UNICEF’s support for data collection: the Multiple Indicator Cluster Surveys (MICS)
This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn health services.
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.
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Pneumonia kills more children than any other illness – more than AIDS, malaria and measles combined. Over 2 million children die from pneumonia each year, accounting for almost 1 in 5 under five deaths worldwide. Yet, little attention is paid to this disease. This joint UNICEF/WHO report examines ...the epidemiological evidence on the burden and distribution of pneumonia and assesses current levels of treatment and prevention. It is a call to action to reduce pneumonia mortality, a key step towards the achievement of the millennium development goal on child mortality.
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Co-trimoxazole is a fixed-dose combination of two antimicrobial drugs (sulfamethoxazole and trimethoprim) that covers a variety of bacterial, fungal and protozoan infections. Co-trimoxazole preventive therapy is a feasible, well tolerated and inexpensive intervention for people living with HIV to re...duce HIV-related morbidity and mortality. Further, co-trimoxazole is an off-patent drug and widely available in resource-limited settings.
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Mental health is critical to personal well-being, interpersonal relationships, and successful contributions to society. Mental health conditions consequently impose a high burden not only on individuals, families and society, but also on economies. In Jamaica, mental health conditions are highly pre...valent and major contributors to morbidity, disability, and premature mortality.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea...rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
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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... 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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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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The policy brief focuses on four key areas for intervention - air pollution, energy, transport and food systems. Air pollution causes 7 million deaths annually, and is a leading cause of both NCDs and climate change, thus all interventions to reduce air pollution have a positive impact on both human... and planetary health. In the energy sector, transition from fossil fuels to renewable energy is if vital importance to improving health, with mortality rates due to coal-generated electricity 1,000 times higher than for wind-generated electricity.
Promoting active transport such as walking and cycling in place of motorised transport has the dual benefit of reducing both air pollution and physical activity. Livestock production alone accounts for 18% of greenhouse gas emissions, with added emissions from food which are highly process and transported over long distances, and thus locally sourced plant based diets both prevent NCDs and promote human and planetary health.
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Child marriage and female genital mutilation (FGM) threaten the well-being of millions of girls around the world. Both have existed for generations, as manifestations of gender inequality, and have been propagated by discriminatory norms that devalue girls. In many countries where both child marriag...e and FGM are common, girls most at risk for each practice tend to share certain characteristics, such as low levels of education, rural residence, and living in poorer households. Yet, there are distinct differences in what drives each practice, and many communities in which one may be common, will not practice the other.
This report seeks to identify the extent to which child marriage and FGM co-exist. The intersection of these two practices – that is, the share of women who underwent FGM and were married in childhood – is reviewed over time, to determine whether girls’ likelihood of experiencing both practices has changed across generations. Lastly, the analysis identifies the characteristics that most commonly distinguish the girls who experience one practice from those who experience both.
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Health Policy and Planning, Volume 35, Issue 1, February 2020, Pages 47–57, https://doi.org/10.1093/heapol/czz122
Colombia has an underreporting of 30% of the total cases, according to World Health Organization (WHO) estimations. In 2016, successful tuberculosis (TB) treatment rate was 70%, and t...he mortality rate ranged between 3.5% and 10%. In 2015, Colombia adopted and adapted the End TB strategy and set a target of 50% reduction in incidence and mortality by 2035 compared with 2015.
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Nearly 260 000 people died in parts of Somalia between October 2010 and April 2012, including
133 000 children under five during the famine and food crisis in Somalia making it the worst famine in history.
A study commissioned and funded by the Food and Agriculture Organization of the United Natio...n’s food security and nutrition analysis unit for Somalia stated that the famine early warning systems clearly identified the risk of famine in South Central Somalia in 2010–2011 but timely action to prevent the onset of famine was not taken. The result was large scale
mortality, morbidity and population displacement.
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and comorbidities. Recognizing the significance of prim...ary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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Due to high routine vaccination coverage, overall counts of diphtheria case have significantly declined in the Western Pacific Region recently. However, diphtheria is still prevalent in several countries and areas of the Region and remains a public health issue due to its high case fatality rate.
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This Field Guide for Preparedness and Response to Diphtheria Outbreaks in the Western Pacific Region is a reference resource for Member States to develop national guidelines adapted to their local context. Countries may also use this Guide to facilitate outbreak preparedness and public health responses to reduce morbidity and mortality due to diphtheria.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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