Noncommunicable diseases (NCDs) such as cancer, cardiovascular disease, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Kazakhstan. This report provides evidence through three analyses that NCDs reduce economic output and ...discusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs (direct and indirect costs) comprise 2.3 trillion tenge, equivalent to 4.5% of gross domestic product in 2017. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment. For example, the salt policy package achieved a benefit-to-cost ratio of 118.4 over 15 years, a return of more than 118 tenge for every 1 tenge invested.
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Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to ...measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated.
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Practical Approach to Care Kit
Kit de Cuidados em Atenção Primária
Guia de manejo clínico da COVID 19 para Atenção Primária
O PACK Brasil é uma parceria entre a Unidade de Tradução do Conhecimento (KTU), Secretaria Municipal de Saúde de Florianópolis/SC, BMJ e Fundação ProAR. A Fund...ação ProAR é a líder oficial das atividades do PACK no Brasil. Mais informações sobre a ProAR podem ser encontradas em: www.fundacaoproar.org.br
O PACK foi adaptado, traduzido, implementado e avaliado em serviços de atenção primária brasileiros entre 2015 e 2017. Um ensaio clínico randomizado concluiu que o PACK qualificou o atendimento clínico de pacientes adultos com doenças respiratórias crônicas na atenção primária e apoiou o compartilhamento do cuidado entre médicos e enfermeiros. Desde então, foi revisado anualmente, estando alinhado com as políticas públicas locais. Em 2021, foi desenvolvido conteúdos adicionais sobre o manejo da COVID-19.
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Background: Despite several cycles of Mass Drug Administration (MDA), however, the prevalence of Soil-transmitted helminthiasis (STH) remains high in Bangladesh. A clear understanding of local knowledge, attitudes, and practices (KAP) related to the acceptance and utilization of MDA is critical for ...effective implementation of this intervention.
Methods: This research, a cross-sectional descriptive study that utilized quantitative methods, was conducted between February and June 2017. A total of 380 questionnaire surveys were distributed to school-aged children (SAC), the parents of SAC, and school teachers.
Results: Out of 160 SACs, 81.9% knew of STH and 75.6% knew of MDA. SAC showed a high awareness of STH and recognized the importance of preventive measures and MDA. In terms of the parents of SAC and school teachers, close to half of the respondents were knowledgeable about STH and MDA. While nearly all of the participants held positive attitudes toward MDA, the respondents pointed out that school-based MDA presents severe limitations, as non-school-going children are neglected by this effort. A total of 68.3% of all school teachers and 56.8% of all parents of SAC found MDA efforts to be effective.
Conclusion: STH infections still remain a significant public health burden in Bangladesh. Reforming the MDA policy is necessary to achieve the target of STH elimination.
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This report presents the results of the official United Nations estimates and projections of urban and rural populations for 233 countries and areas of the world and for close to 1,900 urban settlements with 300,000 inhabitants or more in 2018, as published in World Urbanization Prospects: The 2018 ...Revision. The data in this revision are consistent with the total populations estimated and projected according to the medium variant of the 2017 Revision of the United Nations global population estimates and projections, published in World Population Prospects: The 2017 Revision. This revision updates and supersedes previous estimates and projections published by the United Nations.
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South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing ...and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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The Lancet October 25, 2022DOI:https://doi.org/10.1016/S0140-6736(22)01540-9
As climate change’s impacts continue to accrue, countries are persistently making wrong choices that are harming human health.
A desperate global thirst for fossil fuels is worsening climate change, leading to more extr...eme weather events that have hit every continent, led to thousands of deaths, and caused $250+ billion in damage in 2021.
• People 65+ and children <1 experienced 3.7 billion more heatwave days in 2021 than the annual average from 1986–2005.
• Heat-related deaths shot up 68% from 2000–2004 to 2017–2021.
