Modern healthcare has given rise to extremely complex and multifaceted ethical dilemmas. All too often physicians are unprepared to manage these competently. This publication is specifically structured to reinforce and strengthen the ethical mindset and prac...tice of physicians and provide tools to find ethical solutions to these dilemmas. It is not a list of “rights and wrongs” but an attempt to sensitise the conscience of the physician, which is the basis for all sound and ethical decision-making. To this end, you will find several case studies in the book, which are intended to foster individual ethical reflection as well as discussion within team settings.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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This report challenges policy-makers and political leaders to tackle fossil fuel production and consumption as a health control issue, in the same way that smoking has been reduced and regulated. Fossil fuel combustion is a major source of toxic air pollution that kills 7 million people every year, ...almost the same as the number of deaths caused by tobacco smoking.
In 2018, the World Health Organization (WHO) recognised air pollution as a major health risk factor. There is widespread public discussion about the effects of fossil fuel combustion and emissions on climate change… but what about the effect on our health? Climate change poses a threat not only to the health of the planet, but also to humans.
The case studies evaluated in this report offer examples of mechanisms that can be used to restrict the production and consumption of unhealthy commodities, so that the health, air pollution and climate communities can learn from one another, using shared approaches and language. These case studies show that the connection with health is a strong argument to support sustainable change.
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The 2020 Financing for Sustainable Development Report, the fifth report of the Inter-agency Task Force on Financing for Development, provides a comprehensive assessment of the state of sustainable finance. Prepared by more than 60 agencies of the United Nations system and partner international organ...izations, the report brings together a wide range of expertise and perspectives. It puts forward a set of policy recommendations to mobilize financing flows, and align them with economic, social and environmental priorities. These recommendations should assist Member States and all other stakeholders as they work toward fully implementing the Addis Agenda and achieve the SDGs.
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The COVID-19 pandemic led to school closures around the world, affecting almost 1.6 billion students. The effects of even short disruptions in a child’s schooling on their learning and well-being have been shown to be acute and long lasting. The capacities of education systems to respond to the cr...isis by delivering remote learning and support to children and families have been diverse yet uneven.
This report reviews the emerging evidence on remote learning throughout the global school closures during the COVID-19 pandemic to help guide decision-makers to build more effective, sustainable, and resilient education systems for current and future crises.
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ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del...ivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Designed ...for implementation in primary healthcare settings, especially in low-resource environments, the package includes protocols for screening, diagnosis, treatment, and management of these diseases. The document emphasizes an integrated approach, supporting universal health coverage by empowering healthcare workers with practical tools to improve NCD care. It aims to reduce premature mortality from NCDs and enhance global health equity.
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The rapid assessment tool (RAT) is meant to assess health facilities within mpox-affected areas that have at least one inpatient bed. Depending on time and resources available, certain facilities may be prioritized during an mpox outbreak. The RAT evaluates 16 infection prevention and control (IPC) ...and water, sanitation and hygiene (WASH) criteria identified as the minimum essential elements required for safe patient care and prevention of transmission within the health facility during readiness or response activities for outbreaks of mpox.
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In support of the African decade of disabled persons | 1st January 199 - 31st of December 2009
This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels ...of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
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Shaping Health programme on Learning from international experience on approaches to community power, participation and decision-making in health,AMHF, TARSC
The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respond to the health and well-being challenges, opportunities and needs of adolescents.
The guidance pro...vides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
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Estima-se que 17,8 milhões de mulheres em todo o mundo com 18 anos ou mais viviam com o VIH em 2015, o equivalente a 51% dos adultos que viviam com o VIH. As raparigas adolescentes e as mulheres jovens são particularmente afectadas; em 2015 representavam 60 por cento dos indivíduos com idades com...preendidas entre os 15-24 anos que viviam com o VIH, e 58 por cento das infecções por VIH recentemente adquiridas entre a população jovem deste grupo etário. Em muitos países, as mulheres que vivem com o VIH não têm acesso equitativo a serviços de saúde de boa qualidade e enfrentam muitas formas de estigma e discriminação entrecruzadas. Além disso, estas mulheres são desproporcionadamente vulneráveis à violência, incluindo as violações dos seus direitos sexuais e reprodutivos.
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he refugee flow to Ethiopia continued during 2018, with 36,1351 persons seeking safety and protection within the country’s borders. At the start of 2019, the nation hosted 905,8312 thousand refugees who were forced to flee their homes as a result of insecurity, political instability, military cons...cription, conflict, famine and other problems in their countries of origin. Ethiopia is one of the largest refugee asylum countries world-wide, and the second largest in Africa, reflecting the ongoing fragility and conflict in the region. Ethiopia provides protection to refugees from some 26 countries. Among the principal factors leading to this situation are predominantly the conflict in South Sudan, the prevailing political environment in Eritrea, together with conflict and draught in Somalia.
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The guide is divided into 3 sections —the first focuses on the conceptual framework for M&E; the second focuses on six key steps for M&E; and further, the appendix provides additional tools, resources, and projects for M&E. With a comprehensive breakdown of the important approaches as well as a ch...ecklist approach to the setting up of a monitoring and evaluation framework, this guide works for almost everyone
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The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach for monitoring and evaluation of the global action plan on AMR. This report analyses the results of the second tripartite self-assessment survey. It has ...been developed and run by the three Tripartite organizations (Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE) and World Health Organization (WHO)) and reflects progress in the human, animal (terrestrial and aquatic), plant, food safety and environmental sectors. 154 countries out of 194 WHO Member States responded to this round of the self-assessment survey – a response rate of 79.4%.
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Women have less access to the development services and support – such as adequate healthcare, education and
modern technology – that make people more resilient to climate change and other shocks and stressors.2
Women’s unequal access to resources, their disproportionate responsibility for ca...re of dependents (typically unpaid),
and the insecurity and precariousness of their paid labour all contribute to the feminisation of poverty and women’s
heightened vulnerability to climate hazards. Climate change is a multiplier of existing vulnerabilities and threatens to
reverse hard-earned development gains for all people, and particularly for women.
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