In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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L'importance de systèmes de surveillance de la mortalité robustes ne peut être surestimée à une époque marquée par des défis sanitaires mondiaux croissants, où les menaces sanitaires pèsent lourd et la dynamique des populations continue d'évoluer. Des données précises et opportunes sur ...la mortalité sont essentielles pour identifier les tendances et détecter les menaces émergentes pour la santé, évaluer l'impact des interventions et orienter les décisions politiques fondées sur des données probantes.
Ce cadre décrit une approche holistique pour renforcer les systèmes de surveillance de routine de la mortalité, en tenant compte des facteurs contextuels uniques et des défis auxquels sont confrontés les pays africains. Il souligne l'importance d'établir des mécanismes de collecte de données efficaces, d'améliorer la qualité et l'exhaustivité des données et de promouvoir le partage des données et la collaboration entre les parties prenantes.
De plus, le cadre reconnaît le rôle central de la technologie dans l'intégration des données provenant de sources de données fragmentées sur la mortalité. Il met en évidence le potentiel des méthodes innovantes de capture de données, des analyses avancées et des systèmes de notification en temps réel pour améliorer la précision, l'efficacité et l'actualité des données sur la mortalité.
Le cadre continental de surveillance de la mortalité s'aligne sur la mission et l'objectif stratégique d'Africa CDC en servant d'élément fondamental dans le renforcement des systèmes de santé publique, l'amélioration des capacités et des capacités de surveillance des maladies, l'élaboration de politiques et d'interventions fondées sur des données probantes et la promotion de la collaboration et de la coordination entre les pays africains pour relever les défis sanitaires et améliorer les résultats sanitaires sur le continent.
La mise en œuvre réussie de ce cadre nécessite un engagement collectif et des efforts concertés de la part des gouvernements, des établissements de santé et de la communauté internationale. Nous espérons que ce document servira de catalyseur pour un changement transformateur, permettant aux pays de mettre en place des systèmes de surveillance de la mortalité résilients qui protègent la santé publique, sauvent des vies et contribuent à la prise de décision fondée sur des données probantes.
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The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that l...ack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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A WHO Guideline for Emergency Risk Communication (ERC) policy and practice.
Recent public health emergencies, such as the Ebola virus disease outbreak in West Africa (2014–2015), the emergence of the Zika virus syndrome in 2015–2016 and multi-country yellow fever outbreaks in Africa in 2016, h...ave highlighted major challenges and gaps in how risk is communicated during epidemics and other health emergencies. The challenges include the rapid transformation in communications technology, including the near-universal penetration of mobile telephones, the widespread use and increasingly powerful influence of digital media which has had an impact on ‘traditional’ media (newspapers, radio and television), and major changes in how people access and trust health information. Important gaps include considerations of context – the social, economic, political and cultural factors influencing people’s perception of risk and their risk-reduction behaviours.
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This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and ...how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
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Loss and damage is an urgent concern, driven by the increasingly harmful effects of climate change. Communities are experiencing new types and forms of climate impact, of higher frequency and intensity, which they are not equipped to handle. These impacts compel vulnerable communities to migrate to ...find alternative livelihoods and ways to survive. But migration generates grave socioeconomic consequences. Through case study analysis from 12 regions in Asia, Africa and the Pacific, this paper explores how climate change-induced migration is creating physical health, mental health and wellbeing issues — both for migrants and the families they leave behind. It then provides recommendations to policymakers on how to strengthen policy, planning and response frameworks to support communities manage health and wellbeing risks created by climate impacts.
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HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination...; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
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The health and socioeconomic crisis triggered by the COVID-19 pandemic has hit the countries of Latin America hard and laid bare the profound inequities about which numerous international, regional and national reports have sounded warnings in recent decades. In this context, the historical politica...l and economic exclusion and marginalization of the more than 800 indigenous peoples in the region has been accentuated as a result of insufficient State responses to the crisis, which have not adequately considered the collective rights of these peoples and have had little cultural relevance.
This document provides an overview of the situation of indigenous peoples in the region in the face of the COVID-19 pandemic. It analyses both the State’s and indigenous peoples’ own responses to the crisis, as well as offering a set of recommendations to rectify the neglect of these peoples in the management of the pandemic, centring on their collective rights.
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This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), which is funded by USAID and based at the Johns Hopkins Center for Communication Programs, offers structured guidance for improving social and behavioural change communication (SBCC) strategies relat...ed to malaria in pregnancy (MiP). Designed for programme managers and stakeholders, the toolkit addresses critical communication gaps in MiP programming, particularly among service providers. It provides tools to help users integrate MiP into situation analyses, segment audiences, define behavioural objectives and draft strategic communication plans.
