Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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Emergence of antimicrobial resistance is a result of the use, overuse and misuse of antibiotics both in humans and animals. In Ethiopia, there are indications on the misuse of antibiotics by health care providers’, unskilled practitioners, and drug consumers. These coupled with rapid spread of res...istant bacteria and inadequate surveillance contributed to the problem. Bacterial infections are the major causes of death in Ethiopia. Studies on antibacterial resistance and on bacterial infections have shown that emerging antibacterial resistance threatens the management of bacterial infections; however, the prevention and containment has received far too little attention.
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The Infection Prevention and Control (IPC) Guidelines aim to support healthcare workers improve quality and safety health care. The Guidelines further aim to promote and facilitate the overall goal of IPC by providing evidence-based recommendations on the critical aspects of IPC, focusing on the fun...damental principles and priority action areas. All health service organizations should consider the risk of healthcare-associated infection(s) (HAI) and antimicrobial resistance (AMR) transmission to implement these recommendations. The IPC Guidelines also set national standards for the prevention and control of HAIs and to ensure compliance to the National Quality Standards.
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Thirty years ago, the United Nations General Assembly adopted the Convention on the Rights of the Child at a moment of rapid global change marked by the end of apartheid, the fall of the Berlin Wall and the birth of the World Wide Web. These developments and more brought momentous and lasting evolut...ion, as well as a sense of renewal and hope for future generations. In a reflection of that hopeful spirit, the Convention has since become the most widely ratified human rights treaty in history.
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WHO’s Ambition and Action in Nutrition 2016-2025 is anchored in the six global targets for improving maternal, infant and young child nutrition and the global diet-related NCD targets.
In support of the 2030 Agenda for Sustainable Development, particularly SDG2 and SDG3, and in concert w...ith the 2016-2025 UN Decade of Action on Nutrition, WHO’s Ambition and Action in Nutrition 2016-2025 aims for “A world free from all forms of malnutrition where all people achieve health and well-being”. It defines the unique value of WHO for advancing nutrition: the provision of leadership, guidance and monitoring and proposes a theory of change. Finally, following a set of guiding principles, it proposes priority actions for WHO, the delivery model and a clear allocation of roles across the Organization.
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WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), has published global standards for prosthetics and orthotics. Its aim is to ensure that prosthetics and orthotics services are people-centred an...d responsive to every individual’s personal and environmental needs. The standards advocate for the integration of prosthetics and orthotics services into health services, under universal health coverage. Implementation of these standards will support countries to fulfil their obligations under the Convention on the Rights of Persons with Disabilities and towards the Sustainable Development Goals, in particular Goal 3: Ensure healthy lives and promote well-being for all at all ages.
The standards provide guidance on the development of national policies, plans and programmes for prosthetics and orthotics services of the highest standard. The standards are divided into two documents: the standards and an implementation manual. Both documents cover four areas of the health system:
policy (governance, financing and information);
products (prostheses and orthoses);
personnel (workforce);
and provision of services.
The Standards have been developed through consultation with experts from around the globe via a steering group, development group and external review group.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im...munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic p...alliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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A module from the suite of health service capacity assessments in the context of the COVID-19 pandemicINTERIM GUIDANCE5 February2021
The Community needs, perceptions and demand: community assessment toolcan be used by countries to conduct a rapid pulse survey of community health needs and perceptio...ns around effective use of essential health services during the COVID-19 outbreak. The assessment helps to establish an early warning system on the need to implement coping strategies to continue to respond to communities’ health needs throughout the course of the pandemic. This assessment tool is informed by WHO and partner tools and guidance on community health needs, continuity of essential health services and readiness planning for COVID-19
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This manual describes some of the strategic, managerial, financial, technical and scientific aspects to be considered in establishing a national EQA programme for clinical laboratories and other testing services at all health care levels
The new review paper, The Impacts of Climate Change on Health, identifies the extent to which increasing emissions, extreme weather and temperatures elevate health risks, from infectious disease to malnutrition, and assesses the associated health burden. It concludes that the health burden will exce...ed the level of demand that health systems are prepared for.
