Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
more
Chapter 1 provides new data on the latest developments in the global treatment effort, highlighting positive trends as well as aspects that require improvement. Chapter 2 summarizes the impact of the scale-up in reducing AIDS-related mortality and new HIV infections. Chapter 3 examines the sequence ...of steps in the continuum of care from HIV diagnosis to successful provision of ART services and outlines key supportive innovations. Chapter 4 discusses the implications and anticipated impact of the new "Consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection
more
New data from the WHO reveal that an estimated 2.2 billion cases of malaria and 12.7 million deaths have been averted since 2000, but the disease remains a serious global health threat, particularly in the WHO African Region. According to WHO’s latest World malaria report, there were an estimated ...263 million cases and 597 000 malaria deaths worldwide in 2023. This represents about 11 million more cases in 2023 compared to 2022, and nearly the same number of deaths. Approximately 95% of the deaths occurred in the WHO African Region, where many at risk still lack access to the services they need to prevent, detect and treat the disease.
more
The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation experiences in eight African countries and targets st...akeholders at the national level that are involved in the provision of maternal and child services, including national and local policymakers and implementers of malaria, maternal health, child health, reproductive health and community health programmes, and nongovernmental and other organizations.
more
In May the Sixty-sixth World Health Assembly adopted resolution WHA66.12 (1) on 17 neglected tropical diseases (NTDs). Among other measures, the resolution urges Member States to:
• ensure country ownership of prevention, control, elimination and eradication programmes;
• expand and implemen...t interventions and advocate for predictable, long-term international financing for activities related to control and capacity strengthening;
• integrate control programmes into primary health-care services and existing programmes;
• ensure optimal programme management and implementation;
• achieve and maintain universal access to interventions and reach the targets of the roadmap.
more
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
more
Personne ne se rend dans un établissement de soins de santé pour tomber malade. On s’y rend pour aller mieux, pour accoucher, pour se faire vacciner. Cependant, des centaines de millions de gens sont confrontés à un risque accru d’infection quand ils se font soigner dans des établissements ...de santé où les services de première nécessité font défaut, y compris les services d’approvisionnement en eau, d’assainissement et d’hygiène (WASH) et les services de gestion des déchets médicaux. Non seulement l’absence de services WASH dans les établissements de santé compromet la sécurité sanitaire des patients et leur dignité, mais il peut éventuellement exacerber la propagation d’infections résistant aux antimicrobiens et compromettre les efforts faits en vue de l’amélioration de la santé maternelle et infantile.
more
This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care. This publication addresses medical devices for six types of cancer: breast, cervical, colorectal, leukem...ia, lung and prostate. The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals. The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information. The third section lists the priority medical devices required to manage cancer in seven different units of health care services: 1. Vaccination, clinical assessment and endoscopy, 2. Medical imaging and nuclear medicine, 3. Surgery, 4. Laboratory and pathology, 5. Radiotherapy, 6. Systemic therapy and 7. Palliative and end of life care
more
This new guideline on non-clinical interventions to reduce unnecessary caesarean sections incorporates the views, fears and beliefs of both women and health professionals about caesarean sections. It also considers the complex dynamics and limitations of health systems and organizations and relation...ships between women, health professionals and organization of health care services.
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
Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charities such as nongovernmental organizations (NGOs), armies, and international organizations such as the ...International Red Cross/Red Crescent movement. They comply with the classification and minimum standards set by the World Health Organization (WHO) and its partners and bring to an emergency their training and self-sufficiency so as not to burden the national health system. EMT initiatives strengthen national surge capacities and facilitate the deployment of internationally classified teams of health- care professionals to countries and territories during emergencies, particularly during disease outbreaks and natural disasters, providing immediate assistance when national health systems are overwhelmed . Considering that they aim to support the provision of quality clinical care services to populations affected by public health emergencies, the expectation is that financial resources and equipment will be available to enable the performance of the requested task.
more
A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists working on this disease, the manual details the exac...t procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
more
HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes and pu...blic health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
more
The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six weeks after birth. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, ...primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services.
