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Modelling the health impacts of disruptions to essential health services during COVID-19 Module 1
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVI
...
D-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
more
Epidemiology
Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or
...
drink.1-4 The hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
Vector-borne transmission occurs only in the Americas, where an estimated 8 to 10 million people have Chagas disease.5 Historically, transmission occurred largely in rural areas in Latin America, where houses built of mud brick are vulnerable to colonization by the triatomine vectors.4 In such areas, Chagas disease usually is acquired in childhood. In the last several decades, successful vector control programs have substantially decreased transmission rates in much of Latin America, and large-scale migration has brought infected individuals to cities both within and outside of Latin America.
more
UNICEF, WHO Whole of Syria Nutrition, Cluster, the Global Nutrition Cluster, the IFE Core Group, and partners call for ALL involved in the response to the earthquakes in Syria to protect, promote, and support the feeding and care of infants and young children, their caregivers, especially pregnant,
...
postpartum, and breastfeeding women. This is critical to support maternal and child survival, growth and development, and to prevent malnutrition, illness and death. This joint statement has been issued to help secure immediate, coordinated, multi-sectoral action on infant and young child feeding (IYCF) to support and provide care for infants and their caregivers during the emergency response of the Earthquake in Syria.
more
The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic
has disproportionately affected people with diabetes population, exposing them to a
high risk for severe illness and mortality. Globally, diabetes was responsible for
...
over fourmillion deaths in the year 2019. It was the leading cause of end-stage kidney disease, adult-onset blindness and cardiovascular diseases. Further, there was a considerable heterogeneity in the prevalence of complications and deaths associated with diabetes across the countries.
more
Malaria in pregnancy is a significant health problem in malaria-endemic areas. It not only causes substantial childhood morbidity and mortality but also increases the risks of adverse events for pregnant women and their developing fetuses. Most of t
...
he burden in these areas is due to infection with Plasmodium falciparum. Artemisinin-based combination therapy (ACT) has been recommended as first-line treatment for uncomplicated P. falciparum malaria in all populations, including pregnant women in their second and third trimesters, since 2006. However, for women in their first trimester of pregnancy, WHO recommended as first-line treatment a combination of quinine and clindamycin.
Based on a review of the evidence conducted in 2022, WHO now recommends artemether–lumefantrine, the ACT with the most human safety data available, as the preferred treatment for uncomplicated P. falciparum malaria in the first trimester of pregnancy. This document presents all relevant evidence on the effects and safety in early pregnancy of artemisinins and partner medicines used in ACTs from both studies in experimental animals and observational studies in humans.
more
The 2015-16 MDHS is a national sample survey that provides up-to-date information on fertility levels; marriage; fertility preferences; awareness and use of family planning methods; child feeding practices; nutrition; adult and childhood mortality;
...
awareness and attitudes regarding HIV/AIDS; women’s empowerment; and domestic violence. The target groups were women and men age 15-49 residing in randomly selected households across the country. In addition to national estimates, the report provides estimates of key indicators for both urban and rural areas in Myanmar and also for the 15 states and regions.
more
The report focuses on several key areas where health outcomes are falling short, and provides insight into ways in which countries can improve the situation for their children and adolescents. Areas in focus include mental health, overweight/obesity and adolescent risk-taking behaviour.
The report
...
shows, for example, that:
- mental health remains a neglected subject – only one quarter of countries are collecting data on the number of children treated by a mental health professional;
- half of countries do not regulate the marketing of food to children, despite the fact that childhood obesity rates are high across the Region and physical activity rates are low;
- almost half of countries have no policy that affects the availability of unhealthy foods at school;
- 2 in 5 girls and 1 in 3 boys who are having sex do not protect themselves; and
one third of countries do not offer legal access to contraception without parental consent for those under 18 years of age.
more
The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o
...
f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
more
WHO Model Formulary for Children
recommended
WHO Model Formulary for children based on the Second Model List of Essential Medicines for Children 2009.
