The devastating impacts of the 2015–16 El Niño will be felt well into 2017. This crisis was predicted, yet overall, the response has been too little too late. The looming La Niña event may further hit communities that are already deeply vulnerable. To end this cycle of failure, there is an urgen...t need for humanitarian action where the situation is already dire, to prepare for La Niña later this year, to commit to comprehensive new measures to build communities’ resilience, and to mobilize global action to address climate change which is creating a ‘new normal’ of higher temperatures, drought and unpredictable growing seasons.
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Version 2, January 2016
The primary purpose of this document is to provide 3MDG stakeholders with some essential information on the MNCH core-indicators for 3MDG, which were derived from the 3MDG Logical Framework, Data Dictionary for Health Service Indicators (2014 June, DoPH, MoH), A ...Guide for Monitoring and Evaluating Child Health Programmes (MEASURE Evaluation, September 2005) and Monitoring Emergency Obstetric Care (WHO/UNICEF/UNFPA/AMDD). Partners are strongly encouraged to integrate the MNCH indicators into their ongoing monitoring and evaluation (M&E) activities.
These indicators are designed to help Partners assess the current state of their activities, their progress towards achieving their targets, and contribution towards the national response. This guideline is designed to improve the quality and consistency of data collected at the township level, which will enhance the accuracy of conclusions drawn when the data are aggregated.
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This profile is part of a series of Climate Risk Country Profiles developed by the World Bank Group (WBG). The country profile synthesizes most relevant data and information on climate change, disaster risk reduction, and adaptation actions and policies at the country level. The country profile seri...es are designed as a quick reference source for development practitioners to better integrate climate resilience in development planning and policy making. This effort is managed and led by Veronique Morin (Senior Climate Change Specialist, WBG) and Ana E. Bucher (Senior Climate Change Specialist, WBG)
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to:
Consider... the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov...ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term...ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
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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.
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Climate change, increasing population densities, and intensified globalisation in trade, travel and migration are among the most important factors shaping the 21st century. Each impacts upon population health and the risk of infectious disease, particularly those originating at the human-animal-envi...ronmental interface. The recognition that many risk drivers of infectious disease fall outside of the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security. In response, the One Health concept has emerged, as have related initiatives addressing Planetary Health and Biodiversity and Human Health. From a public health perspective and operationally speaking, the One Health approach offers great potential, emphasising as it does cooperation and coordination between multiple sectors. Yet despite having been a focal point for discussion for over a decade, numerous challenges facing the implementation of One Health preparedness strategies remain. While some are technical, related to the requirement for innovative early warning systems or new vaccines, for example, others are institutional and cultural in nature, given the transdisciplinary nature of the topic. There have thus been calls to address One Health from multiple perspectives, from ecology to the social sciences. In order to further explore this issue and to identify priority areas for action for strengthening One Health preparedness in Europe, ECDC convened an expert consultation on 11–12 December 2017.
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The Guidelines for the Use of the APCA African Palliative Outcome Scale (POS) has been developed by the APCA, in collaboration with
stakeholders, to help appropriately trained health practitioners and researchers across the region to utilise the APCA African POS in their work place (Powell et... al, 2007; Warria et al, 2007). Not only do the guidelines provide a clear rationale for measuring palliative care outcomes, but they also outline practical information on how to use the tool to collect data and analyse its results. So why is there a need for these guidelines?
Palliative care as a concept and discipline is not well understood across Africa, and its development is still embryonic in many countries. While there are many obstacles that hinder palliative care development on the continent, a key challenge is the lack of accurate information about the palliative care being provided and its outcomes. The APCA African POS is a useful tool to help us measure these outcomes and, given that
measuring palliative care outcomes remains a relatively new concept, it is important to guide people on how to use the tool. Of course, these guidelines are not intended to address everything related to the measurement of palliative care outcomes; they contain only essential information for providers. More detailed information on the use of outcome tools, and in particular within the research setting, can be gained from contacting relevantly trained professionals.
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Abridged version. In this abridged version of the Evidence-based Clinical Practice Guidelines for the Follow-Up of at-risk neonates, we provide recommendations for the care of newborns up to 2 years of age, corresponding to the first phase of their follow-up. The recommendations are intended for all... health sector staff responsible for the primary care of these neonates: general practitioners, family practitioners, pediatricians, neonatologists, pediatric ophthalmologists, pediatric otolaryngologists, nursing professionals, specialists in other fields, and multidisciplinary staff involved in the care process. The purpose of these guidelines is to facilitate policy implementation processes carried out by decision-makers and members of government bodies, and will also be useful for parents, mothers, and caregivers. The main topics covered by this document include the hospital discharge criteria, including screening tests; information and support for parents, mothers, and caregivers; screening at the follow-up visit, and the frequency of follow-ups until the infant is 2 years of age. These guidelines do not address matters related to nursing or comorbidities.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the...y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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Six months after its launch on 24 April, the Access to COVID-19 Tools (ACT) Accelerator has already delivered concrete results in speeding up the development of new therapeutics, diagnostics, and vaccines. Now mid-way through the scale-up phase, the tools we need to fundamentally change the course o...f this pandemic are within reach. But to deliver the full impact of the ACT-Accelerator – and ultimately an exit to this global crisis – these tools need to be available everywhere. On behalf of the ACT-Accelerator Pillar lead agencies – CEPI, Gavi, the Global Fund, FIND, Unitaid, Wellcome Trust, the World Bank, and the World Health Organization, as well as the Bill & Melinda Gates Foundation – I am pleased to share this document setting out the near-term priorities, deliverables and financing requirements of the ACT-Accelerator Pillars and Health Systems Connector. Urgent action to address these financing requirements will boost the impact of the ACTAccelerator achievements to date, fast-track the development and deployment of additional game-changing tools, and mitigate the risk of a widening gap in access to COVID-19 tools between low- and high-income countries. Delivering on this promise requires strong political leadership, financial investment, and incountry capacity building. COVID-19 cannot be beaten by any one country acting alone. We must ACT now, and ACT together to end the COVID-19 crisis.
