Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAH...O) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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Miscellaneous
Child and adolescent psychiatric emergencies
Chapter J.1
Personne ne va dans un établissement de soins de santé pour tomber malade. On s’y rend pour se faire soigner, pour accoucher
ou pour se faire vacciner. Cependant, des centaines de millions de personnes s’exposent à un risque accru d’infection en cherchant à obtenir des soins dans des éta...blissements de santé dépourvus de produits de première nécessité, notamment de services d’approvisionnement en eau, d’assainissement et d’hygiène, de gestion des déchets biomédicaux et de nettoyage (services WASH). L’absence de services WASH dans les établissements de santé compromet la sécurité et la dignité des patients, tout en menaçant d’exacerber la propagation d’infections résistantes aux agents antimicrobiens et en fragilisant les efforts déployés pour améliorer la santé des enfants et des mères.
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A practical guide for hospital administrators, health disaster coordinators, health facility designers, engineers and maintenance staff to achieve Smart Health Facilities by conserving resources, cutting costs, increasing efficiency in operations and reducing carbon emissions
The NGO Safety and Security Training Report provides a narrative of the research findings, an updated curriculum, and guidance tools for training. It is based on extensive research and interviews with members of the NGO community. The report draws upon existing training materials, community consulta...tions, survey responses, job descriptions, as well as relevant trends in humanitarian and development practice. It captures good practice and global understanding in regard to quality and consistency of NGO security training.
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Background paper 13
The Independent Panel for Pandemic Preparedness and Response
May 2021
This document aims to provide guidance to countries in the identification of priority areas
for intervention as part of the Situational Analysis of their National Cholera Control or
Elimination Plans (NCPs).