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2
Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and
one-fi fth of adolescents are obese, while rates of overweight and obe
...
sity among adults approach 60%. Obesity is the major modifi able risk factor for diabetes.
more
Community Health Worker Training Curriculum - Facilitator's Guide
Baylor Tingathe Community Outreach Programme
Baylor College of Medicine Children’s Foundation Malawi
(2016)
CC
This curriculum was designed to train newly recruited health care workers (HCW) in the basic knowledge and skills needed to improve different HIV services within the health facility including identification, linkage, retention and support. In addition to HIV basics, the training has supplementary un
...
its focused on PMTCT, psychosocial support, opportunistic infections, tuberculosis and HIV, nutrition and family planning in order to give a more well-rounded and comprehensive training of related topics.
more
Factors to take into account when choosing, reviewing and changing medicines.
Rescue therapy:
For symptomatic hyperglycaemia, consider insulin or a sulfonylurea and review when blood glucose control has been achieved.
Diet and lifestyle advice:
At each point reinforce advice about diet and life
...
style.
more
Type 2 diabetes in adults
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2023)
CC2
The document provides the NICE Quality Standard for managing Type 2 diabetes in adults (QS209). It outlines evidence-based recommendations for preventing Type 2 diabetes, structured education, continuous glucose monitoring (CGM), medication such as SGLT2 inhibitors, and regular care processes to mon
...
itor complications. The guidelines emphasize individualized care, addressing health inequalities, and improving patient outcomes. They are intended to support healthcare professionals and services in delivering high-quality, equitable diabetes care.
more
Type 2 diabetes in adults: management
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2022)
CC2
This guideline covers care and management for adults (aged 18 and over) with type 2 diabetes. It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long-term complications.
Type 1 diabetes in adults
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2023)
CC2
The document provides quality standards for managing Type 1 diabetes in adults, emphasizing areas like structured education, continuous glucose monitoring (CGM), cardiovascular risk management, and diabetic foot assessment. It aims to improve care processes, reduce complications, and enhance patient
...
outcomes through evidence-based and patient-centered approaches. The guidelines also focus on supporting inpatient self-management and ensuring equality and accessibility in diabetes care.
more
Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a
...
ge of the population, an increase in obesity and also perhaps to increasing survival of those with diabetes.
more
Compendium of WHO and other UN guidance on health and environment - 2022 update
World Health Organization WHO
World Health Organization WHO; UN environment programme; UNDP; unicef
(2022)
C_WHO
The combined effects from ambient (outdoor) air pollution and indoor (household, in particular) air pollution cause approximately 7 million premature deaths every year, largely as a result of increased mortality from stroke, IHD, COPD, lung cancer and acute respiratory infections (1). Air pollution
...
can occur in both the outdoor and indoor environments. Cook-stoves in homes, motor vehicles, industrial facilities and forest fires are common sources of air pollution. Air pollutants with the strongest evidence for adverse health outcomes include particulate matter (PM; both PM 2.5 (i.e. particles with an aerodynamic diameter
equal to or less than 2.5 μm) and PM10 (i.e. particles with an aerodynamic diameter equal to or less than 10 μm), ozone (O 3), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ) and carbon monoxide (CO). Air pollution is however composed of many more pollutants (1).
more
Alcohol consumption is deeply embedded in the social landscape of many societies. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and trends i
...
n the marketing of alcoholic beverages, as well as implemented alcohol control measures. At the individual level, the patterns and levels of alcohol consumption are determined by many different factors, including gender, age and individual biological and socioeconomic vulnerability factors, as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking encourage alcohol consumption delay appropriate health-seeking behaviour and weaken community action
more
The document is a summary report by the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, focusing on a capacity-building workshop held in Abu Dhabi in 2019. The workshop addressed the management and care of substance use disorders, aiming to improve technical and manage
...
rial capacities in areas such as policy development, treatment services, prevention, monitoring, and international collaboration. Participants included representatives from 12 countries, WHO collaborating centers, and other UN agencies.
more
The materials focus on promoting healthy eating habits and reducing risk factors for non-communicable diseases such as obesity, diabetes, and heart disease. They emphasize actions to limit sugar, salt, and fat intake, including policy recommendations for eliminating trans-fats, reducing saturated fa
...
