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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributa
...
ble to health system failures exceeded deaths from Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
more
WHO consolidated guidelines on tuberculosis: Module 6: tuberculosis and comorbidities, 2nd ed
recommended
Addressing TB comorbidities and risk factors is central to the World Health Organization (WHO) End TB Strategy. These guidelines consolidate the latest WHO recommendations on TB and key comorbidities. The guidelines are a living document and will include dedicated sections for each key TB comorbidit
...
y or health-related risk factor. The first edition focused on HIV-associated TB, updating the WHO policy on collaborative TB/HIV activities. This second edition expands on the previous edition and consolidates new and existing recommendations on interventions to address undernutrition in people with TB, to provide food assistance to households of people with TB in food-insecure settings, and to screen for TB among those who are undernourished or food insecure.
more
Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations, refugees,
migrants, and minorities experience the highest degree
of socio-economic margina
...
lization. Marginalized people
become even more vulnerable in emergencies.1 This is due
to factors such as their lack of access to effective surveillance
and early-warning systems, and health services. The
COVID-19 outbreak is predicted to have significant impacts
on various sectors.
The populations most at risk are those that:
• depend heavily on the informal economy;
• occupy areas prone to shocks;
• have inadequate access to social services or political
influence;
• have limited capacities and opportunities to cope and
adapt and;
• limited or no access to technologies.
By understanding these issues, we can support the capacity
of vulnerable populations in emergencies. We can give
them priority assistance, and engage them in decision-making
processes for response, recovery, preparedness, and
risk reduction.
more
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
...
3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more
This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector devel
...
opment plans and the Health Sector Reform Strategy 2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
more
A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are
...
having on countries most affected by HIV. Yet it also showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.
more
A manual for physicians and other senior health workers. This fourth revision of the manual reflects recent clinical experience and research findings in diarrhoea case management. Compared to earlier versions, it includes revised guidelines on the management of
...
children with acute diarrhoea using the new reduced (low) osmolarity ORS formulation and using zinc supplements, which have been shown to reduce duration and severity of diarrhoeal episodes, and revised guidelines for the management of bloody diarrhoea. Guidelines in the manual are based on the revised WHO chart that are included at the end of this document.
more
The main objective of the 2014-15 RDHS was to obtain current information on demographic and health indicators, including family planning; maternal mortality; infant and child mortality; nutrition status of mothers and children; prenatal care, delive
...
ry, and postnatal care; childhood diseases; and pediatric immunization. In addition, the survey was designed to measure indicators such as domestic violence, the prevalence of anemia and malaria among women and children, and the prevalence of HIV infection in Rwanda. For the first time, this 2014-15 RDHS also includes indicators to monitor HIV testing among children age 0-14 as well as domestic violence for males age 15-59.
more
People younger than 20 years comprise 35% of the global population and 40% of the global population of least-developed nations. The number of children - neonates, infants, children, and adolescents
...
up to 19 years of age - who need pediatric palliative care (PPC) each year may be as high as 21 million. Another study found that almost 2.5 million children die each year with serious health related suffering and that more than 98% of these children are in low- and middle-income countries (LMICs) (3). While estimates differ, there is no doubt that there is an enormous need for prevention and relief of suffering among children - for PPC.
more
This is an open-access training course for frontline healthcare providers who manage acute illness and injury with limited resources. Produced in response to requests from multiple countries and international partners, the BEC package includes a Par
...
ticipant Workbook and electronic slide decks for each module. Integrating the guidance from WHO Emergency Triage, Assessment and Treatment (ETAT) for children and the Integrated Management of Adult/Adolescent Illness (IMAI), BEC teaches a systematic approach to the initial assessment and management of time-sensitive conditions where early intervention saves lives
more
Grounded in the foundations of child centered community development, the success of this strategy will be measured by how individual countries contribute to their child protection systems and partner at various levels to combat violence against children
...
. This strategy is a result of a highly consultative process that reached children and youth, Plan International staff, external specialists globally and the paper has been put in place with the joint efforts of the global child protection programming reference group.
more
The importance of growing up in a nurturing and supportive family environment cannot be underestimated. Raising children in a warm, loving environment sets them on a positive developmental trajectory for later life success (Biglan et al, 2012). Conv
...
ersely, children raised in homes with inconsistent and harsh parenting or with high levels of conflict can be adversely impacted.