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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE...COVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
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The National AIDS Control Council recognizes the growing, organized and progressive inter-faith religious voice in the spheres of governance and development in Kenya. Across the country, the Faith Sector has been involved in HIV prevention, treatment, care and support to programmes towards... the HIV response.On behalf of the board and the NACC family, I want to thank the Faith Sector Working Group (FSWG) and the Faith Religious Leaders for their contribution in HIV prevention by recognizing their comparative advantage in moulding behaviors among the various populations. We pride in your ability of being able to reach millions of Kenyans at any given time. This is the more reason why NACC wishes to sincerely thank you for working closely with us on the HIV response.We appreciate the Faith Sector support to the provision of HIV and health care services provision which has facilitated access to health services even in the remotest parts our country. The role played by the Religious Leaders in addressing stigma and discrimination as the greatest barrier to access of HIV and Health services by PLHIV and other vulnerable populations is well acknowledged.Finally, our gratitude goes to the theologians who participated in the development of the Faith Sector HIV messages booklet, which provides a tool to facilitate the Religious Leaders with knowledge to address the gaps in the HIV response among the congregants.
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Terminology used to describe the transmission of pathogens through the air varies across scientific disciplines, organizations and the general public. While this has been the case for decades, during the coronavirus disease (COVID-19) pandemic, the terms ‘airborne’, ‘airborne transmission’ a...nd ‘aerosol transmission’ were used in different ways by stakeholders in different scientific disciplines, which may have contributed to misleading information and confusion about how pathogens are transmitted in human populations.
This global technical consultation report brings together viewpoints from experts spanning a range of disciplines with the key objective of seeking consensus regarding the terminology used to describe the transmission of pathogens through the air that can potentially cause infection in humans.
This consultation aimed to identify terminology that could be understood and accepted by different technical disciplines. The agreed process was to develop a consensus document that could be endorsed by global agencies and entities. Despite the complex discussions and challenges, significant progress was made during the consultation process, particularly the consensus on a set of descriptors to describe how pathogens are transmitted through the air and the related modes of transmission. WHO recognizes the important areas where consensus was not achieved and will continue to address these areas in follow-up consultations.
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Esta publicación presenta la Agenda para las Américas sobre salud, medioambiente y cambio climático 2021-2030. Esta agenda es un llamamiento al sector de la salud para que lidere la labor a fin de abordar los determinantes ambientales de la salud en la Región de las Américas. La Organización P...anamericana de la Salud (OPS) colaborará con sus Estados Miembros para alcanzar el propósito y el objetivo de esta agenda de promover el bienestar de todos a todas las edades, utilizando un enfoque sostenible y equitativo en el que se otorgue prioridad a la reducción de las inequidades en la salud. La agenda se ha elaborado bajo la égida de la Estrategia mundial de la OMS sobre salud, medio ambiente y cambio climático, y se basa en los compromisos establecidos en la Agenda de Salud Sostenible para las Américas 2018-2030 y el Plan Estratégico de la OPS 2020-2025. La agenda se elaboró en consulta con el grupo técnico asesor y mediante un proceso de toma de decisiones basado en el consenso con los Estados Miembros durante el período 2019-2020. Con la finalidad de alcanzar el Objetivo de Desarrollo Sostenible 3, la agenda se centra en: mejorar el desempeño de los programas e instituciones de salud pública ambiental; fomentar sistemas de salud sostenibles y resilientes desde el punto de vista medioambiental; y promover ciudades y comunidades saludables y resilientes desde el punto de vista medioambiental. Su aplicación será específica para cada contexto y se basará en las necesidades y realidades de los diversos países. Beneficiará a los países y territorios al promover prácticas de buena gobernanza, fortalecer el liderazgo y la coordinación en el sector de la salud, fomentar la acción intersectorial, centrarse en la prevención primaria, y mejorar la evidencia disponible y la comunicación. Facilitará el acceso a los recursos humanos, técnicos y financieros necesarios para abordar los determinantes ambientales de la salud y garantizará que la Región se involucre plenamente en los procesos y acuerdos mundiales sobre salud, medioambiente y cambio climático.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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