April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t...he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
more
Risk Communication and Community Engagement (RCCE) is an essential part of any disease outbreak response. Risk communication in the context of an Ebola outbreak refers to real time exchange of information, opinion and advice between frontline responders and people who are faced with the threat of Eb...ola to their survival, health, economic or social wellbeing. Community engagement refers to mutual partnership between Ebola response teams and individuals or communities in affected areas, whereby community stakeholders have ownership in controlling the spread of the outbreak.
It is intended to be used to guide RCCE work which is central to stopping the outbreak and preventing its further amplification. Unlike other areas of response, RCCE draws heavily on volunteers, frontline personnel and on people without prior training in this area. As such, the document provides basic background information, scopes the socio-economic and cultural aspects (that are known at the time of publication), and provides the latest evidence-based advice and approaches
more
Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally,... research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
more
Thirty years ago, the United Nations General Assembly adopted the Convention on the Rights of the Child at a moment of rapid global change marked by the end of apartheid, the fall of the Berlin Wall and the birth of the World Wide Web. These developments and more brought momentous and lasting evolut...ion, as well as a sense of renewal and hope for future generations. In a reflection of that hopeful spirit, the Convention has since become the most widely ratified human rights treaty in history.
more
It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
more
Today, the World Health Organization (WHO) is advancing the global fight against acute malnutrition in children under 5 with the launch of its new guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition). This milestone is a crucial response to the persistent... global issue of acute malnutrition, which affects millions of children worldwide.
In 2015, the world committed to achieving the Sustainable Development Goals (SDGs), including the ambitious target of eliminating malnutrition in all of its forms by 2030. However, despite these commitments, the proportion of children with acute malnutrition has persisted at a worrying level, affecting an estimated 45 million children under five worldwide in 2022.
In 2022, approximately 7.3 million children received treatment for severe acute malnutrition (SAM). Although treatment coverage has increased, children with SAM in many of the worst affected countries are still unable to access the full necessary care for them to recover.
The Global Action Plan (GAP) on child wasting recognized the need for updated normative guidance to support governments in the prevention and management of acute malnutrition. WHO answered this call to action and developed a comprehensive guideline that provides evidence-based recommendations and good practice statements and will be followed by guidance and tools for implementation.
more
External quality assessment (EQA) is an important component of quality systems for blood transfusion services. Establishing external quality assessment programmes for screening of donated blood for transfusion-transmissible infections (TTI): implementation guide aims to support WHO member States in ...establishing and operating EQA programmes for screening donated blood for TTI. The guides has been designed for use by national health authorities and EQA organizing institutions in the development of EQA programme. It will also give participating laboratories an insight into the organization of EQA programmes for TTI screening and an understanding of the benefits of participation.
more
To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom...ote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
more
In this era, grand challenges lies in biodiversity loss, climate change, and global noncommunicable diseases signify that planet and humanity are in crisis. Scholarly evidence from human and animal kingdom suggest that there is an optimism in planetary health which can provide a unique and novel con...cept where efforts toward survival and remediation can be made. With accurate navigation, the current challenges can be mitigated leading to a new reality, one in which the core value is the well‐being of all. This paper discusses the drivers of planetary health and the role of community health workers (CHWs) in making health‐care system more resilient that can produce multiple benefits to community and overall planetary health. A web‐based international database such as Google, Google Scholar, SCOPUS/MEDLINE/PubMed, and JSTOR was searched relevant to a planetary health framework. The study findings suggest that CHWs can offer health care interventions through environmental health cobenefits across the spectrum of health effects of climate change cause and effects. These actions have been divided into four major categories (i. health care promotion and prevention, ii. health care strengthening, iii. advocacy, and iv. education and research) that CHWs perform through a variety of roles and functions they are engaged in protecting planetary health. CHWs contribute toward achieving sustainable development goals such as planetary health and focus on environment sustainability and well‐being of entire mankind.
more
Lancet Glob Health 2019 Published Online January 24, 2019 http://dx.doi.org/10.1016/S2214-109X(18)30479-0
The health-care system collapse underway in Venezuela is a cause of utmost concern for its people and, increasingly, for the wider region. Declines in provision of basic services, such as ...childhood immunisation, malaria control, water, sanitation, and nutritional support, have led to increasing morbidity and mortality rates from an array of preventable diseases, including malaria, measles, and diphtheria. Secondary and tertiary care have also been greatly affected, due to declining investment, out-migration of providers, and spiralling hyperinflation that has driven the country and its people into poverty.1 As is so often, and so tragically, the case, the most affected populations have been the most vulnerable: infants and children, their mothers, the poor (now the great majority of the populations), and indigenous people
more
The guide to implementing the One Health Joint Plan of Action (OH JPA) at national level provides practical guidance on how countries can adopt and adapt the OH JPA to strengthen and support national One Health action.
Building on the OH JPA theory of change, this guide describes three pathways a...nd five key steps to implement the OH JPA at national level:
Pathway 1 -- Governance, policy, legislation, financing and advocacy
Pathway 2 -- Organizational and institutional development, implementation and sectoral integration
Pathway 3 -- Data, evidence, information systems and knowledge exchange.
The stepwise approach comprises:
Situation analysis including stakeholder mapping and review of existing assessment results
Set-up/strengthening of a multisectoral, One Health coordination mechanism
Planning for implementation, including activity prioritization and leveraging of resources
Implementation of national One Health action plans
Review, sharing and incorporation of lessons learned.
more
The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t...he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
more
Gender-based violence, including rape is a problem throughout the world, occurring in every society, country and region. Refugees and internally displaced people are particularly at risk of this violation during every phase of an emergency situation. The systematic use of sexual violence as a method... of warfare is well documented and constitutes a grave breach of international humanitarian law.
The Arabic Version can be downloaded here: http://reliefweb.int/report/syrian-arab-republic/guidelines-health-staff-caring-gender-based-violence-survivors-including
more
New research explores the stress children in World Vision programmes in the Middle East and Eastern Europe region are under due to COVID-19. In addition to their fear that they themselves or their loved ones will catch the disease, children worry about economic hardships, the loss of their education..., increased violence and social isolation. But in the midst of it all, a clear message comes through – young people are hopeful about the future, they want to make a contribution and they want their voices to be heard.
more
The report underscores that sexual and reproductive health and rights are often the first to be sacrificed during epidemics and that the gains of the past decade must be protected. The report also makes it clear that scarce resources must be focused on the most marginalized women and girls, includin...g sex workers, gender diverse people, women in prison and migrants and others without proof of employment or residence.
more
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...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.
more
The world has been turned on its head by the coronavirus disease 2019 (COVID-19) pandemic. This has provided a stark wakeup call on the severe under-financing of health systems around the world. It has laid bare the inequalities and limitations in the capacities of countries at all levels of develop...ment to prevent major health crises or respond to them. But it doesn’t have to be this way.
more
: interim guidance, 17 February 2021
This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). It emphasizes the importance of being prepared and responding quickly and outlines key actions and measures that... the blood services should take to mitigate the potential risk to the safety and sufficiency of the blood supplies during the pandemic.
It should be read in conjunction with WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks, which provides general guidance on the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply.
more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
more