BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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DHS Further Analysis Reports No. 111
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delive...ry, and timely postnatal care (PNC).
This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12 regions. We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use. We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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The document will provide information for Ministries of Health and hospital sentinel sites on why and how to determine the denominator of at-risk children <5 years of age and rate of meningitis hospitalizations for a sentinel hospital site conducting IB-VPD surveillance. Such a methodology is curren...tly unavailable and this estimation is critical to enable interpretation of surveillance data, particularly pre- and post- vaccine introduction
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou...gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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The annual Joint Meeting of the Food and Agriculture Organization of the United Nations (FAO) Panel of Experts on Pesticide Residues in Food and the Environment and the World Health Organization (WHO) Core Assessment Group on Pesticide Residues (JMPR) was held in Rome, Italy, from 13 to 22 September.... The FAO panel of experts had met in preparatory sessions from 8 to 12 September. The Meeting was held in pursuance of recommendations made by previous Meetings and accepted by the governing bodies of FAO and WHO that studies should be undertaken jointly by experts to evaluate possible hazards to humans arising from the occurrence of pesticide residues in foods. During the meeting the FAO Panel of Experts was responsible for reviewing pesticide use patterns (use of good agricultural practices), data on the chemistry and composition of the pesticides and methods of analysis for pesticide residues and for estimating the maximum residue levels that might occur as a result of the use of the pesticides according to good agricultural use practices. The WHO Core Assessment Group was responsible for reviewing toxicological and related data and for estimating, where possible and appropriate, acceptable daily intakes (ADIs) and acute reference doses (ARfDs) of the pesticides for humans. This report contains information on ADIs, ARfDs, maximum residue levels, and general principles for the evaluation of pesticides. The recommendations of the Joint Meeting, including further research and information, are proposed for use by Member governments of the respective agencies and other interested parties.
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The Leprosy Programme and Transmission Assessment (LPTA) is an activity that is carried out by internal teams towards the end of Phase 1 (see Leprosy Elimination Framework in the Annex) when a subnational jurisdiction (typically second-tier) reaches the milestone for interruption of transmission, i....e., zero autochthonous child cases for a consecutive period of five years. It also needs to be done at the end of Phase 2, when the second milestone of elimination of leprosy disease has been reached. An LPTA will be carried out to document that all relevant programme criteria have been met and examine trends of epidemiological indicators in such jurisdiction to confirm that the milestone has been achieved. The LPTA includes assessment of health facilities that provide leprosy services. LPTA comprises of review of epidemiological data, health facility assessment and data validation and verification of the programme criteria through observation during a field visit. The evidence collected in this way in subnational health administrative units is compiled in a Leprosy Elimination Dossier to be submitted to WHO when the country reaches the milestone for elimination of disease in the country as whole. Countries that have not detected any new leprosy cases in the past three years or more can use the LPTA at national level prior to or as part of the verification process. Countries likely to be among the first to apply for verification may have had no new cases detected for more than 10 years.
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The intended purpose of this compendium is to provide program managers, organizations, and policy makers with a menu of indicators to better “know their HIV epidemic/know their response” from a gender perspective. The indicators in the compendium are all either part of existing indicators used i...n studies or by countries or have been adapted from existing indicators to address the intersection of gender and HIV. The indicators can be measured through existing data collection and information systems (e.g. routine program monitoring, surveys) in most country contexts, though some may require special studies or research.
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The Facilitator’s Guide for the basic-needs based Response Options Analysis and Planning (ROAP) is a step-by-step guide comprising tools and templates to carry out a multi-sectoral response analysis and planning of response options, in a sudden-onset or chronic crisis.
Being that so, the Guide i...s conceived to be applied hand in hand with the BNA Guidance and Toolbox, and other assessments methodologies. It is expected to assist in analysing data from different sources - including humanitarian staff’ own
knowledge and experience on the sector, cash, protection matters - to come up with response decisions
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The document contains a set of indicators that can be used for monitoring traditional and complementary medicine (T&CM) systems in a country.
