For most people in displacement contexts, there are simply not enough vaccines available in the places where they are hosted: 85% of refugees are hosted in lower- and middle-income countries, while in the first six months of this year 85% of vaccines went to wealthy countries; lower- and middle inco...me countries have still received only a fraction of the vaccine doses they require.3 Shortages in these countries can also pose particular risks to vaccination campaigns aimed at displaced populations, as they can result in them being deprioritized.
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The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W...e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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2nd edition
WASH FIT is a risk-based, continuous improvement framework with a set of tools for undertaking water, sanitation and hygiene (WASH) improvements as part of wider quality improvements in health care facilities. It is aimed at small primary, and in some instances secondary, health care fa...cilities in low and middle income countries.
An app, for front line data collection is also available in the Android Google Play store or as a web app
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Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. ...The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Human rights-based approaches to the creation of knowledge involve application of human rights principles to both the content and process of knowledge creation. Human rights-based approaches have special significance for the sexual and reproductive health and rights (SRHR) of all people, in particul...ar for women and girls, people living with disability, lesbian, gay, bisexual, trans, queer or Intersex (LGBTQI) populations, refugees, migrants and other marginalised populations.
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Following the declaration of the 9th Ebola Disease Outbreak (EVD) on 8 May 2018 by the Democratic Republic of Congo (DRC) Ministry of Health, the WHO has raised the alert for neighbouring countries of the Democratic Republic of the Congo (DRC) which share extensive borders, hosting DRC refugees and ...are used as corridors for DRC population movement. On 1 August 2018, just one week after the declaration of the end of the Ebola outbreak in Equator province, the 10th Ebola epidemic of the DRC was declared in the provinces of North Kivu and Ituri, which are among the most populated provinces in the DRC that also share borders with Uganda and Rwanda.
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Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se...verely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violence against children. The report signals a clear need... in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.
The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.
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In many of Myanmar’s contested regions, healthcare services are provided through two parallel governance systems – by the government’s Ministry of Health, and by providers linked to ethnic armed organizations. Building upon efforts to build trust between these two actors following ceasefires s...igned in 2011 and 2012, the new National League for Democracy-led government offers an unprecedented opportunity to increase cooperation between these systems and to ensure health services reach Myanmar’s most vulnerable populations.
The report provides an overview of existing health service arrangements in these areas, from both the Ministry of Health and from ethnic and community-based health organizations. It then unpacks the concept of “convergence”, highlighting key opportunities and policy recommendations for both government and non-government actors.
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After a decade of crisis, Syria remains one of the world’s most complex humanitarian crises. Continued hostilities, new and protracted displacement, increased returns and the sustained destruction of communities have impacted Syrians’ lives and futures in a devastating way. The 2021 Humanitarian... Needs Overview (HNO) identified that 13.4 million people, more than half of country’s pre-crisis population, need humanitarian support. Of this figure, 12.4 million require health care.
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This is only the cover of the book. Download the whole Toolkit at: www.cdc.gov/reproductivehealth/Refugee/
Understanding the reproductive health needs of conflict-affected women will enable organizations to implement and enhance programs and services to improve the health of women and their fam...ilies. The Reproductive Health Assessment Toolkit (RHA) for Conflict-Affected Women provides user-friendly tools to quantitatively assess the reproductive health needs of conflict-affected women aged 15–49 years. The RHA Toolkit enables field staff to collect data to inform program planning, monitoring, evaluation, and advocacy. It promotes using the collected data to enhance services and improve the reproductive health of women and their families.
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To assess national-level responses to NCDs, WHO has implemented NCD country capacity surveys periodically since 2001. This report is the latest in that series. Since the first survey round, the NCD Country Capacity Survey (NCD CCS) has been conducted a further seven times, most recently in 2021. In ...the survey, completed by the NCD focal point within each country’s ministry of health or similar agency, countries are asked to report on the following topics relating to NCDs: (i) public health infrastructure, partnerships and multisectoral collaboration; (ii) policies, strategies and action plans; (iii) health information systems and surveillance; (iv) health system capacity for detection, treatment and care; and, added for 2021, (v) the impact of the COVID-19 pandemic on NCD-related resources and activities. The questionnaire is web-based and requires supporting documentation wherever possible. In the 2021 round, data were collected from May onwards, with the last survey responses arriving in September. Validation was carried out by WHO regional offices and WHO headquarters. Country responses to previous rounds of the survey were incorporated into the analysis to assess progress since 2010. Although all 194 Member States responded to the survey, data comparisons were restricted to the 160 countries that had responded to all rounds of the survey since 2010.
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The Leprosy Programme and Transmission Assessment (LPTA) is an activity that is carried out by internal teams towards the end of Phase 1 (see Leprosy Elimination Framework in the Annex) when a subnational jurisdiction (typically second-tier) reaches the milestone for interruption of transmission, i....e., zero autochthonous child cases for a consecutive period of five years. It also needs to be done at the end of Phase 2, when the second milestone of elimination of leprosy disease has been reached. An LPTA will be carried out to document that all relevant programme criteria have been met and examine trends of epidemiological indicators in such jurisdiction to confirm that the milestone has been achieved. The LPTA includes assessment of health facilities that provide leprosy services. LPTA comprises of review of epidemiological data, health facility assessment and data validation and verification of the programme criteria through observation during a field visit. The evidence collected in this way in subnational health administrative units is compiled in a Leprosy Elimination Dossier to be submitted to WHO when the country reaches the milestone for elimination of disease in the country as whole. Countries that have not detected any new leprosy cases in the past three years or more can use the LPTA at national level prior to or as part of the verification process. Countries likely to be among the first to apply for verification may have had no new cases detected for more than 10 years.
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The document "Diabetes and Ramadan: Practical Guidelines 2021," published by Elsevier, provides updated guidance for managing diabetes during Ramadan fasting. Developed by the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance, the guidelines address ke...y aspects for individuals with diabetes who choose to fast, including risk assessment, blood glucose monitoring, insulin and medication adjustments, and the management of special populations (such as pregnant women, the elderly, and those with chronic conditions). Emphasis is placed on individualized patient education before Ramadan to ensure safe fasting practices and minimize risks like hypoglycemia and hyperglycemia.
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This report provides an update on the level of poverty based on 2013/14 Integrated Household Living Conditions Survey (EICV4) focusing on poverty as measured in consumption terms. The report also highlights other trend dimensions of living conditions captured in other surveys that complement and pro...vide a holistic understanding of poverty and living conditions.
Rwanda’s economy has been growing steadily at about 8% since 2001 with GDP per capita more than tripling from US$ 211 in 2001 to US$ 718 in 2014. Food crop production growth was more than twice that of population growth between 2007 and 2014.
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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.
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Briefing Note 8.
Ecosystem-based adaptation (EbA) is a strategy for adapting to the adverse impacts of climate change by harnessing nature and the services it can provide. This strategy is crucial for cities and peri-urban areas, threatened by a multitude of climate hazards and home to more than ha...lf the human population as of 2018. Despite some outmigration from the largest cities during the COVID-19 pandemic, urbanization will continue, and by 2035, 62.5 percent of the world’s population is expected to reside in urban areas. However, given the need to retrofit, replace and upgrade deteriorating urban infrastructure, and to meet the challenges of climate change, including the urban heat island effect, droughts and more intense flooding, many experts and policymakers see in these demands an opportunity to reinvent cities as greener, less prone to pandemics, and more liveable.
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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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