The COVID-19 pandemic has had an unprecedented impact on health care systems that, in many instances, worsened the already existing assistance gaps. When it comes to Latin America and Central America, this challenge adds to the consequences mass mobilizations have had in recent years, which have exc...eeded the national capacities to provide prompt assistance and social protection, particularly in the health care field. This pandemic has a direct impact on people on the move since the movement restriction policies and the lockdown and social distancing measures have reduced their ability to insert themselves into economic activities that were already precarious in many cases. Consequently, they have less access to food, housing, medicines and other essential consumer goods, and fewer possibilities of getting to their countries of destinati
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Nigeria’s healthcare system faces significant challenges in financing and quality, impacting the delivery of services to its growing population. This study investigates healthcare workers’ perceptions of these challenges and their implications for healthcare policy and practice. A cross-sectiona...l survey was conducted with 600 healthcare professionals from eight states across Nigeria, representing a variety of healthcare occupations. Participants completed a questionnaire that assessed their perceptions of healthcare financing, quality of care, job satisfaction, and motivation using a 5-point Likert scale, closed- and open-ended questions. Descriptive statistics, Chi-squared test, and regression analysis were used to analyze the data. The findings revealed that healthcare workers were generally not satisfied with the current state of healthcare financing and system quality in Nigeria. Poor funding, inadequate infrastructure, insufficient staffing, and limited access to essential resources were identified as major challenges.
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BMJ Open Quality 2017;6:e000145. doi:10.1136/
bmjoq-2017-000145Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care received. This knowdo gap is a source of preventab...le maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices.
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Welcome to our implementation research case example focusing on chagas disease and Ecuador. This module offers a comprehensive exploration of the strategies employed to address the challenges posed by Chagas disease, a neglected tropical disease prevalent in Latin America. With a specific focus on t...he southern Ecuador context, this course describes the relationship between public health interventions, socioeconomic factors, and community understanding, all of which are essential for the prevention, treatment, and diagnosis of chagas disease
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EXPERT OPINION ON DRUG SAFETY 2018, VOL. 17, NO. 11, 1129–1144.
Malaria during and after pregnancy contributes significantly to maternal mortality and adverse fetal outcomes. While effective and safe antimalarial treatments are essential, quinine — an older, less effective drug — has long bee...n favoured due to the limited safety data available on newer drugs. This review summarises the results of human studies investigating the safety and efficacy of antimalarial drugs during pregnancy and lactation.
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The WHO recommends parenteral artesunate over quinine and artemether for treating severe Plasmodium falciparum malaria in adults and children. Intravenous administration is preferred. A new one-step, arginine-based formulation eliminates the need for dilution steps, reducing errors and accelerating ...the initiation of treatment—a critical factor for survival. This formulation was first prequalified by the WHO in 2023. By contrast, the conventional two-step artesunate formulation, which was prequalified in 2010, requires more complex preparation. Clear guidance is essential, as product-specific protocols differ. These training materials aim to support the correct and effective administration of the medication.
Accessed on 27/06/2025.
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Malar J 23, 333 (2024). https://doi.org/10.1186/s12936-024-05165-w.
Prioritization of spending on prevention, anti-malarial medicines, and health systems strengthening can fight incident cases and fatalities simultaneously, especially in resource-scarce, malaria-endemic countries. Furthermore, imp...roving the availability, frequency of collection, and quality of detailed disaggregated spending data is essential to support work that strengthens the evidence base on spending efficiency and work that improves understanding of how spending on malaria could be leveraged to bridge gaps in equity across population groups.
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Offering additional pre-exposure prophylaxis (PrEP) choices has the potential to increase uptake and effective use of PrEP, and of HIV prevention overall, as it allows people to choose a method that they prefer.
In this guideline, WHO recommends an offering long-acting injectable lenacapavir (LEN...) as an additional HIV prevention choice, as part of combination HIV prevention approaches. LEN, administered twice a year as PrEP, has been shown to be highly effective at reducing the risk of HIV acquisition. In this guideline, WHO also recommends using HIV rapid diagnostic tests (RDTs) for individuals initiating or continuing long-acting injectable PrEP, such as LEN and long acting injectable cabotegravir (CAB-LA). Flexible HIV testing approaches are essential for ensuring that testing does not become a barrier to accessing or continuing PrEP, including long-acting injectable options.
