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The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of
recommended preventive measures (wearing a mask in public, keeping a distance from
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other people and regular handwashing). The roll-out of the vaccines, however, raised concerns that vaccination may lead to lower adherence to the existing
preventive measures. The advice from the World Health Organization (WHO) was to continue these public health and
social measures after being vaccinated.1 However, evidence from other epidemics suggests that there is lower adherence to
preventive measures when some level of protection exists (for example, individuals who use human immunodeficiency virus
pre-exposure prophylaxis
more
PHSM are vital in reducing the risk and scale of infectious disease transmission and lowering hospitalization and deaths. Examples include contact tracing, quarantine and isolation, mask use, ventilation, school or workplace measures, mobility restr
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ictions and travel requirements.
While these measures are essential, decision-making on PHSM becomes particularly complex during rapidly evolving health emergencies, with incomplete information and under significant public and political pressure, especially when the pathogen is novel or poorly understood. In such contexts, guidance needs to be agile and responsive, developed and adapted based on emerging evidence and shifting epidemiological patterns. Decision-makers are frequently confronted with difficult trade-offs, having to balance measures that are:
─ effective but socially disruptive;
─ cost-effective but logistically burdensome;
─ beneficial for public health but economically disruptive; or
─ practical but inequitable or unethical
more
With Safety Tips for Conducting Community Meetings
Updated July 2020
This document includes key Risk Communication and Community Engagement (RCCE) considerations during shifting lockdown measures, safety
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measures for conducting in-person community meetings, and a template that brings both of these considerations together to help agencies adapt their RCCE approaches as these measures shift.
more
This checklist helps to identify the necessary measures to be implemented to mitigate infection transmission among travellers and ground-crossing staff in the context of the COVID-19 pandemic. It features key questions and considerations for gauging
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the capacity of responding to COVID-19 transmission risks and informing on reducing them at and around ground crossings. It does so in the form of a structured questionnaire. The guidance will have particular relevance for National International Health Regulations Focal Points and competent authorities at the point of entry, including relevant representatives of ground crossing authority/ies of the country such as public health authorities, and representatives from other sectors, including law enforcement, customs and migration.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the governmen
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t of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care syst
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ems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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The checklist is aligned with, and builds upon, existing COVID-19-related WHO guidelines and is structured around protective measures related to: 1) hand hygiene and respiratory etiquette; 2) physical distancing; 3) use of masks in schools; 4) envir
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onmental cleaning and ventilation; and 5) respecting procedures for isolation of all people with symptoms. The checklist is designed to support policy-makers, staff and officials from the education and health sectors, local authorities, school principals/leaders and administrators, teachers’ unions, community leaders, school staff, teachers, parents and caregivers.
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There is widespread recognition of the growing threat of infectious disease epidemics and pandemics spreading across countries or continents—especially following the recent Ebola and COVID-19 pandemics. Vulnerable groups (including children, older adults, ethnic minorities and other at-risk group
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s) have disproportionately borne the brunt of significant health, social, and economic effects of these epidemics and pandemics, with varying degrees of support received depending on the context. While many argue that communities should or need to play a critical role in supporting and leading preparedness and response efforts, work still needs to be done to engage them effectively. In many instances, modes of engagement with communities—especially by state authorities–have come too late, often as an afterthought are not adequately thought through and have undermined public trust in and support for, disease prevention and control measures
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Alcohol consumption is deeply embedded in the social landscape of many societies. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and trends i
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n the marketing of alcoholic beverages, as well as implemented alcohol control measures. At the individual level, the patterns and levels of alcohol consumption are determined by many different factors, including gender, age and individual biological and socioeconomic vulnerability factors, as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking encourage alcohol consumption delay appropriate health-seeking behaviour and weaken community action
more
Chagas disease or American trypanosomiasis is, together with geohelminths, the neglected disease that causes more loss of years of healthy life due to disability in Latin America. Chagas disease, as determined by the factors and determinants, shows that different contexts require different actions,
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preventing new cases or reducing the burden of disease. Control strategies must combine two general courses of action including prevention of transmission to prevent the occurrence of new cases (these measures are cost effective), as well as opportune diagnosis and treatment of infected individuals in order to prevent the clinical evolution of the disease and to allow them to recuperate their health. All actions should be implemented as fully as possible and with an integrated way, to maximise the impact. Chagas disease cannot be eradicated due because of the demonstrated existence of infected wild triatomines
in permanent contact with domestic cycles and it contributes to the occurrence of at least few new cases. However, it is possible to interrupt the transmission of Trypanosoma cruzi in a large territory and to eliminate Chagas disease
as a public health problem with a dramatic reduction of burden of the disease.
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On this website you can download videos, posters and information on basic protective measures against the new coronavirus COVID-19
The target audience of this document (and the associated online companion tool) includes WHO country offices in Member States of the African Region; Member States’ ministries of health and their public
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health emergency operation centres; relevant external assessment teams; and partners looking to identify preparedness gaps and
support interventions that help address them. In the event of a suspected or confirmed VHF case, the document also serves to provide any intervening partner with a sense of what structures should be in place, in order to guide
scale-up activities in line with regional and national plans.
more
The CSMH compiled a list of assessment measures that are in the public domain (free of charge) and available online for clinicians. Below are the recommended
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measures can be used in school mental health programs to help assess symptoms of clinical disorders (e.g. depression, anxiety, ADHD) an in some cases are useful for tracking student progress and outcomes over time.
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state that efficiency measurement can be a substantial contribution to saving lives. Therefore we analyse t
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he performance of health centres in rural Burkina Faso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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This interim operational guide outlines infection prevention, control, and water, sanitation, and hygiene measures for home care and isolation of mpox in resource-limited settings. It focuses on practical strategies to manage and prevent the spread
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of the virus when persons with mpox are isolated at home in settings with limited resources. This document is intended for health and care workers, caregivers, and public health authorities.
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Over the past few decades, the world has witnessed considerable progress in women’s, children’s and adolescents’ health (WCAH) and the Sustainable Development Goals (SDGs). Yet deep inequities remain between and within countries. This scoping
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review aims to map financing interventions and measures to improve equity in WCAH in low- and middle-income countries (LMICs).
more
Assessing the Impact of Workforce Nutrition Programmes on Nutrition, Health and Business Outcomes: A Review of the Global Evidence and Future Research Agenda
Dhillon, C.N.; Ortenzi, F.
International Journal of Environmental Research and Public Health
(2023)
CC
One in three people globally suffers from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all
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its forms. This narrative literature review aims to understand the impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We used PubMed as our primary research database, complemented by Google Scholar, to identify systematic reviews, meta-analyses, and randomised controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualised counselling and worksite environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on the impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps.
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This document provides recommendations on essential measures to protect the health and safety of operators and other persons involved in emergency vector control of Aedes spp. mosquitoes, including
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space spraying of insecticides, larvicide application and, in some cases, indoor residual spraying. It is intended to be used by vector control managers and operators, public health workers, medical professionals, district health officers and ministries of health.
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.
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It emphasizes the importance of a multisectoral approach, 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.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discha
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rge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic or mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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