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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to
...
accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
more
This document highlights landmarks and key milestones in the development and implementation of the global agenda for noncommunicable diseases (NCDs) over the last two decades. It summarizes where the world was in 2000, where it is in 2022, and where the world wants to be in terms of NCD prevention a
...
nd control by 2030. It recalls the commitments made by heads of state and governments, and outlines the technical guidance provided by the World Health Organization (WHO) in support of national efforts to achieve the internationally agreed NCD targets for 2025 and 2030.
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Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Union Framework for Antimicrobial Resistance Control 2
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020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
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The target audience of this document (and the associated online companion tool) includes WHO country offices in Member States of the African Region; Member States’ ministries of health and their public health emergency operation centres; relevant external assessment teams; and partners looking to
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identify preparedness gaps and
support interventions that help address them. In the event of a suspected or confirmed VHF case, the document also serves to provide any intervening partner with a sense of what structures should be in place, in order to guide
scale-up activities in line with regional and national plans.
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Pillar 3 of the Global technical strategy for malaria 2016–2030 calls for the transformation of malaria surveillance into a core intervention in all malaria-endemic countries, as well as in countries which have eliminated malaria but remain susceptible to re-establishment of transmission. This ref
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erence manual covers subjects that are relevant to both settings.
The target readership of this manual includes staff working in ministries of health, national malaria programmes and health information systems; partners involved in malaria surveillance; and WHO technical officers who advise countries on malaria surveillance.
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The framework recommends expanded coverage of malaria diagnostic and treatment services, intensified vector control to drive down transmission, strengthened malaria surveillance, and increased transborder collaboration, especially in terms of efforts to control the sale and use of artemisinin monoth
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erapies. Since it is unlikely that national malaria control programs will be able to implement all the activities described in this framework simultaneously, a list of suggested priority activities has been included in the Annex.
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TArtificial intelligence (AI) is transforming health systems, reshaping how care is planned, delivered and governed. This report presents the first assessment of AI integration into health systems across the whole of the WHO European Region, based on findings from the 2024–2025 survey on AI for he
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alth care. It examines national strategies, governance models, legal and ethical frameworks, workforce readiness, data governance, stakeholder engagement, private sector roles and the uptake of AI applications. Drawing on insights from 50 Member States, the report explores how countries are navigating opportunities and challenges, highlighting emerging trends, gaps and practices to guide policy-makers towards coherent, ethical and people-centred approaches to AI in health care.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management
...
and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc
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e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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It is against this background that the Ministry of Health and Sanitation with its partners have
taken the lead to develop Essential Health Services Package (EHSP). The MOHS believes that the
development of EHSP; defining the services that should be available at each level of care
(community to
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tertiary level), for each age cohort, and across each public health functions, not
only allows for more effective and equitable health service delivery, but also for the
establishment of a functional referral system and allocation of appropriate investments for high
impact interventions. The package is expected to set precedence in defining ‘essential’ set of
services for the population in Sierra Leone, structurally promoting integration of health services,
and providing succinct guidance to partners and stakeholders on the country priorities.
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Effective malaria case management requires quick access to diagnostics and antimalarial treatments to reduce illness and death. Artemisinin-based combination therapy (ACT) has been essential to malaria treatment since 2001, as it combines artemisinin for rapid parasite reduction with a partner drug
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to ensure complete cure. However, resistance to antimalarial drugs, where parasites survive standard doses, threatens malaria control.
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Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by the presence of hyperglycaemia in the absence of treatment. The heterogeneous aetiopathology includes defects in insulin secretion, insulin action, or both. The long-term specific complications of diabe
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tes include retinopathy, nephropathy, and neuropathy. People with diabetes are also at increased risk of other diseases, including cardiac, peripheral arterial and cerebrovascular disease, cataracts, erectile dysfunction, and nonalcoholic fatty liver disease. They are also at an increased risk of some infectious diseases such as tuberculosis, and are likely to experience poorer outcomes.
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Rational Use of Inhaled Medications for the Patient with COPD and Multiple Comorbid Conditions: Guidance for Primary Care
Tisiligianni, I.; Hoines, K.; Jensen, C.; et al.
International Primary Care Respiratory Group (IPCRG)
(2019)
CC2
The document discusses the complexities of managing patients with COPD and multiple comorbidities, highlighting the importance of personalized care and the appropriate use of inhaled corticosteroids (ICS). It outlines common comorbidities, such as asthma, osteoporosis, and diabetes, and offers guida
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nce on optimizing treatment regimens while minimizing risks and polypharmacy in primary care settings.
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This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management for asthma and suggests an appropriate strategy for implementing supported self-management.
For many years, Community Health Care Workers (CHWs) in Tanzania and Africa in general have played significant role in community health promotion. Their specific roles have been changing from time to time. However, their key roles have over time included giving health education and dissemination of
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health information to communities, invariably moving on to include other services such as offering curative services and conducting community surveys. Deployment of CHWs has mainly been a response to the severe shortage of the human resource for health in most African countries due to brain drain for various reasons that include unattractive terms and conditions of employment. On the other hand the human resources for health (HRH) is a result of positive growing demand for health services, a situation confronted by inadequate supply of trained health personnel from training institutions to meet the demand.
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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base
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d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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Malaria in pregnancy is a significant health problem in malaria-endemic areas. It not only causes substantial childhood morbidity and mortality but also increases the risks of adverse events for pregnant women and their developing fetuses. Most of the burden in these areas is due to infection with P
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lasmodium falciparum. Artemisinin-based combination therapy (ACT) has been recommended as first-line treatment for uncomplicated P. falciparum malaria in all populations, including pregnant women in their second and third trimesters, since 2006. However, for women in their first trimester of pregnancy, WHO recommended as first-line treatment a combination of quinine and clindamycin.
Based on a review of the evidence conducted in 2022, WHO now recommends artemether–lumefantrine, the ACT with the most human safety data available, as the preferred treatment for uncomplicated P. falciparum malaria in the first trimester of pregnancy. This document presents all relevant evidence on the effects and safety in early pregnancy of artemisinins and partner medicines used in ACTs from both studies in experimental animals and observational studies in humans.
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Framework of Indictors and Targets
