INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20...30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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STUDY REPORT | This study of the impact of the Nepal earthquake of 25 April, 2015, aims to understand the impact factors leading to the exclusion of older people and persons with disabilities from humanitarian action, barriers to their inclusion, and the extent to which their skills and knowledge we...re utilised to promote inclusive humanitarian action and, using this understanding, to formulate a set of recommendations for promoting inclusion. These recommendations will be used to sensitise the broader humanitarian community to the need for inclusive disaster risk management practices in future emergency responses which pay attention to factors such as gender, age, disability and ethnicity, and build upon the capacities of older people and persons with disabilities.
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The WHO Guidance for Conducting a Country COVID-19 Intra-Action Review (IAR) was developed to guide countries to conduct periodic review(s) of their national and subnational COVID-19 response, so countries do not miss critical opportunities for learning and improvement to better respond to the COVID...-19 outbreak in their countries, especially as the possibility of a protracted pandemic becomes increasingly probable. The IAR is a country-led facilitated process conducted during the COVID-19 outbreak in-country, bringing together a small group of COVID-19 responders with knowledge of the public health response pillars under review. Although IARs can be conducted online or face-to-face, the online format is recommended, especially if community transmission remains high in the country. The IAR will identify practical areas for immediate remediation and sustained improvement of the ongoing response.
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The report offers a snapshot of the drivers behind the persistent exclusion of persons with disabilities and proposes a framework to build an actionable agenda building on promising practices available in the region. The COVID-19 pandemic has laid bare the urgent need to build more inclusive and res...ilient societies. The region has shown its resilience in recovering from many crises in the past. Today, we are at a crucial flection point where it is clear that universal policies and economic growth alone are insufficient to eradicate the remaining pockets of exclusion. A disability-inclusive recovery should be at the core of the region’s rebuilding strategy. This matters in its own right but is also of utmost importance for the sustainability of the region.
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This report is the first of its kind. It brings together various data sets to present the current status of hand hygiene, highlight lagging progress, and call governments and supporting agencies to action, offering numerous inspiring examples of change.
During the COVID-19 pandemic, hand hygiene ...received unprecedented attention and became a central pillar in national COVID prevention strategies. However, concern with hand hygiene should not only be as temporary public health measure in times of crisis, but as a vital everyday behaviour that contributes to health and economic resilience. Hand hygiene is a highly cost-effective investment, providing outsized health benefits for relatively little cost.
Despite efforts to promote hand hygiene, the rates of access to hand hygiene facilities remain stubbornly low. If current rates of progress continue, by the end of the SDG era in 2030, 1.9 billion people will still lack facilities to wash their hands at home.
This report presents a compelling case for investment in five key ‘accelerators’ as a pathway towards achieving hand hygiene for all – governance, financing, capacity development, data and information, and innovation. These accelerators are identified under the UN-Water SDG 6 Global Acceleration Framework.
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—and over 2.7 million deaths attrib...uted to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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This working paper is a case study on South Sudan as an important refugee country of origin. The case study looks at issues of forced displacement in South Sudan and underscores the linkages between internally displaced persons and South Sudanese refugees. The case study highlights the importance of... understanding local contexts and root drivers of conflict and displacement. It reviews evaluations of programmes in South Sudan, including past efforts at state building and refugee resettlement to look at learning within the international community. The study was undertaken as part of a wider research project on learning from evaluations to improve responses to situations of forced displacement .
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During the year 2022, COVID-19 continued to be a significant challenge in Eritrea as in many other countries across the world. As COVID-19 devastated communities around the world, WHO worked with the MoH to strengthen the National and Sub-National health systems in order to meet community needs and ...mitigate the devastation during the pandemic and beyond.
One of the major achievements in the year 2022 was the beginning of the journey towards validation of
the elimination of mother to child transmission of HIV, syphilis, and hepatitis B. This is the culmination of years
of commitment and determination by the political leadership, national and international partnerships to
reduce the associated indices to levels that qualify for elimination.
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Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as h...igh as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
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Atlas of African Health Statistics 2022: Health situation analysis of the WHO African Region
Since 2019, we have been implementing Phase 2 of the regional Transformation Agenda, which informs and aligns with the global WHO Transformation, to ensure WHO is accountable, driven by re- sults and provid...ing value for money in the pursuit of better health. Our global priority in this period is to contribute to delivering on the triple billion targets of expanding universal health coverage, protecting people from emergencies, and promoting health and well-being for people across the Region.
