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2
In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub–Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long–term fiscal obligations for countries affected by HIV/ AIDS. As donor assistance for
...
health remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co–finance domestic HIV/AIDS responses. Based on analysis of non–health sectors, we identify innovative financing instruments that could be used in the HIV response.
more
A year ago, the second Special Session of the World Health Assembly (WHASS) unanimously agreed to start a diplomatic process for a new binding instrument aimed at ensuring the international community is better prepared for the next
...
health emergencies. The establishment of an Intergovernmental Negotiating Body (INB) at the WHO paved the terrain for a proper negotiation, which has started to unfold. The INB will be releasing the “conceptual zero draft” of the treaty text in early December 2022.
more
Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success.
The NTLP is
...
poised to attain the ambitious goal pronounced by the government of eliminating TB by 2030, in line with the Sustainable Development Goals (SDGs) and the World Health Organization End TB Strategy. The programme exponentially increased TB notifications from as low as 35,922 people with TB in 2018 to 40,726 in 2020 and in 2021 the TB notifications rose to 50,825 (a 25% increase against 2020 performance). The NTLP also registered incredible success in sustaining high TB Preventive Treatment (TPT) initiations among persons living with HIV and a high TB treatment success rate among drug-susceptible TB cases. New and relapse TB notifications in children below 15 years increased by 43%, from 2,724 in 2020 to 3,890 in 2021. TB notifications ratio between children aged 0-4 and 5-14 was 0.9, an improvement from what we achieved in 2018 (the ratio was 0.7). The proportion of TB patients who are HIV positive continued to decrease, reaching 34% in 2021 from 39% in 2020. Sustained increases in TB notifications, treatment success rate, and TPT initiations have resulted in a rapid decrease in the TB incidence rate that reached 307 per 100,000 population in 2021 against a rate of 391 in 2015.
more
Guidelines for Management of ST-Elevated Myocardial Infarction
Directorate General of Health Services
Ministry of Health & Family Welfare Government of India
(2022)
CC
Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi
...
on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
more
Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among
...
high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
more
Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden
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of Disease study (GBD), ischaemic heart disease was the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
more
Since 2016, the Pan American Health Organization (PAHO) has been promoting the implementation of the HEARTS Initiative in the Americas as a regional adaptation of the World Health Organization's Glo
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bal HEARTS Initiative. During this time, 33 countries in the Region of the Americas have committed to implementing HEARTS, and PAHO has developed many technical resources to support them. Most of these resources are clinical tools for primary healthcare teams and focus on quality improvement. This compendium aims to group all these clinical tools in a single document under a simple format that facilitates their practical implementation in daily clinical practice. The reader will notice that each tool is summarized on a single page and presented in a modular format. Therefore, each tool can be used together or separately as needed. In addition, at the bottom of each tool, the reader will find the references and hyperlinks to access full texts in case deeper knowledge is required.
more
The Kenya Health Policy 2014-2030 aims at attaining the highest possible standard of health in a manner responsive to the health needs of our popul
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ation. One of the major policy directions towards realizing the intentions of this policy is to halt and reverse the
rising burden of non-communicable diseases.
more
Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the o
...
nset of Diabetes Type 2, even in high-risk individuals.
more
Diabetes in children and young people
National Institute for Health and Care Excellence (NICE)
National Institute for Health and Care Excellence (NICE)
(2022)
CC2
The document "Diabetes in Children and Young People" by NICE (National Institute for Health and Care Excellence) provides quality standards for the diagnosis, management, and support of diabetes in children and adolescents.
Hypertension in adults: diagnosis and management
the National Institute for Health and Care Excellence (NICE)
the National Institute for Health and Care Excellence (NICE)
(2023)
CC
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di
...
agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
more
Action Plan for Implementation of Recommendations from the Evaluation of PAHO's Response to COVID-19
An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions
...
to future response to health emergencies. The final report of EPRC culminates with eight evidence-based recommendations of actions to strengthen future pandemic responses, while building a resilient recovery in the Region. The recommendations by the external team focus on PAHO’s governance and management, on specialized regional mechanisms, diversified funding models, and use of new technologies, among others.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
...
sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
Tuberculosis (TB) is among the top ten most common causes of death globally and as a single infectious disease it top among infectious diseases. Furthermore, it is noted as the top causes of death among people infected with the human immunodeficiency virus (HIV). Despite recent decreases in the numb
...
er of notified cases, Namibia still has a high TB burden and is included among the top 30 high-burden TB countries by the World Health Organisation (WHO). In the 2018 Global TB Report, the estimated incidence rate of TB in Namibia was 423/100,000. The same report estimated that 60 people per 100,000 populations died of TB in Namibia, which is a concern, for a disease that is curable and preventable.
more
En los últimos decenios se han logrado avances significativos en el control de la esquistosomiasis así como de las geohelmintiasis, y la OMS ha trazado una hoja de ruta para guiar la aplicación de las políticas y las estrategias planteadas en Accelerating work to overcome the global impact of ne
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glected tropical diseases
more
The "National Guideline for Cholera Surveillance and Outbreak Response" by the Ethiopian Public Health Institute (EPHI) provides a comprehensive approach to combating cholera outbreaks in Ethiopia. It emphasizes the importance of a multisectoral app
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roach, including case management, WASH measures, and the use of cholera vaccines. A key component is the establishment of Cholera Treatment Centers (CTCs) that provide 24/7 care. Additionally, the guideline stresses water quality monitoring and hygiene practices to prevent the spread of cholera and protect public health.
more
This manual is designed to provide comprehensive malaria case management training for health workers at all levels, including clinical, nursing, dispensing, laboratory and records staff. The training covers the use of malaria rapid diagnostic tests
...
(RDTs) and the treatment of severe malaria. The five-day training programme includes interactive modules supported by job aids. The ideal group size is 20–30 participants, supported by a team of three trainers. Trainers should thoroughly review the manual, including the 'Adult Learning Techniques' module, and follow the 'Facilitator's Guide', while participants should use the 'Simplified Participant's Guide'. The training includes pre- and post-tests to assess knowledge improvement. Continuing Medical Education (CME) is encouraged after the training, and resources are provided in the appendix.
more
The purpose of this guide is to provide updated clinical guidance on TB/HIV, with an emphasis on diagnostic aspects—including new techniques—as well as current treatment, while maintaining a public health approach. By compiling and consolidating
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the latest World Health Organization recommendations on the subject into a single guide, the aim is to create a reference and consultation document that is frequently used, and that unifies and standardizes the comprehensive management of TB/HIV co-infection in healthcare facilities based on the principle of “two diseases, one patient.” It also seeks to support the updating of national standards and guidelines on co-infection and to complement the coordinated work that must exist between TB and HIV prevention and control programs at all levels, within the framework of the twelve internationally recommended TB/HIV collaborative activities.
more
The framework recommends expanded coverage of malaria diagnostic and treatment services, intensified vector control to drive down transmission, strengthened malaria surveillance, and increased transborder collaboration, especially in terms of efforts to control the sale and use of artemisinin monoth
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erapies. Since it is unlikely that national malaria control programs will be able to implement all the activities described in this framework simultaneously, a list of suggested priority activities has been included in the Annex.
more
The Manual for Indoor Residual Spraying in Urban Areas for Aedes aegypti Control is intended not only for operational personnel and middle and senior management of programs responsible for the prevention and control of Aedes-borne diseases, but also for the academic community involved in Aedes resea
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rch, private pest control personnel, and the general public.
more
