In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t...echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
more
A new frontier for integrated care.
Until now, most efforts to promote integrated care have focused on bridging the gaps between health and social care or between primary and secondary care. But the NHS five year forward view has highlighted a third dimension – bringing together physical and ment...al health. This report makes a compelling case for this ‘new frontier’ for integration. It gives service users’ perspectives on what integrated care would look like and highlights ten areas that offer some of the biggest opportunities for improving quality and controlling costs.
more
Mental disorders are one of the top public health challenges in the WHO European Region, affecting about 25% of the population every year. In all countries, mental health problems are much more prevalent among the people who are most deprived. The WHO European Region therefore faces diverse challeng...es affecting both the mental well-being of the population and the provision and quality of care for people with mental health problems.
The European Mental Health Action Plan focuses on seven interlinked objectives and proposes effective action to strengthen mental health and well-being. Investing in mental health is essential for the sustainability of health and socioeconomic policies in the European Region. The Action Plan corresponds to the four priority areas of the European policy framework for health and wellbeing, Health 2020, and will contribute directly to its implementation.
more
During the first year of the Covid-19 pandemic, the world’s economy slowed. Yet, the global annual average particulate pollution (PM2.5) was largely unchanged from 2019 levels. At the same time, growing evidence shows air pollution—even when experienced at very low levels—hurts human health. T...his recently led the World Health Organization (WHO) to revise its guideline for what it considers a safe level of exposure of particulate pollution, bringing most of the world—97.3 percent of the global population—into the unsafe zone. The AQLI finds that particulate air pollution takes 2.2 years off global average life expectancy, or a combined 17 billion life-years, relative to a world that met the WHO guideline. This impact on life expectancy is comparable to that of smoking, more than three times that of alcohol use and unsafe water, six times that of HIV/AIDS, and 89 times that of conflict and terrorism.
more
India is the world’s second most polluted country. Air pollution shortens average Indian life expectancy by 5 years,
relative to what it would be if the World Health Organization (WHO) guideline fine particulate pollution (PM2.5) of 5 μg/m3 was met. Some areas of India fare much worse than avera...ge, with air pollution shortening lives by almost 10
years in the National Capital Territory of Delhi, the most polluted city in the world.
more
In Central and West Africa, regions together comprising 27 countries and 605 million people, the average person is exposed to particulate pollution levels that are more than 4 times the World Health Organization’s (WHO) guideline of 5 μg/m³1. If these particulate pollution levels persist, averag...e life expectancy in the regions would be 1.6 years lower, and a total of 971 million person-years would be lost, relative to if air quality met the WHO guideline. The Democratic Republic of the Congo, Rwanda and Burundi, are the top three most polluted countries in the region.
more
Bangladesh is the world’s most polluted country. Air pollution shortens the average Bangladeshi’s life expectancy by 6.9 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m³ was met. Some areas of Bangladesh fare much worse than average, with air poll...ution shortening lives by nearly 9 years in Dhaka, the country’s most polluted city.
more
Pakistan is the world’s fourth most polluted country. Air pollution shortens the average Pakistani’s life expectancy by 3.8 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 Some areas of Pakistan fare much worse than average, with air pol...lution shortening lives by almost 7 years in the country’s most polluted regions, like Lahore and Peshawar.
more
Nepal is the world’s third most polluted country. Air pollution shortens average Nepalese life expectancy by 4.1 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 The highest concentrations of air pollution are observed in Nepal’s southwes...tern districts, which share their borders with the highly-polluted Indo-Gangetic Plain of India. Here, residents stand to lose nearly 7 years of life expectancy.
more
Many determinants are known to affect brain health at different stages of life. The position paper provides a conceptual framework for what brain health is and how brain health can be optimized throughout life with actions across the following clusters of determinants: physical health, healthy envir...onments, safety and security, learning and social connection, and access to quality services. Optimizing brain health can not only reduces the prevalence and burden of neurological disorders, but also improve mental and physical health overall and create positive social and economic impacts, all of which contribute to greater well-being and help advance society, irrespective of the presence or absence of disorders.
more
The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community engagement, disease control regulations, and multisector approaches to improve resilience, EHS quality..., and equity.
more
What are the FP and CAC competencies?
Through the clear articulation of the family planning and comprehensive abortion care (FP and CAC) competencies for the primary health care workforce, the aim is to advance improvements in FP and CAC service delivery by aligning health worker education approach...es with population health needs and health system demands.
This document, which describes these competencies in detail, is intended to:
be a foundational tool to be adopted and adapted by educators and regulators for FP and CAC providers (students) with a pre-service training pathway of at least 12 months;
describe competencies that are relevant to current and future health practice;
enable widespread use of the competencies not only for curriculum development for pre-service education, but also for in-service education, regulation, qualifications, quality assurance, personal development, performance evaluation, recruitment, management and career progression;
focus on the core functions of FP and CAC providers within broader efforts towards achieving universal health coverage
more
Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. ...Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
more
This guidance describes a catalogue of indicators for maternal, newborn, child and adolescent health (MNCAH) that can be monitored through health management information system data. It is a module of the WHO Toolkit for Routine Health Information Systems (RHIS) Data and links to relevant indicators ...from other programmatic modules of the WHO toolkit. The document provides guidance on possible analysis and visualization of the indicators, including considerations for interpreting and using the data for decision-making. An annex on data quality considerations for MNCAH managers provides suggestions for reviewing and interpreting routine health facility data through a quality lens.
more
The mhGAP guideline supports countries to strengthen capacity to deal with the growing burden of mental, neurological and substance use (MNS) conditions and narrow the treatment gap. This new edition includes 30 updated and 18 new recommendations, alongside 90 pre-existing recommendations. This is t...he third iteration of the guideline and reflects 15 years of investment in the mhGAP programme. The revised recommendations ensure that mhGAP continues to offer high-quality, timely, transparent, and evidence-based guidance to support non-specialist health workers in low-income and middle-income countries in providing treatment and care to individuals with MNS conditions.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –... are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
more
Evidence- and rights-based national policies, guidelines and legislation play a key role in improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH), framing the enabling environment for equitable provision and accessibility of quality services. The SRMNCAH policy sur...vey monitors the existence of national SRMNCAH laws, policies, strategies and guidelines and the extent to which they are aligned with WHO recommendations on SRMNCAH. This publication reports on the findings from the 2023 WHO SRMNCAH policy survey.
more
The postpartum period is a critical time for mothers and newborns, who require essential hygiene and personal items, such as menstrual pads, clothes, and diapers, to ensure their well- being and health. Although these items are simple, they can significantly enhance well- being. Conversely, lacking ...these essentials can increase the risk of infections for mothers and newborns.
In Gaza, the current emergency situation has meant women face significant limitations in accessing these essential items due to market unavailability, financial constraints, high security risks, and border closures.
In response, organizations working in sexual and reproductive health in Gaza have united to provide postpartum kits (PPKs) to mothers and newborns effectively.
With approximately 4,000 live births occurring in Gaza each month, it is crucial for partners to collaborate in advocating for resources and ensuring timely procurement and distribution of these kits.
Moreover, to ensure equitable access and consistent quality of the kits for all women, partners have agreed on a unified set of criteria for their composition and distribution.
more