In 2007, the World Health Assembly passed a Resolution titled ‘Better Medicines for Children’. This resolution recognized the need for research and development into medicines for children,
...
including better dosage forms, better evidence and better information about how to ensure that medicines for treating the common childhood diseases are given at the right dose for children of all ages.
more
Disabled village children. 2nd edition
recommended
A guide for community health workers, rehabilitation workers, and families.
This manual covers identifying primary and secondary disabilities, developing skills for daily living, and working through behavior problems. The new 2018 edition features new topics, including mental and developmental di
...
sabilities, microcephaly and Zika, causes of birth defects and childhood disability, epilepsy and seizures, hearing loss and vision problems, HIV, leprosy, and more, and has updated information on polio, cerebral palsy, juvenile arthritis, muscular dystrophy, and medications.
Readers will find instructions on how to build six different wheelchairs using local resources; useful therapy techniques, such as making fun and educational toys; ideas for improving playground accessibility for all children; and low-cost rehabilitation aids and adaptations for home and community.
You can download chapter 4 for free. The complete book is available at Hesperian Book STore
more
In where under-five mortality is high and vitamin A deficiency is a public health problem, two high-dose supplements of vitamin A per year, spaced four to six months apart, can strengthen children’s immune systems and improve their chances of survival.
During much of early ... childhood – from 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive. more
During much of early ... childhood – from 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive. more
The articles in this compendium elaborate on some of the ideas shared at the symposium. Together, they provide a broad view of the dynamic interactions among physical, sexual and brain development that take place during adolescence. They highlight some of the risks to optimal development – includi
...
ng toxic stress, which can interfere with the formation of brain connections, and other vulnerabilities unique to the onset of puberty and independence. They also point to the opportunities for developing interventions that can build on earlier investments in child development – consolidating gains and even offsetting the effects of deficits and traumas experienced earlier in childhood.
more
The COPSI project is divided into three phases: the first in which the intervention is developed, the second in which researchers evaluate the intervention in a randomised controlled trial, and the final one in which the results of the trial are analysed and disseminated.
A COPSI resource kit has
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been developed comprising the COPSI training manual for the community health workers, intervention flip chart, 14 intervention handouts, recovery stories booklet and videos about people with schizophrenia and their families telling their stories of illness and recovery in a deeply personal way.
To access the videos, please click to http://www.sangath.in/copsi/ to watch the video based in Tamil Nadu and to watch the video based in Maharashtra.
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to
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essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care providers to coordinate the continued care of children and adolescents with long-term conditions and dise
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ases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –
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are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The Internati
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onal Union Against Tuberculosis and Lung Disease (The Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of
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the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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WHO guideline on HIV service delivery
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Updated guidance on the integration of diabetes, hypertension and mental health services, and interventions to support adherence to antiretroviral therapy. The guideline offers practical implementation guidance for countries and key stakeholders as well as outlining key research gaps. As life expec
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tancy for people living with HIV continues to increase, managing noncommunicable diseases, mental health, and adherence to antiretroviral therapy is essential to sustaining treatment success, quality of life, and engagement in care. A life course approach addresses these needs from childhood through older age. Service integration supports more person-centred, coordinated care across the life course.
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This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), which is funded by USAID and based at the Johns Hopkins Center for Communication Programs, offers structured guidance for improving social and behavioural change communication (SBCC) strategies relat
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ed to malaria in pregnancy (MiP). Designed for programme managers and stakeholders, the toolkit addresses critical communication gaps in MiP programming, particularly among service providers. It provides tools to help users integrate MiP into situation analyses, segment audiences, define behavioural objectives and draft strategic communication plans.
MiP poses a significant public health challenge, contributing to maternal and neonatal mortality and morbidity in sub-Saharan Africa. Although effective interventions exist, such as the use of insecticide-treated nets, intermittent preventive treatment in pregnancy (IPTp) and timely diagnosis and treatment, their implementation remains inconsistent. The I-Kit supports more effective SBCC planning and implementation, with the aim of increasing the uptake and impact of these interventions and ultimately reducing malaria-related deaths and illness among pregnant women and newborns.
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