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2
Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
...
diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
more
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary
...
care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (which may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
more
Ramped-up cancer services could save 7 million lives over the next decade—and addressing huge service gaps between rich and poor countries is key to success, according to this report.
In 2019,
...
over 90% of high-income countries reported that comprehensive cancer treatment services were available through the public health system, compared to fewer than 15% of low-income countries, according to WHO.
But poorer countries can make substantial strides with a universal health coverage approach and use of the latest science to meet their particular needs.
The report lays out proven ways to prevent new cancer cases without breaking the bank, including tobacco-control measures and vaccines that protect against common cancers.
more
Strategic communication is at the heart of public health and more important than ever in the digital age. Using communication strategically requires expertise, skills and resources to plan, implement and evaluate interventions that encourage governm
...
ents to implement policies that improve people’s lives and well-being, that empower health workers to deliver the best care possible, and that encourage people to take actions that protect and improve their health and that of their family and community. This Regional Action Framework on Communication for Health (C4H) aims to support Member States in implementing the C4H approach. It outlines steps to be taken by WHO and Member States to use C4H to achieve shared public health goals in the Western Pacific.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs mu
...
st balance the breadth and depth of tasks to maintain CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
This report found that fewer than 15 percent of more than 3,000 school-age asylum-seeking children on the islands were enrolled in public school at the end of the 2017-2018 school year, and that in government-run camps on the islands, only about 100 children, all preschoolers, had
...
access to formal education. The asylum-seeking children on the islands are denied the educational opportunities they would have on the mainland. Most of those who were able to go to school had been allowed to leave the government-run camps for housing run by local authorities and volunteers
more
This is a case-ascertained prospective investigation of all identified health care contacts working in a health care facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Stud
...
y population) receives care. Note that this study can be done in health care facilities at all 3 levels of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers.
There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for:
To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level.
To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers.
To evaluate effectiveness of infection prevention and control measures among health care workers
To evaluate effectiveness of infection prevention and control programmes at health facility and national level
more
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetr
...
ation. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
more
HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operatio
...
nal guidance on further integrating CVD management
• technical guidance on evaluating the impact of CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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A focus on Cambodia and Ethiopia
o date, little evidence is available on how such integration occurs at country level. To address this knowledge gap, WHO has conducted several in-depth situational analysis in countries that are undertaking actions
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to improve WASH in Health Care Facilities as part of their quality of care improvement efforts. The purpose of the situation analyses was to capture mechanisms that “jointly support” WASH in HCF and quality of care improvements and also identify barriers and challenges to implementing and sustaining these improvements.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t
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hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physi
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cal activity occurs may promote physical activity at a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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EPI 2: First-line anti-epileptic medication for management of acute convulsive seizures, when intravenous access is available [2015]
mhGAP; WHO
(2015)
C_WHO
SCOPING QUESTION: In adults with acute convulsive seizures, where intravenous access is available, which first-line anti- epileptic medication should be used to abort seizures when compared
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to comparator?
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Original publication developed by CBM. CBM is an international Christian disability & development organisation committed to improving the quality of life of persons with disabilities in the poorest parts of the world. www.cbm.org
Baby-Friendly Hospital Initiative: revised, updated and expanded for Integrated Care - Section 2; Session 1: The national infant feeding situation
WHO, UNICEF
(2009)
The revised package of BFHI materials includes five sections: 1. Background and Implementation, 2. Strengthening and Sustaining the BFHI: A course for decision-makers, 3. Breastfeeding Promotion and Support in a Baby-friendly Hospital: a 20-hour course for maternity staff, 4. Hospital Self-Appraisal
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and Monitoring, and 5. External Assessment and Reassessment. Sections 1 to 4 are widely available while section 5 is for limited distribution.
Slides
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Public Health Aspects of Mental Health Among Migrants and Refugees: A Review of the Evidence on Mental Health Care for Refugees, Asylum Seekers and Irregular Migrants in the WHO European Region
Priebe, S.; D. Giacco, and Rawda El-Nagib.
World Health Organization WHO; Regional Office Europe
(2016)
C_WHO
Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for me
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ntal disorders before, during and after migration. The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems
P. Thierry Houngbo, Tjard De Cock Buning, Joske Bunders, Harry L. S. Coleman, Daton Medenou, Laurent Dakpanon†, Marjolein Zweekhorst
International Journal of Health Policy and Management IJHPM
(2017)
C2
Int J Health Policy Manag 2017, 6(10), 587–600
Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained
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to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and cost-effectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems.
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22 April 2022, This document provides updated interim recommendations on the use of masks by health workers providing care to patients with suspected or confirmed COVID-19. This update is prompted b
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y new evidence around mask use and COVID-19 transmission, as well as the emergence of variants of concern including Omicron. Masks continue to be a critical tool to prevent the spread of COVID-19. These interim guidelines supersede the recommendations provided in the WHO recommendations on mask use by health workers, in light of the Omicron variant of concern published on 22 December 2022.
WHO continually evaluates the emerging evidence and will review these interim recommendations within two months and issue new guidance as needed.
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Serving the needs of Key Populations: Case examples of innovation and good practice in HIV Prevention, Diagnosis, Treatment and Care
A. Armstrong; C. Irvine; C. Figueroa; A. Verster; R. Baggaley et al.
World Health Organization WHO
(2017)
C_WHO
This WHO guidelines highlight innovative, community-led, and peer-driven approaches to reduce HIV risks among key populations—sex workers, trans people, MSM, people who inject drugs, and prisoners. Effective practices integrate services, utilize t
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rained peers for testing (HTS), and provide stigma-free, targeted care to increase engagement
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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
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to manage and prevent the spread 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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