Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue...s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
Website last accessed on 10.04.2023
The Chagas disease is frequently referred to as the effects that the parasite Trypanosoma cruzi (T. cruzi) has on people’s health. However, from our perspective, Chagas is much more than that: it is a complex socioenvironmental health problem in which elemen...ts of different nature converge and interact. The biomedical and epidemiological aspects, which are most frequently addressed, are only a piece of the puzzle that needs to be complete in order to understand Chagas in all its complexity. Social, environmental, economic, political, cultural, and educational elements turn out to be essential in comprehending the magnitude of the problem without prejudice or stigmatizations.
more
These Massive Open Online Courses (MOOCs) explore the ecological dimensions of the world’s religions. Developed over the course of several years, they draw on a rich variety of lectures, videos, readings, and interviews with scholars, religious leaders, and environmental practitioners from around ...the world. They highlight religious ideas and practices inspiring ecojustice movements in response to the challenges of the climate emergency, biodiversity loss, and pollution. Developed over the course of several years, they draw on a rich variety of lectures, videos, readings, and interviews with scholars, religious leaders, and environmental practitioners from around the world. They highlight religious ideas and practices inspiring eco-justice movements in response to the challenges of the climate emergency, biodiversity loss, and pollution
more
Lancet Public Health 2022 Published Online October 25, 2022 https://doi.org/10.1016/S2468-2667(22)00197-9
Executive summary
In the past few decades, major public health advances have happened in Europe, with drastic decreases in premature mortality and a life expectancy increase of almost 9 years ...since 1980. European countries have some of the best health-care systems in the world. However,Europe is challenged with unprecedented and overlapping crises that are detrimental to human health and livelihoods and threaten adaptive capacity, including the
COVID-19 pandemic, the Russian invasion of Ukraine, the fastest-growing migrant crisis since World War 2, population displacement, environmental degradation, and deepening inequalities. Compared with pre-industrial times, the mean average European surface air temperature increase has been almost 1°C higher than the average global temperature increase, and 2022 was the hottest European summer on record.
more
We developed an integrated vector surveillance (IVS) proposal for cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) in the Americas, based on eco-epidemiological studies conducted by researchers of the Leishmaniasis Research Network of Argentina. For CL, the transmission was explained in ...the framework of the edge effect, the increase of vectors and risk of exposure at ecotones and environmental interfaces, and typified as ephemeral, transient, or permanent edges, supporting a cost-effective IVS strategy for early warning of CL outbreaks through an environmental modification alert network, which includes multiple sources of information and actors. In relation to VL, the earliest colonization sites and spatial distribution were explained by modeling and forecasting the most likely hotspots, persistent in time and space, and modulated by environmental variables. Therefore, for VL, a scalar strategy of critical site selection is proposed from a “city” scale based on secondary sources such as remote sensing for the definition of possible areas to monitor and intervene, a scale of restriction from possible to most likely areas through local knowledge, and a “focal site” scale of trap placement through field observation; in this way, IVS activities are carried out at a few sites of the urban landscape and allow a sustainable program.
more
Control of pollution from antibiotic manufacturing is a key part of safeguarding the longevity of antibiotics for all. Pollution contributes to antibiotic resistance and potentially undermines the effectiveness of medicines. High levels of antibiotics in water bodies downstream of manufacturing site...s have been widely documented. Currently, antibiotic pollution from manufacturing is largely unregulated and quality assurance criteria typically do not address environmental emissions.
more
This checklist has been developed to support hospital preparedness for the management of COVID-19 patients.
Elements to be assessed have been divided into the following areas:
Establishment of a core team and key internal and external contact points
Human, material and facility capacit...y
Communication and data protection
Hand hygiene, personal protective equipment (PPE), and waste management
Triage, first contact and prioritisation
Patient placement, moving of the patients in the facility, and visitor access
Environmental cleaning
For each area mentioned above, the elements or processes were identified and the items to be checked are listed below.
A procedure for the self-auditing of compliance with this checklist should be considered.
more
The Fifth Integrated Household Living Survey (EICV5) was conducted from October 2016 to October 2017, and is designed to provide accurate and up-to-date information that are useful to government, analysts and the public as they seek to monitor and evaluate efforts to reduce poverty.
This report pre...sents and discusses key results from the EICV5 in the areas of demographic characteristics, migration, health, education, the characteristics of households and dwellings in Rwanda, economic activity patterns, environmental issues and households' access to credits and savings.
more
Indoor air pollution is caused by burning solid fuel sources – such as firewood, crop waste, and dung – for cooking and heating.
Burning such fuels, particularly in poor households, results in air pollution that leads to respiratory diseases, which can result in premature death. The WHO calls... indoor air pollution "the world's largest single environmental health risk."
more
Background: Foreign aid continues to play an essential role in health sector development in low-resource countries, particularly in terms of providing a vital portion of their health expenditures. However, the relationship between foreign aid allocation and malaria policy formulation and/or implemen...tation among state aid recipients remains unknown.
