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1
Relevance and effectiveness of World Bank support for public sector capacity building in Sub-Saharan Africa from 1995 to 2004. Benin is part of a six country case study.
This is the first national Policy to combat AMR in Cambodia. It was developed based on conclusions and recommendations of a country situaytion analysis.
National Action Plan on Antimicrobial Resistance/Afghanistan
Ministry of Public Health, Afghanistan
Food and Agriculture Organization of the United Nations FAO
(2017)
C2
AMR is one of the Key priority of the global health security agenda action package, as well as it is one of the commitments of Ministry of Public Health Afghanistan to combat AMR. In Afghanistan because of war and some other political issues the borders of the
...
country are not well secured and well controlled therefore control of smuggling of medicine is a big challenge in front of the rational use of medicine. Lack of knowledge (professionals and public), poor economic state, conflict of war, presence of remote areas and etc…. are the other main challenges for this to won the battle of combating AMR.
more
This document provides guidance on the implementation of the shielding approach in urban areas in LICs and crisis-affected regions. It is intended for the community itself, national and local governance institutions, and humanitarian and development actors operating in the
...
country.
more
Namibia is no exception to the growingglobal concern on the increasing burden of NCDs. Namibia is an upper middle income country with fast economic growth since independence in 1990. The country i
...
s bearing the double burden of communicable and noncommunicable diseases and rapid urbanization. There is also high income inequality among the population.
more
The Bolivarian Republic of Venezuela has been facing a sociopolitical and economic situation that has negatively impacted social and health indicators. There have been intensified population movements both within the country and to other countries,
...
particularly to Argentina, Brazil, Chile, Colombia, Costa Rica, Curaçao, Dominican Republic, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, and Uruguay. Since 2017, an estimated 5.2 million Venezuelans have migrated to other countries, including an estimated 4.3 million who have gone to countries in Latin America and the Caribbean.
more
To evaluate the epidemiological evolution of patients with HIV (PtHIV), between 2002 and 2012, in a day-hospital that became an HIV reference centre for south-west Burkina Faso.
This was a retrospective study of PtHIV followed in the Bobo Dioulasso university hospital since 2002. The study was ba
...
sed on clinical data recorded using ESOPE software and analysed using Excel and SAS.
more
The Federal Ministry of Health (FMOH) has been coordinating sector wide reforms that aim to improve equity and quality of health services. It is widely known that; the sector is growing in line the overall growth and transformation plan of the
...
country and the sector is being guided by the health sector transformation plan (HSTP). As part of these efforts, to achieve the targets set, the sector identified information revolution as one of the transformational agendas. In the meantime, Appropriate and timely use of health and health-related information is an essential element in the process of transforming the health sector.
more
Globally, approximately 56.8 million people are in need of palliative care
services; 78% of them living in low and middle-income country yet only
about 12% have their needs being met causing great suffering for many.
The development of this target product profile (TPP) was led by the WHO Department of Control of Ne-
glected Tropical Diseases (NTD) following standard WHO guidance for TPP development. In order to
identify and prioritize diagnostic needs, a WHO NTD Diagnostics Technical Advisory Group (DTAG)
was
...
formed, and different subgroups were created to advise on specific NTDs, including a subgroup
working on the human African trypanosomiasis (HAT) diagnostic innovation needs. This group of in-
dependent experts included leading scientists, public health officials and endemic-country end-user rep-
resentatives. Standard WHO Declaration of Interest procedures were followed. A landscape analysis of
the available products and of the development pipeline was conducted, and the salient areas with unmet
needs were identified
more
Following the publication of Guidelines on certification of elimination of human onchocerciasis in 2001 by the World Health Organization (WHO), these are the first evidence-based guidelines developed by NTD Department according to the international standards. They provide a set of recommendations th
...
at would guide national programme managers in collaboration with their respective oversight committees on when to stop mass drug administration (MDA) and conduct post-treatment surveillance (PTS) activities for a minimum period of 3 to 5 year before confirming the interruption of transmission of Onchocerca volvulus parasite and hence its elimination. They also include steps to undertake for verification of elimination of transmission of the parasite in the whole endemic country by the International Verification Team (IVT) prior to the official acknowledgement by WHO Director General.
more
Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant
...
imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
more
Financing Global Health 2015 is the seventh edition of IHME’s annual series on global health financing. This report captures trends in development assistance for health (DAH) and government health expenditure as source (GHE-S) in low- and middle-income countries. Annually updated GHE-S and DAH est
...
imates are produced to aid decision-makers and other global health stakeholders in identifying funding gaps and invesment opportunities vital to improving population health. This year, IHME made a number of improvements to the data collection and methods implemented to generate Financing Global Health estimates.
more
South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing
...
and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
more
Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-
...
incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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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
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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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Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update
Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al.
African Journal of Thoracic and Critical Care Medicine
(2021)
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sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-
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country realities are important to support optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of
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the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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Antimicrobial resistance (AMR) is a global public health crisis that resulted in 1.14 million deaths in 2021. According to the Institute for Health Metrics and Evaluation estimates, 96 416 of these deaths occurred in the World Health Organization (WHO) Eastern Mediterranean Region. All 22 countr
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ies/territories in the Eastern Mediterranean Region are enrolled in the global AMR
surveillance system, and 17 countries/territories reported data in 2024 (for the year 2023). The total number of isolates reported to the system increased sixfold between 2017 and 2022, but the proportion of blood isolates is relatively very low. Most of the data come from public sector laboratories or hospitals, although the private sector has increased its participation in some countries/territories recently. Three pathogens account for three quarters of all the reported pathogens – Escherichia coli
(26%), Klebsiella pneumoniae (23%), and Staphylococcus aureus (22%).
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In the absence of a such a measure, and building on the success of developing the APCA African
Palliative Outcome Scale (POS) for adults, the African Palliative Care Association has developed the
APCA African Children’s POS. The tool has been validated across diseases, countries, settings and
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languages and used in both quality improvement and research studies. Moreover, feedback on the
tool from doctors and nurses who have used it has been very supportive, with providers perceiving
it as an easy-to-use instrument that helps them undertake holistic assessments that in part entail
discussing difficult issues.
This booklet is a practical guide intended to help users employ the APCA African POS correctly.
Following a discussion of the origins and background to the APCA African PPOS, the guide discusses
the measurement of outcomes, the development of the tool and its use (including the analysis of
collected data), before finishing with illustrative examples of the use of the questionnaire.
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