The core indicator set consists of 16 indicators that were considered essential and collectively able to provide information on T&CM inputs, processes and ou...tputs. A longer list of reference indicators is also available for countries that wish to monitor more indicators or that want to consider alternative metrics that would better suit each country’s T&CM situation, priorities and monitoring capacities.
Each core and reference indicator is accompanied by a set of metadata. This provides information on the indicator rationale, definitions, data elements (numerator, denominator and data disaggregation), frequency of measurement, and data sources. It is a guide towards more standardized data measurement as well as data interpretation.
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—and over 2.7 million deaths attrib...uted to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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The COVID-19 outbreak has restricted global mobility, whilst heightening the risk of exploitation of vulnerable populations. This report provides a snapshot of the COVID-19 epidemiological situation and mobility restrictions, and of the current migration trends along the Eastern Corridor migration r...oute, in addition to an analysis of the impact that movement restrictions have had in Djibouti, Ethiopia, Somalia, and Yemen. Moreover, it provides information on the main protection concerns for migrants and assistance provided, and COVID-19 risk mitigation measures. This report utilizes data collected through IOM’s Displacement Tracking Matrix (DTM) Flow Monitoring Points (FMPs), Migrant Response Centres (MRCs), Assisted Voluntary Return (AVR) data, as well as anecdotal information provided by IOM team members working in the region.
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Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita...ble. We combined data from six Demographic and Health Surveys conducted in Senegal between 1992/93 and 2014. We examined FP trends over time among WRAU and subgroups, and trends in knowledge of FP and intention to use among women with unmet need for FP. Our results show that percent demand satisfied is lower among rural poor women and adolescents than WRAU, although higher among unmarried women. Marked recent increases have been observed in all subgroups, however fewer than 50% of women in need of FP use modern contraception in Senegal. Knowledge of FP has risen steadily among women with unmet need; however, intention to use FP has remained stable at around 40% since 2005 for all groups except unmarried women (75% of whom intend to use). Significant progress in meeting the need for FP has been achieved in Senegal, but more needs to be done particularly to improve acceptability of FP, and to strategically target interventions toward adolescents and rural poor women.
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10 May 2021. Manufactureres:
SK Bioscience Co. Ltd. [COVID-19 Vaccine (ChAdOx1-S [recombinant])]
Serum Institute of India Pvt. Ltd. [COVISHIELD™, ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant)]
The ChAdOx1-S/nCoV-19 [recombinant] vaccine is a replication-deficient adenoviral vecto...r vaccine against coronavirus disease 2019 (COVID-19). The vaccine expresses the SARS-CoV-2 spike protein gene, which instructs the host cells to produce the protein of the S-antigen unique to SARS-CoV-2, allowing the body to generate an immune response and to retain that information in memory immune cells. Efficacy shown in clinical trials in participants who received the full series of vaccine (2 doses) irrespective of interval between the doses was 63.1%, based on a median follow-up of 80 days, but tended to be higher when this interval was longer. The data reviewed at this time support the conclusion that the known and potential benefits of ChAdOx1-S/nCoV-19 [recombinant] vaccine outweigh the known and potential risks.
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The aim of this handbook is to provide network members and other laboratories involved in the diagnosis of tuberculosis, with an agreed list of key diagnostic methods and their protocols in various areas of TB diagnosis, ranging from microbiological diagnosis of active TB to the diagnosis of latent ...TB infection. This handbook offers a single source of reference by compiling all methods, with a strong focus on standard (reference) and evidence-based methods. In so doing, it will also contribute to the improvement of disease surveillance data for Europe.
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Large-Scale UN Response Needed to Address Health and Food Crises
This report is based on interviews with more than 150 health care professionals, Venezuelans seeking or in need of medical care who recently arrived in Colombia and Brazil, representatives from international and nongovernmental humani...tarian organizations. In addition, researchers analyzed data on the situation inside Venezuela from official sources, hospitals, international and national organizations, and civil society organizations.
