Chaque année dans le monde, plus de 500 000 femmes et filles meurent suite aux complications imputables à la
grossesse et à l’accouchement. Plus de 99% de ces décès surviennent dans des pays comme le Bénin. Et pourtant les
décès maternels ne racontent qu’une partie de la vérité. En e...ffet, pour chaque femme ou fille qui meurt de causes
imputables à la grossesse, il existe environ 20 à 30 en plus qui souffriront d’invalidités à court et à long termes,
telles que les fistules obstétricales, les ruptures utérines ou salpingite
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The objective of this study is to analyze the strengths, weaknesses, sustainability, and impact of the tsunami response in Sri Lanka and Indonesia 10 years later. A cross cutting theme of this study is the assessment of whether communities are now better prepared to respond to and cope with disaster....
Three key lessons for the future of humanitarian response are highlighted:
Lesson 1: Participation is the cornerstone of humanitarian response and recovery;
Lesson 2: Partnership as a prerequisite for long-term change;
Lesson 3: Creating momentum for risk reduction.
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state that efficiency measurement can be a substantial contribution to saving lives. Therefore we analyse the performance of health centres in rural Burkina F...aso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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Journal of Biosocial Science / Volume 34 / Issue 04 / October 2002, pp 525 - 539
DOI: DOI:10.1017/S0021932002005254, Published online: 24 September 2002
This paper examines determinants of one aspect of sexual behaviour – coital frequency – among 2188 married women in the Central African Re...public using a secondary analysis of data from the Demographic and Health Survey of 1994–95. Female genital cutting (or circumcision) is practised in the Central African Republic and self-reported circumcision status was included in the questionnaire enabling it to be examined as a possible determinant of coital frequency. Multiple logistic regression was used to find a subset of factors independently associated with coital frequency.
Decreased coital frequency was found in those who had longer duration of marriage, those who were not the most recent wife in a polygamous marriage and those who had more surviving children. Coital frequency was higher in more educated women and those not contracepting because they wanted to get pregnant. After adjusting for confounders no association between
female genital cutting and coital frequency was found. The extent to which women can control coital frequency in this culture is not known and fertility desires may override any negative effects of circumcision on sexual pleasure.
It was therefore not possible to draw conclusions about how female genital cutting affects a woman’s desire for sexual intercourse and consequently there is a need to develop research methods further to investigate this question.
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Over the ages, human societies have altered local ecosystems and modified regional climates. Today the human influence has attained a global scale. This reflects the recent rapid increase in population size, energy consumption, intensity of land use, international trade and travel, and other human a...ctivities. These global changes have heightened awareness that the long-term good health of populations depends on the continued stability of biosphere's ecological, physical and socioeconomic systems.
The world's climate system is an integral part of the complex of life-supporting processes. Like other large systems, the global climate system is coming under pressure from human activities.
This book seeks to describe the context and process of global climate change, its actual or likely impacts on health, and how human societies and their governments should respond with particular focus on the health sector.
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Neglected tropical diseases (NTDs) are targeted for global control or elimination. Recognising that the populations most in need of medicines to target NTDs are those least able to support and sustain them financially, the pharmaceutical industry created mechanisms for donating medicines and experti...se to affected countries through partnerships with the WHO, development agencies, non-governmental organisations and philanthropic donors. In the last 30 y, companies have established programmes to donate 17 different medicines to overcome the burden of NTDs. Billions of tablets, capsules, intravenous and oral solutions have been donated, along with the manufacturing, supply chains and research necessary to support these efforts. Industry engagement has stimulated other donors to support NTDs with funds and oversight so that the ‘heath benefit’ return on investment in these programmes is truly a ‘best value in public health’. Many current donations are ‘open-ended’, promising support as long as necessary to achieve defined health targets. Extraordinary global health advances have been made in filariasis, onchocerciasis, trachoma, trypanosomiasis, leishmaniasis, schistosomiasis, intestinal parasites and others; and these advances are taking place in the context of strengthening health systems and meeting the global development goals espoused by the WHO. The pharmaceutical manufacturers, already strong collaborators in initiating or supporting these disease-targeted programmes, have committed to continuing their partnership roles in striving to meet the targets of the WHO’s new NTD roadmap to 2030.
