This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), helps national and local stakeholders to design country-specific social and behavioural change communication (SBCC) campaigns that address the threat posed by substandard, spurious, falsified and fal...sely labelled (SSFFC) malaria medicines. These poor-quality medicines endanger lives by failing to treat malaria effectively, undermine health systems, and contribute to drug resistance.
The I-Kit provides practical guidance and resources in six sections, including global examples, campaign design elements, media engagement strategies and tools for knowledge sharing. It is intended for health promotion officers, drug regulators, communication specialists and global health partners. Drawing heavily on experiences in Nigeria, the I-Kit promotes evidence-based, context-sensitive SBCC interventions to safeguard communities against SSFFC malaria medicines and enhance treatment outcomes.
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Activity Brief.Formative research revealed that gold miners in remote regions of Guyana viewed malaria as an unavoidable and minor risk compared to other dangers. Building on these insights, Breakthrough ACTION co-created the 'Lil Mosquito, Big Problem' (LMBP) social and behavioural change campaign,... which targeted miners in malaria-endemic areas (Regions 7 and 8). Adopting a human-centred design approach, the campaign collaborated with the Ministry of Health, mining organisations, and miners throughout its development. LMBP used visual, low-literacy materials featuring animated and live-action characters to raise awareness of the risks of malaria and encourage key behaviours such as timely testing, adhering to treatment and consistently using insecticide-treated nets. Launched in 2019 and scaled up until 2024, this multi-channel campaign aimed to change attitudes and improve malaria prevention in these hard-to-reach communities.
Accessed on 20/06/2025.
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National tuberculosis (TB) prevalence surveys provide a nationally representative measurement of the burden of TB disease in the population, at a given point in time. Repeat surveys allow assessment of trends and tracking of progress towards national and global targets for reductions in TB disease b...urden. Survey data also provide important insights that can help national TB programmes to identify ways to improve TB diagnosis and treatment.
National TB prevalence surveys are relevant in countries that do not yet have national disease notification and vital registration systems that are of sufficiently high quality and coverage to allow reliable tracking of TB disease burden.
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The ongoing global pandemic of SARS-CoV-2 (Covid-19) poses unique diagnostic and clinical management challenges in regions where seasonal epidemic-prone diseases are endemic. Diseases such as dengue, malaria, seasonal influenza, leptospirosis, chikungunya, scrub typhus and bacterial infections often... present with febrile syndromes that mimic or co-exist with SARS-CoV-2 infection, complicating diagnosis and treatment. This document provides guidelines for preventing, diagnosing and managing such co-infections. A high level of suspicion is essential during the monsoon and post-monsoon seasons, taking into account region-specific disease prevalence. While the WHO's case definition for SARS-CoV-2 is broad and sensitive, the need for parallel testing for co-infections, in accordance with the protocols of the MoHFW, ICMR, NVBDCP and NCDC, is necessitated by overlapping clinical features. Ensuring the availability of reliable rapid diagnostic kits and applying integrated clinical and laboratory approaches are crucial to improving patient outcomes in the context of concurrent infections.
Accessed on 26/08/2025.
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Malaria remains a significant public health concern in the SADC region, accounting for 20% of childhood deaths, as well as prompting numerous outpatient visits and hospitalisations. Around three-quarters of the population, including 35 million children under the age of five and 8.5 million pregnant ...women, are at risk. Transmission patterns vary from high and stable in the north to malaria-free in the south, with low, unstable and seasonal zones in between. Although interventions such as indoor residual spraying (IRS), insecticide-treated nets (ITNs/LLINs), intermittent preventive treatment in pregnancy (IPTp), rapid diagnostic tests (RDTs), and artemisinin-based combination therapies (ACTs) have reduced the malaria burden, challenges persist in terms of funding, human resources, surveillance, and cross-border coordination. Achieving malaria elimination in the SADC region requires harmonised regional standards, strengthened surveillance, and improved access to quality treatment and policy prioritisation.
Accessed on 27/08/2025.
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Updated guidance on the integration of diabetes, hypertension and mental health services, and interventions to support adherence to antiretroviral therapy. The guideline offers practical implementation guidance for countries and key stakeholders as well as outlining key research gaps. As life expec...tancy for people living with HIV continues to increase, managing noncommunicable diseases, mental health, and adherence to antiretroviral therapy is essential to sustaining treatment success, quality of life, and engagement in care. A life course approach addresses these needs from childhood through older age. Service integration supports more person-centred, coordinated care across the life course.
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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.
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Every year, nearly 250 million people move across borders temporarily or permanently for a job opportunity, studying, to flee a crisis back home, or for other reasons. Another 750 million move for similar reasons within the borders of their countries. With the understanding that human mobility affec...ts public health, and health affects human mobility and migrants, for decades, IOM has been providing critical health services to women, children and men on the move, while standing by governments for technical and operational support as needed. In 2019, in lower-income settings and in complex emergencies, along the world’s most perilous migration routes, in the aftermath of natural disasters or in response to disease outbreaks, IOM’s health teams have provided hundreds of thousands with primary health-care consultations, mental health and psychosocial support, sexual and reproductive health care, pre-migration health services, and much more.
This year, more than ever before, as the world reels from the socioeconomic impact of COVID-19, we have experienced that health is a cross-cutting component of overall human development and well-being.
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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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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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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa...ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population wa...s very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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Mental health problems are common and cause great suffering to individuals and communities around the world. They have a significant impact not only on the physical and mental health of those affected but also on their families and the communities they live in. At the same time, all communities have... their own traditional mechanisms for support and contain a range wide of resources that can be helpful in preventing mental health conditions from developing, promoting positive mental health and supporting the recovery of people that are struggling with a mental health condition.
In the wider context, people living with a mental health condition are often excluded from their communities and experience various violations to their basic human rights (discrimination, violence, exclusion from employment opportunities). The World Health Organization (WHO) estimates that the mean prevalence of global mental health disorders is 10.8% while the prevalence in emergency settings is 22.1% in any conflict-affected population.
During emergencies and crisis, the stigma, exclusion and discrimination towards people living with mental health conditions is often higher, which can cause isolation and protection issues. Communities can play a crucial role in promoting mental health as well as enhancing primary care and access. Their role is to help reduce mental health inequalities by providing community resources that connect people to community-based resources and by providing mental health education. This also helps to reduce the massive mental health treatment gap.
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he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian responses to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH servic...es. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
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Manuel de formation pour les agents de santé communautaire pour l'évaluation des signes de danger et l'administration d'un traitement préalable au transfert immédiat vers une structure de santé.
Ce manuel a été développé par le Programme Spécial de Recherche et de Formation concernant l...es Maladies Tropicales (TDR) pour aider à la formation des Agents de Santé Communautaire (ASC) sur l'utilisation de l'artésunate par voie rectale comme traitement de pré-transfert.
Ceci est fondé sur la stratégie de prise en charge intégrée des maladies de l'enfant (lMCI), et une publication antérieure "Caring for the sick child in the community» qui avait été produite par le Département Santé de la mère, du nouveau-né, de l'enfant et de l'adolescent de l'OMS.
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Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis. Web Annex C