The Cartagena Declaration on Refugees was adopted by the Colloquium on the International Protection of Refugees in Central America, Mexico and Panama on November 22, 1984. The declaration is a non-binding agreement but has been incorporated in refugee law in various countries. The Cartagena Declarat...ion on Refugees bases its principles on the “commitments with regards to refugees” defined in the Contadora Act on Peace and Cooperation (which are based on the 1951 UN Refugee Convention and the 1967 Protocol).
It includes a range of detailed commitments to peace, democratization, regional security and economic co-operation. It also provided for regional committees to evaluate and verify compliance with these commitments.
This document contains the Spanish, French and English versions of the original text.
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The Access to Controlled Medications Programme identified the development of treatment guidelines that cover the treatment of all types of pain as one of the core areas of focus for improving access to opioid analgesics. Such guidelines are interesting both for health-care professionals and policy-...makers. They are also important in improving access to controlled medicines for determining when those opioid medicines and when non-opioid medicines are preferred.
Based on a Delphi study, WHO planned the development of three treatment guidelines, covering chronic pain in children, chronic pain in adults and acute pain.
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The use of explosive weapons, such as bombs, rockets, and mortar and
artillery shells, in cities, towns and villages and in other populated areas
has devastating humanitarian consequences. Explosive weapons act mainly
through the projection of blast and fragmentation wi...thin an area. Their use,
in populated areas, causes severe suffering to civilians, both in terms of
death and serious injury resulting directly from the explosion, and in terms
of damage to property and public infrastructure, which can indirectly affect
civilian well-being and survival, sometimes for many years after a conflict
has ended. Explosive weapons also leave behind explosive remnants that
pose a threat to populations until those remnants are removed. [...] The study finds that the regulation of explosive weapons under international
law and policy is fragmentary and incoherent.
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Tuberculosis treatment failure results in increased risk of morbidity, drug resistance, transmission and mortality. There are few data about tuberculosis treatment outcomes in Burkina Faso. The current study investigated the factors associated with tuberculosis treatment failure in the central east ...health region of Burkina Faso.
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Bull World Health Organ 2018;96:450–461 | doi: http://dx.doi.org/10.2471/BLT.17.206466
The aim of our study was to determine whether an intervention designed
to involve the male partners of pregnant women in Burkina Faso in facility-based maternity care influences care-seeking and healthy practi...ces after childbirth.
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This technical report contains the results from the FEEDcities Project – Eastern Europe and Central Asia, a cross-sectional survey of the local urban food environment conducted in Chișinău, Republic of Moldova between June and August 2016. It characterizes the vending sites, the food offered and... the nutritional composition of both industrial and homemade street foods. It also describes the nutritional composition of foods sold in supermarkets and fast-food outlets.
The study was conducted within a bilateral partnership between the World Health Organization and the Institute of Public Health of the University of Porto, in collaboration with the Faculty of Medicine, the Faculty of Nutrition and Food Sciences and the Faculty of Pharmacy of the University of Porto (WHO registration 2015/591370 and 2017/698514). The study was funded through a voluntary contribution of the Ministry of Health of the Russian Federation.
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This technical report presents the results of a cross-sectional survey conducted in Sarajevo, the Federation of Bosnia and Herzegovina, Bosnia and Herzegovina, between June and August 2017, as part of the FEEDcities Project (Food Environment Description in cities – eastern Europe and central Asia).... The aim of the report is to describe the city’s local street food and takeaway food environment, exploring the characteristics of food vending sites, the industrially produced and homemade foods they typically offer, and the nutritional composition of these foods. Finally, the report provides guidance on how to address its findings through policy action.
