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9
En la actualidad, las guías basadas en la evidencia constituyen una de las herramientas más útiles para mejorar la salud pública y la práctica clínica. Su finalidad es formular intervenciones con sólidas pruebas de eficacia, evitar riesgos innecesarios, utilizar los recursos de forma eficient
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e, disminuir la variabilidad clínica y, en esencia, mejorar la salud y garantizar una atención de calidad, razón de ser de los sistemas y servicios de salud. Las presentes directrices se elaboraron siguiendo la metodología GRADE con el apoyo de un panel de expertos clínicos de distintos países, todos ellos convocados por la Organización Panamericana de la Salud. Por medio de la respuesta a doce preguntas clave sobre el diagnóstico clínico y el tratamiento del dengue, el chikunguña y el zika, se formulan recomendaciones basadas en evidencia para pacientes pediátricos, jóvenes, adultos, personas mayores y embarazadas expuestos a estas enfermedades o con sospecha o diagnóstico confirmado de infección. La finalidad de las directrices es evitar la progresión a las formas graves y a los eventos mortales que puedan causar. Las recomendaciones están dirigidas a profesionales de la salud, incluidos el personal médico general, residente y especialista; y los profesionales de enfermería, así como a estudiantes de medicina y enfermería, quienes de una u otra forma participan en la atención de pacientes con sospecha de dengue, chikunguña o zika. También se dirige a los administradores de las unidades de salud y a los equipos directivos de los programas nacionales de prevención y control de enfermedades arbovirales, quienes tienen la responsabilidad de facilitar el proceso de aplicación de estas directrices. Esperamos que esta publicación beneficie no solo al personal de salud, que dispondrá de información científica actualizada y de la mejor calidad posible, sino a los menores, los adultos, las embarazadas, las personas mayores y la población en general, quienes recibirán una mejor atención de salud prestada por personal médico debidamente capacitado.
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WHO’s sentinel surveys of acquired HIV resistance to dolutegravir among people receiving dolutegravir-containing antiretroviral therapy is intended for easy and frequent implementation. Results from sentinel surveys provide insight into the prevalence and year-over-year trends of dolutegravir resi
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stance in adults, children and adolescents receiving dolutegravir-based ART.
This sentinel method is implemented complementary to WHO-recommended methods for estimating nationally representative levels of acquired HIV drug resistance.
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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
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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.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel
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erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in
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health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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Antimicrobial resistance (AMR) is a threat to global health and development and it contributes to millions of deaths worldwide each year. Inappropriate use and overuse of antibiotics are driving an increase in AMR and have a detrimental impact on the effectiveness of these critical medicines. Throug
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h the Global Action Plan on AMR, WHO is working to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
There is a recognized need for high-quality resources to improve antibiotic prescribing globally. To address this need, a pragmatic approach was taken by WHO to develop actionable guidance for empiric antibiotic use.
The WHO AWaRe (Access, Watch, Reserve) antibiotic book provides concise, evidence-based guidance on the choice of antibiotic, dose, route of administration, and duration of treatment for more than 30 of the most common clinical infections in children and adults in both primary health care and hospital settings. The information included in the book supports the recommendations for antibiotics listed on the WHO Model Lists of Essential Medicines and Essential Medicines Children and the WHO AWaRe classification of antibiotics.
The WHO AWaRe antibiotic book is accompanied by summary infographics for each infection for both adults and children that provide a quick-reference guide for health care workers at the point of care.
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The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain AMR. The system started with surveillance of AMR in bacteria causing common human infections and has expanded its scope to include surveillance
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of antimicrobial consumption (AMC), invasive fungal infections, and a One Health surveillance model relevant to human health. To meet future challenges, it is in continuous evolution to enhance the quality and representativeness of data to inform the AMR burden accurately. As of the end of 2022, 127 countries, territories and areas participate in GLASS.
