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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.
more
For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source
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of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
more
Adapted from: Standard Treatment Guidelines and Essential Medicine List PHC. The syndromic approach to Sexually Transmitted Infections (STIs) diagnosis
and management is to treat the signs or symptoms (syndrome) of a group of
diseases rather than treating a specific disease. This allows for the tr
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eatment
of one or more conditions that often occur at the same time and has been
accepted as the management of choice.
more
The target audience of this document (and the associated online companion tool) includes WHO country offices in Member States of the African Region; Member States’ ministries of health and their public h
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ealth emergency operation centres; relevant external assessment teams; and partners looking to identify preparedness gaps and
support interventions that help address them. In the event of a suspected or confirmed VHF case, the document also serves to provide any intervening partner with a sense of what structures should be in place, in order to guide
scale-up activities in line with regional and national plans.
more
As escolas realizam diariamente inúmeras atividades que ajudam a promover a saúde e o bem-estar dos alunos, famílias e comunidades. Existem evidências claras dos benefícios da abordagem das escolas promotoras da saúde (EPS), que visam melhorar os resultados globais de saúde da comunidade educ
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ativa (física, mental e social) e obter melhores resultados de aprendizagem. O termo escola promotora da saúde é aqui utilizado para se referir a instituições de todos os níveis de ensino (pré-escolar, primário e secundário) que adoptam uma abordagem abrangente para promover a saúde e o desempenho escolar nas suas comunidades, utilizando o potencial organizacional das escolas para promover o bem-estar físico, socioemocional e psicológico, o que contribuirá para uma melhor saúde e resultados educacionais positivos. Espera-se que este guia contribua tanto para o pessoal dos estabelecimentos de ensino como para o pessoal de saúde e outro pessoal das escolas, reforçando a sua motivação, reconhecendo cada uma das componentes da iniciativa e promovendo a sua aplicação, adaptada e recriada de acordo com as características do respectivo contextos. O guia apresenta as bases conceptuais e operacionais da iniciativa Escolas Promotoras de Saúde, incentivando a motivação das equipas que coordenam a sua implementação e fornece ferramentas conceptuais e metodológicas que permitem promover a iniciativa Escolas Promotoras de Saúde de forma crítica e contextualizada. Este guia será útil para todo o pessoal que trabalha em instituições de ensino nos níveis inicial, primário e secundário, incluindo pessoal de gestão, ensino, psicologia escolar e pessoal auxiliar e administrativo. Atenderá também profissionais de diversos setores (educação, saúde e desenvolvimento social) cujas atividades estão ligadas à saúde e ao bem-estar em instituições de ensino nos três níveis
more
This interim operational guide outlines infection prevention, control, and water, sanitation, and hygiene measures for home care and isolation of mpox in resource-limited settings. It focuses on practical strategies to manage and prevent the spread of the virus when persons with mpox are isolated at
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home in settings with limited resources. This document is intended for health and care workers, caregivers, and public health authorities.
more
Leprosy/Hansen disease is a chronic infectious disease primarily impacting the skin and peripheral nerves. If left untreated, leprosy can have long-term consequences, including deformities and disabilities, which are associated with stigma. Leprosy is one of the 21 neglected tropical diseases (NTDs)
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, a group of conditions prevalent in tropical regions. In the “WHO Roadmap for Neglected Tropical Diseases 2021–2030”, leprosy, human African trypanosomiasis (HAT) and onchocerciasis are targeted for interruption of transmission. Acknowledging the growing necessity for establishing a process to verify the absence of new autochthonous leprosy cases, a technical guidance has been developed outlining a clear pathway, demarcating phases with
indicators and milestones leading towards the elimination of leprosy disease.
more
Indoor residual spraying (IRS) involves applying residual insecticide to potential vector resting sites on the interior surfaces of human dwellings or other buildings. The main aim of IRS is to kill vectors before they are able to transmit pathogens to humans. When carried out correctly, IRS has his
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torically been shown to be a powerful intervention to reduce adult vector density and longevity for mosquitoes, sand flies and triatomine bugs and can reduce the transmission of vector-borne diseases.
