This document was prepared by UNICEF Regional Office for West and Central Africa, under the leadership of Christophe Valingot and the review of Joachim Peeters (WASH Specialist) and Arnaud Laillou (Nutrition Specialist), on behalf of the WASH Regional Group and the Nutrition Regional Group.
This ...WASH - Nutrition strategic guidance note for West and Central Africa builds on the precedent WASH-in-NUT strategy elaborated in 2012 and is the regional outcome of a multiyear collaborative work conducted at country level between 2018 and 2022, in Mali, Niger, Nigeria Chad, Burkina Faso. This work is based on a strong multi-partner collaboration, involving national technical directorates of the water and sanitation sector as well as technical directorates of Health and Nutrition, civil society organizations, national and international NGOs as well as United Nations agencies.
This document can serve as a technical and strategic guide for any partner wishing to strengthen the intersectorality of WASH-Nutrition programmes. It presents the regional WASH & Nutrition context, a brief review of the latest scientific evidence, and proposes an integrated WASH-Nutrition programming framework adapted to the regional context of West and Central Africa. Beyond the implementation of programmes, this document also calls for the explicit and concrete inclusion of WASH-Nutrition integration into national policy documents.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur...ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-...incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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In recent decades, there have been concerted efforts to improve mental health services for youths alongside the challenges of rising healthcare costs and increasing demand for mental health needs. One important phenomenon is the shift from traditional clinic-based care to community based mental heal...th services to improve accessibility to services and provide patient-centred care. In this article, we discuss the child and adolescent community mental health efforts within the Asia-Pacific region.
Brain Sci.2017,7, 126; doi:10.3390/brainsci7100126
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This document presents a policy to guide and support Member States of the Pan American Health Organization (PAHO) and the Pan American Sanitary Bureau (PASB) in their technical cooperation to improve mental health as a priority for advancing health, social, and economic development in the Region in ...the context of the COVID-19 pandemic and beyond.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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This briefing note summarises key mental health and psychosocial support (MHPSS) considerations in relation to the 2019 novel coronavirus (COVID-19) outbreak.
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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Non-communicable diseases (NCDs) & injuries and mental health conditions constitute a serious impediment to achieving the vision of Agenda 2063 to build an integrated, prosperous, and peaceful Africa driven by its own citizens. Each year, these conditions cause millions of premature deaths and disab...led lives across Africa. These conditions also lead to annual economic loss of multiple billion US-Dollars. Their burden both in terms of disease morbidity/mortality and socio-economic impact is increasing.
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As the Group of Eight (G8) world leaders meet in Saint Petersburg, Russia for this year’s G8 Summit, it is important to take stock of international efforts to finance the response to the global HIV/AIDS epidemic. Financing a sufficient and sustained response to the epidemic has emerged as one of t...he world’s greatest challenges, and one that will be with us for the foreseeable future. Often, those countries most affected are also least able to respond, increasing their vulnerability to HIV/AIDS and in turn further complicating their ability to address the epidemic, as is the case for many nations in sub-Saharan Africa. In addition, concerns have been raised about “second wave” nations, particularly China, India, and Russia, which stand on the brink of generalized epidemics if more is not done now
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In: Bonk M., Ulrichs T (eds). Global Health: Das Konzept der Globalen Gesundheit. Berlin: De Gruyter, 2021, pp. 523–556
Wohlstand, Gesundheit und Gesundheitsausgaben sind eng miteinander verknüpft. Im weltweiten Durchschnitt haben alle drei seit vielen Jahren stetig zugenommen. Im Vergleich hab...en Menschen in Ländern mit höheren Einkommen eine höhere Lebenserwartung. Die höchste Krankheitslast pro Mensch tritt in Ländern mit niedrigem Einkommen auf. Den größten Anteil an der gesamten globalen Krankheitslast haben Länder mit mittlerem Einkommen, in denen rund drei Viertel der Weltbevölkerung lebt. Im Mittel sind die Gesundheitsausgaben in Ländern mit höheren Einkommen insgesamt sowie pro Kopf höher als die Gesundheitsausgaben in Ländern mit niedrigeren Einkommen.
