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Accessed: 02.05.2020
These interim IPC recommendations for health settings have been developed through the contributions of many individuals and institutions, such as the Centers for Disease Control-Kenya; ITECH; US Agency for International Development (USAID) Medicines, Technologies, and Pharmaceu
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tical Services (MTaPS) Program; and WHO that are committed to ensuring that the transmission of COVID-19 to HCWs and the public within the health care setting is limited. The Ministry of Health (MOH) through the Directorate of Health Standards Quality Assurance and Regulations wishes to thank all the contributing authors led by the sub-committee on case management and IPC for the COVID-19 response for their expertise and time given to writing these guidelines.
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The crisis caused by the COVID-19 pandemic exacerbated preexisting structural economic inequalities, and had a disproportionate impact on informal workers, especially on women and young people, who lost jobs and income. The situation was even more difficult for single-parent households led by women,
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who also had to endure more housework and care tasks. As shown by various research studies, the asymmetric distribution of care tasks, taken up by women, is an inequality factor.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati
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ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also di
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rected at policy-makers, health-care planners and programme managers, academic institutions, non-governmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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Effective implementation of WHO PEN, combined with other very cost effective population-wide interventions, will help even resource constrained settings to attain the global voluntary targets related to
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reduction of premature mortality and preventionof heart attacks and strokes.
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DHS Methodological Report No. 20
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method— ... principal component analysis (PCA).
We scored the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method— ... principal component analysis (PCA).
We scored the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the fir ... st day of antenatal care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133 more
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the fir ... st day of antenatal care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133 more
A two-week mission was conducted by WASH and quality UHC technical experts from WHO headquarters and supported by the WHO Ethiopia Country Office (WASH and health systems teams) in July 2016, to understand how change in WASH services and quality imp
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rovements have been implemented in Ethiopia at national, sub-national and facility levels; to document existing activities; and through the “joint lens” of quality UHC and WASH, to identify and seek to address key bottlenecks in specific areas including leadership, policy/financing, monitoring and evaluation, evidence application and facility improvements. Ethiopia has implemented a number of innovative and successful interventions.
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a systematic review and meta-analysis Derek K Chu et al. on behalf of the COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors.
Published: The Lancet June 01, 2020 DOI: https://doi.org/10.1016S0140-6736(20)31142-9
'We did a systematic review of 172 observational studies in health-
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care and non-health-care settings across 16 countries and six continents... Physical distancing of 1 m or more was associated with a much lower risk of infection, as was use of face masks (including N95 respirators or similar and surgical or similar masks [eg, 12–16-layer cotton or gauze masks]) and eye protection (eg, goggles or face shields)...'
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and chal
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lenges, maps existing international commitments and frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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o support and guide countries and partners to strengthen a health systems response to address violence against women, WHO has produced several tools, including:
• clinical and policy guidelines
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;
• implementation handbooks and manuals;
• training curriculum;
• evidence-based policy, prevention and intervention strategy packages.
The resource package consolidates these documents to support countries to develop or update their national or subnational guidelines, protocols, standard operating procedures, health provider training materials, and multisectoral action plans to prevent and respond to violence against women.
The resource package is also intended to be used for training and sensitization of policy-makers, advocates, health care providers and managers of services and programmes to address violence against women.
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers
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to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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Injection Safety and Safe Disposal of Medical Waste National Communication Strategy and Health Care Waste Management Standard
Operating Procedures (SOPs).
The overall objective of the consultancy was to
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review and align the three national technical and communication guiding documents on HCWM to the WHO Blue Book and other global standards and recommendations. The specific objectives of the assignment were ; to establish how well aligned the Kenya Healthcare Waste Management Guidelines, 2011, are to the WHO Blue Book on healthcare waste management, global recommendations and other global conventions on environmental protection; to establish the extent to which the Kenya Injection Safety and Safe Disposal of Medical Waste National Communication Strategy is aligned to the National Health Communication Guidelines, 2013; to determine the extent to which the current Standard Operating Procedures are aligned to the best available technologies (BAT) and best environmental practices (BEP) and international practices; and to assess current health care waste management practices at the health facilities supported by the GEF project.
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The Guidelines for the Prevention, Surveillance and Management of COVID-19 Infection amongst Health Care Workers (HCW) in Zimbabwe were developed to prevent, detect and manage HCW COVID-19 infection
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, an emerging pandemic affecting the whole world. The HCW is at the fore front of this pandemic, thus the need for standardised operating procedures is of utmost importance. These guidelines therefore seek to reduce the significant morbidity and mortality among the HCW, ultimately ensuring the reduction of the cost to the health care worker and the Ministry of Health and Child Care (MoHCC) as a whole. The Ministry of Health and Child Care requires that all health care workers in various health care settings follow infection prevention and control procedures.
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The war in Ukraine has had devasting impact on women and girls
worldwide, widening gender gaps and increasing rates of food insecurity, malnutrition and energy poverty. This brief reviews the available evidence of that impact, recommending urgent attention
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to its consequences for women and girls. Its findings underline the global impacts on gender equality and women’s rights that have been compounded by climate change, environmental degradation and the COVID-19 pandemic,
demonstrating further entrenched inequalities and human rights violations.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of
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care. Such services are also essential for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also di
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rected at policy-makers, health-care planners and programme managers, academic institutions, non-governmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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The COVID-19 pandemic has created challenges for forcibly displaced persons and the humanitarian organizations working to support them. With restrictions on movement and limited access
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to refugees, asylum-seekers, internally displaced persons (IDPs) and stateless persons across the globe, UNHCR is supporting displaced communities to take the lead in the prevention of, and the response to, the existing and emerging protection needs of women, men, girls and boys of diverse backgrounds.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health
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care systems throughout the Region. Though there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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Objectives and scope of the document
This document was developed to provide recommended management strategies for problems and disorders that are specifically related to the occurrence of a major s
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tressful event. The recommended strategies will form the basis of a new module to be added to the WHO (2010) mhGAP Intervention Guide for use in non-specialized specialized health-care settings.
The scope of the problems covered by these guidelines is:
symptoms of acute stress in the first month after a potentially traumatic event, with the following subtypes:
- symptoms of acute traumatic stress (intrusion, avoidance and hyperarousal) in the first month after a potentially traumatic event;
- symptoms of dissociative (conversion) disorders in the first month after a potentially traumatic event;
- non-organic (secondary) enuresis in the first month after a potentially traumatic event (in children);
- hyperventilation in the first month after a potentially traumatic event;
- insomnia in the first month after a potentially traumatic event;
posttraumatic stress disorder (PTSD);
bereavement in the absence of a mental disorder.
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