An in-depth analysis of the health-seeking behaviour of patients and health system response in seven countries of the Eastern Mediterranean Region
This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A... comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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More than 40% of the world population is 24 years old or younger, the vast majority of whom live in low- and lower middle–income countries. Globally, a quarter of disability-adjusted life years (DALYs) for mental disorders and substance abuse is borne by this age group and about 75% of mental diso...rders diagnosed in adulthood have their onset before the age of
24 years . Most children and young people in developing countries, however, do not have access to mental health care.
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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 –... 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 United Nations Development Programme (UNDP) today released two new data dashboards that highlight the huge disparities in countries’ abilities to cope with and recover from the COVID-19 crisis.
The pandemic is more than a global health emergency. It is a systemic human development crisis, a...lready affecting the economic and social dimensions of development in unprecedented ways. Policies to reduce vulnerabilities and build capacities to tackle crises, both in the short and long term, are vital if individuals and societies are to better weather and recover from shocks like this.
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The report underscores that sexual and reproductive health and rights are often the first to be sacrificed during epidemics and that the gains of the past decade must be protected. The report also makes it clear that scarce resources must be focused on the most marginalized women and girls, includin...g sex workers, gender diverse people, women in prison and migrants and others without proof of employment or residence.
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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be...come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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This study, although not generalizable, builds up the literature on worker training needs in developing countries, and would be of benefit for speech-language pathologists and worker trainers. This paper aimed to investigate the training needs of Malaysian workers in relation to people with communic...ation disability. The primary aim was to investigate common self-perceived training needs in relation to communication disability and to find how important these needs are to workers. A secondary aim was to explore the relationship between selected worker variables and training needs.
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CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to b...e successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further assessment
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ON LIFE SUPPORT3The Democratic Republic of Congo’s Ebola outbreak has been contained, but confl ict and under-development leave over three million children at risk from measles and other killer diseases. The country’s medical services – ill-equipped and under-resourced – are on life support ...and in no condition to protect children unless urgent measures are taken.
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Confronted with the important issue of patient safety, in 2002 the Fifty-fifth World Health Assembly adopted a resolution urging countries to pay the closest possible attention to the problem and to strengthen safety and monitoring systems. In May 2004, the Fifty-seventh World Health Assembly approv...ed the creation of an international alliance as a global initiative to improve patient safety. The World Alliance for Patient Safety was launched in October 2004 and currently has its place in the WHO Patient Safety programme included in the Information, Evidence and Research Cluster.
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Background: Traumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term
violence. In South Afri...ca, the lifetime prevalence for PTSD in the general population is estimated at 2.3%.
Aim: To examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a community sample of adolescents.
Setting: Low-socioeconomic communities in KwaZulu-Natal.
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UNHCR, the UN Refuge Agency, and NGO partners are launching an appeal for US$2.7 billion to address the live-saving humanitarian needs of South Sudanese refugees in 2019 and 2020.
Five years on since the onset of a brutal civil war, over 2.2 million South Sudanese refugees have sought safety in six... neighboring countries Uganda, Sudan, Ethiopia, Kenya, the Democratic Republic of the Congo (DRC) and Central African Republic (CAR). Another 1.9 million remain internally displaced inside South Sudan
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This fourth annual report monitors global progress towards the 2023 target for global elimination of industrially produced trans-fatty acids (TFA), highlighting achievements during the past year (October 2021 – September 2022). Countries are responding to the World Health Organization (WHO) call t...o action by putting into place best-practice TFA policies. Mandatory TFA policies are currently in effect for 3.4 billion people in 60 countries (43% of the world population); of these, 43 countries have best-practice policies in effect, covering 2.8 billion people (36% of the world population).
Over the past year, several additional countries took action to eliminate industrially produced TFA: best-practice policies came into effect in India in January 2022, Uruguay in May 2022 and Oman in July 2022. Best-practice policies were passed in Bangladesh in November 2021 (to come into effect in December 2022) and in Ukraine in September 2020 (to come into effect in October 2023), best-practice TFA policies are projected to pass soon in Mexico, Nigeria and Sri Lanka.
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The WHO Regional Office for Europe has established the Childhood Obesity Surveillance Initiative in more than half the countries in the Region for routine monitoring of the policy response to the emerging obesity epidemic. The aim of the Initiative is to measure trends in overweight and obesity in c...hildren aged 6.0–9.9 years to get a clear understanding of the epidemic and to allow inter-country comparisons. This document outlines the common protocol agreed for use in the Initiative.
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The report “Build back fairer: achieving health equity in the Eastern Mediterranean Region” provides ground breaking insights into the state of health inequities in the Region and urges countries to take action to address the social determinants of health to reverse the worsening trend of inequi...ty – aggravated by the COVID-19 pandemic, ongoing conflict, mass movements of people, environmental challenges, gender inequities and unemployment.
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Trachoma is an eye infection that for thousands of years caused many people to go blind across all continents. As the result of development and targeted interventions, trachoma is now limited to an estimated 57 countries, often affecting the poorest
populations of the world. Today, more than 2 mill...ion people are either blind or suffer from a very painful disability as the result of trachoma.
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There has been a rapid expansion of cash-based, social protection programmes in sub-Saharan Africa (SSA) in recent years as Governments increasingly realise the enormous benefits cash transfers offer (World Bank, 2018). In fact, as an investment in human capital and inclusive economic development, ...social protection is arguably one of the most efficient uses of Government resources and “one of the smartest investments that policymakers can support” (Cummins, 2021).
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The World Health Organization (WHO)6, the Civil Society Action Committee and the Lancet Migration global collaboration are amongst many organisations that have advised governments against returning irregular migrants during the Coronavirus disease 2019 (COVID-19) pandemic. The expulsion of i...rregular migrants to under-prepared countries puts migrants and communities at risk, and is against the principles of solidarity and public health that should inspire action during these challenging times. It also puts at risk the staff who implement these policies. Detention, overcrowded conditions and lack of hygiene all render irregular migrants more vulnerable to the impact of COVID-19. Irregular laborers, agricultura land food workers, cleaners and caregivers are all essential in the response to the pandemic, there fore the temporary or longer term regularisation of migrants to facilitate their access to health, social services and employment should be considered as a humane, practical and self-interested alternative to forcible return.
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Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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