Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to t...he trauma to which many were exposed. Several interventions were carried out with aims to integrate mental health into primary health care services. The interplay between socio-cultural beliefs and health (both mental and physical) in Haiti has been widely commented upon by both foreign aid and local caregivers. Observations frequently highlight barriers to the willingness of patients to seek care and to their acceptance of biomedicine over traditional Vodou beliefs. The perception of Haitian beliefs as barriers to the availability and acceptance of mental health care has intensified the difficulty in providing effective recommendations and interventions both before and after the earthquake. Argued in this review is the importance of considering the interactions between socio-cultural beliefs and mental health when developing models for the prevention, screening, classification and management of mental illness in Haiti. These interactions, especially relevant in mental health care and post-disaster contexts, need to be acknowledged in any healthcare setting. The successes and failures of Haiti’s situation provide an example for global consideration.
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Recommendations for a public health approach
HIV/AIDS Programme
Despite a historical association with poor tolerability, a comprehensive review on safety of antileishmanial chemotherapies is lacking. We carried out an update of a previous systematic review of all published clinical trials in visceral leishmaniasis (VL) from 1980 to 2019 to document any reported ...serious adverse events (SAEs).
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PILOT SURVEY REPORT: BIRIM, HO, MANYA
The report is based on in-depth qualitative research in countries along the Eastern and Central Mediterranean routes. It focuses on Iraqi and Nigerian migrants as case studies, as Nigeria is the number one country of origin for migrants travelling along the Central Mediterranean route. Iraqis repres...ent the third biggest group of migrants who travelled along the Eastern Mediterranean route in 2016.
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Zanoni BC, et al. BMJ Glob Health 2016;1:e000004. doi:10.1136/bmjgh-2015-000004
Guidelines for Handling Temperature Sensitive Vaccines and Pharmaceuticals
WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Updated May 2017
This document is meant to respond to the questions:
■ What health interventions should be delivered during pregnancy, childbirth and the postnatal period?
■ What health behaviours should the women practise (or not practise) during these periods to care for ...herself and her baby?
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Journal of The Association of Physicians of India, Vol. 63 November 2015,, pp.77-96
Much of our knowledge about PTSD is based on studies of adults. As evidenced by the birth of new scientific disciplines (e.g., developmental translational neuroscience), it is clear that what we learn from research involving adults may not necessarily be applicable to children and adolescents. Indee...d, the field of child and adolescent PTSD and trauma is relatively young, although the knowledge base has increased substantially over the past 2 decades. Moreover, task force members recognize that mental health professionals may have many different perspectives on child and adolescent trauma, particularly in regard to the specific nature of its effects and what interventions may be most effective in reducing negative outcomes and enhancing adaptive functioning. Although we attempt to summarize here what is currently known about child and adolescent PTSD and trauma, we welcome ongoing discussion and novel perspectives, which help to advance the field.
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This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws o...f their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all the unwanted effects of medications are mentioned.
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This document is meant to respond to the questions:
■ What health interventions should the adolescent receive and when should s/he receive it?
■ What health behaviours should the adolescent practise (or not practise)?
The Member States of the Pan American Health Organization/World Health Organization (PAHO/WHO)
that appear in the tables below have used the assessment instrument for mental health systems (WHOAIMS)
(1), as have Anguilla, the British Virgin Islands, Montserrat, and Turks and Caicos, all British
O...verseas Territories. For the purpose of this report, the countries and territories were grouped into three subregions, as follows:
Central America, Mexico, and the Latin Caribbean, the non-Latin Caribbean, and South America. The tables
also indicate the year each national WHO-AIMS report was published.
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A Practical Guide for Mental Health Service Providers