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1
This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both inpatient and outpatient management of severe acute
...
malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 in the WHO Pocketbook for Hospital Care for Children, and the 2013 update on SAM (outpatient management). The global threat of increasing antimicrobial resistance and new data on efficacy and safety profiles requires a re-review of the current evidence to ensure recommendations are the most appropriate. The evidence base for the use of antibiotics in children presenting with uncomplicated SAM has been recently enlarged.
more
The WHO country office for Ghana, began the year 2019 with a 4-day staff retreat at the Busua Beach Resort in the Western Region from 04 to 08 March 2019. The theme for the retreat was ‘Impacting the Health and Lives of the people
...
of Ghana through the Triple Billion Goal”. The staff outlined priorities and strategies to strengthen WHO’s contribution to the national health agenda during the year. Working in collaboration with the Ministry of Health/Ghana Health Service and other allied health institutions and stakeholders, the WHO country office, provided support aimed at achieving its
mission which is attaining the highest level of health by the people in the country though its six operational areas which are (i) Communicable Diseases (ii) Non-Communicable Diseases, (iii) Promoting Health through the Life Course (iv), Health Systems, (v) Preparedness, Surveillance and Response (vi) Corporate services and enabling functions.
more
Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effec
...
tive as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
more
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management
...
of cardiovascular diseases and provide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
more
Coronavirus Disease-19 (COVID-19) was declared a global pandemic on 11 March 2020, and Malawi declared its first case on 2 April. As of 30 April, there were 36 confirmed positive cases
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of COVID-19 and 3 deaths. A State of Disaster was declared by President Arthur Peter Mutharika on 20 March and a 21-day lockdown was implemented from 18 April to 9 May. The lockdown measures include: bans on public gatherings; closure of schools; and bans on international flights and cross-border passenger buses.
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WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situatio
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n in a country, including the state of the health sector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
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Meningitis Outbreak Response in Sub-Saharan Africa
Christina Brandes-Barbier, Véronique Millot, Tomas Allen et al
World Health Organization WHO
(2014)
C_WHO
WHO Guideline. Since 2010, countries in the meningitis belt have started to introduce a new serogroup A meningococcal conjugate vaccine conferring individual protection and herd immunity. Following the successful roll-out of this vaccine, epidemics
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due to Neisseria meningitidis serogroup A (NmA) are disappearing, but other serogroups (e.g. NmW, NmX and NmC) still cause epidemics, albeit at a lower frequency and of a smaller size. Due to these changes, WHO organized the review of the evidence to provide recommendations for epidemic control, related to operational thresholds for investigation and response to outbreaks, the use of rapid diagnostic tests, antibiotic regimens in epidemics, and prophylaxis for household contacts of cases
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This document builds on the Background document prepared for the September 4-5, 2014 Consultation. It includes proposed elements to consider during the development of a framework to assist decision-making at global and national
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level.
The aim of the document is to assist Member States and relevant partners in their discussions to identify the best approaches to ensure the accelerated evaluation and use of available or near-term therapies and vaccines for the treatment and prevention of EVD. The document calls for a coordinated effort by the international community to remove unnecessary obstacles towards this goal.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discu
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ssion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapters (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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Lao People’s Democratic Republic (Lao PDR), also referred to as Laos, or Lao, is exposed to natural disasters such as flooding, typhoons, cyclones, drought, and earthquakes. The country is vulnerable to recurrent, sudden-onset and slow onset natural disasters with flooding, storms and typhoons hav
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ing a large effect on the population. The country remains highly vulnerable to agricultural shocks and natural disasters.
Lao has established Community Based Disaster Risk Reduction (CBDRR) practices as a result of the many natural disasters the country faces. CBDRR is implemented at the village level to enhance community preparedness and to decrease village vulnerabilities to disasters.
Lao established the National Disaster Management Committee (NDMC) as its national disaster management platform and the National Disaster Management Office (NDMO) to be responsible for DRM (Disaster Risk Management) and DRR activities in the country. more
Lao has established Community Based Disaster Risk Reduction (CBDRR) practices as a result of the many natural disasters the country faces. CBDRR is implemented at the village level to enhance community preparedness and to decrease village vulnerabilities to disasters.