more
Female Genital Schistosomiasis (FGS) is a gynaecological disease caused by Schistosoma haematobium, a parasitic worm that is acquired by skin contact with freshwater contaminated by schistosome cerceriae. Communities in which the infection is most endemic have limited access to clean water and healt...hcare services. Up to 150 million adolescent girls and women are estimated to be at risk of FGS and about 16–56 milion womens are living with FGS, with the majority of these in sub-Saharan Africa. The variability of these estimates points to the fact that this neglected tropical disease is not well studied and frequently not prioritized by local, regional, and global health policy makers.
more
4th edition 2022 of the Handbook includes new WHO recommendations that expand contraceptive choices. Also, guidance on starting ongoing contraception following emergency contraception is provided.
Drawing on lessons from recent outbreaks, this new edition details tangible me...asures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and the use of digital technologies by providers. It also expands guidance for women and young people at high risk of HIV.
more
On Global Handwashing Day, WHO and UNICEF have released the first-ever global Guidelines on Hand Hygiene in Community Settings to support governments and practitioners in promoting effective hand hygiene outside health care – across households, public spaces and institutions. Framing hand hygiene ...as a public good and a government responsibility, the Guidelines translate evidence into ready-to-adopt actions that enable sustainable access to effective hygiene services. This will reduce diarrhoeal disease, acute respiratory infections and other preventable illnesses, strengthening routine public health where people live, work, visit and study, and emergency preparedness, including outbreaks like cholera.
Despite clear benefits, 1.7 billion people still lacked basic hand hygiene services at home in 2024, including 611 million with no facility at all. Meeting the 2030 target will require accelerated progress – about a doubling in the global rate, and much faster in specific settings (up to 11-fold in least-developed countries and 8-fold in fragile contexts). Hand hygiene remains one of the most cost-effective health investments, reducing diarrhoea by 30% and acute respiratory infections by 17%, with large, measurable gains for population health.
“Clean hands save lives, but results at scale require policy, financing and accountability,” said Dr Ruediger Krech, Director a.i, Department of Environment, Climate Change, One Health & Migration at the World Health Organization. “These Guidelines help countries move beyond fragmented projects to government-led systems that make soap, water, and conditions conducive to everyday hand hygiene the norm.”
“Children and young people pay the highest price when basic hygiene is out of reach,” said Cecilia Scharp, Director, Water Sanitation and Hygiene (WASH) Team, Programme Group, UNICEF. “These Guidelines provide practical steps to ensure facilities are accessible when they need to be – in homes, schools, markets, and transport hubs – so every child can learn, play and thrive with dignity.”
more
After introducing Ethiopia's WASH sector challenges and trends, the plan describes IRC Ethiopia's vision and strategy which draws from IRC and Water For People's joint framework - Destination 2030. It then details the organisational changes and business development needed to implement the strategic ...plan. Detailed targets are provided in the annexes.
At IRC, we believe that turning on a working tap should not be a surprise or cause for celebration. We believe in a world where water, sanitation and hygiene services are fundamental utilities that everyone is able to take for granted. For good.
We face a complex challenge. Every year, thousands of projects within and beyond the WASH sector fail – the result of short-term targets and interventions, at the cost of longterm service solutions.
This leaves around a third of the world’s poorest people without access to the most basic of human rights, and leads directly to economic, social and health problems on a global scale. IRC exists to continually challenge and shape the established practices of the WASH sector.
Through collaboration and the active application of our expertise, we work with governments, service providers and international organisations to deliver systems and services that are truly built to last.
more
The Georgetown Undergraduate Journal of Health Services (2), 2012.
Training Manual
Building on earlier EngenderHealth work in counseling, Counseling for Effective Use of Family Planning responds to an identified gap in existing materials and fills the needs expressed by those in the field. The intended audiences for this curriculum are health care providers, their... supervisors, and the managers of the programs in which they work. The counseling skills addressed here are expected to be relevant to the provision of both preventive and curative health services through the workshop participants’ national health systems. Finally, the curriculum’s participatory approach to defining terms and to generating profiles of potential clients is designed to assist trainees in addressing the realities and exploring the reproductive health priorities of their communities in a culturally appropriate manner.
more