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The goal of this Global Action Plan is to articulate synergistic actions that will be required to prevent HIVDR from undermining efforts to achieve global targets on health and HIV, and to provide the most effective treatment to all people living with HIV including adults, key populations, pregnant ...and breastfeeding women, children and adolescents. The Global Action Plan has five strategic objectives: 1) prevention and response; 2) monitoring and surveillance; 3) research and innovation; 4) laboratory capacity; and 5) governance and enabling mechanisms.
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The aim with this study was to examine in what amount disabled children in South Africa can live a participating life in society, with focus on special needs schools and their capability to empower the children. The data material has been collected through eight qualitative interviews, and observati...ons at seven special needs schools in the country. Through my result I have distinguished three main roads to empower the children: First, to analyze social structures, secondly, to gain knowledge and awareness, and thirdly, to strengthen the children’s self-esteem. I have also analyzed the structural barriers that are hindering disabled children to participate, and illustrated this by describing social policies and their effect on special needs schools in South Africa.
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Final Evaluation
The project objectives were to promote the conservation, sustainable use and cultivation of endangered medicinal plants in Zimbabwe, by demonstrating effective models at the local level, and developing a legal framework for the conservation, sustainable use, and equitable shari...ng of benefits from medicinal plants at the national level. After one year of implementation, the project rationale, indicators and targets were reviewed in order to make them more rigorous as per the new GEF focus on project impact. New indicators and targets were developed in December 2004. The project is composed of five closely linked output areas that have been allocated to different implementing partners to take a lead in. These include the National Herbarium and Botanical Gardens (Output 1), the University of Zimbabwe School of Pharmacy (Output 2), the Southern Alliance for Indigenous Resources (SAFIRE), a regional NGO (Output 2 and 4), and the Attorney General‟s Office (Output 5).
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This course describes the health effects of war, weapons and strategies of violent conflict. Beginning with weapons of mass destruction it then moves on to other weapons and strategies of war such as the use of landmines and mass rape. The course concludes with a number of lessons which give an hist...orical and practical analysis of the response of health professional groups to war and militarisation.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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13 May 2021
To avoid a reversal of progress from the adverse impacts of the COVID-19 pandemic, new knowledge and lessons from successful programmatic innovations are urgently needed to improve TB prevention and care. Experience can provide evidence for innovative approaches and strategies to mainta...in and scale up high-quality TB services. WHO therefore called for case studies on programmatic innovations that address emerging challenges in TB prevention and care during the pandemic in order to collect and disseminate the findings to the TB community. Between November 2020 and February 2021, a total of 23 case studies relevant to the call were accepted from 19 countries in the six regions of WHO. The lessons learnt from these country activities to ensure the continuity of essential services like TB care in the face of the crippling crisis may also inform strategies for minimizing the impact of future emerging pathogens on health services.
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The sixteenth meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases (STAG-NTD) was held as a hybrid meeting, 27–28 September 2022.
Dr Ren Minghui, Assistant Director-General, Universal Health Coverage/Communicable and Noncommunicable Diseases, welcomed participan...ts to the meeting. He said the World Health Organization’s Department of Control of Neglected Tropical Diseases (WHO/NTD) was in a state of transition. Following the death of the late esteemed Director Dr Mwelecele Ntuli Malecela earlier in the year, Dr Gautam Biswas had taken over as Acting Director but would soon retire; the appointment of a new Director was under way. Owing to rotation of STAG-NTD members, this would be the last meeting for some and the first meeting for several new participants. The work however would continue with the same commitment. Discussions over the next two days would focus on critical issues regarding recovery of NTD services following the disruptions caused by coronavirus disease (COVID-19), which had impacted many health services worldwide. He looked forward to receiving the advice and guidance of STAG-N
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Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal
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space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
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22 Sept. 2021
The rapid development of effective Covid-19 vaccines in 2020 gave hope to the world in the darkest days of the deadly pandemic. However, the vaccine roll-out has been massively skewed towards wealthy nations. While rich states have hoarded vaccines, companies have also played a decisi...ve role in restricting fair access to a life-saving health product. This report focuses on six leading vaccine developers, AstraZeneca, BioNTech, Johnson & Johnson, Moderna, Novavax and Pfizer, assessing each company’s human rights policy, pricing structure, records on intellectual property, knowledge and technology sharing, allocation of available vaccine doses and transparency.
Available in Arabic, English, French, German and Spanish
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