more
The document titled "Manual for Stratifying Malaria Risk and the Elimination of Foci" by PAHO provides guidance for countries in the Americas on how to systematically assess and classify malaria transmission risk at subnational levels. It outlines a standardized approach to stratification and the id
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entification of active transmission foci, helping public health authorities prioritize interventions, allocate resources efficiently, and implement targeted strategies to accelerate progress toward malaria elimination.
more
All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement mea
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sures to achieve malaria elimination and prevent its reestablishment by increasing the intensity and quality of interventions, reorienting initiatives, reducing delays that favor transmission, and ensuring adequate monitoring to adjust interventions.
more
This second edition of the Basic Malaria Microscopy package is a stand-alone product,
providing all that is needed to conduct a complete training course
Las enfermedades no transmisibles (ENT) (por ejemplo, las enfermedades cardiovasculares, el cáncer, la diabetes y las enfermedades respiratorias crónicas) y los problemas de salud mental (por ejemplo, la enfermedad de Alzheimer y las demencias relacionadas, la depresión, la ansiedad y los trastor
...
nos del espectro autista) son la principal causa mundial de enfermedades prevenibles, discapacidad y muerte. En este informe se examinan los riesgos que plantean las actuales tasas crecientes de ENT y problemas de salud mental en América del Sur, más allá de los riesgos para la salud, y se ponen de manifiesto sus considerables efectos negativos en el crecimiento económico. Se concibió un modelo analítico que proyecta los efectos macroeconómicos de las ENT y los problemas de salud mental durante el período 2020-2050 en 10 países de América del Sur: Argentina, Bolivia (Estado Plurinacional de), Brasil, Chile, Colombia, Ecuador, Paraguay, Perú, Uruguay y Venezuela (República Bolivariana de). Los resultados revelan que el impacto macroeconómico de las ENT y los problemas de salud mental en América del Sur se traduce en déficits económicos importantes. En términos generales, la pérdida total de PIB en América del Sur asciende a US$ 7,3 billones (US$ internacionales del 2022) en el período 2020-2050, lo que equivale al 4% del PIB total de la región. Es decir, si se eliminaran estas enfermedades y problemas, el PIB anual sería cerca de un 4% mayor cada año durante 30 años
more
The objective of this guideline is to present the complete set of all WHO recommendations and best practice statements relating to abortion. While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in this docume
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nt aim to enable evidence-based decision-making with respect to quality abortion care.
more
These guidelines update earlier WHO recommendations to maximize the HIV prevention impact of safe VMMC services and aim to guide the transition to the sustained provision of interventions with a focus on the health and well-being of both adolescent
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boys and men.
more
Policy brief. In this policy brief, we give an update on those parts of the guidelines which are relevant for sex workers
Through the “Fiji National HIV Surge Strategic Plan 2024-2027,” the ministry will address areas for
Prevention, Diagnostics, Treatment and Care, the Continuum of Care and an intense Monitoring,
Evaluation, Accountability and Learning Framework for the government. This strategic plan aims
to d
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ecentralise services and bring services closer to individuals in a non-stigmatising and
discriminatory manner nationwide.
more
These guidelines focus on the provision of PrEP as part of comprehensive combination prevention,
drawing on implementation and research evidence and WHO recommendations.
This guideline document is a publication of the National AIDS & STI Control Program, Ministry of Health
Kenya
Female genital mutilation (FGM) is a human rights violation deeply rooted in gender inequality and discrimination. FGM violates various human rights under international human rights law including, among others, the rights to equality, life and health
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and the rights to be free from discrimination, torture and cruel, inhuman and degrading treatment. The failure by States to end this harmful practice against women and girls is a violation of States’ obligations to respect, protect and fulfil the enjoyment of all human rights. These obligations are accompanied by certain human rights accountability mechanisms that are critical in holding States to account for implementing their international and regional human rights obligations and commitments
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This guide defines public spaces for children as those that can be easily and freely accessed and enjoyed by all children, either alone or with friends or family, regardless of gender,
ethnicity, sexuality, nationality, social status or physical ability. Whatever their context, these places are saf
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e from physical hazards (such as pollution, waste, traffic, falls or drowning risks); and social risks (such as crime, exclusion, or bullying). Whether they are streets, neighbourhoods, existing public open spaces, or the small, “liminal” spaces, such as stairwells or alleyways from which children carve out a place for themselves
more
