Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system, and findings were further validated during a oneda...y
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
more
The document is a UNICEF cholera toolkit designed to support prevention, preparedness, and response to cholera outbreaks. It provides guidance on water sanitation, hygiene, and health education, along with practical tools and resources for managing outbreaks. It is intended for use by UNICEF teams, ...governments, and partners to integrate cholera prevention into development programs and emergency response strategies.
more
This thematic brief accompanies the Working for Health 2022–2030 Action Plan, serving as a background and rationale to the related actions of the Working for Health progression model (see Annex). The brief aims to inform Member States, nonstate actors and other users of the Action Plan on the con...text of health and care workforce education and employment, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan itself and reflects the topical issues and considerations that shaped its design, including those issues identified in the Seventy-fourth World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce. The importance of these themes was again emphasized at the Seventy-fifth World Health Assembly, when Resolution WHA75.17: Human resources for health was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact.
more
The WHO Guide on Oral Cholera Vaccines in Mass Immunization Campaigns provides guidance on the planning and implementation of oral cholera vaccine (OCV) campaigns. It covers key aspects such as when and where to use OCVs, vaccine specifications, and recommendations for use in endemic areas, outbreak... settings, and complex emergencies. The document outlines steps for macro- and micro-planning, logistics, budgeting, human resource allocation, and risk communication. It also highlights challenges, including cold chain management, vaccine supply, and community engagement, ensuring that vaccination campaigns are efficient and effective in reducing cholera outbreaks.
more
The chapter Fostering Health Systems’ Monitoring to Better Serve Older Populations is part of the publication series entitled Decade of Healthy Aging: Situation and Challenges. The publications are designed to favor the prioritization of effective actions at the local level as well as the monitori...ng of data and public health policies, and providing evidence-based information. Along with the objective of presenting the available updated knowledge about the situation of health and aging at the beginning of the Decade of Healthy Aging in the Americas, this publication gives information about health systems’ monitoring to better serve the needs of older adults and emphasizes the need for societies and health systems to better adapt to an aging population. It introduces the 360-tool as a guide to adapt health systems through monitoring tracers/indicators and highlighting the data and information that is readily available, disaggregated by age. This information can aid in decision-making and resource allocation to support older adults’ needs. Concerning the 360-tool development, a consensus has been reached on seven tracer indicators with high relevance to informing policy, and case studies in selected countries have assessed the feasibility of this approach. The list of indicators and the process related to the development of the tool are presented in this publication. The Decade of Healthy Aging 2021-2030 is a period to guide action towards the transformation of societies by fostering the inclusion of older people in every decision. This publication intends to contribute to this strategy and highlight the upcoming challenges and opportunities on healthy aging.
more
The main objective of this mission was to assess the level of preparedness of Guinea-Bissau in respect of the WHO consolidated checklist. The checklist helps countries to assess and test their level of readiness it is being used to identify concrete action to be taken and where countries will requir...e support from partners. It lists 10 key components and tasks for both countries and the international community that should be completed within 30, 60 and 90 days from the date of issue of the list, with minimal requirements for equipment, material and human resources.
The components include: overall coordination; rapid response teams; public awareness and community engagement; infection prevention and control; epidemiological and laboratory surveillance; contact tracing; points of entry; laboratory; social mobilization and risk communication; budget.
more
To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
more
Every year, nearly 250 million people move across borders temporarily or permanently for a job opportunity, studying, to flee a crisis back home, or for other reasons. Another 750 million move for similar reasons within the borders of their countries. With the understanding that human mobility affec...ts public health, and health affects human mobility and migrants, for decades, IOM has been providing critical health services to women, children and men on the move, while standing by governments for technical and operational support as needed. In 2019, in lower-income settings and in complex emergencies, along the world’s most perilous migration routes, in the aftermath of natural disasters or in response to disease outbreaks, IOM’s health teams have provided hundreds of thousands with primary health-care consultations, mental health and psychosocial support, sexual and reproductive health care, pre-migration health services, and much more.
This year, more than ever before, as the world reels from the socioeconomic impact of COVID-19, we have experienced that health is a cross-cutting component of overall human development and well-being.
more
The report and an accompanying series of studies show the global uptake of the World Health Organization (WHO) Surgical Safety Checklist in its first ten years since its launch and recommend ways the Checklist can be more effectively used to improve surgical safety for millions at risk.
The report ...found that uptake has been remarkably positive: the Checklist has been adopted in almost 90% of operating rooms in countries with a high Human Development Index (HDI), a country-level measure of health, education, and standard of living. It was referenced by at least 139 (70%) of the world's countries and is included as a national standard by the health ministries of at least 20 countries. The Checklist has also had beneficial qualitative impact, introducing a culture of safety and improved communication within surgical teams, increasing patient trust, and improving job satisfaction.
more
An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, the WHO Global report on health equity for persons w...ith disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. Furthermore, the Sustainable Development Goals and global health priorities will not progress without ensuring health for all.
more
Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many ...infections becoming increasingly limited, expensive, and, in some cases, non-existent.
