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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of
...
the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
more
Nearly 800 women die every day from preventable maternal causes, and in 2022 alone, an estimated 2.3 million newborns died. For every maternal death, countless more women endure life-altering injuries, infections, and disabilities related to childbirth.
Maternal deaths are concentrated in the poo
...
rest regions and conflict-affected areas. In 2020, sub-Saharan Africa accounted for nearly 70% of all maternal deaths, with just 22 countries responsible for 81% of the global total. Humanitarian crises and fragile health systems exacerbate these challenges, with maternal mortality rates in crisis-affected areas often double the global average. The barriers to progress are multifaceted, including inadequate funding, poor-quality healthcare, harmful gender and social norms, and critical gaps in data and accountability.
more
States have committed and assumed obligations to address multiple and intersecting forms of discrimination against refugees, internally displaced persons, asylum seekers, returnees and stateless persons. The Global Compact on Refugees places ending discrimination of any kind based on the grounds of
...
race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, disability, age, or other status at the centre of action to prevent displacement and to ensure peaceful coexistence between refugee and host communities. Narratives about cultural diversity and inclusion are important, but there is also a pressing need in many societies for conversations and action to address racism, racial discrimination, xenophobia and related intolerance.
more
This Roadmap is structured around a results-based framework of outcomes, outputs and deliveraebles, to ensure that WHO maintains appropriate levels of organizational readiness, supports country-level capacity building and preparedness, deploys efficiently and effectively to respond to outbreaks and
...
emergencies at national and subnational levels, and engages effectively with partners and stakeholders throughout
more
El Niño conditions persisting during the 2015/16 planting season have caused the worst drought in 35 years in Southern Africa, resulting in a second consecutive failed harvest. This has created severe food shortages and compounded existing vulnerabilities. Since July 2016, Namibia and Botswana have
...
declared national drought emergencies, in addition to the declarations made earlier by Lesotho, Malawi, Swaziland and Zimbabwe. Madagascar issued a letter of solidarity with the SADC Appeal, and Mozambique has maintained a red alert in affected areas.
more
Beyond borders. How to make the global compacts on migration and refugees work for uprooted children
The report presents successful case studies from around the world, including the implementation of minimum protection standards for refugee children in Germany, cross border child protection systems in West Africa, and finding alternatives to the detention of migrant children in Zambia. Other countr
...
ies featured in the report include Afghanistan, Italy, Jordan, Lebanon, South Sudan, Vietnam, Uganda and the U.S. Each of the initiatives can be replicated in different contexts and inform child-focused actions and policy change at national, regional and global levels to be agreed in the framework of the Compact.
more
The World Health Organization (WHO) endorses the use of population-based prevalence surveys for estimating the prevalence of trachoma. In general, the prevalence of TF in children aged 1–9 years and the prevalence of TT in adults aged ≥ 15 years are measured at the same time in any district bein
...
g surveyed. This was the approach of the Global Trachoma Mapping Project, which undertook baseline surveys in > 1500 districts worldwide in order to provide the data required to start interventions where needed.
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined. more
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined. more
The World Health Organization (WHO) endorses the use of population-based prevalence surveys for estimating the prevalence of trachoma. In general, the prevalence of TF in children aged 1–9 years and the prevalence of TT in adults aged ≥ 15 years are measured at the same time in any district bein
...
g surveyed. This was the approach of the Global Trachoma Mapping Project, which undertook baseline surveys in > 1500 districts worldwide in order to provide the data required to start interventions where needed.
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined. more
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined. 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 first 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 first 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
This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both inpatient and outpatient management of severe acute malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 i
...
n the WHO Pocketbook for Hospital Care for Children, and the 2013 update on SAM (outpatient management). The global threat of increasing antimicrobial resistance and new data on efficacy and safety profiles requires a re-review of the current evidence to ensure recommendations are the most appropriate. The evidence base for the use of antibiotics in children presenting with uncomplicated SAM has been recently enlarged.
more
The mission of the Women’s Health Council is to inform and influence the development of health policy to ensure the maximum health and social gain for women in Ireland.
Its membership is representative of a wide range of expertise and interest in women’s health.
The Women’s Health Council
...
has five functions detailed in its Statutory Instruments:
1. Advising the Minister for Health and Children on all aspects of women’s health.
2. Assisting the development of national and regional policies
and strategies designed to increase health gain and social gain for women.
