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HIV-1 drug resistance (HIVDR) genotyping is an essential component of the WHO global HIVDR surveillance strategy. Plasma “gold standard” specimen type for HIVDR genotyping, but its use may not be feasible in rural, remote areas in low- and middl
...
e-income countries, since preparing and storing it require personnel and laboratory infrastructure that are often lacking. An alternative specimen type is dried blood spots (DBS), which can be made without special laboratory processing. DBS are more easily transported than plasma because they can be shipped at ambient temperature as non-hazardous materials using regular mail or courier services.
3rd edition
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An evidence-informed approach for non-formal, out-of-school CSE programmes that aims to reach young people from left-behind populations
This guidance is intended to assist anyone designing and/or implementing CSE in out-of-school settings, especially in l
...
ow- and middle-income countries. This includes international and national civil-society organizations, community-based organizations, government departments, UN agencies, health authorities, non-formal education authorities and youth development authorities. It is also intended for anyone else involved in the design, delivery and evaluation of sexuality education programmes out of school, especially those working with the specific groups of young people addressed in the guidance.
more
Project protocol
Introduction Ready-to-eat food sold in the street represents a global phenomenon, more common in urbanized areas, that constitutes an important dietary source in populations from low- and middle-
...
income countries. However, research on the kind of street food offered and its composition is scarce. The main objective of this study is to characterize the urban street food environment, including vending places, the food offered, its nutritional composition, food purchasing patterns and advertising.
Methods and analysis This protocol provides a framework for a stepwise, standardized characterization of the street food environment; it consists of three steps that are of increasing complexity and demand increasingly great human and technical resources. Step 1 comprises identification of street food vending sites and characterization of the products available; this stage may be complemented with an evaluation of food advertising in the streets. Step 2 comprises description of street food purchasing patterns, by direct observation. Step 3 requires collection of food samples for bromatological analysis. Different levels of data collection may be defined for each step; hereafter, these are presented as core and expanded evaluations. For the most part, data analysis involves descriptive statistics and basic spatial analysis.
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No one should be harmed in healthcare. And yet, at least five people die every minute of patient safety failures in low and middle income countries
...
alone. We can all do something to save these lives. Join us, commit to Patient Safety. Speak up for Patient Safety
more
These organisations have joined forces to accelerate access to COVID-19 vaccines, therapeutics and diagnostics by leveraging multilateral finance and trade solutions, particularly for low- and middle-incom
...
e countries.
The aim is to vaccinate at least 40 percent of people in every country by the end of 2021, and at least 60 percent by mid-2022. The effort will track, coordinate, and advance delivery of COVID-19 vaccines, therapeutics and diagnostics, working with governments and partners at the global and local levels to address finance and trade barriers to ensure that vulnerable populations have access to these life-saving tools. It supports the goals of the ACT-Accelerator and complementary initiatives.
more
Surgical site infections (SSI) are a serious problem globally; they are the most frequent type of health care-associated infection (HAI) observed on admission in low- and middle-income
...
countries (LMICs). Approximately one in 10 people who have surgery in LMICs acquire an SSI, and SSI is reported as the second most common HAI in Europe and the United States of America. Therefore, it is crucial to include SSI prevention activities in your overall IPC programme.
more
Childhood cancer is curable for the vast majority of children when essential diagnostic, therapeutic and supportive care services are accessible. However, profound inequalities in outcomes exist within and between countries with as few as 20% or 30%
...
of children living in low- and middle-income countries surviving.
The Global Initiative for Childhood Cancer Overview document presents the CureAll approach to support governments, partners and communities achieve the best possible cancer care for all children. This approach, summarized as four pillars of action supported by three enablers, will improve the care for children with cancer around the world.
more
This technical report summarizes the discussions on the status of programmatic transition to tenofovir, lamivudine and dolutegravir (TLD) in low– and middle- income
...
countries, addressing the best practices and major challenges faced by HIV programmes.
The latest data on safety and efficacy of dolutegravir (DTG) containing regimens were also reviewed. The document identified the remaining gaps in knowledge, research, monitoring, and surveillance on DTG and TLD transition and listed the future priorities.
more
Providing financial protection to the population for larger health care expenses arising out of hospital-based care, has come forth as a crucial element in the attainment of Universal Health Coverage (UHC) through the recent health financing reforms of low
...
-and middle-income countries (LMIC). Over the last decade, the state of Assam in India, in an effort to ensure equitable health care access, has formulated multiple health protection schemes at different points of time. This has resulted in several such schemas which have had their own objectives, designs, institutional setups, and governance mechanisms. Moreover, they have reportedly been operating in relative silos.
more
Breast cancer is the most common cancer worldwide and the leading cause of cancer deaths among women, disproportionately affecting low- and middle-income
...
countries. The Global Breast Cancer Initiative strives to reduce breast cancer mortality by 2.5 percent per year, which over a 20-year period can save 2.5 million lives. The purpose of this core technical package is to outline a pathway for incremental, sustainable improvements tailored to country-specific needs based on three key strategies and objectives: health promotion for early detection; timely diagnosis; and comprehensive breast cancer management. This document provides a common framework linking policy makers, stakeholders, the clinical community, program managers and civil society to evidence-based systematic approaches that can facilitate health systems strengthening and reduce inequities in women’s health throughout their life cycles
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Even before Russia invaded Ukraine, the global economy was suffering from the repercussions of several man-made conflicts, climate shocks, COVID-19 and rising costs — with devastating consequences for poor people in low-
...
income and developing countries. The war in Ukraine — a major “breadbasket” for the world — is deepening these challenges on an unprecedented scale. In the immediate, swift and bold action is required by both wealthy and low-income nations to avert further humanitarian and economic catastrophe.