Introduction - Chapter A.12
more
Operational Updates
Emergency Relief & Nutrition Rakhine: A significant increase in internal displacements due to continued armed conflict between the Myanmar military (Tatmadaw) and Arakan Army was reported in northern and central Rakhine State increasing from 6,000 people in February to 20,000 i
...
n March. WFP delivered a one-month ration of food to 2,220 newly displaced people in central Rakhine State, with plans to extend support to additional displaced populations based on coordination with other actors meeting current needs, including the Government and ICRC. WFP continued providing emergency relief assistance to 96,050 conflict-affected people from 173 Muslim, Buddhist and Hindu villages in Buthidaung and Maungdaw townships of northern Rakhine State. In addition, WFP reached over 16,300 children under 5 years through nutrition interventions. In central Rakhine, 4,740 pregnant and lactating women (PLWs) and 24,160 children under 5 years were reached with nutrition interventions, and over 128,040 food-insecure people received relief assistance.
more
Constituting the second part of the World Drug Report 2022, the present booklet contains an overview of the global demand for and supply of drugs.
The first chapter of the booklet begins with the latest estimates of the number of people who use dru
...
gs, the distribution of those users by type of drugs, age and sex, and recent trends in the use of drugs. The chapter also reviews the impact of the coronavirus disease (COVID-19) pandemic on drug use patterns and service provision. Other issues examined in the chapter are the health consequences of drug use, including the number of people in treatment for drug use disorders and the extent of drug injecting and of HIV and hepatitis C among people who inject drugs. The chapter concludes with a review of the extent to which strategies, policies and interventions are in place to respond to the drug use problem.
more
Infectious diseases are constantly in transition. New diseases develop, known dis-eases become widespread or reemerge, and occasionally a disease is eradicated.Infectious diseases such as HIV, tuberculosis, and cholera are significant causes ofillne
...
ss and death in many parts of the world. Health care personnel are on thefront lines, helping to protect their clients from infectious diseases and treatingthem when infections occur. During the course of their work, health care person-nel perform clinical procedures or other activities that can expose both them andtheir clients to potentially infectious microorganisms. Many of their clients aresick and thus may be more susceptible to infections or may have infections thatcan be transmitted to others. Fortunately, all staff working at health care facilities can perform simple proce-dures to minimize risk—to themselves and clients—and reduce the spread ofinfections. These practices can be integrated at minimal cost into the routineworkday at clinics and hospitals around the world. This reference booklet isspecifically designed for use at all levels of the health care system, from thelargest hospitals to the smallest dispensaries or health posts, in settings whereresources are scarce. This booklet, which was first published in 1999, has now been updated. Whilemost practices remain the same, there have been a few important changes—forexample, in recommendations related to hand hygiene and standard precautions.Nonetheless, this booklet continues to present practical recommendations forsimple and relatively low-cost procedures that can be implemented anywhere,with basic supplies and little to no high-technology equipment.
more
This guide is designed to assist UNICEF staff and partners, in establishing and
operating Child Friendly Spaces (CFS) in an emergency. It attempts to provide
readers with the main principles of a CFS and the processes on how to establish
one.
Th
...
e overall aim is to improve the standards and capacity of field staff, by providing
the required knowledge to support the design and operations of child friendly
spaces.
It will facilitate an understanding of how to develop a CFS in contexts in which
children’s well-being are threatened or damaged as a result of conflict or natural
disasters. More specifically, this guide attempts to broaden and strengthen the
knowledge, skills and attitudes of protection officers/field staff so that they are able
to respond to the multi-faceted needs of children.
more
Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in
...
children and poor oral hygiene, several social and environmental factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
more
International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines
recommended
ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO)
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with authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive prote
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ction for individuals across the lifespan. By adopting a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness and inadequate knowledge on the aetio-pathogenesis of the disease together
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with inadequate capacity for COPD care contributes to preventive and management challenges. Thus, the majority of patients with COPD are misdiagnosed, misclassified and mismanaged or undertreated. With the struggling improvement in the quality of healthcare in Africa, studies conducted over the last 10 years indicates the rising trends in both the risk factors and the burden of COPD. The role of new risk factors such as indoor pollution, infections with human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB), in the pathogenesis of COPD in Africa is increasingly being recognized. This literature review attempts to collect and synthesize information that could be useful in improving COPD care and informing the governments to take appropriate actions for prevention, diagnosis and management of COPD in Africa.
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