3. Developing expertise on women’s health within the health services.
4. Liaising with other relevant international bodies which have similar functions as the Council.
5. Advising other Government Ministers at their request.
more
The following protocol has been designed to investigate the First Few X cases (FFX) and their close contacts. It is envisioned that the FFX 2019-nCoV investigation will be conducted across several countries or sites with geographical and demographical diversity. Using a standardized protocol such a
...
s the protocol provided here, epidemiological exposure data and biological samples can be systematically collected and shared rapidly in a format that can be easily aggregated, tabulated and analyzed across many different settings globally for timely estimates of 2019-nCoV infection severity and transmissibility, as well as to inform public health responses and policy decisions. This is particularly important in the context of a novel respiratory pathogen, such as 2019-nCoV
more
This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public health care. The Standards identify major components and features of effective systems for the tre
...
atment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
...
e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading
...
to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
more
One Health Joint Plan of Action (2022-2026)
World Organisation for Animal Health
Food and Agriculture Organization of the United Nations; United Nations Enviroment Programme; Wolrd Health Organization; World Organisation for Animal Health
(2022)
C_WHO
The desired impact of the OH JPA is a world better able to prevent, predict, detect and
respond to health threats and improve the health of humans, animals, plants and the
environment while contributing to sustainable development. The OH JPA aims to work
towards this vision in the following way:
...
• Provide a framework for action and propose a set of activities the four organizations
can offer together to advance and sustainably scale up One Health.
• Provide upstream policy and legislative advice and technical assistance, to help
set national targets and priorities across the sectors for the development and
implementation of One Health legislation, initiatives and programmes.
• Take stock of existing cross-sectoral global and regional initiatives around One
Health, identify and advise on synergies and overlaps, and support coordination.
• Mobilize and make better use of resources across sectors, disciplines and
stakeholders.
• The OH JPA is guided by a theory of change and makes use of One Health principles
to strengthen collaboration, communication, capacity building and coordination
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WHO/Europe has launched a new guide, providing support to countries on how to apply behavioural and cultural insights (BCI) for health. It presents a simple step-wise approach, complemented by a rich collection of detailed considerations, tools and exercises. The guide is the first of its kind, spec
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ifically developed for use by public health professionals developing policies, services and communications informed by BCI across health topics.
Some of the most persistent public health challenges involve human behaviour. Using a BCI lens means that health policies, services and communications can be tailored to the needs and circumstances of people and communities, and thereby help combat these challenges. The new Tailoring Health Programmes (THP) guide describes how this can be done.
Building on several topic-specific guides that focused on applying BCI to routine and influenza vaccination and tackling antimicrobial resistance, as well as external evaluations and a rigorous peer-review process, this guide is the result of over a decade of work by WHO/Europe. The THP approach has already been adopted in over 20 countries and has received positive feedback from public health agencies.
“This guide is the culmination of a decade of work involving many colleagues at country, regional and global levels. The guide is our “BCI bible”, guiding our work with and in countries to help tackle persistent health challenges,” said Katrine Bach Habersaat, Regional Advisor for BCI at WHO/Europe.
Karina Godoy, Senior Analyst and National Focal Point for Behavioural Insights at the Public Health Agency of Sweden, who is employing the approach described in the guide across several health projects, comments: “The THP guide is easy to use and at the same time provides detailed guidance and inspiration where needed. We have decided to translate the document into Swedish and use the approach widely”.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
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t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers and partners to plan and implement readiness and response activities for Ebola disease outbreaks. The toolkit conta
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ins: information about Ebola disease; RCCE considerations on how to approach key issues during Ebola disease outbreaks; tools for understanding the context in which Ebola disease outbreaks occur; methods for collecting data to inform strategy development and bring evidence into the planning and implementation of activities; guidance to support prevention and response interventions; and links to existing RCCE tools and training. It is one of a suite of toolkits on RCCE readiness and response to a range of disease and response areas.
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The Guidelines for the Use of the APCA African Palliative Outcome Scale (POS) has been developed by the APCA, in collaboration with
stakeholders, to help appropriately trained health practitioners and researchers across the region to utilise the APCA African POS in their work place (Powell et
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al, 2007; Warria et al, 2007). Not only do the guidelines provide a clear rationale for measuring palliative care outcomes, but they also outline practical information on how to use the tool to collect data and analyse its results. So why is there a need for these guidelines?
Palliative care as a concept and discipline is not well understood across Africa, and its development is still embryonic in many countries. While there are many obstacles that hinder palliative care development on the continent, a key challenge is the lack of accurate information about the palliative care being provided and its outcomes. The APCA African POS is a useful tool to help us measure these outcomes and, given that
measuring palliative care outcomes remains a relatively new concept, it is important to guide people on how to use the tool. Of course, these guidelines are not intended to address everything related to the measurement of palliative care outcomes; they contain only essential information for providers. More detailed information on the use of outcome tools, and in particular within the research setting, can be gained from contacting relevantly trained professionals.
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