Conscious of the public health threats of AMR to both humans, animals and the environment, the ministries of health and sanitation, agriculture forestry and food security and the environmental protection agency put together a national multi-sectoral coordinating group tasked with the responsibility of establishing mechanisms to integrate all initiatives into a single concerted action and development of the national AMR strategic plan (2018-2022). The National Strategic Plan on Antimicrobial Resistance is the first approach which addresses AMR specifically.
more
The COVID-19 pandemic has exacerbated and added yet another layer of vulnerability to an already dire web of vulnerabilities of girls in the African continent, which constitute about 49% of the total child population. Critically, gender equality and girls’ multidimensional vulnerability have been ...accentuated to an unprecedented level. The pandemic has triggered major concerns about the potential reversal of the strides achieved over the years towards gender equality and human development in Africa.
more
Water security, or having the right amount and quality of water in the right place at the right time, fosters social and economic progress. Where water is sufficient to meet demand, it can promote economy wide growth and enable countries to reach their food security, energy security, and human devel...opment goals. Where it is scarce, excessive, or unclean it can exacerbate multiple dimensions of poverty. Neither of these two worlds is protected from future water crises, which are heavily influenced by changing local circumstances
more
nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate chang...e risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.
more
As a result of Russia’s invasion of Ukraine, the people of Ukraine, especially the most vulnerable, are paying an enormous price. Lives and livelihoods are being lost, with more than ten million people forced from their homes— and their country—in search of safety. The war has unleashed catast...rophic damage to the country’s economy and threatens lasting increases in poverty and societal upheaval. The scale of the war and the devastation it has caused have jeopardized Ukraine’s hard-fought development gains, through destruction of production and property, disruption of trade, diminished investment due to amplified uncertainty, and erosion of human capita
more
It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
more
Safe sanitation is essential for health, from preventing infections to improving and maintaining mental and social
well-being. Lack of adequate sanitation contributes to diarrhoeal diseases, parasitic infections, and undernutrition, as
well as posing significant risks and causing anxiety, especial...ly for women and girls. Achieving universal access to safe
sanitation, which protects health, privacy, and dignity, is a global development goal and a recognized basic human right.
more
The 10 recommendations in the COP26 Special Report on Climate Change and Health propose a set of priority actions from the global health community to governments and policy makers, calling on them to act with urgency on the current climate and health crises.
The recommendations were developed in ...consultation with over 150 organizations and 400 experts and health professionals. They are intended to inform governments and other stakeholders ahead of the 26th Conference of the Parties (COP26) of the United Nations Framework Convention on Climate Change (UNFCCC) and to highlight various opportunities for governments to prioritize health and equity in the international climate movement and sustainable development agenda. Each recommendation comes with a selection of resources and case studies to help inspire and guide policymakers and practitioners in implementing the suggested solutions
more
Int. J. Environ. Res. Public Health 2018, 15(12), 2626; https://doi.org/10.3390/ijerph15122626
Climate change is increasing risks to human health and to the health systems that seek to protect the safety and well-being of populations. Health authorities require information about current associatio...ns between health outcomes and weather or climate, vulnerable populations, projections of future risks and adaptation opportunities in order to reduce exposures, empower individuals to take needed protective actions and build climate-resilient health systems. An increasing number of health authorities from local to national levels seek this information by conducting climate change and health vulnerability and adaptation assessments. While assessments can provide valuable information to plan for climate change impacts, the results of many studies are not helping to build the global evidence-base of knowledge in this area. They are also often not integrated into adaptation decision making, sometimes because the health sector is not involved in climate change policy making processes at the national level. Significant barriers related to data accessibility, a limited number of climate and health models, uncertainty in climate projections, and a lack of funding and expertise, particularly in developing countries, challenge health authority efforts to conduct rigorous assessments and apply the findings. This paper examines the evolution of climate change and health vulnerability and adaptation assessments, including guidance developed for such projects, the number of assessments that have been conducted globally and implementation of the findings to support health adaptation action. Greater capacity building that facilitates assessments from local to national scales will support collaborative efforts to protect health from current climate hazards and future climate change. Health sector officials will benefit from additional resources and partnership opportunities to ensure that evidence about climate change impacts on health is effectively translated into needed actions to build health resilience.
more
The recruitment and use of children violates their rights and causes them physical, developmental, emotional, mental, and spiritual harm. The impact on their mental and physical well-being breaches the most fundamental human rights and represents a grave threat to durable peace and sustainable deve...lopment, as cycles of violence are perpetuated. The Paris Commitments adopted in Paris in February 2007 are an expression of strengthened international resolve to prevent the recruitment of children and highlight the actions governments can and should take to protect children affected by conflict. The Paris Principles are the operational guidelines related to sustainable reintegration of children formerly associated with armed forces and groups.
more