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Food and nutrition security in the Democratic Republic of the Congo is subject to the relentless impact of conflict, epidemics and climate events t
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hat have persisted in the country for decades, further compounded by the global COVID-19 pandemic. Lack of infrastructure and investment in agriculture, health and human capital development combine to impede progress towards the achievement of Sustainable Development Goals 2 and 17. While there are several legal instruments and policies that promote food and nutrition security, poor coordination, weak national capacity and exponential population growth present serious obstacles to the achievement of zero hunger. Political instability and siloed sectoral responses to humanitarian and development needs have also affected results to date.
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This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corpo
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ration (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed since the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
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The outbreak of COVID-19 comes with unpredictable primary and secondary impacts on vulnerable and food-insecure populations across the world. Mortality and morbidity appear to be most acu
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te for elderly people, and those with underlying health conditions. At the same time, the widely anticipated economic downturn could have a more devastating effect on the world’s poor than the virus itself
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for
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blood pressure, blood sugar and blood cholesterol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Background
Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death.
Methods
This review is based on articles retriev
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ed by a selective search in PubMed, as well as on relevant guidelines.
Results
Evidence-based treatment options are available only for congestive heart failure with a low ejection fraction. Pharmacotherapy is based on neurohumoral inhibition of the renin-angiotensin-aldosterone system and the adrenergic system. The prognosis of patients with this condition has been further improved recently through the introduction of combined angiotensin receptor antagonists and neprilysin inhibitors. Modern implantable devices are a further component of treatment. Implantable defibrillators and special pacemakers for cardiac resynchronization are well established; the utility of alternative devices (baroreflex modulation or cardiac contractility modulation) needs to be investigated in further studies. It was recently shown that the catheter-based treatment of secondary mitral regurgitation with a MitraClip improves the outcome of selected patients.
Conclusion
The treatment of chronic systolic heart failure as recommended in the relevant guidelines, with drugs and implanted devices if indicated, can significantly improve the clinical outcome.
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The report is geared towards mayors, local government officials and city policy planners.It highlights key areas where city leaders can tackle the drivers of NCDs, including tobacco use, air polluti
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on, poor diets and lack of exercise, and improve road safety.
From anti-tobacco actions in Beijing and Bogor, to road safety initiatives in Accra and Bangkok, a bike sharing scheme in Fortaleza, and actions to create walkable streets for seniors that have reduced elderly pedestrian deaths by 16% in New York City, the report aims to share knowledge between urban policy planners.
Of the 19 case studies cited, 15 are from developing countries, where 85% of premature adult deaths through NCDs take place, and over 90% of road traffic fatalities are recorded. You can download the case studieson the website https://www.who.int/ncds/publications/tackling-ncds-in-cities/en/.
Over 90% of future urban population growth will be in low or middle-income countries, and seven of the world’s 10 largest cities are in developing countries.
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In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care and treatment in Ghana. The purpose of this analysis was to identify the gaps wi
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thin the current delivery of paediatric HIV care and support system and develop a road map for effective implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept). more
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept). more
Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, ma
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lnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice
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Nearly 800 women die every day from preventable maternal causes, and in 2022 alone, an estimated 2.3 million newborns died. For every maternal death, countless more women endure life-altering injuries, infections, and disabilities related to childbi
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rth.
Maternal deaths are concentrated in the poorest regions and conflict-affected areas. In 2020, sub-Saharan Africa accounted for nearly 70% of all maternal deaths, with just 22 countries responsible for 81% of the global total. Humanitarian crises and fragile health systems exacerbate these challenges, with maternal mortality rates in crisis-affected areas often double the global average. The barriers to progress are multifaceted, including inadequate funding, poor-quality healthcare, harmful gender and social norms, and critical gaps in data and accountability.