We found a health system in utter collapse with increased levels of maternal and infant mortality; the spread of vaccine-preventable diseases, such as measles and diphtheria; and increases in numbers of infectious diseases such as malaria and tuberculosis (TB). Although the government stopped publishing official data on nutrition in 2007, research by Venezuelan organizations and universities documents high levels of food insecurity and child malnutrition, and available data shows high hospital admissions of malnourished children.
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The issue of Antimicrobial resistance has become one of the most substantial health issues, prompting the World Health Assembly (WHA) to urge Member States to finalise tailor made national action plans by May 2017, aligning them with objectives of the Global Action Plan (GAP). These cover awareness,... surveillance and research, hygiene infection prevention & control, optimal use of antimicrobial medicines and economic case for sustainable investment. Indonesia, by virtue of its geographical terrain and complex interactions with diverse stakeholders, indicates a higher burden of AMR. Most of the country’s data currently relies on local studies conducted by labs and universities. To get a more accurate estimate of the situation, one has to rely on results from the Regional Resistance Surveillance Programme. By undertaking such measure, Indonesia would acquire data to detect AMR trends at a national level.
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The report aims to capture lessons from the COVID-19 pandemic and to highlight the opportunity for more ambitious global action: expanding sustainable access to vaccines for all towards the Immunization Agenda 2030 and pandemic prevention, preparedness and response efforts. The report is organized i...n two sections: the first section provides WHO insights on global vaccine market dynamics, drawing from data provided by Member States, which are, in turn, analysed and displayed in the second section.
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Version 2.3 , 21 April 2022. The CVIC tool supports credible COVID-19 vaccination costing to facilitate a dialogue with stakeholders, while maintaining sensitivity to protect essential health services.
The CVIC tool provides a structured and comprehensive estimation of incremental operational and... selected capital costs of introducing and deploying COVID-19 vaccines, in alignment with the National Deployment and Vaccination Plan (NDVP). This is essential for resource mobilization, budgeting, and delivery strategy refinement and optimization. The tool has been pre-populated with data from global databases and provides a total cost estimate over an immunization programme over the period of 2021-2023, after which COVID-19 vaccination is expected to be integrated into national immunization plans. Countries can customize the priority target populations based on WHO SAGE guidance and select multiple delivery strategies and vaccine products. The tool is available in all six UN working languages (Arabic, Chinese, English, French, Russian and Spanish) and Portuguese. An e-learning course on CVIC is available at OpenWHO.
In this updated version 2.3 of the tool, some minor bugs have been fixed and new features have been added
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The Strategy provides a high-level unifying framework to leverage existing capacities, address barriers and strengthen the use of genomic surveillance in the detection, monitoring and response to public health threats. Genomic surveillance is part of the broader surveillance and laboratory system, a...nd its implementation should reinforce end-to-end capacities including sample collection, diagnostics, data sharing and analysis. The strategy aims to facilitate the connectivity between different disease control programs and surveillance networks. This interoperability will strengthen the cross-cutting essential public health laboratory functions underpinning genomics holistically. The strategy articulates the overarching goal, objectives and strategic actions needed. These are dependent on commitments from countries, partners and WHO for their implementation.
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The objective of Health in the Americas: Overview of the Region of the Americas in the Context of the COVID-19 Pandemic is to respond to the need to address important public health issues in an increasingly timely manner, while serving as a platform with a close focus on specific issues of regional ...importance. This 2022 edition is the second in its new format, providing an overview of the analysis, as well as an in-depth description of the key issues related to COVID-19 in the Region of the Americas. This overview is supported by the Health in the Americas+ virtual platform, which offers interactive resources for data analysis and allows for the comparison of information disaggregated by subregions and countries.
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