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The Lancet Regional Health Americas Volume 37100832 September 2024
The Lancet Regional Health - Americas 2024;30: 100681
Published Online 3 February 2024 https://doi.org/10.1016/j.lana.2024.100681
Guidelines approved by the WHO Guidelines -Review Committee; second edition
The report provides an update on the cholera outbreak in Haiti as of January and February 2024. A total of 79,411 suspected cases have been reported, with 4,608 confirmed cases and 1,172 deaths across all 10 departments. The most affected regions include Ouest, Centre, Artibonite, and Nord, with chi
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ldren aged 1-9 being the most impacted. Despite a recent decline in reported cases, underreporting due to security issues remains a concern. Response efforts include coordination meetings, epidemiological surveillance, case management, WASH interventions, vaccination campaigns, and community engagement. However, logistical challenges, insecurity, and funding shortages are hindering effective response efforts.
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Rwanda’s national health sector is focused on the equitable delivery of high-quality health services. The Government of Rwanda (GoR) recognizes that developing human resources in the health sector is a critical factor to the well-being of the population. Development of the health workforce has bee
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n guided by the Human Resources for Health (HRH) Programme (2012-2019) and its successor, the National Strategy for Health Professions Development (NSHPD) (2020-2030). Rwanda has made significant progress in enhancing its skilled health workforce, with notable improvements in the health professional-to-population ratio over the past decade, attaining 13.4 doctors, nurses, midwives, pharmacists, and dentists per 10 000 people in 2022. Despite such progress, health workforce levels remain below national and global recommendations.
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The humanitarian crisis in Northeast Nigeria, driven by conflict, climate-related shocks, and food insecurity, has created immense challenges for the health sector in Borno, Adamawa, and Yobe (BAY) States. About 1.8 million people remain displaced(1), with inadequate access to healthcare services an
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d persistent disease outbreaks, malnutrition, and mental health challenges. This strategy outlines a comprehensive localization approach to strengthen the health sector's capacity by empowering local and national actors (L/NAs) include state and local government structures to lead humanitarian responses at respective levels with minimal oversight functions.
The localization strategy aligns with the global commitments of the Grand Bargain 2.0, prioritizing equitable partnerships, capacity sharing, and resource mobilization to enhance sustainable, community-owned health systems(2). Key components include increasing the visibility and meaningful participation of L/NAs in health sector coordination, promoting direct funding to local actors, and addressing systemic barriers such as governance, leadership, capacity, and resource gaps.
The global humanitarian community made a commitment, as reflected in the Grand Bargain 2.0, to localization (3) to improve the efficiency and effectiveness of humanitarian aid. A key priority of this commitment is to empower local actors to take a leading role in delivering assistance, ultimately leading to better outcomes for affected communities. A localized health response, strengthened by partnerships, can achieve several key outcomes, including rapid response and access, community acceptance, cost-effectiveness, links to long-term development, and increased accountability to the community. Localization in health matters because it ensures sustainable and community-owned health responses.
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The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has
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developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
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recommandations à l’intention des agents de santé
Tsetse traps and targets (insecticide-impregnated screens) function by attracting the flies to a device that collects and/or kills them. Traps can be used for entomological surveillance, and also for control. Targets are simpler than traps, but are not used for surveillance. They are impregnated wit
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h biodegradable insecticides in order to kill any flies that alight on them. Traps can also be impregnated with insecticides. Traps and targets can both be used to eliminate a fraction of the tsetse population.
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How to successfully apply for, administer, and manage the Zithromax® donation for trachoma elimination
Version 1: March 9, 2021. A living document
The WHO Vision and eye screening implementation handbook (VESIH) offers a step-by-step guidance for conducting vision and eye screenings in community and primary care settings. The evidence-based interventions are drawn from the WHO Package of eye care interventions and developed with a focus on del
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ivering screenings easily, safely, and effectively in low- and low–intermediate-resource settings. The early identification through screenings ensures timely treatments and management to avoid vision impairment in high-risk populations, including newborns, pre-school children, school children, and older adults.
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The second edition of the Women and Trachoma: Achieving Gender Equity in the Implementation of SAFE manual provides an updated resource for realistically increasing, improving, and supporting gender representation within trachoma elimination efforts at all levels. From the trachoma workforce to the
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patients, from trichiasis surgeons to schoolteachers, and from national to international managers and coordinators, the manual breaks down the various levels of trachoma elimination programming to highlight the areas where women and girls can have a greater impact in elimination effort
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Twenty-Fourth Annual Trachoma Control Program Review, Summary Proceedings
Indoor residual spraying (IRS) involves applying residual insecticide to potential vector resting sites on the interior surfaces of human dwellings or other buildings. The main aim of IRS is to kill vectors before they are able to transmit pathogens to humans. When carried out correctly, IRS has his
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torically been shown to be a powerful intervention to reduce adult vector density and longevity for mosquitoes, sand flies and triatomine bugs and can reduce the transmission of vector-borne diseases.
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The Global Programme on Tuberculosis & Lung Health of the World Health Organization (WHO/GTB) is now combining all current recommendations into one overall set of consolidated guidelines on TB. The guidelines contain recommendations pertaining to all areas related to the programmatic management of T
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B (e.g. screening, preventive treatment, diagnostics, patient support, and the treatment of drug-susceptible TB and DR-TB). The consolidated guidelines contain modules specific to each programmatic area.
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The "National Guideline for Cholera Surveillance and Outbreak Response" by the Ethiopian Public Health Institute (EPHI) provides a comprehensive approach to combating cholera outbreaks in Ethiopia. It emphasizes the importance of a multisectoral approach, including case management, WASH measures, an
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d the use of cholera vaccines. A key component is the establishment of Cholera Treatment Centers (CTCs) that provide 24/7 care. Additionally, the guideline stresses water quality monitoring and hygiene practices to prevent the spread of cholera and protect public health.
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The "Regional Action Plan 2017–2030: Towards a Malaria-Free South-East Asia Region" by the World Health Organization (WHO) outlines a strategic framework to eliminate malaria in the 11 countries of the WHO South-East Asia Region by 2030. It focuses on reducing transmission, particularly of Plasmod
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ium falciparum and P. vivax, addressing multidrug resistance, improving surveillance, and ensuring universal access to diagnosis, treatment, and prevention. The plan sets clear objectives and milestones and emphasizes strong governance, cross-border collaboration, community involvement, and sustainable financing to achieve and maintain a malaria-free status across the region.
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World malaria report 2024
recommended
New data from the WHO reveal that an estimated 2.2 billion cases of malaria and 12.7 million deaths have been averted since 2000, but the disease remains a serious global health threat, particularly in the WHO African Region. According to WHO’s latest World malaria report, there were an estimated
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263 million cases and 597 000 malaria deaths worldwide in 2023. This represents about 11 million more cases in 2023 compared to 2022, and nearly the same number of deaths. Approximately 95% of the deaths occurred in the WHO African Region, where many at risk still lack access to the services they need to prevent, detect and treat the disease.
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