This year’s Atlas of African Health Statistics is being produced in the context of the COVID-19 pandemic that we have been expe- riencing for over two years. The ongoing coronavirus pandemic, together with other health emergencies in the WHO African Re- gion, is yet again testing the strength and resilience of our health systems. Indeed, the impact of COVID-19 is visible in the disruption of services. The report also presents the latest data for more than 50 health-related indicators of the Sustainable Development Goals and WHO’s “triple billion” targets and provides comprehensive country-level statistics using the results chain of the AFRO frame- work of actions for strengthening health systems to achieve UHC and the health-related SDGs.
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This operational guidance on MHPSS provides a practical orientation and tools for UNHCR country operations. It covers specific points of good practice to consider when developing MHPSS programming and offers advice on priority issues and practical difficulties, while also providing some background i...nformation and definitions. Since MHPSS is a cross cutting concept this operational guidance is relevant for programming in various sectors, including health, community based protection, education, shelter, nutrition, food security and livelihoods.
The focus of this operational guidance is on refugees and asylum seekers, but it may apply to other persons of concern within UNHCR operations such as stateless persons, internally displaced persons and returnees. The guidance is meant for operations in both camp and non-camp settings, and in both rural and urban settings in low and middle-income countries with a UNHCR presence.
The guidance should be adapted according to different contexts. A standardized format for programme implementation cannot be offered because this depends to a large extent on existing national capacities and local opportunities.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to:
Consider... the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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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....
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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The report underscores that sexual and reproductive health and rights are often the first to be sacrificed during epidemics and that the gains of the past decade must be protected. The report also makes it clear that scarce resources must be focused on the most marginalized women and girls, includin...g sex workers, gender diverse people, women in prison and migrants and others without proof of employment or residence.
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This article identifies the three core defining characteristics of healing environments for children and young people who have been exposed to chronic adversity and trauma. A large body of evidence highlights the pervasive and devastating developmental impacts of such exposure but there is also emer...ging evidence about the elements of living and learning environments that foster recovery and resilience. The Three Pillars framework has been developed to inform and empower those who live with or work with these young people but who are not necessarily engaged in formal therapy.
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In March 2020 the IASC Reference Group on Mental Health and Psychosocial Support uniting 57 humanitarian organizations as member issued the Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak. This document has proven to be very useful in the response and has... till now been translated in 24 languages. It covers a set of recommended activities as well as messages for different target groups.
The current document is an annex to the Interim Briefing Note and is meant to support the MHPSS operational response within the various sectors of humanitarian work. Approaches and interventions to MHPSS are not confined to one sector, but need to be integrated within many existing sectors and clusters.This document contains a wealth of operational information and practical approaches that can be used for humanitarian programming in health, SGBV, community-based protection, nutrition, camp management and camp coordination.
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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Mental disorders impose an enormous burden on society, accounting for almost one in three years lived with disability globally. •In addition to their health impact, mental disorders cause a significant economic burden due to lost economic output and the link between mental disorders and costly, po...tentially fatal conditions including cancer, cardiovascular disease, diabetes, HIV, and obesity.•80% of the people likely to experience an episode of a mental disorder in their lifetime come from low- and middle-income countries.• Two of the most common forms of mental disorders, anxiety and depression, are prevalent, disabling, and respond to a range of treatments that are safe and effective. Yet, owing to stigma and inadequate funding, these disorders are not being treated in most primary care and community settings.
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The discourse on climate change and migration has shifted from labelling migration merely as a consequence of climate impacts, to describing it as a form of human adaptation. This article explores the adaptation framing of the climate change and migration nexus and highlights its shortcomings and ad...vantages. While for some groups, under certain circumstances migration can be an effective form of adaptation, for others it leads to increased vulnerabilities and a poverty spiral, reducing their adaptive apacities. Non-economic losses connected to a change of place further challenge the notion of successful adaptation. Even when migration improves the situation of a household, it may conceal the lack of action on climate change adaptation from national governments or the international community. Given the growing body of evidence on the diverse circumstances and outcomes of migration
in the context of climate change, we distinguish between reactive and proactive migration and argue for a precise differentiation in the academic debate
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