Methods: Publicly available data were collected with the country as observational unit to set up the conceptual framework. The quality and strength of relationships between socioeconomic, environmental and institutional parameters were estimated by Pearson and polychoric correlations. A correlation matrix was explored by factor analysis.
more
Background: Foreign aid has been shown to be favourably biased towards small countries. This study investigated whether country size bias also occurs in national malaria policy and development assistance from international agencies. Methods: Data from publicly available sources were collected with c...ountries as observational units. The exploratory data analysis was based on the conceptual framework with socio-economic, environmental and institutional parameters. The strength of relationships was estimated by the Pearson and polychoric correlation coefficients. The correlation matrix was explored by factor analysis.
more
This interim guidance is aimed at healthcare workers who may receive patients
exposed to chemical weapons at their healthcare facilities.
It provides questions to guide the identification of contaminated patients,
recommendations on personal protection, procedures for decontamin...ation,
guidance for triage and identification of categories of exposure, and treatment
regimens for individual chemicals.
Arabic version available: http://www.who.int/environmental_health_emergencies/deliberate_events/interim_guidance_ar.pdf
more
Soil transmitted helminth (STH) infections are among the most common human infections worldwide with over 1 billion people affected. Many estimates of STH infection are often based on school-aged children (SAC). This study produced predictive risk-maps of STH on a more finite scale, estimated the nu...mber of people infected, and the amount of drug required for preventive chemotherapy (PC) in Ogun state, Nigeria. Georeferenced STH infection data obtained from a cross-sectional survey at 33 locations between July 2016 and November 2018, together with remotely-sensed environmental and socio-economic data were analyzed using Bayesian geostatistical modelling. Stepwise variable selection procedure was employed to select a parsimonious set of predictors to predict risk and spatial distribution of STH infections. The number of persons (pre-school ages children, SAC and adults) infected with STH were estimated, with the amount of tablets needed for preventive chemotherapy. An overall prevalence of 17.2% (95% CI 14.9, 19.5) was recorded for any STH infection. Ascaris lumbricoides infections was the most predominant, with an overall prevalence of 13.6% (95% CI 11.5, 15.7), while Hookworm and Trichuris trichiura had overall prevalence of 4.6% (95% CI 3.3, 5.9) and 1.7% (95% CI 0.9, 2.4), respectively. The model-based prevalence predictions ranged from 5.0 to 23.8% for Ascaris lumbricoides, from 2.0 to 14.5% for hookworms, and from 0.1 to 5.7% for Trichuris trichiura across the implementation units. The predictive maps revealed a spatial pattern of high risk in the central, western and on the border of Republic of Benin. The model identified soil pH, soil moisture and elevation as the main predictors of infection for A. lumbricoides, Hookworms and T. trichiura respectively. About 50% (10/20) of the implementation units require biannual rounds of mass drug administration. Approximately, a total of 1.1 million persons were infected and require 7.8 million doses. However, a sub-total of 375,374 SAC were estimated to be infected, requiring 2.7 million doses. Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, either for resource acquisition or identifying priority areas for delivery of interventions in Ogun State, Nigeria.
more
Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes are also vectors of chikungunya, yellow fever and Zik...a viruses. Dengue is widespread throughout the tropics, with local variations in risk influenced by climate parameters as well as social and environmental factors.
more
The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of ...the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
more
The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key... challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
more
South Africa has possibly the highest incidence of malignant mesothelioma anywhere, thanks to more than a century of mining asbestos in the Northern Cape, North- West, Limpopo and Mpumulanga provinces. There are three types of asbestos and all were mined in South Africa; the most carcinogenic is cro...cidolite, of which production peaked in 1977. The last asbestos mine closed only in 2002, and massive environmental contamination from unrehabilitated mines and mine dumps will ensure ongoing exposure well into the future.
more
The checklist is aligned with, and builds upon, existing COVID-19-related WHO guidelines and is structured around protective measures related to: 1) hand hygiene and respiratory etiquette; 2) physical distancing; 3) use of masks in schools; 4) environmental cleaning and ventilation; and 5) respectin...g procedures for isolation of all people with symptoms. The checklist is designed to support policy-makers, staff and officials from the education and health sectors, local authorities, school principals/leaders and administrators, teachers’ unions, community leaders, school staff, teachers, parents and caregivers.
more
Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – cause nearly three-quarters of deaths in the world. Their drivers are social, environmental, commercial and genetic, and their presence is g...lobal. Every year 17 million people under the age of 70 die of NCDs, and 86% of them live in low- and middle-income countries.
Users can explore the data below by country, accessing detailed information on noncommunicable diseases and their key risk factors
more
The report “Build back fairer: achieving health equity in the Eastern Mediterranean Region” provides ground breaking insights into the state of health inequities in the Region and urges countries to take action to address the social determinants of health to reverse the worsening trend of inequi...ty – aggravated by the COVID-19 pandemic, ongoing conflict, mass movements of people, environmental challenges, gender inequities and unemployment.
more