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Las violencias por motivos de género atraviesan a mujeres, LGBTI+, niñeces y adolescencias con gran impacto en múltiples dimensiones de la vida y el sistema de salud tiene un rol fundamental en su detección temprana, en la evaluación del riesgo, en la prevención y la atención integral.Por
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eso, desde el Ministerio de Salud de la Nación y la Organización Panamericana de la Salud (OPS/OMS) presentamos el Manual Clínico “Atención integral de la salud ante situaciones de violencias por motivos de género. Herramientas para equipos de salud”, adaptado técnica y culturalmente a nuestro país a partir de la versión original de la Organización Mundial de la Salud (OMS). El presente manual está dirigido a todas las personas que integran equipos de salud interdisciplinarios e intersaberes del sistema sanitario (formadas en Medicina, Psicología, Enfermería, Trabajo Social, asesoramiento legal, agentes sanitarios, administración, promotoras y promotores de la salud, etc.) en especial a quienes trabajan en el primer nivel de atención. Su propósito es brindarles herramientas para la atención integral a mujeres, LGBTI+» y niñas, niños, niñes y adolescentes (en adelante, NyA) que atraviesan o han atravesado situaciones de violencias por motivos de género (en adelante, VMG).
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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex.
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La carga de la diabetes es enorme, posicionándola como uno de los principales desafíos que enfrenta la salud pública en la actualidad. Actualmente, se estima que 62 millones de personas viven con diabetes en la Región de las Américas y las proyecciones muestran que su prevalencia seguirá aumen
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tando en los próximos años. La Región muestra el mayor número de años de vida saludable perdidos (ya sea por discapacidad o muerte prematura) debido a la diabetes en todo el mundo. Los altos costes asociados a su tratamiento producen una pesada carga económica. Sus complicaciones pueden afectar seriamente la calidad de vida de las personas que viven con diabetes, sus familias y la sociedad y sobrecargar los sistemas de salud. Este informe muestra los últimos datos comparables internacionalmente sobre la diabetes y sus principales factores de riesgo por año, país y sexo. También incluye un resumen de la respuesta de los sistemas de salud de los países a la diabetes, incluidos planes nacionales, objetivos, vigilancia, directrices y acceso a medicamentos y tecnologías esenciales, y sintetiza información sobre las complicaciones relacionadas con la diabetes y la estrecha relación entre la diabetes y otras patologías, como enfermedades cardiovasculares, tuberculosis y COVID-19.
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South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing
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and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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This publication describes the history of malaria in Uzbekistan. It evaluates the policies and strategies applied after the re-establishment of local transmission to contain malaria outbreaks in the 1990s and early 2000s, and highlights the interventions subsequently used to eliminate malaria in the
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country. Uzbekistan was officially certified by WHO as a malaria-free country in 2018. Lessons for countries embarking upon elimination are distilled. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
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People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi
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enced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.
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The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with
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disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and often reactive nature of non-governmental organisation (NGO) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.
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With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across countries by development level. Using internatio
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nally comparable data on disability inequalities in 40 countries, we assess disability inequalities through the use of regression analyses with a variety of development measures. Results support the hypothesis only partially: disability inequalities related to education, employment, and multidimensional poverty are found to be significantly larger in countries at higher levels of development. However, this is not the case for rates of access to water, sanitation, clean fuel, electricity, housing, and assets. These results, overall, hold when using different development and
outcome indicators, and when focusing on specific subgroups of the population. The potential implications of these findings are discussed. Further research is needed to understand, for education and employment, the factors and processes that contribute to larger disability inequalities in countries at higher levels of development and what strategies might be pursued to reduce them.
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Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
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Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
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hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
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People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. Th
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is case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.
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Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The
Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and
communicating) to allow collection of co
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mparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi.
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Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We aimed to better understand social norms and commun
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ity perceptions of preterm infants and KMC (facility-initiated and community-continued) in Malawi, a country with a high preterm birth rate, to inform a pilot social and behavior change program.
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The Ministry of Health and Social Services (MOHSS) undertook a situation analysis in respect of human resources for health in order to improve health and social services outcomes following varios sector targeted interventions. The situation analysis report covers the period up to December 2018 and r
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esults from this situation analysis were presented at various forums for broader discussion and input.
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On 31 May 2022, the Konrad-Adenauer-Stiftung (KAS) Namibia – Angola Office handed over equipment to the Namibian Federation of the Visually Impaired (NFVI), at their head office in Windhoek. The main objective of this handover is to support the federation with equipment including a Perkins Braille
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r Classic Manual and a Tactile Heat Swell Form Machine, to aid the braille/transferal of text to braille. Additionally, to enable the federation to capacitate their members with the necessary resources, to bring crucial information closer to persons with visual impairments (inclusion) and promote practical application of the Namibian Constitution, with special reference to Chapter 3.
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Namibia has a two-tier health system: public health under the Ministry of Health and Social Services (MoHSS) and the private health service. MoHSS‘ vision is to be the leading provider of quality health care and social services according to international set standards. Since Namibia’s independe
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nce, the government adopted Primary Health Care (PHC) as the approach to providing health service and as a key strategy in attaining the goal of health. Good health is also strengthened by the Sustainable Development Goals (SDGs). The SDGs provide a road map for human development and, among others, systematically address the social determinants of health. Notable is Goal 3, which focuses on good health and well-being.
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Reflecting its commitment to achieving the Sustainable Development Goals (SDGs), Namibia volunteered to undertake a second national review of the SDGs in 2021. The focus is on three SDG dimensions, namely, Economic, Social, and Environmental. These three dimensions are comprehensively integrated in
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the fifth National Development Plan (NDP5) pillars: Economic Progression, Social Transformation, Environmental Sustainability, and Good Governance.
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PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to de
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termine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
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The South African WHO Country Cooperation Strategy (CCS) 2023–2027 focuses on four key strategic priorities based on the country’s health needs and disease epidemiology, while also considering the need for building resilient health systems for UHC and health security in the post pandemic period.
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These include:
1. augment health systems strengthening reforms to accelerate progress towards universal health coverage.
2. address the quadruple burden of diseases and promote well-being across the life course in view of achieving global targets.
3. build health systems resilience and strengthen health emergency preparedness and response capacities.
4. enhance multisectoral collaboration and global partnerships for concerted action on health and its determinants.
In order to harness its expertise across its three levels, namely: the WHO Country Office (WCO), WHO Regional Office for Africa, and WHO headquarters, WHO will work closely and collaboratively with the Government of South Africa to implement the 2023–2027 strategic priorities.
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While motivational factors vary, opportunities for career advancement, stimulating and challenging tasks, opportunities for promotion, and co-worker recognition are core factors that can engender retention of rural health workers. Interventions are required to enhance rural health worker motivation
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and retention, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. Strategies around retention need to be addressed as these would better enable rural primary health workers to cope with the challenging conditions they work in rural areas.
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UNICEF, as the lead agency of a multi-partner approach across 21 member states in Eastern and Southern Africa, identified that this point represents a moment for the WASH sector to take stock of progress towards SDG6,
understand the gaps in our current knowledge on levels of access, and take cours
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e corrective actions to ensure that SDG6 is met in the remaining 10 years to 2030 vision.
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