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Tanzania has an estimated 2.9 million adults with diabetes, 35% of whom are undiagnosed, and over 22,000 people living with type 1 diabetes. While the 2023 Universal Health Insurance law aims to improve access to care, only 15% of people are insured. Over 700 clinics provide diabetes care and offer ...free insulin to children and young adults. However, challenges remain regarding insulin availability, diagnostics, patient education and the healthcare workforce. Community engagement, training and policy advocacy are essential for improving diabetes management and achieving universal health coverage.
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Emergency medicine in Rwanda is underdeveloped. Limited training and infrastructure mean that the country has a high mortality rate from acute conditions such as trauma, malaria and obstetric complications. As Rwanda's disease burden shifts, there is a critical need for standardised emergency care. ...This Emergency Medicine Clinical Guideline (EMCG) provides essential protocols and principles that are tailored to the Rwandan context. The aim is to improve the delivery of emergency care at district and referral hospitals. It is intended as a practical resource for all healthcare providers involved in the management of undifferentiated emergencies.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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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 ...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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This report is not a country scorecard. Rather, its purpose is to act as a compass to guide progress towards health in the SDGs.
There has been a significant improvement in the state of health in the region with healthy life expectancy - time spent in full health - in the region increasing from 50....9 years to 53.8 between 2012 and 2015 - the most marked increase of any region in the world.
What is making Africans sick is changing. The top killers are still lower respiratory infections, HIV and diarrhoeal disease and countries have routinely focused on preventing and treating this trio, often through specialized programmes. The payoff has been significant declines in deaths due to these diseases. There has been a 50% reduction in the burden of disease caused by what have been the top 10 killers since 2000 and death rates have dropped from 87.7 to 51.1 deaths per 100,000 persons between 2000 and 2015...
Chronic diseases like heart disease and cancer are now claiming more lives with a person aged 30 to 70 in the region having a one in five chance of dying from a noncommunicable disease (NCDs).
Countries are specifically failing to provide essential services to two critical age groups – adolescents and the elderly...
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Tanzania, like other developing countries, is facing a higher burden of cardiovascular diseases (CVDs). The country is experiencing rapid growth of modifiable and intermediate risk factors that accelerate CVD mortality and morbidity rates. In rural and urban settings, cardiovascular risk factors suc...h as tobacco use, excessive alcohol consumption, unhealthy diet, hypertension, diabetes, hyperlipidemia, overweight, and obesity, are documented to be higher in this review. Increased urbanization, lifestyle changes, lack of awareness and rural to urban movement have been found to increase CVD risk factors in Tanzania. Despite the identification of modifiable risk factors for CVDs, there is still limited information on physical inactivity and eating habits among Tanzanian population that needs to be addressed. Conclusively, primary prevention, improved healthcare system, which include affordable health services, availability of trained health care providers, improved screening and diagnostic equipment, adequate guidelines, and essential drugs for CVDs are the key actions that need to be implemented for cost effective control and management of CVDs. Effective policy for control and management of CVDs should also properly be employed to ensure fruitful implementation of different interventions.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approximately twice as high as high-resource settings (15 o...ut of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan Africa. HAT transmission l...ast soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
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National Child Traumatic Stress Network National Center for PTSD | The field of school safety and emergency management has evolved significantly over the past decade. Tragically, acts of violence, natural disasters, and terrorist attacks have taught us many lessons. We also know that other types of ...emergencies can impact schools, including medical emergencies, transportation accidents, sports injuries, peer victimization, public health emergencies, and the sudden death of a member of the school community. We now recognize the need for school emergency management plans that are up-to-date and take an “all-hazards” approach with clear communication channels and procedures that effectively reunite parents and caregivers with students. We have also learned that preparing school administrators, teachers, and school partnering agencies before a critical event is crucial for effective response, the value of ongoing training and emergency exercises, and that having intervention models that address the public health, mental health, and psychosocial needs of students and staff is essential to a safe school environment and the resumption of learning.
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