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2
La carga de la diabetes es enorme, posicionándola como uno de los principales desafíos que enfrenta la salud pública en la actualidad. Actualmente, se estima que 62 millones de personas viven con diabetes en la Región de las Américas y las proyecciones muestran que su prevalencia seguirá aumen
...
tando en los próximos años. La Región muestra el mayor número de años de vida saludable perdidos (ya sea por discapacidad o muerte prematura) debido a la diabetes en todo el mundo. Los altos costes asociados a su tratamiento producen una pesada carga económica. Sus complicaciones pueden afectar seriamente la calidad de vida de las personas que viven con diabetes, sus familias y la sociedad y sobrecargar los sistemas de salud. Este informe muestra los últimos datos comparables internacionalmente sobre la diabetes y sus principales factores de riesgo por año, país y sexo. También incluye un resumen de la respuesta de los sistemas de salud de los países a la diabetes, incluidos planes nacionales, objetivos, vigilancia, directrices y acceso a medicamentos y tecnologías esenciales, y sintetiza información sobre las complicaciones relacionadas con la diabetes y la estrecha relación entre la diabetes y otras patologías, como enfermedades cardiovasculares, tuberculosis y COVID-19.
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To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of equity and evidence-based policies, strategies and interventions to accelerate equitable progress in
...
the health of women, children and adolescents. Although progress has been made, great inequities persist. Women from the LAC region’s poorest countries are almost four times more likely to die due to complications during childbirth than those living in the wealthiest countries. Through the years, several tools, instruments and methods (TIMs) have been developed by global, regional and country partners that can be used to conduct systematic equity-based analyses and/or re-designs of health systems, programs, strategies and interventions. The main purpose of this document is to present an overview of existing TIMs that can be used by policymakers, program managers, development partners, nongovernmental organizations, academia and civil society partners to strengthen systematic identification, analysis and responding to social inequities in the health of women, children and adolescents in LAC. The TIMs included were identified through a systematic search process
more
Cholera is a major health risk in many parts of the world, affecting millions of people every year. Since mid-2021, the world has been facing an acute upsurge of the 7th cholera pandemic, which is characterized by the number, size and concurrence of multiple outbreaks, the spread to areas that had b
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een free of cholera for decades and alarmingly high mortality rates. The mortality associated with these outbreaks is of particular concern as many countries have reported higher case fatality ratios (CFR) than in previous years
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WHO/Europe has launched a new guide, providing support to countries on how to apply behavioural and cultural insights (BCI) for health. It presents a simple step-wise approach, complemented by a rich collection of detailed considerations, tools and exercises. The guide is the first of its kind, spec
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ifically developed for use by public health professionals developing policies, services and communications informed by BCI across health topics.
Some of the most persistent public health challenges involve human behaviour. Using a BCI lens means that health policies, services and communications can be tailored to the needs and circumstances of people and communities, and thereby help combat these challenges. The new Tailoring Health Programmes (THP) guide describes how this can be done.
Building on several topic-specific guides that focused on applying BCI to routine and influenza vaccination and tackling antimicrobial resistance, as well as external evaluations and a rigorous peer-review process, this guide is the result of over a decade of work by WHO/Europe. The THP approach has already been adopted in over 20 countries and has received positive feedback from public health agencies.
“This guide is the culmination of a decade of work involving many colleagues at country, regional and global levels. The guide is our “BCI bible”, guiding our work with and in countries to help tackle persistent health challenges,” said Katrine Bach Habersaat, Regional Advisor for BCI at WHO/Europe.
Karina Godoy, Senior Analyst and National Focal Point for Behavioural Insights at the Public Health Agency of Sweden, who is employing the approach described in the guide across several health projects, comments: “The THP guide is easy to use and at the same time provides detailed guidance and inspiration where needed. We have decided to translate the document into Swedish and use the approach widely”.
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Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors.
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Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
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This report compiles data for the first time on the far-reaching consequences of uncontrolled hypertension, including heart attacks, strokes and premature death, along with substantial economic losses for communities and countries. It also contains information on the global, regional and country-lev
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el burden of hypertension and progress of control efforts.