The study was conducted through a bilateral partnership between the World Health Organization (WHO) and the Institute of Public Health of the University of Porto, in collaboration with the Faculty of Medicine, the Faculty of Nutrition and Food Sciences, the Faculty of Pharmacy of the University of Porto (WHO registration 2015/591370 and 2017/698514) and the Institute of Public Health of the Federation of Bosnia and Herzegovina. The study was funded through a voluntary contribution of the Ministry of Health of the Russian Federation, and through a contribution made by the Swiss Agency for Development and Cooperation (SDC)/Swiss Government to a joint WHO/SDC project, “Reducing Health Risk Factors in Bosnia and Herzegovina: Developing and Advancing Modern and Sustainable Public Health Strategies, Capacities and Services to Improve Population Health”, implemented in Bosnia and Herzegovina.
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This technical report presents results from the FEEDcities Project – Eastern Europe and Central Asia, a cross-sectional survey conducted in Almaty, Aktau and Kyzylorda, Kazakhstan, between July and August 2017, to evaluate the local street food environment. It characterized the vending sites, the ...food offered and the nutritional composition of the industrial and homemade foods available in these settings. The policy implications of the findings are outlined.
The study was conducted within a bilateral partnership between WHO and the Institute of Public Health of the University of Porto, in collaboration with the Faculty of Medicine, the Faculty of Nutrition and Food Sciences and the Faculty of Pharmacy of the University of Porto (WHO registration 2015/591370 and 2017/698514). The study was funded through a biennial collaborative agreement and joint programmes between the Government of Kazakhstan and United Nations agencies in Kazakhstan for Kyzylorda and Mangystau oblasts, a voluntary contribution by the Ministry of Health of the Russian Federation and the Resolve to Save Lives project of Bloomberg Philanthropies.
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The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the diseasehave wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments(EDs) have rapidly adapted provision of care in response to the pandemic. This qualitativ...e study utilized insight frommultidisciplinary frontline staff to understand the changes in paediatric emergency healthcare utilization duringCOVID-19 the experiences of working within the restructured health system.
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COVID-19 infection affects all age groups including newborns, however, literature is scarce on the fetal and neonatal outcomes of babies exposed in-utero, especially in Africa. The objectiveof this study was to document the perinatal outcomes of COVID-19 pregnancies and del...iveries that occurredduring the pandemic in Nigeria.
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For humanitarian organisations to respond effectively to complex crises, they require access to up-to-date evidence-based guidance. The COVID-19 crisis has highlighted the importance of updating global guidance to context-specific and evolving needs in humanitarian settings. Our study aimed to under...stand the use of evidence-based guidance in humanitarian responses during COVID-19. Primary data collected during the rapidly evolving pandemic sheds new light on evidence-use processes in humanitarian response.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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Health is routinely considered in strategic environmental assessment (SEA) and environmental impact assessment (EIA), following requirements of European Union directives and the Protocol on Strategic Environmental Assessment to the Convention on Environmental Impact Assessment in a Trans...boundary Context (Espoo Convention). Policy-makers and other sources report that these assessments mostly adopt a biophysical perspective and that few cases consider or define health in a manner which is consistent with the WHO Constitution, by considering the wider social, economic, behavioural and institutional aspects of health. This systematically conducted review of over 333 SEA and EIA cases in the WHO European Region shows that while about 80% of assessments pursue a narrow, biophysical interpretation of health, around 10% consider wider determinants when defining health, and another 10% consider wider determinants of health in the actual assessment. Twelve case studies are presented, literature is reviewed and implications for practice are considered.
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To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find t...hat patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
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During the COVID-19 health crisis, community pharmacists had an enhanced role in supporting health-care systems that were overburdened by managing seriously ill patients. This study was undertaken to determine the patterns of community supply of antiviral and antibacterial agents from community phar...macies during the COVID-19 pandemic in selected countries in eastern Europe and central Asia. Nine countries – Armenia, Georgia, Kazakhstan, Kyrgyzstan, North Macedonia, the Russian Federation, Serbia, Tajikistan and Uzbekistan – participated in this cross-sectional study.
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Parasites & Vectors volume 11, Article number: 264 (2018)
Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector... control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians’ therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.
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Background: One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public... is deficient. This study was therefore designed to assess the current level of awareness and knowledge of the Nigerian public of AMR.
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen...t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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