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This document provides technical guidance on concepts, definitions, indicators, criteria, milestones and tools to assist leprosy programmes in their journey towards the goals of interruption of transmission and elimination of leprosy disease and through the post-elimination period. Importantly, it p...rovides criteria with benchmarks, where possible, for all key aspects of leprosy programmes and services. Not only those related to elimination efforts, but also those related to diagnosis and management of leprosy, leprosy-related disabilities, mental wellbeing, stigma and discrimination and inclusion and participation of persons affected by leprosy. The document emphasises that the elimination of leprosy is a long-term, continuous journey on the one hand, while, on the other, clear milestones can be recognised on the way and programme implementation can be assessed against benchmarks, guiding appropriate action to keep the programme on track.
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The thirty-seventh meeting of the Programme, Budget and Administration Committee was held in Geneva from 25 to 27 January 2023 and chaired by Ms Aishath Rishmee (Maldives). The Committee adopted its agenda and agreed its programme of work. In his opening remarks, the Director-General emphasized the ...crucial work on the financial future of the Organization, most significantly implementation of the Programme budget 2022−2023 and development of the Proposed programme budget 2024−2025, which would be the first to benefit from the agreed increase in assessed contributions. He welcomed the work of the Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance with its recommendations for long-term improvements in reform, prevention of and response to sexual abuse and harassment, new web-based information portals and a new replenishment process for consideration by Member States. Efforts were also under way to improve impact at country level, and he would continue to report to Member States on progress. He was heading an agile, proactive and fast-responding WHO, committed to implementing plans approved by Member States.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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Epidemics and pandemics of infectious diseases are occurring more often, and spreading faster and further than ever, in many different regions of the world. The background factors of this threat are biological, environmental and lifestyle changes, among others. A potentially fatal combination of new...ly-discovered diseases, and the re-emergence of many long-established ones, demands urgent responses in all countries. Planning and preparation for epidemic prevention and control are essential. The purpose of the Managing epidemics handbook is to provide expert guidance on those responses. Building on the first edition, the second edition provides concise and basic up-to-date knowledge with which public health officials can respond effectively and rapidly at the very start of an outbreak. Part I of the handbook provides insights on epidemics of the 21st century and offers context on the upsurge of recent epidemics. Part II has been updated and offers 10 key facts about 19 deadly diseases including tips on the interventions required to respond. Part III presents various Tool boxes that summarize guidance on several important topics. The handbook focuses on practical and indispensable things to know about infectious diseases that are most important for national, political and operational decision-makers; it also links readers to more exhaustive WHO guidan
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Epidemics and pandemics of infectious diseases are occurring more often, and spreading faster and further than ever, in many different regions of the world. The background factors of this threat are biological, environmental and lifestyle changes, among others. A potentially fatal combination of new...ly-discovered diseases, and the re-emergence of many long-established ones, demands urgent responses in all countries. Planning and preparation for epidemic prevention and control are essential. The purpose of the Managing epidemics handbook is to provide expert guidance on those responses. Building on the first edition, the second edition provides concise and basic up-to-date knowledge with which public health officials can respond effectively and rapidly at the very start of an outbreak. Part I of the handbook provides insights on epidemics of the 21st century and offers context on the upsurge of recent epidemics. Part II has been updated and offers 10 key facts about 19 deadly diseases including tips on the interventions required to respond. Part III presents various Tool boxes that summarize guidance on several important topics. The handbook focuses on practical and indispensable things to know about infectious diseases that are most important for national, political and operational decision-makers; it also links readers to more exhaustive WHO guidan
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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-income countries (LMICs), at least 1 of these components is often missing, res...ulting 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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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall...y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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Volume 3, Cancer, presents the complex patterns of cancer incidence and death around the world and evidence on effective and cost-effective ways to control cancers. The DCP3 evaluation of cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packa...ges that are cost-effective and suited to low-resource settings. Main messages from the volume include:
-Quality matters in all aspects of cancer treatment and palliation.
