproportionately affected people with diabetes population, exposing them to a
high risk for severe illness and mortality. Globally, diabetes was responsible for over fourmillion deaths in the year 2019. It was th...e leading cause of end-stage kidney disease, adult-onset blindness and cardiovascular diseases. Further, there was a considerable heterogeneity in the prevalence of complications and deaths associated with diabetes across the countries.
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This module covers common Non-Communicable Diseases such as Hypertension, Diabetes and three common cancers (Cervical,
Breast and Oral cancer). The focus of this module is on building the knowledge and skills of the Multi-Purpose Workers (MPW) in
undertaking Population Based Screening, identifi ca...tion of cases for referral, follow up, recognition of complications, prevention
and health promotion. This module can be used by the female
or male MPW. However, while the content of the overall module
is the same for both some tasks will be different, particularly
those related to screening which the female MPW will have to
undertake. It is expected that the ANM/MPW will work closely
with the ASHA in her area. Together they form a front line worker
team to serve the needs of the community. The content of this
module will be covered in three days.
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A catalogue of family planning job aids for low resource settings, which includes a brief description and key messages as well as pros and cons for each job aid.
Accessed June 2014.
4th edition 2022 of the Handbook includes new WHO recommendations that expand contraceptive choices. Also, guidance on starting ongoing contraception following emergency contraception is provided.
Drawing on lessons from recent outbreaks, this new edition details tangible me...asures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and the use of digital technologies by providers. It also expands guidance for women and young people at high risk of HIV.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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The National Institute for Transforming India (NITI) Aayog has developed the Composite Water Management Index (CWMI) to enable effective water management in Indian states in the face of extreme water stress. The Index and this associated report are expected to: (1) establish a clear baseline and ben...chmark for state-level performance on key water indicators; (2) uncover and explain how states have progressed on water issues over time, including identifying high-performers and under-performers, thereby inculcating a culture of constructive competition among states; and, (3) identify areas for deeper engagement and investment on the part of the states. Eventually, NITI Aayog plans to develop the index into a composite, national-level data management platform for all water resources in India.
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This programmatic brief explores how to expand HIV and STI prevention and contraceptive method options in contraceptive services and, thus, to reduce HIV and STI incidence among adolescent girls and women. It focuses on settings with extremely high HIV prevalence and incidence. This brief complement...s existing guidance on HIV prevention and sexual and reproductive health and rights (SRHR), amplifies calls for action and outlines more comprehensive approaches to integration of SRHR and HIV services. It also emphasizes the importance of SRHR for women living with HIV. It aligns with updated WHO recommendations for contraceptive eligibility for women at high risk of HIV and other HIV guidance for adolescent girls and young women.
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This regional advocacy strategy on HIV and AIDS, tuberculosis (TB) and sexually transmitted infetions (STIs) is intended for use by Southern African Development Community (SADC) Member States at a national level. This is an overall advocacy strategy highlighting the most important issues relating to... HIV and AIDS, TB and STIs in the Southern African region. It provides a broad advocacy framework for each of the issues identied, along with key targets, messages, and interventions
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These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living w...ith HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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Objective: The study aimed to describe the current epidemiological, clinical and immunological profile of newly
detected HIV - positive patients in Northern Benin by 2016. Methods: It was a prospective study conducted from May 2 to
October 31, 2016 on three main sites of care of people living with... HIV (PLHIV) in the department of Borgou in Benin. All
new cases of HIV infection have been systematically and comprehensively recruited. Initial epidemiological, clinical and
immunological data were collected using a questionnaire. These data were entered and analyzed using the Epi Info 7 software.
Results: In total, 185 adults (68 male and 117 female) newly screened HIV positive were included in this study. The middle age
was 36.2 ± 10.9 years and the sex ratio was 0.6 One hundred and thirty-five patients (73%) were between 25 and 50 years old.
In terms of the profession, 132 patients (71.3%) were engaged in liberal activities (craftmen, traders and retailers). The
majority was schooled (113 or 61.1%) and resided in urban areas (146 or 79%). One hundred and sixteen patients lived in
couple (62.7%) with an average monthly income estimated at 70 US Dollars. Clinically, 123 patients (66.5%) were in WHO
stage III. The body mass index was over 18.5 kg/m2 in 124 patients (67%). The median number of TCD4 lymphocytes was
254.5 cells/ml and 25 patients (13.5%) had a number of CD4 over 500 cells/ml. HIV1 was really predominant (97.8%). Most
patients (152 or 82.2%) had been screened for clinical suspicion. Conclusion: HIV infection in Benin remains the prerogative
of young, female, educated and poor people. Screening is delayed and hence the need to develop innovative strategies for early
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It provides insight into WHO’s work that aims to improve the health of the people of the United Republic of Tanzania in collaboration with key stakeholders.
The COVID-19 pandemic has exposed the inadequacy of investments in public health, the persistence of profound economic and social inequalities and the fragility of many key global systems and approaches.
This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This is followed by key figures for the region, the role of WHO in country support and, recognizing the im...portance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
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A lot has happened this year. While we continued to tackle the COVID-19 pandemic, we were hit by disease outbreaks and
humanitarian crises. Yet, despite these challenges, we marched on, resolute in resolving critical health systems issues to increase
access to quality healthcare services. To furth...er our vision and bring concrete actions to reality, under
the leadership of the Government of South Sudan, we developed the Health Sector Strategic Plan to define the strategic
approaches, key interventions, mapping resource needs, and the implementation framework to strengthen the health system
to deliver essential quality health services equitably for 2023 to 2027. For WHO, this Plan will usher in a new reality -- access
to lifesaving or health-promoting interventions is doable and possible, making the health sector fairer, especially for those
unable to pay
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The COVID-19 pandemic arrived in an evolving epidemiological context where some countries are experiencing a progressive decrease in HIV positivity in their testing programme as they are moving closer to the first 95 target. Distinguishing changes in HIV testing services due to the COVID-19 pandemic... from those resulting from evolving HIV testing strategies is crucial for adapting services and helping countries define their strategic mix of testing options moving forward. There is a need to focus, prioritize and plan for strategic efforts to prevent going further off the track toward achieving global targets and goals.
To support these efforts, WHO in partnership with ministries of health conducted an in-depth analysis of HIV testing services and antiretroviral therapy (ART) initiation prior to and during reported COVID-19 disruptions. Additional publicly available Global Fund and PEPFAR data was also reviewed and analysed. This analysis, and coordination with ministries of health, identified key service delivery adaptations utilized during COVID-19-related disruptions and formed the basis of this strategic guide.
This document focuses on current country needs, as well as plans for prioritization and potential surge support needs in the event of future disruptions. Although the data and implications are specific to sub-Saharan Africa, key principles and lessons can be applied elsewhere.
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