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Publication Years
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Toolboxes
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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.
more
Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent measles outbreaks which started in August 2021, and t
...
he highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
more
While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng
...
es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
more
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
...
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.
more
The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of
...
the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
more
The African Palliative Care Association is pleased to publish the first edition of Palliative Care Standards for Africa. The development of these standards was achieved through wide consultation with service beneficiaries and providers, and they have been developed to suit different levels of
...
service delivery, from primary to tertiary. These standards are underpinned by the World Health Organization’s definition of palliative care, and recognise that scaling up palliative care requires a public health approach with four pillars: policy, education, drug availability and implementation. In addition, the increasing need to establish specific indicators of quality and effectiveness for palliative care has been a big driving force behind these comprehensive standards. It is APCA’s wish that they will provide a framework for the development of evaluation
and performance indicators that can facilitate programme improvement and development. The standards are designed to allow the development or improvement of palliative care across the different services levels, within the organisational capacity of various service providers. They describe a relationship between primary, intermediary and tertiary level service providers, with expectations for all providers articulated through detailed criteria for each standard. It is therefore expected that these standards will influence the planning and delivery of palliative care services at all levels of health care service delivery.
more
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.
more
he United Nations Development Programme’s (UNDP) Gender Equality Strategy 2022-2025 has
been created during turbulent times. Multiple crises and risks are threatening the world and
we are witnessing an alarming backlash against women’s rights and gender equality. Since the
COVID-19 pandemic h
...
it, women have been nearly twice as likely to lose their jobs compared to
men. Yet less than 20 percent of policy measures implemented by countries across the world have
addressed women’s economic insecurity. Gender inequality also takes a toll on men and other
affected groups. For men, rigid gender norms can fuel risky behaviours resulting in violence, poor
health, and lower life expectancy.
more
This document consolidates, for the first time, WHO recommendations on the prevention, testing, treatment and monitoring of hepatitis B and C, and includes testing strategies for hepatitis D. Drawing on a decade of evidence-based guidance issued between 2015 and 2025, it provides a single, practical
...
handbook to support global progress toward eliminating viral hepatitis by 2030.
The document also highlights simplified service delivery models that promote decentralization, integration with primary care and related programmes such as HIV and tuberculosis, as well as task sharing and differentiated care to expand access and improve efficiency. It further underscores the need for robust data and monitoring systems to support effective programme implementation.
more
The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach
...
ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
more
- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to
...
essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
more
This document was prepared by UNICEF Regional Office for West and Central Africa, under the leadership of Christophe Valingot and the review of Joachim Peeters (WASH Specialist) and Arnaud Laillou (Nutrition Specialist), on behalf of the WASH Regional Group and the Nutrition Regional Group.
This
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WASH - Nutrition strategic guidance note for West and Central Africa builds on the precedent WASH-in-NUT strategy elaborated in 2012 and is the regional outcome of a multiyear collaborative work conducted at country level between 2018 and 2022, in Mali, Niger, Nigeria Chad, Burkina Faso. This work is based on a strong multi-partner collaboration, involving national technical directorates of the water and sanitation sector as well as technical directorates of Health and Nutrition, civil society organizations, national and international NGOs as well as United Nations agencies.
This document can serve as a technical and strategic guide for any partner wishing to strengthen the intersectorality of WASH-Nutrition programmes. It presents the regional WASH & Nutrition context, a brief review of the latest scientific evidence, and proposes an integrated WASH-Nutrition programming framework adapted to the regional context of West and Central Africa. Beyond the implementation of programmes, this document also calls for the explicit and concrete inclusion of WASH-Nutrition integration into national policy documents.
more
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.
more
Step Up for TB 2020 Tuberculosis Policies in 37 Countries A survey of prevention, testing, and treatment policies and practices.
The country scorecard reflects how many of 14 internationally recommended key policies are in place at the national level, based on the Step Up for TB 2020 report survey
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.
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Tracking development assistance for health for low- and middle-income countries gives policy makers information about spending patterns and potential improvements in resource allocation. We tracked the flows of development assistance and explored th
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e relationship between national income, disease burden, and assistance
more
This Plan envisions a future with the elimination of cervical cancer as a public health problem as a result of universal access to sexual health and STI prevention services, HPV vaccines, effective screening and precancer treatment services, treatment of invasive cervical cancer, and palliative care
...
. It foresees that all women and girls, regardless of age, race, ethnicity, socioeconomic status, HIV status, or disability will have timely access to quality cervical cancer prevention, care, and treatment so that they can live in good health throughout the life course and enjoy the health-related human rights.
The goal is to accelerate progress toward the elimination of cervical cancer as a public health problem in the Americas by reducing incidence and mortality rates by one-third by 2030.
more
This report presents the findings of the Estimating the Size of Populations through a Household Survey (ESPHS) study that took place in 2011. The study utilized a single household survey to estimate the size of several key populations, including sex workers, men who have sex with men (MSM), injectin
...
g drug users (IDU), and clients of sex workers. These populations include several groups outlined in the National Strategic Plan for HIV and AIDS as most at risk for HIV infection, specifically sex workers and MSM.
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This training guide applies a participatory approach, reflecting the considerable evidence that adults learn best by practicing and reflecting on their experiences. It thus emphasizes exercises to improve skills in counseling that support clients to adopt optimal nutrition practices. Women’s nutri
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tion and infant feeding in the context of HIV are also addressed. Guidelines to link the prevention of malnutrition with treatment via the Integrated Management of Acute Malnutrition are also included. It can also be conducted with nutrition managers to equip them to provide supportive supervision to health and community workers.
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