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Background: Investing in the health workforce is key to achieving the health-related Sustainable Development Goals. However, achieving these Goals requires addressing a projected global shortage of 18 million health workers (mostly in low- and middl
...
e-income countries). Within that context, in 2016, the World Health Assembly adopted the WHO Global Strategy on Human Resources for Health: Workforce 2030. In the Strategy, the role of official development assistance to support the health workforce is an area of interest. The objective of this study is to examine progress on implementing the Global Strategy by updating previous analyses that estimated and examined official development assistance targeted towards human resources for health. Methods: We leveraged data from IHME’s Development Assistance for Health database, COVID development assistance database and the OECD’s Creditor Reporting System online database. We utilized an updated keyword list to identify the relevant human resources for health-related activities from the project databases. When possible, we also estimated the fraction of human resources for health projects that considered and/or focused on gender as a key factor. We described trends, examined changes in the availability of human resources for health-related development assistance since the adoption of the Global Strategy and compared disease burden and availability of donor resources.
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Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. There are significant differences in the burden of cardiovascular disease and associated risk factors, across high-income
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countries and low- and middle-income countries. Cardiac imaging by echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography myocardial perfusion imaging are well-established non-invasive tests that aid in the diagnosis, risk stratification, and management of various cardiac diseases. However, there are significant inequalities in availability and access to imaging modalities in low- and middle-income countries attributed to financial constraints, disparities in healthcare and technical infrastructure. In the post-COVID-19 pandemic era, these disparities are exaggerated by the continued technological advancements driving innovations in the field of cardiovascular (CV) imaging in high-income countries, while there is an urgent need to provide sustainable access to diagnostic imaging for patients in economically strained healthcare systems in regions like Africa. This review aims to highlight the inequalities in the burden of cardiac disease, associated risk factors, and access to diagnostic CV imaging tests, while also exploring the need for sustainable solutions to implementing CV imaging all over the world.
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Key facts
- Cardiovascular diseases (CVDs) are the leading cause of death globally.
- An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.
- Over three quarters of CVD deaths take place in
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low- and middle-income countries.
- Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2019, 38% were caused by CVDs.
- Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.
- It is important to detect cardiovascular disease as early as possible so that management with counselling and medicines can begin.
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Key facts
- An estimated 1.28 billion adults aged 30–79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries
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- An estimated 46% of adults with hypertension are unaware that they have the condition.
- Less than half of adults (42%) with hypertension are diagnosed and treated.
- Approximately 1 in 5 adults (21%) with hypertension have it under control.
- Hypertension is a major cause of premature death worldwide.
- One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.
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Delivery of comprehensive arrhythmia care requires the simultaneous presence of many resources. These include complex hospital infrastructure, expensive implantable equipment, and expert personnel. In many low- and middle-
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income countries (LMICs), at least 1 of these components is often missing, resulting in a gap between the demand for arrhythmia care and the capacity to supply care. In addition to this treatment gap, there exists a training gap, as many clinicians in LMICs have limited access to formal training in cardiac electrophysiology. Given the progressive increase in the burden of cardiovascular diseases in LMICs, these patient care and clinical training gaps will widen unless further actions are taken to build capacity. Several strategies for building arrhythmia care capacity in LMICs have been described. Medical missions can provide donations of both equipment and clinical expertise but are only intermittently present and therefore are not optimized to provide the longitudinal support needed to create self-sustaining infrastructure. Use of donated or reprocessed equipment (eg, cardiac implantable electronic devices) can reduce procedural costs but does not address the need for infrastructure, including diagnostics and expert personnel. Collaborative efforts involving multiple stakeholders (eg, professional organizations, government agencies, hospitals, and educational institutions) have the potential to provide longitudinal support of both patient care and clinician education in LMICs.
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Anaemia is a global public health concern, especially afflicting adolescent girls, women 15–49 years of age, pregnant women, and children in low- and middle-income
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countries. WHO estimates that in 2019 30% (571 million) of women aged 15–49 years, 37% (32 million) of pregnant women, and 40% (269 million) of children 6–59 months of age were affected by anaemia, with the WHO African Region and South-East Asia
Region being most affected(
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The World Health Organization's fact sheet on diabetes provides an overview of the disease, highlighting its increasing prevalence, particularly in low- and middle-income
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countries. It outlines the main types of diabetes—Type 1, Type 2, and gestational diabetes—detailing their characteristics and risk factors. The document emphasizes the importance of early diagnosis and management to prevent complications such as heart disease, kidney failure, and vision loss. Preventive measures include maintaining a healthy diet, regular physical activity, and avoiding tobacco use. The fact sheet also discusses WHO's initiatives aimed at monitoring, preventing, and controlling diabetes globally.
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The World Health Organization's fact sheet on diabetes provides an overview of the disease, highlighting its increasing prevalence, particularly in low- and middle-income
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countries. It outlines the main types of diabetes—Type 1, Type 2, and gestational diabetes—detailing their characteristics and risk factors. The document emphasizes the importance of early diagnosis and management to prevent complications such as heart disease, kidney failure, and vision loss. Preventive measures include maintaining a healthy diet, regular physical activity, and avoiding tobacco use. The fact sheet also discusses WHO's initiatives aimed at monitoring, preventing, and controlling diabetes globally.
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The document discusses physical inactivity as a major risk factor for non-communicable diseases (NCDs), which contribute to two-thirds of global deaths, primarily in low- and middle-income
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countries. It emphasizes the global prevalence of physical inactivity and its health risks, such as increased mortality and chronic diseases. The text advocates for simple, sustainable interventions to promote physical activity, such as public initiatives like car-free days, to prevent and manage NCDs. It highlights the importance of exercise in improving physical and mental health and calls for collaborative, comprehensive approaches to increase activity levels.
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