Situation analysis
Description of the disaster
An Ebola epidemic that started in March 2014 in Guinea has relentlessly continued to claim lives and to spread to other countries in West Africa. The current Ebola outbreak is the largest in history and the first to affect multiple countries simu...ltaneously. There have been over 24 000 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (table 1), with almost 10 000 reported deaths (outcomes for many cases are unknown). A total of 58 new confirmed cases were reported in Guinea, 0 in Liberia, and 58 in Sierra Leone in the 7 days to 8 March (4 days to 5 March for Liberia). Many experts believe that the official numbers substantially understate the size of the outbreak because of families' widespread reluctance to report cases. Because of the fluidity of movement of people between West Africa and several countries in the East African countries, especially Kenya and Ethiopia (who in turn have extensive interaction with other countries in the region in terms of human movement), the risk of an outbreak of Ebola in East Africa is as eminent as in any of the countries bordering the affected countries. The IFRC regional office intends to support National Societies to raise their Ebola preparedness and response capacity through training, technical support in planning and implementation of Ebola related activities, and coordination both within and outside the movement.
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ECDC launched the HEPSA (Health Emergency Preparedness Self-Assessment) tool, in order to support countries in improving their level of public health emergency preparedness. The tool is worksheet-based and is targeted at professionals in public health organisations responsible for emergency planning... and event management. It consists of seven domains that define the process of public health emergency preparedness and response: 1) Pre-event preparations and governance; 2) Resources: Trained workforce; 3) Support capacity: Surveillance; 4) Support capacity: Risk assessment; 5) Event response management; 6) Post-event review; 7) Implementation of lessons learned.
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The Guide
Ratgeber Parkinson – Englisch
Accessed: 11.03.2019
Event-based surveillance (EBS) is defined as the organized collection, monitoring, assessment and interpretation of mainly unstructured ad hoc information regarding health events or risks, which may represent an acute risk to health. Both indicator-based and event-based surveillance components serve... the early warning and response (EWAR) function of the public health surveillance system. The Framework for Event-based Surveillance offers guidance to public health practitioners seeking to implement EBS at each administrative level in their countries.
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La surveillance basée sur les événements est définie comme la collecte, le suivi, l'évaluation et l'interprétation organisés d'informations ponctuelles non structurées concernant des événements ou des risques de santé, qui peuvent représenter un risque aigu pour la santé. Les composant...es de surveillance axées sur les indicateurs et sur les événements servent à la fonction d'alerte précoce et de réponse du système de surveillance de la santé publique. Le cadre de la surveillance axée sur les événements offre des conseils aux praticiens de la santé publique qui cherchent à mettre en œuvre une surveillance axée sur les événements à chaque niveau administratif de leur pays.
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This document sets out the preparedness and response plan of the Nigerian Primary Health Care System for COVID-19 Acute Respiratory Disease. It outlines the planning scenarios, key areas of work and priority activities required for the Primary Health Care Sector to quickly scale up its core capacity... to prevent, quickly detect, characterize and efficiently respond, in a coordinated manner to the COVID-19 pandemic. These include guidelines for the setup and operationalization of COVID-19 response platforms at the national and state levels, guidelines for the provision of PHC services during the pandemic to minimize transmission in PHCs as well as guidelines for preparedness and response of PHC Centres and communities for COVID-19 case detection and response.
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In the context of health, stigma is the negative association between a person or group of people who share certain characteristics and a specific disease. In an outbreak, this may mean people are labeled, stereotyped, discriminated against, treated separately, and/or experience loss of status becaus...e of a perceived link with a disease.
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This document, a first of its kind, clearly sets out the standards for rehabilitation and provides guidance on building or strengthening the capacity of EMTs in this area.The importance of early rehabilitation for functional outcomes is well documented. Rehabilitation needs can p...ersist far beyond the departure of EMTs; therefore, close, supportive collaboration must be established with local services. Emergency response presents an opportunity to rebuild devastated health systems and build local rehabilitation capacity. This document emphasizes the importance of aligning practices to the local context and maximizing opportunities for training and mentorship. The minimum standards and recommendations described will result in faster access of patients to rehabilitation services and equipment and a better transition between EMTs and local health facilities.
Available in English, German, Arabic, Chinese
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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 aim of this survey was to provide evidence-based recommendations to improve the overall quality of Emergency Medical Services (EMS) in Ukraine, with a special focus on the oblasts (administrative regions) of Luhansk and Donetsk. The objectives were to: describe the EMS system in Ukraine with reg...ards to its capacity, utilization and efficiency across selected geographic regions and catchment areas to assess the utilization and outcomes of current prehospital EMS care; identify perceived needs in key areas based on input from local stakeholders, including EMS providers, hospital-care providers administrative staff and patients; create an evaluation model of EMS performance; and provide recommendations for improvements to the EMS system in Ukraine.
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PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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On 6 February at 4:17 am, a 7.8 degrees magnitude earthquake struck southern Turkey near Syria’s
northern border. The US Geological Survey said the earthquake was centered about 33 km (20 miles)
from Gaziantep, a major city and provincial capital. Tremors were felt as far away as Lebanon, Greece...,
Palestine, and the island of Cyprus. Another big earthquake was felt on the same day at around 1:24
pm local time, largely in the same affected areas. Aftershocks will continue to shake the area as fault
lines adjust to such a huge initial tremor. There’s even a risk—albeit a small one—of an aftershock
bigger than the original quake.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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The first quadripartite biennial report summarizes progress in the implementation of multisectoral national action plans, actions by the quadripartite organizations, actions by the global governance structures, key environmental dimensions, highlights areas for accelerated action, and shares case st...udies from six countries. An Annex with extensive data on the global action plan’s monitoring and evaluation indicators is included. The report was developed through contributions from all 6 WHO regions, member states, various headquarters departments and units, and technical teams from FAO, WOAH and UNEP.
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The purpose of this manual is to provide guidance on how to implement Pan American Health Organization (PAHO) recommendations for malaria elimination at the local level. It is a streamlined, more operational version of the Manual for Stratifying Malaria Risk and Elimination of Foci, aimed primarily ...at operational teams working in the field. The content has been prioritized and the steps of the process organized to facilitate greater understanding by local teams. Adjustments have also been made to underscore its versatility for all malaria transmission scenarios in the Region of the Americas.
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