Ramped-up cancer services could save 7 million lives over the next decade—and addressing huge service gaps between rich and poor countries is key to success, according to this report.
In 2019, over 90% of high-income countries reported that comprehensive cancer treatment services were available... through the public health system, compared to fewer than 15% of low-income countries, according to WHO.
But poorer countries can make substantial strides with a universal health coverage approach and use of the latest science to meet their particular needs.
The report lays out proven ways to prevent new cancer cases without breaking the bank, including tobacco-control measures and vaccines that protect against common cancers.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig...nity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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o support and guide countries and partners to strengthen a health systems response to address violence against women, WHO has produced several tools, including:
• clinical and policy guidelines;
• implementation handbooks and manuals;
• training curriculum;
• evidence-based polic...y, prevention and intervention strategy packages.
The resource package consolidates these documents to support countries to develop or update their national or subnational guidelines, protocols, standard operating procedures, health provider training materials, and multisectoral action plans to prevent and respond to violence against women.
The resource package is also intended to be used for training and sensitization of policy-makers, advocates, health care providers and managers of services and programmes to address violence against women.
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and challenges, maps existing international commitments and... frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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In most contexts, the social stigma surrounding mental health issues exists because of cultural norms and a lack of understanding of mental health’s complexities and realities, resulting in isolation, increased vulnerability, and lack of support for people with mental health problems.
This stig...ma has been exacerbated during COVID-19, as more people may need mental health or psycho-social support but cannot access it due to the cessation of in-person services and limited remote care option
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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul...nerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me...thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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A two-week mission was conducted by WASH and quality UHC technical experts from WHO headquarters and supported by the WHO Ethiopia Country Office (WASH and health systems teams) in July 2016, to understand how change in WASH services and quality improvements have been implemented in Ethiopia at nati...onal, sub-national and facility levels; to document existing activities; and through the “joint lens” of quality UHC and WASH, to identify and seek to address key bottlenecks in specific areas including leadership, policy/financing, monitoring and evaluation, evidence application and facility improvements. Ethiopia has implemented a number of innovative and successful interventions.
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Injection Safety and Safe Disposal of Medical Waste National Communication Strategy and Health Care Waste Management Standard
Operating Procedures (SOPs).
The overall objective of the consultancy was to review and align the three national technical and communication guiding documents on HCWM to th...e WHO Blue Book and other global standards and recommendations. The specific objectives of the assignment were ; to establish how well aligned the Kenya Healthcare Waste Management Guidelines, 2011, are to the WHO Blue Book on healthcare waste management, global recommendations and other global conventions on environmental protection; to establish the extent to which the Kenya Injection Safety and Safe Disposal of Medical Waste National Communication Strategy is aligned to the National Health Communication Guidelines, 2013; to determine the extent to which the current Standard Operating Procedures are aligned to the best available technologies (BAT) and best environmental practices (BEP) and international practices; and to assess current health care waste management practices at the health facilities supported by the GEF project.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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DHS Methodological Report No. 20
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method—principal component analysis (PCA).
We scored ...the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index.
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The Guidelines for the Prevention, Surveillance and Management of COVID-19 Infection amongst Health Care Workers (HCW) in Zimbabwe were developed to prevent, detect and manage HCW COVID-19 infection, an emerging pandemic affecting the whole world. The HCW is at the fore front of this pandemic, thus ...the need for standardised operating procedures is of utmost importance. These guidelines therefore seek to reduce the significant morbidity and mortality among the HCW, ultimately ensuring the reduction of the cost to the health care worker and the Ministry of Health and Child Care (MoHCC) as a whole. The Ministry of Health and Child Care requires that all health care workers in various health care settings follow infection prevention and control procedures.
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Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. ...The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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Improvements in water sanitation and hygiene (WASH) and wastewater management in all sectors are critical elements of preventing infections and reducing the spread of antimicrobial resistance (AMR) as identified in the Global Action Plan to combat AMR. Yet, at present, WASH and wastewater management... actors and improvement actions are under-represented in AMR multi-stakeholder platforms and national action plans (NAPs). This WHO/FAO/OIE technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR NAPs and sector specific policy to combat AMR. Evidence and actions are presented in the domains of; coordination and leadership, households and communities, health care facilities, animal and plant production, manufacturing of antimicrobials, and surveillance and research.
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This guidance addresses rationale, risk-based scenarios, practical considerations prior to adoption of the self-testing products, quality assurance, safety and ethical considerations, and data management considerations for COVID-19 self-testing. The Africa CDC recommends the use of rapid antigen sel...f-testing within two key scenarios. The first includes testing for case identification within scenarios with a high risk of infection, including symptomatic cases and contacts of a confirmed case. The second scenario involves general screening within scenarios of low or unknown risk exposure allowing for self-care such as before gatherings with at-risk individuals and prior to participation in events involving members of different households. Within these scenarios, a positive test result indicates likelihood of current infection, while a negative test result indicates a lower risk of active infection, though it does not rule out infection altogether. All positive cases should be managed following the national COVID-19 management protocol of Member States.ssur
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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Strategic communication is at the heart of public health and more important than ever in the digital age. Using communication strategically requires expertise, skills and resources to plan, implement and evaluate interventions that encourage governments to implement policies that improve people’s ...lives and well-being, that empower health workers to deliver the best care possible, and that encourage people to take actions that protect and improve their health and that of their family and community. This Regional Action Framework on Communication for Health (C4H) aims to support Member States in implementing the C4H approach. It outlines steps to be taken by WHO and Member States to use C4H to achieve shared public health goals in the Western Pacific.
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Accessed: 27.04.2020
Leaving no one behind in the Covid-19 Pandemic: a call for urgent global action to include migrants & refugees in the Covid-19 response
People on the move, whether they are economic migrants or forcibly displaced persons such asylum seekers, refugees, and internally displa...ced persons (hereafter called migrants & refugees), should be explicitly included in the responses to the coronavirus disease 2019 pandemic. This global public health emergency brings into focus, and may exacerbate, the barriers to healthcare these populations face. Many migrant & refugee populations live in conditions where physical distancing and recommended hygiene measures are particularly challenging. The Covid-19 pandemic reveals the extent of marginalisation migrant & refugee populations face. From an enlightened self-interest perspective, the Covid-19 disease outbreak control measures will only be successful if all populations are included in the response. It is counter- productive to exclude migrant & refugee populations from the preparedness and response to the Covid-19 pandemic.
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Women and girls have specific needs that are often ignored during crisis. While on the run or while living in shelters, women and girls continue to become pregnant, but they often lack access to basic sexual and reproduc-tive health care. Without assistance by midwifes or access to contraceptives, w...omen and girls are at increased risk of unsafe sex, unwanted pregnancy and unsafe delivery, and are at a higher risk of infection by HIV and other sexually transmitted infections. In addition, displaced women have virtually no access to protection, security, justice, and other services related to gender-based violence (GBV). For these reasons, the delivery of sexual and reproduc-tive health and rights (SRHR) as well as GBV services to conflict-affected communities – most of whom are living in protracted displacement – is a key part of UNFPA’s Women and Girls First Programme (WGF). The initia-tive is a commitment to prevent and respond to violence perpetrated against women and girls in Myanmar, and to realize their sexual and reproductive health and rights.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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