ts, and improving public awareness through education and labelling. These strategies aim to create healthier food environments and improve dietary behaviors globally.
more
Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by the presence of hyperglycaemia in the absence of treatment. The heterogeneous aetiopathology includes defects in insulin secretion, insulin action, or both. The long-term specific complications of diabe
...
tes include retinopathy, nephropathy, and neuropathy. People with diabetes are also at increased risk of other diseases, including cardiac, peripheral arterial and cerebrovascular disease, cataracts, erectile dysfunction, and nonalcoholic fatty liver disease. They are also at an increased risk of some infectious diseases such as tuberculosis, and are likely to experience poorer outcomes.
more
Stroke happens either when the blood supply to part of your brain is cut off because of a blood clot, or when a brain
artery ruptures and leads to a haemorrhage. Stroke is a leading cause of death and disability worldwide, but most strokes can
be prevented by addressing a small number of key risk
...
factors.
more
The document "Diabetes and Ramadan: Practical Guidelines 2021," published by Elsevier, provides updated guidance for managing diabetes during Ramadan fasting. Developed by the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance, the guidelines address ke
...
y aspects for individuals with diabetes who choose to fast, including risk assessment, blood glucose monitoring, insulin and medication adjustments, and the management of special populations (such as pregnant women, the elderly, and those with chronic conditions). Emphasis is placed on individualized patient education before Ramadan to ensure safe fasting practices and minimize risks like hypoglycemia and hyperglycemia.
more
Hypertension in adults: diagnosis and management
the National Institute for Health and Care Excellence (NICE)
the National Institute for Health and Care Excellence (NICE)
(2023)
CC
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.
more
The risk communication and community engagement (RCCE) competency framework is a resource that details the essential behaviours and activities necessary for effective communication and engagement with communities before, during and after public health emergencies. The purpose of this framework is to
...
establish and promote a common understanding of behavioural competencies and how they should be applied for high-performing and community-centred health emergency programmes. It is intended to support the development of standardized training programmes, professional development and talent acquisition and to enhance the capabilities of public health professionals involved in RCCE. Its goal is to inform the establishment of a skilled, well-trained RCCE workforce that consistently understands and executes the necessary behaviours and activities required to conduct RCCE activities with competence and professionalism.
more
The war in Gaza has resulted in many hundreds of spinal cord injuries (SCI), which will have a devastating impact on those injured and their families for the rest of their lives.
The optimal management of SCI requires effective pre-hospital care, early specialized imaging (using CT or MRI) and in
...
many cases early surgical interventions by a highly specialised neurosurgical team. Surgery requires many hours of use of a sterile operating room environment and supportive critical care capacity, as well as intensive post-operative care – none of which is currently possible due to the ongoing war, destruction, and disruption of health services in Gaza.
An alternative to surgery is conservative management – this requires intensive nursing care under full spinal precautions for many weeks in order to allow for bone and soft tissue healing and prevent further injury to the spinal cord. The patient is unable to move independently in bed during this period. Those caring for the patient need to be able to safely reposition them every 2 hours, and manage all their bowel and bladder care needs. The patient needs good nutrition and hydration at all times, as well as access to medication to support bowel care, manage pain (including neuropathic pain). A caregiver must remain with the patient to be trained to provide ongoing care and assist with daily care.
more
The war in Gaza has resulted in thousands of amputations, including early estimates of over 1000 children, all of whom have immediate and life-long needs. Surgical amputations performed under extremely difficult conditions are likely to be sub-optimal, meaning many of those amputated will require fu
...
rther surgery. People with amputations also require early and ongoing rehabilitation and access to a long-term prosthetics service. In Gaza, at present, none of this is possible due to damage or destruction of services, premises, displacement and scattering of rehabilitation professionals around Gaza strip and abroad and insecurity.
more
The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based service delivery in different countries.
Countries were selected for their geographic diversity, type o
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f service delivery model, and programmatic scale-up.
This brief reviews Malawi’s community health model to inform future policy, program design, and implementation in other countries.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue
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s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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