• Climate change is abetting infectious disease transmission, warming coastal waters and leading to the spread of Vibrio bacteria like the one that causes cholera, and expanding the reach of the malaria parasite.
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Since the World Health Organization (WHO) launched the Global Antimicrobial Resistance Surveillance System (GLASS) in 2015, there has been rapidly growing awareness among many African countries that they need to be doing more to combat antimicrobial resistance (AMR). The Africa Centres fo...r Disease Control and Prevention (CDC) was officially inaugurated in January 2017 and will support countries commencing surveillance for serious infectious disease threats in Africa, including resistance. Review of the recent WHO GLASS report suggests that, while certain nations do have some surveillance systems in place, very few countries in Africa currently conduct effective routine surveillance.
African Journal of Laboratory MedicineISSN: (Online) 2225-2010, (Print) 2225-2002
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The aim of the operational framework is to ensure 1) accurate collection, handling, shipment and storage of specimens collected in countries implementing HIV drug resistance surveillance; and 2) the availability of quality-assured HIV genotyping laboratory services producing comparable and reliable ...results at the national, regional and global levels.
This publication updates the WHO HIVResNet HIV drug resistance laboratory operational framework published in 2017 and reflects technical and strategic developments over the past three years.
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The article "Air Pollution: The Emergence of a Major Global Health Risk Factor" discusses the significant health impacts of air pollution, a leading risk factor for global mortality. It highlights the adverse effects of fine particulate matter (PM2.5) and tropospheric ozone, linking them to cardiova...scular and respiratory diseases, cancer, and reduced life expectancy. While high-income countries have reduced air pollution levels, low- and middle-income countries face rising pollution, contributing to 4.9 million deaths in 2017. The article emphasizes the need for research to understand pollution’s health effects, identify key sources, and evaluate the effectiveness of interventions to improve air quality globally.
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Die befragten Jugendämter und Fachverbände schildern laut des Berichts einerseits einen guten Ablauf des Verteilverfahrens. Zugleich dokumentiert der Bericht, dass junge Menschen sich der Verteilung noch immer entziehen, untertauchen und sich eigenständig zu Freunden und Verwandten oder in städt...ische Ballungsgebiete begeben. Angaben zur steigenden alltagsrelevanten psychischen Belastung aufgrund von traumatischen Erfahrungen im Herkunftsland und während der Flucht bestätigen auch die Ergebnisse der Online-Befragung durch den Bundesfachverband vom Herbst 2017.
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In order to meet changing global population needs and consumer expectations, healthcare systems worldwide are under transformation and face restructuring. As systems adapt and shift their emphasis in response to the disparate requests for healthcare services, oppor-tunities emerge for nurses, especi...ally the APN, to meet these demands and unmet needs (Bryant-Lukosius et al. 2017; Carryer et al. 2018; Cassiani & Zug 2014; Cooper & Docherty 2018; Hill et al. 2017; Maier et al.2017). In 2002, the International Council of Nurses (ICN) pro-vided an official position on Advanced Practice Nursing (ICN 2008a). Since that time, worldwide development has increased significantly and simultaneously this field of nursing has matured. ICN felt that a review of its position was needed to assess the relevance of the definition and characteristics offered in 2002. This guid-ance paper defines diverse elements such as assump-tions and core components of the APN. The attributes and descriptors presented in this paper are intended to promote a common vision to continue to enable a greater understanding by the international nursing and healthcare communities for the development of roles commonly identified as Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP).