-Cancer registries that track incidence, mortality, and survival paired with systems to capture causes of death are important to understanding the national cancer burden and the effect of interventions over time.
-Effective interventions exist at a range of prices. Adopting ‘resource appropriate’ measures which allow the most effective treatment for the greatest number of people will be advantageous to countries.
-Prioritizing resources toward early stage and curable cancers is likely to have the greatest health impact in low income settings.
-Research prioritization is no longer just a global responsibility.
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The webpage from the Pan American Health Organization (PAHO) discusses the heightened risk that individuals with noncommunicable diseases (NCDs)—such as cardiovascular diseases, diabetes, and cancer—face regarding severe illness and mortality from COVID-19. It emphasizes the necessity of informi...ng the public about these health risks and adapting healthcare services to ensure the continuity of essential NCD care during the pandemic. The page provides information and guidance for healthcare providers and the public on managing NCDs in the context of COVID-19, highlighting the importance of addressing NCDs and their risk factors with a medium- to long-term perspective.
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The webpage from the Pan American Health Organization (PAHO) discusses the heightened risk that individuals with noncommunicable diseases (NCDs)—such as cardiovascular diseases, diabetes, and cancer—face regarding severe illness and mortality from COVID-19. It emphasizes the necessity of informi...ng the public about these health risks and adapting healthcare services to ensure the continuity of essential NCD care during the pandemic. The page provides information and guidance for healthcare providers and the public on managing NCDs in the context of COVID-19, highlighting the importance of addressing NCDs and their risk factors with a medium- to long-term perspective.
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An essential component of the return process is counselling, which aims to support counselling beneficiaries to make an informed decision on their future migration pathways. Counselling provides the space for migrants to exert their agency, supports them to prepare for return and positively contr...ibutes to their reintegration in countries of origin. The question of how to prepare and provide return counselling is of significant concern for all actors involved in the return process itself, but until
now very little has been done to offer a standardized approach to return counselling. The Return Counselling Toolkit intends to address this question and proposes a rights-based and migrant-centred approach to return counselling, which builds upon
IOM standards and the Organization’s long-standing experience in providing return and reintegration counselling to thousands of migrants every year, in a multiplicity of countries and contexts.
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The document titled "Use of Non-Sugar Sweeteners: WHO Guideline" provides recommendations from the World Health Organization on the use of non-sugar sweeteners (NSS) to reduce sugar intake, manage weight, and prevent diet-related noncommunicable diseases (NCDs). It discusses the potential effects of... NSS on body weight, blood sugar control, and long-term health risks such as type 2 diabetes and cardiovascular disease. The guideline highlights limited evidence on the benefits of NSS for weight control and raises concerns about possible health risks with long-term use, leading WHO to suggest limiting NSS consumption as a preventive health measure.
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Over 90% of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) and asthma occurs in low-income and middle-income countries (LMICs) due to well documented factors including decreased access to screening, trained health professionals, and therapies for disease manageme...nt. Inhaler therapy (eg, aerosolised medications by inhalation, nebulisation, or propellant) is the mainstay of treatment for COPD and asthma. Adherence to maintenance medications for COPD and asthma results in improved lung function and quality of life, as well as decreased hospitalisation and mortality. WHO have included short-acting beta-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids on the essential medications list, with a target goal of achieving 80% availability of these medications in public and private facilities. However, despite these efforts, accessibility, and affordability of medications for COPD and asthma remains scarce.
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Antimicrobials are medicines, including antibiotics, antivirals, antifungals, and antiparasitics, that are used to prevent and treat infections in humans, animals, and plants. Antimicrobial Resistance (AMR) arises when bacteria, viruses, fungi, and parasites no longer respond to these medicines, ren...dering them ineffective and making infections more difficult to treat. This resistance increases the risk of disease spread, severe illness, disability, and death. Although AMR is a natural phenomenon driven by genetic
changes in pathogens, it is significantly accelerated by human activities such as the misuse and overuse of antimicrobials in healthcare, agriculture, and animal husbandry.
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