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Public health emergencies, including pandemics, highlight the need for health systems and services that are prepared, resilient and ready to respond to health security threats. Endorsed by Member States in 2023, the Asia Pacific Health Security Action Framework (APHSAF) is designed to engage m...ultisectoral actors in health security, and to reflect the complex nature of current and future public health emergencies. The Framework presents six interconnected, multisectoral domains of work that together form a comprehensive, multi-hazard health security system — emphasizing the One Health approach. The Framework also supports progress towards the Sustainable Development Goals and universal health coverage while meeting the responsibilities and obligations of the International Health Regulations (2005).
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This provisional Facilitator's Kit provides a complete framework for a 3-day training on Community Preparedness for Reproductive Health and Gender. The goal is to build community capacity to prepare and respond to risks and inequities faced by women and girls during emergencies.
This country snapshot provides an overview of national data relating to sexual and reproductive health and rights (SRHR) throughout the life course. Realization of SRHR requires provision of comprehensive, people-centred services, that address the different elements of SRHR, and which are supported ...by an enabling environment, quality health systems, and meaningful community engagement. Multiple, synergistic cross-linkages exist within and between the different SRHR elements, leading to sequential outcome benefits throughout the life course.
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A broad range of UNHCR’s key priorities overlap with MHPSS issues – for example, child protection and sexual and gender-based violence [SGBV] prevention and response.
Despite all these existent synergies, UNHCR’s current policies and guidelines do not sufficiently link with MHPSS principles.... For example, the Community Services section, which is closely aligned to the principles of MHPSS and could be well-positioned to guide the implementation of related programs, has not adopted the MHPSS language or approach.
There are opportunities for UNHCR to engage more strongly and clearly in this field. However, this requires a vision for how the organisation as a whole, and particular sectors within the organisation, will engage within the field of MHPSS activities. For a start, UNHCR can work to improve its understanding and framing of mental health and psychosocial issues, and how these issues fit within its broader mandate.
While the majority of MHPSS activities are delivered by implementing partners, UNHCR staff require familiarity with core principles in the field, such as the Intervention Pyramid contained in the IASC Guidelines, in order to support and monitor quality MHPSS activities.
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A review of current literature and up date data from the field, April 2015.
This report has been published in part in J Hosp Inf. 2015;90:1-9.
http://www.ncbi.nlm.nih.gov/pubmed/?term=ebola+nosocomial+shears
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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This guideline provides health policy-makers and decision-makers in health professional training institutions with advice on the rationale for health-care providers’ use of counselling skills to address sexual health concerns in a primary health care setting
It estimates that there have been 228,000 additional deaths of children under five in these six countries [Afghanistan, Nepal, Bangladesh, India, Pakistan and Sri Lanka] due to crucial services, ranging from nutrition benefits to immunisation, being halted.
It says the number of children being tr...eated for severe malnutrition fell by more than 80% in Bangladesh and Nepal, and immunisation among children dropped by 35% and 65% in India and Pakistan respectively...
It also estimates that there have been some 3.5 million additional unwanted pregnancies, including 400,000 among teenagers, due to poor or no access to contraception...
The interruption to health services also affected those suffering from other diseases - the report predicts an additional 5,943 deaths across the region among adolescents who couldn't get treated for tuberculosis, malaria, typhoid and HIV/Aids.
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24 Nov. 2021
Action against gender-based violence being pushed to the outlying margins of the global COVID-19 response
A new Oxfam report shows an undeniable increase in gender-based violence (GBV) during the COVID-19 pandemic around the world to which too many governments and donors are not doi...ng enough to tackle.
The report, The Ignored Pandemic: The Dual Crisis of Gender-Based Violence and COVID-19, showed the number of calls made by survivors to domestic violence hotlines in ten countries during the first months of lockdown. The data reveals a 25 – 111 percentage surge; in Argentina (25%), Colombia (79%), Tunisia (43%), China (50%), Somalia (50%), South Africa (69%), UK (25%), Cyprus (39%), Italy (73%) and the largest increase in Malaysia where calls surged by over 111%.
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