Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytolo...gy, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a ‘screen-and-treat’ approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. This guideline provides recommendations for strategies for a screen-and-treat programme
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Reference Guide Version 2. Revised. The Nutrition Program Design Assistant is a tool to help organizations design the nutrition component of their community-based maternal and child health, food security, or other development program. The tool focuses on prevention and also provides guidance on recu...perative approaches that are needed when there is a high prevalence of acute malnutrition
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Notable progress has also been made on other key health indicators such as reducing maternal, infant and child deaths and malnutrition, increasing immunization coverage, eliminating infectious diseases such as polio and reducing the incidence of malaria, tuberculosis and diarrhoeal diseases.
But ...despite such substantial progress, the country now faces new and emerging new challenges such as the rising burden of noncommunicable diseases, increased risks associated with disasters, environmental threats and health emergencies during disease outbreaks including the COVID-19 pandemic that is a serious public health threat to Bangladesh. To establish a resilience system for future potential pandemics, the national capacity for emergency preparedness and early response to health emergencies needs to be bolstered considerably.
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WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i...n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
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Recovery partnership preparation package: Building capacity to reactivate safe essential health services and sustain health service resilience.
In the aftermath of an emergency, the recovery partnership preparation package supports the establishment and implementation of institutional health partne...rships, or ‘twinning partnerships’. These partnerships focus on shared learning and improvement in the services that are being delivered. The Twinning Partnerships for Improvement (TPI) approach supports capacity-building, the re-establishment of safe essential health services and encourages joint long term efforts on service delivery strengthening
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Good primary care may lead to fewer avoidable hospitalizations, but unsafe primary care can cause avoidable illness and injury, leading to unnecessary hospitalizations, and in some cases, disability and even death.Implementing system changes and practices are crucial to improve safety at all levels ...of health care. Recognizing the paucity of accessible information on primary care, World Health Organization (WHO) set up a Safer Primary Care Expert Working Group. The Working Group reviewed the literature, prioritized areas in need of further research and compiled a set of nine monographs which cover selected priority technical topics. WHO is publishing this technical series to make the work of these distinguished experts available to everyone with an interest in Safer Primary Care.The aim of this technical series is to provide a compendium of information on key issues that can impact safety in the provision of primary health care.
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This publication offers practical advice on implementing HIV and STI programmes for transgender people, with a focus on transgender women, aligned with the 2011 Recommendations and the 2014 Key Populations Consolidated Guidelines. It contains examples of good practice from around the world that may ...support efforts in planning programmes and services, and describes issues that should be considered and how to overcome challenges.
This tool describes how services can be designed and implemented to be acceptable and accessible to transgender women. To accomplish this, respectful and ongoing engagement with them is essential.
This tool gives particular attention to programmes run by transgender people themselves, in contexts where this is possible.
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In recent years, high prices of pharmaceutical products have posed challenges in high- and low-income countries alike. In many instances, high prices of pharmaceutical products have led to significant financial hardship for individuals and negatively impacted on healthcare systems’ ability to prov...ide population-wide access to essential medicines.
Pharmaceutical pricing policies need to be carefully planned, carried out, and regularly checked and revised according to changing conditions. Strong, well-thought-out policies can guide well-informed and balanced decisions to achieve affordable access to essential health products.
This guideline replaces the 2015 WHO guideline on country pharmaceutical pricing policies, revised to reflect the growing body of literature since the last evidence review in 2010. This update also recognizes country experiences in managing the prices of pharmaceutical products.
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In this contingency planning guidance, a set of actions to prepare for emergencies from all hazards and to help minimize their impact, is proposed. These actions include the development, implementation, simulation, monitoring and regular update of risks-based contingency plans.
This document is to support local authorities, leaders and policy-makers in cities and other urban settlements in identifying effective approaches and implementing recommended actions that enhance the prevention, preparedness and readiness for COVID-19 in urban settings, to ensure a robust response ...and eventual recovery. It covers factors unique to cities and urban settings, considerations in urban preparedness, key areas of focus and preparing for future emergencies.
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First published in 2020, this toolkit is intended for clinicians working in acute care, managing adult and paediatric patients with acute respiratory infection, including severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock. The main objective is to provide key tools for us...e in the care of critically ill patients – from hospital entry to hospital discharge.
The 2022 updated version includes new tools and adapted algorithms, checklists, memory aids for COVID-19 and influenza, and the latest clinical evidence regarding clinical management of SARI. It is intended to help clinicians care for SARI patients: from epidemiology of severe acute respiratory infections, screening and triage, infection prevention and control, monitoring of patients, laboratory diagnosis, principles of oxygen therapy and different types of ventilation (invasive and non-invasive), as well as antimicrobial and immunomodulator therapies, to ethical and quality of care assessments.
The first edition is availbel in Ukrainian and Russian
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УСПЕХИ В РЕАЛИЗАЦИИ ПОЛИТИКИ В ОТНОШЕНИИ КОНТРОЛЯ НАД АЛКОГОЛЬНОЙ ПРОДУКЦИЕЙ, 2010–2019 ГГ
A detailed overview is provided of the implementation of alcohol policies described in the 10 action areas of the European Action Plan ...to Reduce the Harmful Use of Alcohol 2012–2020 (EAPA), including the current status of implementation of the five action areas of the WHO-led SAFER initiative:
Strengthen restrictions on alcohol availability;
Advance and enforce drink–driving countermeasures;
Facilitate access to screening, brief interventions and treatment;
Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship and promotion; and
Raise prices on alcohol through excise taxes and pricing policies.
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Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should h...ave some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
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July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in... the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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Early damage assessments indicate that at least 800,000 people could be directly exposed to minor to severe damages, including communication, access, security, loss of livelihoods, infrastructure, and health services could be impacted.
Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi...nes.
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Ethiopia is Africa’s second most populous country; with a population of 102 million and a growth rate of 2.6% in 2020, it is also the world’s 12th most populous one. The country is home to various ethnicities, with more than 80 different spoken languages. The country borders six countries. Most ...of the population in Ethiopia lives in central and northern plateaus. The southeastern and eastern parts of the country are sparsely populated and inhabited by pastoralist communities. Ethiopia is also home to many (estimated at 1 million) refugees from South Sudan, Somalia, Somaliland, and Eritrea. Though fewer in numbers, Ethiopia also hosts Syrian and Sudanese refugees.
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For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source... of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Malawi is a landlocked country with a surface area of 118,484 km2. Administratively, the country is divided into three regions, namely the Northern, Central and Southern regions. The country has 28 districts, which are further divided into traditional authorities (TA) ruled by chiefs. The TAs are su...b-divided into villages, which form the smallest administrative units. The Village Development Committees (VDCs) under the TAs are responsible for development activities. Politically, each district is divided into constituencies that are represented by Members of Parliament (MPs) in the National Assembly for purposes of legislations. Constituencies are further divided into wards which are represented by a ward councillor at district assembly.
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