This special issue on Newborn Health in Global Health Action is being launched to share the experience of how to scale up a cost-effective package of newborn care that involves families, community health workers and health facilities. The results of this community randomized trial, the Uganda Newbor...n Study (UNEST), show that home visits in pregnancy and soon after delivery resulted in improved breastfeeding practices, skin-to-skin care immediately after birth, delaying a baby’s first bath, and hygienic care of the baby’s umbilical cord among the poorest households with lowest access to care.
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The report focuses on several key areas where health outcomes are falling short, and provides insight into ways in which countries can improve the situation for their children and adolescents. Areas in focus include mental health, overweight/obesity and adolescent risk-taking behaviour.
The report ...shows, for example, that:
- mental health remains a neglected subject – only one quarter of countries are collecting data on the number of children treated by a mental health professional;
- half of countries do not regulate the marketing of food to children, despite the fact that childhood obesity rates are high across the Region and physical activity rates are low;
- almost half of countries have no policy that affects the availability of unhealthy foods at school;
- 2 in 5 girls and 1 in 3 boys who are having sex do not protect themselves; and
one third of countries do not offer legal access to contraception without parental consent for those under 18 years of age.
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Guideline
Iron deficiency is one of the most common forms of nutritional deficiencies, particularly among vulnerable groups such as women, children and low-income populations. Iron deficiency often precedes anaemia, and anaemia during pregnancy is one of the strongest predictors of anaemia duri...ng the postpartum period, beginning just after childbirth throughout the subsequent 6 weeks. The consequences of iron deficiency and anaemia during the postpartum period can be serious and have long-term health implications for the mother and her infant.
This guideline reviews the evidence on the safety and effectiveness of iron supplementation in postpartum women.
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With this study, we estimated the burden of serious fungal infections for the general healthy population and for those at risk, including those infected with HIV, patients with asthma, as well as those under intensive care. We also highlight from studies in progress of high incidences of histoplasm...osis, CM and Pneumocystis jirovecii in adult HIV-infected patients.
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Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of drug-resistant TB has been developed and forms part of the Five Year National Strateg...ic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols
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Policy Brief.
WHO recommends that pregnant women receive testing for HIV, syphilis and hepatitis B (HBSAg) at least once during pregnancy, preferably in the first trimester.
Dual HIV/syphilis rapid diagnostic tests (RDTs) can be used as the first test for pregnant women as part of antenatal care (...ANC).
These simple tests can be used at the point-of-care and are cost-saving compared to standard testing in ANC. They enable more women to be diagnosed with HIV and syphilis so that they can access treatment and prevent transmission to their children.
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A treatment literacy guide for pregnant women and mothers living with HIV
Positive Health, Dignity and Prevention for Women and their Babies is intended for use by networks of women living with HIV, women’s groups, peer educators and others wishing to help guide women living with HIV t...hrough the decisions they will need to take before, during and after their pregnancy. It is not intended as a substitute for going to a health facility and seeking information from a healthcare worker.
The facilitator’s manual and flipchart are intended to be used by leaders of support groups, peer educators or lay counsellors to facilitate small groups or community sessions with women living with HIV. Together, they provide accurate and comprehensive information to enable pregnant women and mothers living with HIV to know their rights and make informed decisions about their health, and the health of their baby.
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DHS Further Analysis Reports No. 111
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delive...ry, and timely postnatal care (PNC).
This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12 regions. We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use. We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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Nigeria is Africa’s most populous nation and accounts for nearly one quarter of the continent’s maternal, newborn and child deaths. In the spirit of the global Countdown to 2015 for Maternal, Newborn and Child Health and the Nigerian Saving One Million Lives Initiative, these state data profiles... have been designed to prompt and inform policy and programme action.
Without data there can be no accountability. Without accountability we risk making no progress for Nigeria’s women and children. The data included in these profiles come mainly from large-scale, periodic household surveys. Continued efforts are needed to strengthen civil registration, vital statistics and health management information systems, as well as the institutional capacity to gather and use these data.
Updated from 2011, these data profiles can be used to compare progress in different areas, identify opportunities to address specific coverage gaps, and monitor implementation.
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Module 10
Testing providers
July 2017
Module 10: Testing providers. This module is for people who provide testing services at PrEP sites and laboratories. It offers guidance in selecting testing services, including screening of individuals before PrEP is initiated and monitoring while they ar...e taking PrEP. Information is provided on HIV testing, creatinine, HBV and HCV, pregnancy and STIs.
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Manufacturers:
SK Bioscience Co. Ltd. [COVID-19 Vaccine (ChAdOx1-S [recombinant])]
Serum Institute of India Pvt. Ltd. [COVISHIELD™, ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant)]
Efficacy shown in clinical trials in participants who received the full series of vaccine (2 doses) ir...respective of interval between the doses was 63.1%, based on a median follow-up of 80 days, but tended to be higher when this interval was longer. The data reviewed at this time support the conclusion that the known and potential benefits of ChAdOx1-S/nCoV-19 [recombinant] vaccine outweigh the known and potential risks.
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This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delivery, and timely postnatal care (PNC).This s...tudy uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12regions.We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use.We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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The purpose of the toolkit is to bring together existing learning and guidance as a starting point for stakeholders to begin SRH preparedness work. Within the SRH sector the field of preparedness is relatively new and growing. More collective effort is required to further evaluate the impact of prep...aredness efforts and push the field forward. This effort is a first attempt at a draft guidance for SRH preparedness, and is intended for field testing. The toolkit recognizes the longstanding work of the field of emergency and disaster risk management, and endeavors to bridge that work with the human rights-oriented and peoplecentered field of sexual and reproductive health.
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Breast cancer. Just reading those words can make many women worry. And that’s natural. Nearly everyone knows someone touched by the disease.
But there is a lot of good news about breast cancer these days. Treatments keep getting better, and we know more than ever about ways to prevent the disease.... These eight simple steps can help lower the risk of breast cancer. Not every one applies to every woman, but together they
can have a big impact. Available in English, Spanish, Vietnamese
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The practical guidance in the operational handbook aims to inform the development or revision of national policies and related implementation guidance on the management of TB in children and adolescents under programmatic circumstances and at different levels of the health system. The operational ha...ndbook can also help countries adequately plan for the uptake of interventions to better address the specific needs of children and adolescents with or at risk of TB. It can contribute to national efforts to build capacity among national and subnational programme managers and among health workers at all levels of the health care system.
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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro...nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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The overall goal of surveillance, case investigation and contact tracing in this context is to stop human-to-human transmission to control the outbreak. The key objectives of surveillance and case investigation are to rapidly identify cases and clusters in order to provide optimal clinical care; to ...isolate cases to prevent further transmission; to identify, manage and follow up contacts to recognize early signs of infection; to protect frontline health workers; to identify risk groups; and to tailor effective control and prevention measures.
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea...lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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Loss and damage is an urgent concern, driven by the increasingly harmful effects of climate change. Communities are experiencing new types and forms of climate impact, of higher frequency and intensity, which they are not equipped to handle. These impacts compel vulnerable communities to migrate to ...find alternative livelihoods and ways to survive. But migration generates grave socioeconomic consequences. Through case study analysis from 12 regions in Asia, Africa and the Pacific, this paper explores how climate change-induced migration is creating physical health, mental health and wellbeing issues — both for migrants and the families they leave behind. It then provides recommendations to policymakers on how to strengthen policy, planning and response frameworks to support communities manage health and wellbeing risks created by climate impacts.
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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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