The fifth GLASS report, produced in collaboration with Member States, summarizes 2020 data on AMR rates in common bacteria from countries, territories, and areas. The report brings new features, including analyses of population testing coverage or AMR trends. For the first time, the report presents 2020 data on AMC at the national level. A new interactive dashboard allow users to explore AMR and AMC global data, country profiles and download the data.
This report marks the end of the early implementation phase of GLASS. In addition to presenting data collected through the latest data call, this report provides a summary of five years of national AMR surveillance data contributed to GLASS from its initiation, presents AMR findings in the context of progress of country participation in GLASS and in global AMR surveillance coverage and laboratory quality assurance systems at (sub)national level.
Patterns of antimicrobial consumption are presented by country with a particular focus on antibacterials. The report also presents the antimicrobial consumption according to the WHO AWaRe antibiotic classification, for penicillins and cephalosporines. From a One Health perspective, the report presents antimicrobial consumption data in the human sector expressed in tons to allow a comparison with antimicrobial consumption from other sectors (not included in this report).
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On November 9, the Russian military announced a full retreat of all their forces from the right bank of Dnipro River; by November 11, 41 settlements, including Kherson city, were de-occupied by Ukrainian forces. Civilians who live in these areas have endured months of combat and occupation. Services
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have been interrupted or severely disrupted due to damage or destruction of facilities and infrastructure through combat actions, looting of the majority of the valuable assets by the retreating Russian troops, and dispersion of the people rendering said services.
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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
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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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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma
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and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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Mientras los países se esfuerzan por avanzar hacia los Objetivos de Desarrollo Sostenible (ODS) y lograr la cobertura sanitaria universal, las desigualdades sanitarias provocadas por la discriminación racial y los factores interrelacionados siguen estando omnipresentes. Las desigualdades que sufre
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n los pueblos indígenas, los afrodescendientes, los romaníes y otras minorías étnicas son preocupantes a nivel mundial; son injustas, prevenibles y remediables
Los propios sistemas de salud son determinantes importantes de la salud y la equidad sanitaria. Pueden perpetuar las desigualdades sanitarias al reflejar el racismo estructural y las prácticas discriminatorias de la sociedad en general. En este sentido, el racismo sistémico (por ejemplo, relacionado con la ubicación de los servicios o los requisitos para acceder a ellos), los prejuicios implícitos, la práctica clínica mal informada o la discriminación por parte de los profesionales de la salud contribuyen a las desigualdades sanitarias. Ahora bien, los sistemas de salud también pueden convertirse en una de las principales fuerzas para combatir las desigualdades a las que se enfrentan las poblaciones que sufren discriminación racial.
La atención primaria de salud (APS) representa la estrategia esencial que permite reorientar los sistemas de salud y las sociedades para que sean más saludables, equitativos, eficaces y sostenibles. En 2018, al cumplirse el 40.º aniversario de la Declaración de Alma-Ata, la Organización Mundial de la Salud (OMS) y el Fondo de las Naciones Unidas para la Infancia (UNICEF) renovaron el énfasis en la atención primaria de salud con su estrategia sobre la atención primaria de salud en el siglo XXI.
La OMS ha señalado 14 mecanismos estratégicos y operacionales con los que los responsables políticos pueden reforzar la atención primaria de salud. Cada mecanismo dispone de múltiples puntos de partida posibles para emprender acciones específicas dirigidas a combatir la discriminación racial, fomentar la atención de salud intercultural y reducir las desigualdades sanitarias que sufren los pueblos indígenas, los afrodescendientes, los romaníes y otras minorías étnicas
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Download (7.4 MB)
Overview
Epilepsy is one of the most common neurological disorders globally. The WHO epilepsy technical brief aims to strengthen action for epilepsy and complements the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031.
The technical bri
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ef presents the key information on epilepsy and recommends actions to policy makers and other stakeholders. Using the concept of levers for change introduced by the Operational Framework for Primary Health Care, it identifies actions on the policy and operational levels that stakeholders should take to strengthen services for people with epilepsy using a person-centered approach based on human rights and universal health coverage.
