This report describes the results of the Lao People's Democratic Republic (LAO PDR) National WASH Survey 2021. The survey examined water, sanitation and hygiene (WASH) and waste management services, as well as climate resilience, in Lao PDR health-care facilities. The survey reveals that while... most facilities (70%) have basic water services, there are significant gaps in the delivery of sanitation, hygiene and health-care waste services, and few facilities are climate resilient, despite a majority being impacted by extreme weather events. Based on these results, the report presents a monitoring framework and national- and HCF-level measures to further enhance WASH services and climate resilience in the country.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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This handbook offers a simple framework of action for actors in local government, and in particular, health leaders such as Civil Surgeons (CSs) and Upazila Health and Family Planning Officers (UHFPQOs), to take ownership and leadership to combat COVID-19 at each district and upazila respectively, w...ith support and guidance from elected representatives and local administration, and through effective engagement of various segments of society including informal health care providers, religious leaders, journalists, police and law enforcement agencies, etc. The toolkit draws extensively from the experiences in Chapainawabganj, Savar and other areas and contains relevant best practises that have already proven effective in these places, which should be readily adaptable to various contexts.
It is important to note that while this framework has been developed in the context of COVID-19 and with related best practises, it is by no means limited to COVID-19 response. Indeed, the experience from Savar shows that the same approach has proven extremely effective in combating the dengue outbreak and the severe floods in 2020, and hence can be used to combat future public health emergencies in Bangladesh and other countries having similar contexts.
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Azraq refugee camp located in Zarqa governorate was established in April 2014. As of June 2023, the camp continues to hosts 40,600 Syrian refugees, with 61% of the population children, and 25% of all households female-headed (UNHCR, 2023).
The water supply system in Azraq has been operational sin...ce 2017 across the four villages of the camp and consists of 300 tap stands, two boreholes and two storage locations (each with 16 T-95 steel tanks).
Based on data from UNICEF (2022), the community is provided on average 2100 cubic meters of safe, treated water a day, which is distributed across the camp via a gravity flow system. A distribution schedule is in place, with water pumped during two shift times each day in the morning and evening. Monthly data reported through ActivityInfo (2023) shows a range 53.5-76.3 million liters per month provided through the network in 2022 for an average of 57 liters/person/day – well above the locally agreed minimum standard of 35 liters/person/day and the SPHERE standard of 15 liters/person/day.
Latrine and shower facilities in the camp are organized through communal WASH blocks shared typically between three households and connected to water and greywater networks. However, based on an ACF and World Vision assessment (2022), 60% of the surveyed households are using private latrines (50% self-constructed latrines, and 10% constructed by WASH actors), 24% of households used communal latrines as private latrines not shared with other families, and 16% reported the use of communal latrines shared with other families.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig...nity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health care. Central to the WASH FIT methodology is training and incremental improvements.
Implementat...ion of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
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Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
The main goal of IPC in the cholera response is to
• To reduce transmission of health care-as...sociated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
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Overview
Internationally harmonized modules on key issues for paediatricians and paediatric nurses, family and public health professionals.
Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP...C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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This report summarizes the World Health Organization’s (WHO) global work on water, sanitation and hygiene (WASH) during 2022. It describes how the Organization continued to deliver its essential WASH programming as elaborated in its 2018–2025 strategy.
This document complements the WREC Waste Management and Recycling Assessment Guidance and can be used by humanitarian partners to assess waste management and recycling facilities through site visits. It is complemented by an Annex listing hazardous and non-hazardous waste types.
The report summarizes the estimates of the burden of disease attributable to unsafe drinking water, sanitation, and hygiene for the year 2019 for four health outcomes - diarrhoea, acute respiratory infections, soil-transmitted helminthiases, and undernutrition - which are included in the reporting o...f the Sustainable Development Goal indicator 3.9.2. The report includes estimates at global, regional and country level for 183 WHO Member States.
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El presente documento contiene directrices provisionales sobre la utilización de mascarillas en comunidades que han notificado la aparición de brotes causados por el nuevo coronavirus (2019-nCoV). Está dirigido a profesionales, coordinadores sanitarios, trabajadores sanitarios y... agentes de salud comunitaria que trabajen en la prevención y el tratamiento de las infecciones o en la esfera de la salud pública. El texto se irá revisando a medida que se disponga de más datos.
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Las mejores prácticas de agua, saneamiento e higiene, en particular el lavado de manos con jabón y agua limpia, deben aplicarse y mantenerse estrictamente, ya que constituyen una barrera adicional importante para la transmisión de COVID-19 y para la transmisión de enfermedades infecciosas en gen...eral (OMS, 2002).
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The Hand Hygiene Self-Assessment Framework is a systematic tool with which to obtain a situation analysis of hand hygiene promotion and practices within an individual health-care facility.
All health-care workers require clear and comprehensive training and education on the importance of hand hygiene, the "My 5 Moments for Hand Hygiene" approach and the correct procedures for handrubbing and handwashing. The following tools and resources are meant to support bridging the knowledge gap... and for you to adopt and adapt to support local improvement.
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Evaluation of hand hygiene practices and related perception and knowledge at a health-care facility is one vital element of the strategy to improve hand hygiene. Continuous monitoring is very helpful in measuring the changes induced by implementation and to ensure that the interventions have been ef...fective in improving hand hygiene practices, perception and knowledge among health-care workers.
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At its 48th session of Codex Committee on Food Hygiene (CCFH), the Committee noted the importance of water quality and safety in food production and processing. CCFH requested the Food and Agriculture Organization of the United Nations
(FAO) and the World Health Organization (WHO) to provide guidan...ce for those scenarios where the use of “clean water” (i.e. water that does not compromise the safety of the food in the context of its use) was indicated in Codex texts and on
where it is appropriate to use “clean water”. In particular, guidance was sought for the use of irrigation water and “clean” seawater and on the safe reuse of processing water.
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In this course, you will learn about the different categories of waste and the process for waste management. Health care waste includes all waste generated by health, research and laboratory facilities in the course of providing health care services. Health care waste in a facility should be managed... from point of generation to final disposal and removal.
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This toolkit provides step-by-step guidance to NTD programme managers and partners on how to engage and work collaboratively with the WASH community to improve delivery of water, sanitation and hygiene services to underserved population affected by many neglected tropical diseases. The toolkit draws... on tools and practices used in the delivery of coordinated and integrated programmes for control, elimination and eradication of NTDs. This second edition include revisions and new tools based on experiences of using the toolkit in more than 20 countries.
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