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Preferential option for the poor in the South African
context of poverty
Missionalia 43:3
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(349–364)
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This rapid review report has identified the wastewater treatment plant (WWTP) options used in emergency settings, with decentralised wastewater treatment systems (DEWATS) and mobile wastewater treat
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ment units performing most effectively and with minimal costs. Examples are taken from refugee camps and internally displaced people (IDP) settlements due to the Iraq war, the Israeli-Palestine conflict, and the civil wars in Syria and Sudan. WWTP options used in Finland, Haiti, Iraq, Jordan, Palestine, Sudan and Turkey are discussed. Lessons learned from China and suggestions for the Rohingya crisis are also included.
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Save the Children in collaboration with the Pune Municipal Corporation (PMC) and the state National Health Mission (NHM) undertook this study in
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the urban slums of Pune City to generate learnings for designing a city-specific public health approach to improve MNH services for the urban poor.
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Taeniasis and cysticercosis caused by the parasite T. solium affect vulnerable populations,
mainly in Latin America, sub-Saharan Africa and Asia, where pigs (the intermediate host) roam
free and
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poor sanitation allows pigs access to human faeces.
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29 Dec 2021. Comprehensive slideset updated regularly to include the latest data and guidance on best practices for COVID-19 diagnosis and prevention of COVID-19 transmission.
This publication describes an arduous campaign to tackle the use of antimicrobials - specifically antibiotics - in the Danish swine-producing sector thanks to
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the collaboration between the regulatory sector within the Ministry of Environment and Food, private veterinary practitioners and swine producers. The document is a retrospective tribute to all those who had the foresight to make significant changes to ensure consumer protection - improving hygiene at primary sites, developing options for intervention, identifying sites for intervention, setting targets, restructuring the relationship between the veterinary services and farmers, and implementing changes in behaviour for greatest impact
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For applying the new operational guidance on CB-MHPSS in the field, UNICEF country offices and partners will need ready access to tools and resourc
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es that can be used to implement the programs. By bringing together resources from different contexts, the compendium makes options available to country offices and partners for programming.
The compendium aims to strengthen UNICEF capacity for MHPSS programming consistent with the IASC Guidelines for MHPSS in Emergencies and described by the 9 circles of support in the UNICEF operational framework.
The compendium is a compiled set of resources, already being used by UNICEF and partners, both national and international, in diverse settings.
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For the estimated 20 million refugees and 25 million internally displaced people worldwide, well-planned settlements can help to maximise their protection and security, and support them to minimise
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the spread of disease, manage natural resources sustainably, and maintain good relations with their hosts until durable solutions to their displacement are achieved.
The result of extensive consultations with a wide range of specialist organisations, this book takes a holistic view of shelter for displaced populations, extending beyond refugee camps to consider support for all of the settlement and shelter options open to displaced people. It offers co-ordinators and specialists a common planning tool which links strategy, programmes, projects, and technical information for use in the field
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The increasing global trend of Antimicrobial resistance (AMR) has gradually emerged as a major public health challenge for the entire world. AMR ha
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s spread to almost all countries and regions, including Pakistan owing to the “misuse and overuse” of Antimicrobials, contributing to the increasing burden of infections due to resistant bacteria, viruses, parasites and fungi, while limiting the treatment options for managing such infections.
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The Antimicrobial Resistance Benchmark has evaluated for the second time how the most important
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players in the antibiotic market are addressing the rise of resistance and the global need for appropriate access to antibiotics. Although we can see progress — it’s hanging by a thread.
We have reached a tipping point where large and prominent drugmakers have retreated from the antibiotics field and smaller innovative biotech companies have gone bankrupt due to the poor financial rewards on offer.
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The compendium is designed for use by staff working directly with communities - e.g. health workers and community volunteers working with disabled and older people and their families in rural areas
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of sub-Saharan Africa.
A few examples of technologies are presented that families can adapt to suit their needs and budgets. Many more options are possible. Most of the ideas are suitable for disabled and older people, but are not only for them. As we get older, many of us find it increasingly difficult to squat and balance, or we might be injured or sick. These technologies might also make facilities easier and more comfortable to use by everyone in the family. The ideas are designed to be suitable for household facilities, not for institutional facilities - e.g. schools and clinics - although some ideas might also be useful in these settings
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