Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse a...nd misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
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Census Report Volume 4-A
This thematic report presents findings on fertility and nuptiality in Myanmar. The analysis hows that the total fertility rate is 2.5 children per woman at the Union level, 1.9 children per woman for urban areas, and 2.8 children per woman for rural areas. Total fertili...ty for States and Regions varies from a high of 5.0 children per woman for Chin State to a low of 1.8 children per woman for Yangon Region. Total fertility appears to have declined at a rate of at least one child per woman per decade between 1970 and 2000. This relatively rapid decline apparently ceased sometime during the 1990s or 2000s. Estimates from the 2001 and 2007 surveys suggest that the level of fertility may have fluctuated between 2000 and 2014, but with no overall trend up or down. The marital status data shows an exceptionally high proportion of women remaining never married at age 50.
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This report is the first of its kind. It brings together various data sets to present the current status of hand hygiene, highlight lagging progress, and call governments and supporting agencies to action, offering numerous inspiring examples of change.
During the COVID-19 pandemic, hand hygiene ...received unprecedented attention and became a central pillar in national COVID prevention strategies. However, concern with hand hygiene should not only be as temporary public health measure in times of crisis, but as a vital everyday behaviour that contributes to health and economic resilience. Hand hygiene is a highly cost-effective investment, providing outsized health benefits for relatively little cost.
Despite efforts to promote hand hygiene, the rates of access to hand hygiene facilities remain stubbornly low. If current rates of progress continue, by the end of the SDG era in 2030, 1.9 billion people will still lack facilities to wash their hands at home.
This report presents a compelling case for investment in five key ‘accelerators’ as a pathway towards achieving hand hygiene for all – governance, financing, capacity development, data and information, and innovation. These accelerators are identified under the UN-Water SDG 6 Global Acceleration Framework.
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This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their n...ewborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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This study aimed to estimate the cost-effectiveness of a community-based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology... to estimate the programme’s achievements and cost-effectiveness.
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An Infographic Guide to Technology-facilitated Gender-based Violence (TFGBV) offers a visually engaging toolkit designed to raise awareness and deepen understanding of the pervasive and harmful impact of TFGBV on women and girls in all their diversity.
This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A... comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20...20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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DHS Working Paper No. 136
A total of 1,222 children age 6-23 months were included in this analysis. Twenty percent of children were stunted and 43% were moderately anemic. Regarding IYCF practices, only 16% of children received a minimum acceptable diet, 25% received diverse food groups, 58% were... fed with minimum meal frequency, 85% currently breastfed, and 59% consumed iron-rich foods. Breastfeeding reduced the odds of being stunted. By background characteristics, male sex, perceived small birth size, children of short stature, and children of working mother were significant predictors of stunting. Iron-rich food consumption was inversely associated with moderate anemia. Among covariates, male sex and maternal anemia were also significant predictors of moderate anemia among children age 6-23 months.
The study concluded that stunting and anemia among young children in Myanmar are major public health challenges that need urgent action.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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At a time when the world is reeling from the deepest global disruption and health crisis of a lifetime, this year’s Living Planet
report provides unequivocal and alarming evidence that nature is unraveling and that our planet is flashing red warning signs of
vital natural systems failure. The ...Living Planet Report 2020 clearly outlines how humanity’s increasing destruction of nature is having
catastrophic impacts not only on wildlife populations but also on human health and all aspects of our lives.
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A Toolkit for Implementation. Module 2: Facilitator’s guide to the orientation workshop on the IFC framework;
The curriculum, which complements the national pediatric ART training, was finalized in 2011 and was subsequently implemented nationally. The training curriculum includes a 15-module Trainer Manual, a Participant Manual, and accompanying PowerPoint slides.
Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-b...ased adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus.
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Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to elimina...te lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.
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Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries.
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Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt...h raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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