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Previous advocacy efforts have achieved tangible goals in terms garnering political commitments
to increase financing for TB—as seen at the 2018 UN High-Level Meeting on TB. The challenge
now is to ensure that these commitments are actually met within a global biomedical research
ecosystem that
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is designed and incentivized to prioritize the health needs of wealthy populations
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he global architecture for providing development assistance for health (DAH)
has become increasing complex in the last decade, with many new funding agencies entering the health sector.
This study presents a detailed picture of European Union (EU) and EU member state originating DAH
between 2006
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and 2009; with a sp
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Trustworthy, evidence-based health guidelines form the basis of national policies affecting both patients and health-care workers. Emphasizing the link between robust evidence and people’s trust in their health systems, Dr Hans Henri P. Kluge, WHO Regional Director for Europe said at the launch ev
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ent, “Trust and transformation are key words for us, especially when we talk about improving and strengthening our health systems. Transformation should first and foremost serve the interests of patients and health-care workers”.
While it is not always easy to demonstrate the immediate effect of guidelines on people’s health, there is no viable alternative to utilizing guidelines based on the best available evidence.
Yet, developing robust guidelines remains a challenge for most countries. “Guidelines need to be both simple to use and timely, they need to address people’s real needs, especially at the local level, and should ultimately reflect the resources available,” said Dr Natasha Azzopardi-Muscat, Director, Country Health Policies and Systems, WHO/Europe. “This means that any successful guideline needs to be adjusted and adapted to local contexts and realities.”
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This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes im
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plementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
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World Humanitarian Data and Trends presents global- and country-level data-and-trend analysis about humanitarian
crises and assistance. Its purpose is to consolidate this information and present it in an accessible way, providing policymakers, researchers and humanitarian practitioners with an evid
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ence base to support humanitarian policy decisions and provide context for operational decisions.
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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
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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.
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This checklist is an operational tool to help national authorities develop or revise national respiratory pathogen (inclusive of influenza and coronaviruses) pandemic preparedness plans.
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
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patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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The guide to implementing the One Health Joint Plan of Action (OH JPA) at national level provides practical guidance on how countries can adopt and adapt the OH JPA to strengthen and support national One Health action.
Building on the OH JPA theory of change, this guide describes three pathways a
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nd five key steps to implement the OH JPA at national level:
Pathway 1 -- Governance, policy, legislation, financing and advocacy
Pathway 2 -- Organizational and institutional development, implementation and sectoral integration
Pathway 3 -- Data, evidence, information systems and knowledge exchange.
The stepwise approach comprises:
Situation analysis including stakeholder mapping and review of existing assessment results
Set-up/strengthening of a multisectoral, One Health coordination mechanism
Planning for implementation, including activity prioritization and leveraging of resources
Implementation of national One Health action plans
Review, sharing and incorporation of lessons learned.
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The World Heart Federation (WHF) is a leading global advocate for stronger legislation and policies regarding cardiovascular disease (CVD) and its risk factors, including raised cholesterol. The present Cholesterol Advocacy Toolkit 2022 provides WHF member organizations with information as well as p
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ractical tools to
support cholesterol advocacy at the local and regional levels.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t
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reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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In 2006, the Special Session of African Union Health Ministers adopted the Maputo Plan of Action for implementing the Continental Policy Framework on sexual and reproductive health and rights (SRHR), which expired at the end of 2015. The goal was for all stakeholders and partners to join forces and
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re-double efforts, so that together, the effective implementation of the Continental Policy framework including universal access to sexual and reproductive health by 2015 in all countries in Africa can be achieved. The Revised Maputo Plan of Action (MPoA) 2016 – 2030 was subsequently endorsed by the African Union Heads of State at the 27th AU Summit in July 2016 in Kigali, Rwanda. The plan reinforces the call for universal access to comprehensive sexual and reproductive health services in Africa and lays foundation to the Sustainable Development Goals, particularly Goal 3 and 5, as well as the African Union Agenda 2063.
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Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated with a number of conditions, disability, and causes o
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f death. These include: strokes; myocardial infarction; end-stage renal disease; congestive heart failure; peripheral vascular disease and blindness. According to Stats SA, in 2017, hypertensive disorders resulted in 19 900 deaths with a further 44 357 deaths associated with cerebrovascular diseases and other heart diseases. This means around 30% of all deaths in 2017 were associated with increased blood pressure.
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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
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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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