Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Mugisha et al. Int J Ment Health Syst (2017) 11:7 DOI 10.1186/s13033-016-0114-2
This 88 page book is designed to help primary care workers understand mental health problems and how they can be treated. Mental health problems from childhood to old age are examined. The book focuses primarily on the Afghan culture but is also relevant to a wider community
A handbook for district and health facility staff
Program Report for Collaborative Agreement: DFD-A-00-08-00309-00 September 30, 2008 -December 31, 2015
Women advancing the end of AIDS
How to respond to, mitigate, and prevent risks to children’s protection and well-being is a profound, if unanswered, question. Practitioners agree that it is necessary to develop or strengthen protective factors at multiple levels, such as the family, community, and national levels.
This report provides updated data on suicide in the Region of the Americas and is issued every five years, this being the fourth edition. In addition to including analysis similar to previous reports (suicide according to age, sex, as well as methods used), this report includes an expanded set of an...alysis on risk factors for suicide in the Americas: the analysis of the annual age-standardized gender-specific suicide mortality rate trends over time by country and sub-region and to identify points of inflection, and evaluates the association of specific risk factors on country-level suicide mortality rates.
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iSupport is a self-help skills and training programme for carers of people with dementia. Worldwide, around 55 million people have dementia. Dementia causes significant psychological and emotional impact on families and carers. iSupport aims to prevent and/or decrease mental and physical health prob...lems associated with caregiving and to improve the quality of life of those caring for people with dementia.
iSupport was conceptualized and developed as an online training programme. However, in areas of the world with limited internet bandwidth or low digital literacy, the iSupport hardcopy manual can be printed and used offline.
In five modules, iSupport teaches carers what dementia is and how to respond to common challenges of caregiving. The five modules are (i) introduction to dementia; (ii) being a caregiver; (iii) caring for me; (iv) providing everyday care; and (v) dealing with behaviour changes.
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The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di...agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
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Rehabilitation in health systems provides recommendations for Member States and other relevant stakeholders to strengthen and expand the availability of quality rehabilitation services. Currently, there is a significant unmet need for rehabilitation services and it is frequently undervalued in the h...ealth system. As populations age and the prevalence of noncommunicable diseases and injuries increases, and the demand for rehabilitation grows, strengthening rehabilitation in health systems becomes ever more paramount.
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Noncommunicable diseases (NCDs) are the principal cause of morbidity, disability and premature mortality in Azerbaijan. The most effective way to reduce the NCD burden is to prevent NCD development, by addressing thebehavioural risk factors underlying NCDs at the population and individual leve...ls: smoking, alcohol use, excessive salt intake, low physical activity, overweight and obesity, and unhealthy diets. In Azerbaijan, a national survey of the prevalence of major NCD risk factors, aligned with the WHO-endorsed STEPwise approach to surveillance (STEPS) methodology, was conducted in 2017.
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The Demographic Dividend study on Rwanda assessed the socio economic and human development potential of our country in the short, medium and long-term period using a comprehensive approach. It generated relevant policy and programme information to guide a well informed polciy required to propel Rwan...da towards achieving its aspirations of being high middle income country by 2035 and high income country by 2050.
The primary objectives of this study were to assess Rwanda’s prospects for harnessing the demographic dividend and demonstrate priority policy and programme options that the country should adopt in order to optimise its chances of earning a maximum demographic dividend in the context of its youthful population and medium, long-term socio economic development aspirations.
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Available in English, French and Spanish
Following a long recovery from the economic crisis (2007–2013), young people in the EU proved to be more vulnerable to the effects of the restrictions put in place to slow the spread of the COVID-19 pandemic. Young people were more likely than older groups to experience job loss, financial insecur...ity and mental health problems. They reported reduced life satisfaction and mental well-being associated with the stay-at-home requirements and school closures. While governments responded quickly to the pandemic, most efforts to mitigate the effects of restrictions were temporary measures aimed at preventing job loss and keeping young people in education. This report explores the effects of the pandemic on young people, particularly in terms of their employment, well-being and trust in institutions, and assesses the various policy measures introduced to alleviate these effects.
Summary available in 22 languages
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Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are limited studi...es on the epidemiology and management of cardiac arrhythmias in LMICs. This review will highlight the unique challenges and opportunities that these countries face when managing cardiac arrhythmias.
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