Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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7 April 2021
The holy month of Ramadan (mid-April to mid-May 2021) is marked by social and religious gatherings. Because of the ongoing COVID-19 pandemic, it is imperative to observe the holiday with caution and care. This document provides up-to-date public health advice that can be applied across... different national contexts to make Ramadan-related activities safer.
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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and... population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
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21 January 2022
The overall threat posed by Omicron largely depends on four key questions: (i) how transmissible the variant is; (ii) how well vaccines and prior infection protect against infection, transmission, clinical disease and death; (iii) how virulent the variant is compared to other varian...ts; and (iv) how populations understand these dynamics, perceive risk and follow control measures, including public health and social measures (PHSM).
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Six months after its launch on 24 April, the Access to COVID-19 Tools (ACT) Accelerator has already delivered concrete results in speeding up the development of new therapeutics, diagnostics, and vaccines. Now mid-way through the scale-up phase, the tools we need to fundamentally change the course o...f this pandemic are within reach. But to deliver the full impact of the ACT-Accelerator – and ultimately an exit to this global crisis – these tools need to be available everywhere. On behalf of the ACT-Accelerator Pillar lead agencies – CEPI, Gavi, the Global Fund, FIND, Unitaid, Wellcome Trust, the World Bank, and the World Health Organization, as well as the Bill & Melinda Gates Foundation – I am pleased to share this document setting out the near-term priorities, deliverables and financing requirements of the ACT-Accelerator Pillars and Health Systems Connector. Urgent action to address these financing requirements will boost the impact of the ACTAccelerator achievements to date, fast-track the development and deployment of additional game-changing tools, and mitigate the risk of a widening gap in access to COVID-19 tools between low- and high-income countries. Delivering on this promise requires strong political leadership, financial investment, and incountry capacity building. COVID-19 cannot be beaten by any one country acting alone. We must ACT now, and ACT together to end the COVID-19 crisis.
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The COVID-19 pandemic has raised profound ethical challenges on an unprecedented global scale. These challenges include how to allocate scarce resources (especially vaccines and therapeutics), both within and between countries, whether and when to mandate vaccines and/or masks, whether and how to co...nduct public health surveillance, whether to issue vaccine passports, and how to address stark international and intranational inequities. In addition, there have been ethical concerns about the conduct of COVID-19 research, such as the appropriateness of challenge studies.
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The aim of the SATG was to produce a triage scale for use throughout South Africa. The group was multi-disciplinary and comprised doctors, nurses and paramedics. The result of the SATG’s activities is the South African Triage Scale (SATS), a physiology and symptom based scale which prioritises int...o one of four colours and can be used in hospital Emergency Centres as well as in the pre-hospital setting. The SATS has been validated in the public, private health care setting as well as pre-hospital.
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Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse a...nd misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
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The COVID-19 pandemic is challenging health systems across the world. Rapidly increasing demand for care of people with COVID-19 is compounded by fear, misinformation and limitations on the movement of people and supplies that disrupt the delivery of frontline health care for all people...
This g...uidance addresses the specific role of community-based health care in the pandemic context and outlines the adaptations needed to keep people safe, maintain continuity of essential services and ensure an effective response to COVID-19. It is intended for decision-makers and managers at the national and subnational levels and complements a range of other guidance, including that on priority public health interventions, facility-based care, and risk communication and community engagement in the setting of the COVID-19 pandemic.
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NHỮNG CÂN NHẮC VÀ KHUYẾN NGHỊ THIẾT THỰC CHO CÁC NHÀ LÃNH ĐẠO TÔN GIÁO VÀ CỘNG ĐỒNG TÔN GIÁO TRONG BỐI CẢNH COVID-19
Practical considerations and recommendations for religious leaders and faith-based communities in the context of COVID-19
Religious leaders, faith...-based organizations, and faith communities can play a major role in saving lives and reducing illness related to COVID-19.1 They are a primary source of support, comfort, guidance, and direct health care and social service, for the communities they serve. Religious leaders of faith-based organizations and communities of faith can share health information to protect their own members and wider communities, which may be more likely to be accepted than from other sources. They can provide pastoral and spiritual support during public health emergencies and other health challenges and can advocate for the needs of vulnerable populations.
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The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to ...enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multi...ple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the challenges identified. This emerging movement has not yet agreed upon a code of ethics t...o underpin the rapidly expanding body of research being carried out in its
name. However, a code of ethics might support the principles for planetary health set out in the Canmore Declaration of 2018. Phrases such as “Public Health 2.0”, “Human Health in an Era of Global Environmental Change”, or “A safe and just operating space for humanity” are often used in planetary health discussions, but are not always clearly defined and so far, the field lacks a strong guiding ethical framework. In this paper, we propose a starting point towards a code of ethics for planetary health that builds on the Canmore Declaration.
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The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID...-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
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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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Developmental disabilities are common. Yet, children with developmental disabilities have been neglected in health systems planning and policy provisions for health and continue to experience stigmatization, institutionalization, barriers to access health care and inequalities in health and educatio...n outcomes.
Using findings from research and practice and guided by the tenets of international human rights conventions, this WHO-UNICEF Global Report on children with developmental disabilities provides principles and approaches to intentionally include the needs and aspirations of children and young people with developmental disabilities in policy, programming and public health monitoring. It makes the case for greater accountability and proposes 10 priority actions to accelerate changes towards inclusive environments and responsive multisectoral care systems for children with developmental disabilities.
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Effective Ebola risk communication requires respect and transparency and remains as vital
as ever. An assessment of changing communication needs and preferences in Beni, North Kivu.
In the second year of the current Ebola outbreak response in the Democratic Republic of Congo (DRC), people at ris...k still don’t have clear answers to their questions about the disease in a language they understand. Many local health communicators are themselves confused about the disease prevention and treatment measures they promote. The language, content, and form of communication about Ebola affect how far people understand, trust and act upon it.
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Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate and high priority needs of an affected population and is often the first type of response activated and/or requested by authorities and affected c...ommunities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
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