Lao established the National Disaster Management Committee (NDMC) as its national disaster management platform and the National Disaster Management Office (NDMO) to be responsible for DRM (Disaster Risk Management) and DRR activities in the country. more
Version-1, June 2018
This document provides 3MDG stakeholders with essential information on SRHR indicators, derived from the 3MDG Logical Framework, Data Dictionary for Health Service Indicators (2014 June, DoPH, MoHA), A Guide to Monitoring and Evaluating Adolescent Reproductive Health Progra ... ms (MEASURE Evaluation, June 2000) and Monitoring National Cervical Cancer Prevention and Control Programmes (WHO, PAHO, 2013). Partners are strongly encouraged to integrate the SRHR indicators into their ongoing monitoring and evaluation (M&E) activities.
These indicators are designed to help partners assess the current state of their activities, their progress towards achieving their targets, and contribution towards the national response. This guideline is designed to improve the quality and consistency of data collected at the township level, which will enhance the accuracy of conclusions drawn when the data are aggregated. more
This document provides 3MDG stakeholders with essential information on SRHR indicators, derived from the 3MDG Logical Framework, Data Dictionary for Health Service Indicators (2014 June, DoPH, MoHA), A Guide to Monitoring and Evaluating Adolescent Reproductive Health Progra ... ms (MEASURE Evaluation, June 2000) and Monitoring National Cervical Cancer Prevention and Control Programmes (WHO, PAHO, 2013). Partners are strongly encouraged to integrate the SRHR indicators into their ongoing monitoring and evaluation (M&E) activities.
These indicators are designed to help partners assess the current state of their activities, their progress towards achieving their targets, and contribution towards the national response. This guideline is designed to improve the quality and consistency of data collected at the township level, which will enhance the accuracy of conclusions drawn when the data are aggregated. more
his Framework begins with a desired future scenario and considers actions and interventions necessary to get there. It advocates for holistic view to address tuberculosis. The Framework revisits challenges and actions in four layers: TB specific; challenges in health systems that influence TB
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care; challenges in sectors beyond health that determine TB; and overarching governance issues. Multisectoral action and accountability are embedded in the Framework. The Framework is based on the principles of people-centered care and system development.
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Health Policy and Planning, Volume 35, Issue 1, February 2020, Pages 47–57, https://doi.org/10.1093/heapol/czz122
Colombia has an underreporting of 30% of the total
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cases, according to World Health Organization (WHO) estimations. In 2016, successful tuberculosis (TB) treatment rate was 70%, and the mortality rate ranged between 3.5% and 10%. In 2015, Colombia adopted and adapted the End TB strategy and set a target of 50% reduction in incidence and mortality by 2035 compared with 2015.
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Therapeutics for Ebola virus disease
recommended
The WHO Ebola Virus Disease (EVD) Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with EVD. Providing guidance that is comprehensive and holistic for the op
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timal care of patients with EVD throughout their illness is important.
The living guidance is available in both pdf format (via the ‘Download’ button) and via an online platform in both French and English, and is updated regularly as new evidence emerges.
This first version of the Clinical management for EVD living guidance contains four new recommendations regarding use of therapeutics for EVD, this includes two strong recommendations for the use of monoclonal antibody therapies. This new living guideline is written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures (5, 6). The living guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause
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of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 deaths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to do just that. Drawing on the published literature and the operational experience and expertise
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of different LMICs, the paper points to six key strategies for success and offers a series of practical tips and suggestions on how to implement each one.
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The seventh WHO Report on the global tobacco epidemic analyses national efforts to implement the most effective measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce demand for tobacco.
The report showed that while only 23 countries have implemented ce
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ssation support policies at the highest level, 116 more provide fully or partially cost-covered services in some or most health facilities, and another 32 offer services but do not cost-cover them, demonstrating a high level of public demand for support to quit.
Tobacco use has also declined proportionately in most countries, but population growth means the total number of people using tobacco has remained stubbornly high. Currently, there are an estimated 1.1 billion smokers, around 80% of whom live in low- and middle-income countries (LMICs).
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The report focuses on antibacterial resistance (ABR) in common bacterial pathogens. There is a major gap in knowledge about the magnitude of this problem. Antimicrobial resistance (AMR) threatens the effective revention and treatment
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of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally. It examines the information on AMR, in particular antibacterial resistance (ABR), at country level worldwide.
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In where under-five mortality is high and vitamin A deficiency is a public health problem, two high-dose supplements of vitamin A per year, spaced four to six months apart, can strengthen children
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s immune systems and improve their chances of survival.
During much of early childhood – from 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive. more
During much of early childhood – from 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive. more
In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population. This has resulted in an increased life expectancy, and the achievement
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of Millennium Development Goals such as a reduction in infant and under-five mortality, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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