Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise ...potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Le Plan Stratégique National de Lutte contre le Paludisme 2023–2027 de la Guinée vise à réduire de 80 % l’incidence et la mortalité liées au paludisme d’ici 2027, en s’appuyant sur les leçons des années précédentes. Il prévoit des actions renforcées de prévention (moustiquaire...s, lutte antivectorielle, chimio-prévention saisonnière, prévention chez les femmes enceintes et les enfants), une amélioration de la prise en charge des cas à tous les niveaux (public, privé, communautaire), ainsi qu’un renforcement de la gestion, des ressources, de la gouvernance, de la communication et de l’évaluation. L’objectif final est de guider le pays vers la pré-élimination du paludisme, en assurant l’accès universel à des soins de qualité et en mobilisant tous les acteurs nationaux et internationaux.
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Le Plan Stratégique National de Lutte contre le Paludisme 2021–2027 du Burundi expose la vision d’un Burundi sans décès lié au paludisme d’ici 2027. Le programme vise à réduire de 60 % la morbidité et à atteindre zéro mortalité grâce à une couverture universelle en prévention (m...oustiquaires imprégnées, pulvérisation intradomiciliaire, traitement préventif intermittent), une prise en charge efficace à tous les niveaux (structures sanitaires et communautaires), un renforcement des capacités institutionnelles, et une surveillance épidémiologique renforcée. Le plan insiste sur la bonne gouvernance, l’équité, la mobilisation des ressources, la communication et l’innovation, tout en s’alignant sur les objectifs nationaux et internationaux de santé publique.
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The new five-year agenda of WHO in Africa, The Africa Health Transformation Programme, 2015–2020: a vision for universal health coverage, is the strategic framework that will guide WHO’s contribution to the emerging sustainable development platform in Africa. It articulates a vision for health a...nd development that aims to address the unacceptable inequalities and inequities that have kept our region lagging far behind others in terms of health indices and enjoyment of the highest attainable standard of life.
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n 2015, Member States of the United Nations adopted the 2030 Agenda for Sustainable Development and its accompanying Sustainable Development Goals (SDGs), with the third goal of the agenda focusing on health – good health and well-being. This has the attainment of universal health coverage (UHC) a...s its umbrella target. Since then, the WHO Regional Office for Africa has been supporting countries plan, and monitor progress towards this goal. This report represents an analysis of the evidence so far countries are making towards this goal, and includes the effect COVID-19 has had on its attainment so far. It also makes recommendations on how countries can prioritize their health actions post COVID-19, in a manner that allows acceleration of progress towards UHC.
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The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides a framework to inform the exercise of the new essential functions. The th...ird section proposes a new integrated approach for implementing the EPHFs. The fourth section presents a new list of 11 EPHFs related to each stage of this integrated approach. Finally, in the last section, considerations are put forth to guide EPHF implementation as a means of strengthening the health sector.
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The EHSP in Botswana seeks to attain universal coverage of high-quality package of essential health services. The EHSP is an integrated collection of cost-effective interventions, promotive, preventive, curative, and rehabilitative, that address the main diseases, injuries and risk factors that affe...ct the population. The EHSP has two key purposes:
1) Provide a standardized package of basic services which forms the core of service delivery in all primary health care facilities
2) Promote a redistribution of health services by providing equitable access, especially in underserved areas, population, etc.
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This document outlines PAHO’s regional priorities for the year 2023 to sustain and scale up health emergency and humanitarian assistance in the Americas, with a focus on five priority countries currently facing a prolonged humanitarian crisis and recovering from recent acute emergencies: Colombia,... El Salvador, Guatemala, Haiti, and Venezuela (Bolivarian Republic of). These goals align with and build on the World Health Organization’s Global Health Emergency Appeal for 2023, its principles, priorities, and strategies.
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Primary care - Putting people first: This chapter describes how primary care brings promotion and prevention, cure and care together in a safe, effective and socially productive way at the interface between the population and the health system.
The State of the World's Midwifery
Joule 5, 2687–2714 October 20, 2021 Cell Press
Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk factors such as air pollution. This article discus...ses the implications of such a focus. It then outlines the opportunities for those in public health and environmental science to work together across three key areas to address air pollution, NCDs and climate change: (a) acknowledging the shared drivers, including corporate determinants; (b) taking a ‘co-benefits’ approach to NCD prevention; and (c) expanding prevention research and evaluation methods through investing in systems thinking and intersectoral, cross-disciplinary collaborations.
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