DEVELOPMENT BULLETIN | No.74, June 2011 | Editor: Pamela Thomas | Features and case studies | Progress with implementing conventions and strategies | Progress with capacity building | Progress with disability-inclusive education | Disability-inclusive research | Innovative inclusion | Review of urba...nisation in the Pacific | Development assistance and disability
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Food and nutrition security in the Democratic Republic of the Congo is subject to the relentless impact of conflict, epidemics and climate events that have persisted in the country for decades, further compounded by the global COVID-19 pandemic. Lack of infrastructure and investment in agriculture, ...health and human capital development combine to impede progress towards the achievement of Sustainable Development Goals 2 and 17. While there are several legal instruments and policies that promote food and nutrition security, poor coordination, weak national capacity and exponential population growth present serious obstacles to the achievement of zero hunger. Political instability and siloed sectoral responses to humanitarian and development needs have also affected results to date.
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Brucellosis is widespread in both humans and livestock in many developing countries. The authors have performed a series of epidemiological studies on brucellosis in agro-pastoral areas in Tanzania since 2015, with the aim of the disease control. Previously, the potential of a community-based brucel...losis control initiative, which mainly consisted of the sale of cattle with experience of abortion and vaccinating calves, was assessed as being effective and acceptable based on a quantitative approach. This study was conducted to investigate the feasibility of community-based brucellosis control program using participatory rural appraisals (PRAs) and key-informant interviews. Four PRAs were performed together with livestock farmers and livestock and medical officers in 2017. In the PRAs, qualitative information related to risky behaviors for human infection, human brucellosis symptoms, willingness to sell cattle with experience of abortion, and willingness to pay for calf vaccination were collected, and a holistic approach for a community-based disease control project was planned. All of the communities were willing to implement disease control measures. To avoid human infection, education, especially for children, was proposed to change risky behaviors. The findings of this study showed that community-based disease control measures are promising.
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The threats posed by climate change to agriculture are now well known. Climate change has already resulted in a negative trend in mean crop yield per decade, and this is likely to continue as the century unfolds. In Africa, 650 million people are currently dependent on rain- fed agriculture and, des...pite progress in the Millennium Development Goals, food and nutrition insecurity remainunacceptably high.
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Snakebites are well-known medical emergencies in many parts of the world, especially in rural areas. Agricultural workers and children are the most affected. The incidence of snakebite mortality is particularly high in South-East Asia. Rational use of snake anti-venom can substantially reduce mortal...ity and morbidity due to snakebites. These guidelines are a revised and updated version of Regional Guidelines for the Management of snakebites published by the WHO Regional Office in South-East Asia in 2011. These guidelines aim to promote the rational management of snakebite cases in various health facilities where trained health functionaries and quality snake antivenom are available.
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Noncommunicable diseases (NCDs) are the principal cause of morbidity, disability and premature mortality in Azerbaijan. The most effective way to reduce the NCD burden is to prevent NCD development, by addressing thebehavioural risk factors underlying NCDs at the population and individual leve...ls: smoking, alcohol use, excessive salt intake, low physical activity, overweight and obesity, and unhealthy diets. In Azerbaijan, a national survey of the prevalence of major NCD risk factors, aligned with the WHO-endorsed STEPwise approach to surveillance (STEPS) methodology, was conducted in 2017.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i...n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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The Atlas of Palliative Care in the Eastern Mediterranean Region is the first systematic attempt to assess the status of resources, activities, and needs of palliative care in the region. It provides a comparative picture of the current state of palliative care in simple and clear graphics, utilisin...g texts, tables, figures and maps that reproduce information given by national palliative care leaders in the Eastern Mediterranean. This information is essential for the appropriate planning of the development of palliative care for this region.
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A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Vol.399 Issue 10341 p.2129-2154
Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 s...trategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance.
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Early childhood matters.
This document looks at specific issues regarding the development of young children, in particular from a psychosocial perspective. It is published twice per year by the Bernard van Leer Foundation. The views expressed in Early Childhood Matters are those of the authors and... do not necessarily reflect those of the Bernard van Leer Foundation.
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The report summarizes the estimates of the burden of disease attributable to unsafe drinking water, sanitation, and hygiene for the year 2019 for four health outcomes - diarrhoea, acute respiratory infections, soil-transmitted helminthiases, and undernutrition - which are included in the reporting o...f the Sustainable Development Goal indicator 3.9.2. The report includes estimates at global, regional and country level for 183 WHO Member States.
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Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog.... Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
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In order to understand if the COVID-19 pandemic has impacted food availability and access at markets in Cambodia, the World Food Programme (WFP) monitors the retail and wholesale prices of key food commodities (see Annex 1 and 2) in 45 urban and rural markets across the country (see the Methods sect...ion for more details). An average of 340 traders and market chiefs are interviewed every two weeks, through a call center contracted by WFP. In addition to prices, market chiefs are also interviewed to assess market functionality, including supply and demand issues. Additional information is used to interpret the results and understand the broader context.
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DHS Further Analysis Reports No. 109 - This report documents trends in key child nutrition indicators in Rwanda. Data from the Demographic and Health Surveys (DHS) in 2005, 2010, and 2014-15 were analyzed, disaggregated by selected equity-related variables, and tested for trends. Over the survey per...iod, Rwanda had high rates of exclusive breastfeeding, with regional variation. Rates of continued breastfeeding were also high but generally decreased as mother’s education and household wealth increased in all survey years. Complementary feeding practices varied by region, mother’s education, household wealth, urban-rural residence, and sex of the child.
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This adaptation and implementation guide is part of a five-part Caregiver skills training for families of children with developmental delays or disabilities (CST) package providing guidance on caregiver skills training for families of children aged 2–9 years with developmental delays or disabiliti...es.
This adaptation and implementation guide provides information on how to adapt caregiver skills training materials and delivery strategies to the local context. It includes guidance on development and implementation of contextual and cultural adaptation plans.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, ...coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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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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This companion document to Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030 ("the road map") aims to support a range of stakeholders - including countries in which neglected tropical diseases (NTDs) are endemic, international organi...zations and non-State actors - to achieve the road map targets through a transdisciplinary, cross-cutting One Health approach. Specifically, it provides guidance on the One Health actions needed by major stakeholders and how to support a paradigm shift towards One Health in national NTD programmes. Examples of common One Health challenges and how they can be overcome as well as illustrative cases studies are provided throughout. The companion document was developed through a global consultative process involving stakeholder interviews, interactive workshops, and online public consultation.
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