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EVALUATION REPORT | Esta evaluación es el primer ejercicio mundial de carácter amplio para examinar la respuesta programática del UNICEF en la protección de la infancia en situaciones de emergencia. Su objetivo es fortalecer los programas de protección de la infancia mediante la evaluación del... desempeño en los últimos años y extraer lecciones y recomendaciones que influyan en los programas actuales y futuros. Se espera que los resultados de la evaluación sirvan de base para la puesta en marcha del Plan Estratégico de 2014 a 2017. El diseño de la evaluación incluye estudios de caso de países que analizan los resultados en favor de la infancia con respecto al plan estratégico de mediano plazo (PEMP), los compromisos básicos y preguntas de evaluación seleccionadas. Doce países proporcionaron datos para el análisis, cuatro como estudios de caso con visitas a los países e informes independientes (Colombia, Pakistán, República Democrática del Congo y Sudán del Sur) y otros ocho países con estudios documentales (Afganistán, Estado de Palestina, Filipinas, Haití, Myanmar, Somalia, Sri Lanka y Sudán). Cuatro de los países (Filipinas, Haití, Myanmar y Pakistán) son países afectados por desastres y contextos repentinos, mientras que el resto son sobre todo contextos de conflictos prolongados que incluyen levantamientos violentos repentinos8
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La tuberculosis (TB) continúa siendo un problema mundial de salud pública de grave magnitud, clasificándose como la segunda causa de muerte por enfermedad infecciosa, pese a los aportes logrados en el control las cifras no son alentadoras, de acuerdo con la Organización Mundial de la Salud (OMS)..., en el 2017, se presentaron 10,0 millones de personas que padecieron tuberculosis, estos casos se presentaron en 5,8 millones de hombres, 3,2 millones de mujeres y 1,0 millón de niños
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee...ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric...a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
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Diabetes mellitus is a leading cause of mortality and reduced life expectancy. We aim to estimate the burden of diabetes by type, year, regions, and socioeconomic status in 195 countries and territories over the past 28 years, which provide information to achieve the goal of World Health Organizatio...n Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2025. Data were obtained from the Global Burden of Disease Study 2017. Overall, the global burden of diabetes had increased significantly since 1990. Both the trend and magnitude of diabetes related diseases burden varied substantially across regions and countries. In 2017, global incidence, prevalence, death, and disability-adjusted life-years (DALYs) associated with diabetes were 22.9 million, 476.0 million, 1.37 million, and 67.9 million, with a projection to 26.6 million, 570.9 million, 1.59 million, and 79.3 million in 2025, respectively. The trend of global type 2 diabetes burden was similar to that of total diabetes (including type 1 diabetes and type 2 diabetes), while global age-standardized rate of mortality and DALYs for type 1 diabetes declined. Globally, metabolic risks (high BMI) and behavioral factors (inappropriate diet, smoking, and low physical activity) contributed the most attributable death and DALYs of diabetes. These estimations could be useful in policy-making, priority setting, and resource allocation in diabetes prevention and treatment.
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Robust clinical research capacity in low- and middle-income countries is key to stemming the spread of epidemics, according to a new report from the International Vaccines Task Force (IVTF). The report lays out how to develop the political support, financing and coordination required to build this c...apacity as a crucial component of global epidemic preparedness. The IVTF was convened by the World Bank Group (WBG) and the Coalition for Epidemic Preparedness Innovations (CEPI) in October 2017.
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The present report is based on a longitudinal analysis of assessments on mixed migration routes and dynamics, conducted over the course of 2018. It is based on six rapid thematic studies, conducted over the course of 2018, as well as a longitudinal analysis of changes in mixed migration routes and d...ynamics in Libya since 2017, with analysis based on comparable indicators monitored in late 2016 and early 2017.6 In total, the present report is based on 477 individual in-depth semi-structured interviews with refugees and migrants, conducted in Libya (436) and Italy (41) and 113 key informant interviews, conducted in Libya, Italy and Tunisia.
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Climate-related disasters, heatwaves, climate-sensitive diseases, and severe droughts and floods are taking lives and harming health, livelihoods, and ecosystems across the countries of the Caribbean, as in other Small Island Developing States (SIDS) around the world. In recognition of the high vuln...erability of those countries, the World Health Organization launched in 2017 the Special Initiative on Climate Change and Health in Small Island Developing States, aiming to increase the resilience of these countries and territories to climate variability and climate change
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