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What are the FP and CAC competencies?
Through the clear articulation of the family planning and comprehensive abortion care (FP and CAC) competencies for the primary health care workforce, the aim is to advance improvements in FP and CAC service delivery by aligning health worker education approach
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es with population health needs and health system demands.
This document, which describes these competencies in detail, is intended to:
be a foundational tool to be adopted and adapted by educators and regulators for FP and CAC providers (students) with a pre-service training pathway of at least 12 months;
describe competencies that are relevant to current and future health practice;
enable widespread use of the competencies not only for curriculum development for pre-service education, but also for in-service education, regulation, qualifications, quality assurance, personal development, performance evaluation, recruitment, management and career progression;
focus on the core functions of FP and CAC providers within broader efforts towards achieving universal health coverage
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This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effectiv
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e implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
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Obesity and diet-related noncommunicable diseases (NCDs) have been steadily increasing globally, and with them, a pressing need to implement effective responses to address the contributing factors. Among the available evidence-based policy options that enable healthier choices and improved diets is
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the implementation of taxes on sugar-sweetened beverages (SSBs).
This tax manual is a practical guide for policy-makers and others involved in SSB tax policy development to promote healthy diets and populations. It features summaries and case studies of SSB global taxation evidence, and provides support on the policy-cycle development process to implement SSB taxation — from problem identification and situation analysis through policy design, development and implementation to the monitoring and evaluation phase. Additionally, the manual identifies and debunks industry tactics designed to dissuade policy-makers from implementing these taxes.
SSB taxes can be a win-win-win strategy: a win for public health (and averted health-care costs), a win for government revenue, and a win for health equity.
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Informe mundial sobre la equidad sanitaria para las personas con discapacidad: resumen
The executive summary of the WHO Global oral health status report presents a snapshot of the most recent data on major oral diseases, risk factors, health system challenges and opportunities for reform. The report’s clear conclusion is that the status of global oral health is alarming and requires
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urgent action. The report will serve as a reference for policy-makers and an orientation for a wide range of stakeholders across different sectors to guide advocacy towards better prioritization of oral health in global, regional and national contexts. In addition, the report provides, as a separate online resource, the first-ever country oral health profiles for all 194 WHO Member States, giving unique insights into key areas and markers of oral health that are relevant for decision-makers.
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El resumen ejecutivo del Informe de la OMS sobre la situación mundial de la salud bucodental presenta una instantánea de los datos más recientes sobre las principales enfermedades bucodentales, los factores de riesgo, los retos para los sistemas de salud y las oportunidades de reforma. La clara c
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onclusión del informe es que la situación de la salud bucodental a nivel mundial es alarmante y requiere una acción urgente. El informe servirá de referencia para los responsables de la formulación de políticas y permitirá a un amplio abanico de partes interesadas de diferentes sectores orientar su labor de promoción hacia una mejor priorización de la salud bucodental en los contextos mundial, regional y nacional. Además, el informe proporciona, como un recurso en línea separado, los primeros perfiles nacionales de salud bucodental para los 194 Estados Miembros de la OMS, lo que da una visión única de las áreas y los marcadores clave de la salud bucodental que son relevantes para los responsables de la adopción de decisiones.
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This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be u
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sed mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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Starting on 24 February 2022, a large-scale armed conflict in Ukraine triggered an unprecedented humanitarian crisis across the country, characterised, among other elements, by the displacement of a significant proportion of the Ukrainian population.
As early as April 2022, the International Organi
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zation for Migration (IOM) began observing significant return movements. Conditions of return vary widely, as returnees arrive back to areas not directly affected by the war, but which have experienced a significant influx of internally displaced persons (IDPs), as well as to conflict-affected and recently de-occupied areas which have sustained severe damage.
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