MiP poses a significant public health challenge, contributing to maternal and neonatal mortality and morbidity in sub-Saharan Africa. Although effective interventions exist, such as the use of insecticide-treated nets, intermittent preventive treatment in pregnancy (IPTp) and timely diagnosis and treatment, their implementation remains inconsistent. The I-Kit supports more effective SBCC planning and implementation, with the aim of increasing the uptake and impact of these interventions and ultimately reducing malaria-related deaths and illness among pregnant women and newborns.
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Offering additional pre-exposure prophylaxis (PrEP) choices has the potential to increase uptake and effective use of PrEP, and of HIV prevention overall, as it allows people to choose a method that they prefer.
In this guideline, WHO recommends an offering long-acting injectable lenacapavir (LEN...) as an additional HIV prevention choice, as part of combination HIV prevention approaches. LEN, administered twice a year as PrEP, has been shown to be highly effective at reducing the risk of HIV acquisition. In this guideline, WHO also recommends using HIV rapid diagnostic tests (RDTs) for individuals initiating or continuing long-acting injectable PrEP, such as LEN and long acting injectable cabotegravir (CAB-LA). Flexible HIV testing approaches are essential for ensuring that testing does not become a barrier to accessing or continuing PrEP, including long-acting injectable options.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to:
Consider... the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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The WHO End TB Strategy aims to end the global TB epidemic by 2030, in alignment with Goal 3 of the United Nations (UN) Sustainable Development Goals (SDGs). Member States of the World Health Organization (WHO) and the UN committed to ending the TB epidemic through adoption of WHO’s End TB Strateg...y and the UN SDGs in 2014 and 2015, respectivel
Almost half of the deaths worldwide caused by TB in 2019 occurred in the WHO South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this Region is therefore essential if the global goal of ending the TB epidemic is to be realized. Despite substantial gains made in the Region, the threat to
health worldwide posed by the COVID-19 pandemic has the potential to reverse these gains and eclipse the focus on the global TB emergency.
While continuing to tackle COVID-19-related challenges, countries will need to rapidly and urgently deploy supplementary measures to address the large numbers of missed cases, poor treatment outcomes and, potentially, a higher TB burden.
The Regional Strategic Plan towards Ending TB in the Region 2021–2025 clearly articulates priority interventions, analyses the challenges, bottlenecks and opportunities, and focuses on implementation considerations in the Region.
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This study examines the gendered impacts of the Ebola virus disease (EVD) in Liberia in the largest outbreak of EVD ever recorded. The findings are based on an extensive two-week desk study and one-week participatory field study conducted in January 2015 in the cities of Monrovia and Buchanan in Lib...eria
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Le secteur de la santé et des soins constitue une source d’emploi considérable dans le monde, en particulier pour les femmes. Les personnels de santé et d’aide à la personne représentent environ 3,4 % de la population active mondiale, notamment quelque 10 % dans les pays à revenu élevé e...t un peu plus de 1 % dans les pays à revenu faible ou intermédiaire. Partout dans le monde, ce secteur est hautement féminisé – les femmes y représentent environ 67 % des travailleurs à l’échelle mondiale – et connaît un degré significatif de ségrégation professionnelle entre femmes et hommes. Cependant, la part des femmes dans la population active du secteur varie selon le degré de développement économique. Dans les pays à revenu faible ou intermédiaire, les femmes représentent 63,8 % de la population active du secteur, contre 75,3 % dans les pays à revenu élevé. Les estimations figurant dans le présent rapport montrent que le haut degré de féminisation du secteur est universel, à la fois au niveau des pays et des régions. Les pays où une plus grande part de femmes travaille dans le secteur n’ont pas nécessairement des dépenses plus élevées en matière de santé et de soins.
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Internally displaced children are twice invisible in global and national data. First, because internally displaced people (IDPs) of all ages are often unaccounted for. Second, because age-disaggregation of any kind of data is limited, and even more so for IDPs.
Planning adequate responses to meet... the needs of internally displaced children, however, requires having at least a sense of how many there are and where they are. This report presents the first estimates of the number of children living in internal displacement triggered by conflict and violence at the global, regional and national levels.
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La question des effets du changement climatique sur les hommes et les femmes a été définie par la Commission de la condition de la femme comme une de celles qui doivent davantage retenir l’attention. Les normes, rôles et relations relatifs au genre (voir l’Encadré 1) sont d’importants fac...teurs déterminant la vulnérabilité et la capacité d’adaptation aux effets du changement climatique sur la santé (voir l’Encadré 2). Les femmes et les hommes sont vulnérables face aux effets des événements climatiques extrêmes non seulement du point de vue biologique, mais aussi du fait de leurs rôles et responsabilités sociaux distincts (Easterling, 2000 ; Wisner et al., 2004) qui peuvent varier mais se retrouvent dans toutes les sociétés. Les femmes doivent souvent supporter des charges supplémentaires en cas d’événements climatiques extrêmes du fait des rôles et responsabilités qu’elles sont censées assumer en s’occupant de la famille, alors que les hommes de leur côté supporteront des charges supplémentaires du fait de leur rôle économique.
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