The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides a framework to inform the exercise of the new essential functions. The th...ird section proposes a new integrated approach for implementing the EPHFs. The fourth section presents a new list of 11 EPHFs related to each stage of this integrated approach. Finally, in the last section, considerations are put forth to guide EPHF implementation as a means of strengthening the health sector.
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Este artículo analiza un grupo particularmente vulnerable a la pandemia de la COVID-2019: las personas privadas de libertad (PPLs). Con base en el análisis del Censo Carcelario de 2019, presentamos la situación actual de las PPLs y las condiciones de los establecimient...os penitenciarios de Bolivia, con énfasis en los aspectos que impactan en la salud. Posteriormente, identificamos los principales factores estructurales detrás de la mayor vulnerabilidad epidemiológica y sanitaria de las PPLs, no solo a la COVID-2019, sino a epidemias en general. Diferentes instituciones involucradas en el combate de la pandemia desarrollaron recomendaciones para su prevención y tratamiento en contextos carcelarios. Considerando estas recomendaciones y los datos de la situación de las PPLs de Bolivia, desarrollamos propuestas de reformas políticas y legales para reducir la vulnerabilidad epidemiológica de esta población. Argumentamos que, mientras algunas son sencillas de implementar, muchas se enfrentan a obstáculos estructurales para su ejecución, demandando reformas profundas en la política carcelaria y el sistema penal.
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27 May 2021
This is a document to support the use of pulse oximeter for assessment of suspected and confirmed cases of Covid-19 in the community.
It is a well-known fact that Covid-19 can present as “happy hypoxia” with minimum symptoms of severe respiratory distress despite significant low ox...ygen levels in the blood. The use of pulse oximeter for clinical assessment significantly augments decision making, save lives and provide high quality care. It allows for early detection of patients with hypoxia requiring either close monitoring in the community or timely referral for hospital care.
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Posters & Infographics on different topics, i.e: vaccination, people with high risk of severe Covid-19, for families, work, school, hand hygiene, care at home, public transport
orientaciones provisionales, 14 de junio de 2021
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Considerations on the implementation and adjustment of
public health and social measures in the context of
COVID-19
Interim guidance 14 June 2021
Covid-19 Epidemiological Surveillance Guide: Public Health Emergency of National Importance for Coronavirus Disease 2019 - version 4
Why does WHO consider air pollution a public health emergency? If you live in highly polluted areas does COVID-19 affect you differently? WHO’s Dr Maria Neira explains in Science in 5.
Este documento apresenta um marco conceitual renovado das funções essenciais de saúde pública (FESP) para a Região das Américas, com o qual se pretende dar maior clareza conceitual e operacionalidade ao novo campo de atuação da saúde pública e preencher uma lacuna nas propostas conceituais... sobre o fortalecimento dos sistemas de saúde. O marco proposto apresenta um novo paradigma para a saúde pública, baseado em quatro pilares orientados para a ação: a necessidade de incorporar a abordagem dos direitos humanos às políticas públicas de saúde; a necessidade de a saúde pública ampliar seu enfoque para ter uma abordagem mais ampla dos determinantes sociais da saúde; o papel da saúde pública para garantir de forma integral e integrada o acesso a intervenções de base populacional e atenção individual de qualidade; e a necessidade de as autoridades de saúde atuarem em colaboração com outros setores e com a sociedade civil no desempenho das funções de saúde pública.
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Civil disorder, authority credibility and public health: Chile’s unique sociopolitical
context in dealing with COVID-19.
In the light of the transmissibility of coronaviruses, and the global experience with MERS-CoV (ongoing) and SARS in 2003 which were also caused by coronaviruses, South African authorities have compiled this guideline document to support surveillance, case finding, diagnosis, management and public h...ealth responses to cases under investigation.
*Please note*
The interim guidelines are based on what is currently known about the Coronavirus Disease 2019 (COVID-19). The National Department of Health (NDOH) and National Institute for Communicable Diseases will update these interim guidelines as needed and as additional information becomes available.
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More countries eliminate human African trypanosomiasis as a public health problem: Benin and Uganda (gambiense form) and Rwanda (rhodesiense form)
Human African trypanosomiasis (HAT), or sleeping sickness, transmitted by tsetse flies in sub-Saharan Africa, is a life-threatening disease that afflict...s poor rural populations. It is caused by trypanosome parasites of 2 subspecies: Trypanosoma brucei gambiense in West and Central Africa, and T. b. rhodesiense in East Africa.
HAT transmission can be reduced and interrupted by deploying and maintaining capacities for testing people at risk in order to detect and treat cases, and by controlling tsetse populations that are in contact with humans.
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American trypanosomiasis, commonly called
Chagas disease (CD), was prevalent once in rural areas
of Latin America where poverty is widespread and was
considered a silent and poorly visible disease. It
has become a global neglected tropical disease and a
significant public health th...reat worldwide due to
globalization over last century. More recently, it has
attracted much more attention, and “April 14” has
been designated as “World Chagas Disease Day” by
the World Health Assembly of 2019 to raise
awareness of the disease as a neglected tropical disease,
to improve the rates of early treatment and recovery,
and to achieve the ambitious goal to interrupt its
transmission.
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Leishmaniasis is a major vector-borne disease caused by obligate intramacrophage protozoa of the genus Leishmania, and transmitted by the bite of phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia, in the old and new worlds, respectively. Among 20 well-recognized Leishmania speci...es known to infect humans, 18 have zoonotic nature, which include agents of visceral, cutaneous, and mucocutaneous forms of the disease, in both the old and new worlds. Currently, leishmaniasis show a wider geographic distribution and increased global incidence. Environmental, demographic and human behaviors contribute to the changing landscape for zoonotic cutaneous and visceral leishmaniasis. The primary reservoir hosts of Leishmania are sylvatic mammals such as forest rodents, hyraxes and wild canids, and dogs are the most important species among domesticated animals in the epidemiology of this disease. These parasites have two basic life cycle stages: one extracellular stage within the invertebrate host (phlebotomine sand fly), and one intracellular stage within a vertebrate host. Co-infection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms and more difficult to manage. The disease is endemic to Ethiopia, and the clinical signs are not pathognomic. The visceral form (Kala-azar) may be confused with other similar conditions such as malaria, tropical splenomegaly, schistosomiasis, milliary tuberculosis, and brucellosis. Similarly, cutaneous leishmaniasis should be differentiated from disease like tropical ulcers, impetigo and leprosy. There are several methods of laboratory diagnosis of leishmaniasis, including parasitological, immunological and molecular. Different forms of treatments are available including oral, parenteral, and topical medications such as pentavalent antimonials, liposomal amphotericin B, miltefosine and paromomycin. Methods of control are largely limited to destruction of animal reservoirs, treatment of infected humans, and management of sand fly populations. Development of an effective vaccine against leishmaniasis has been largely unsuccessful and hinders its prevention.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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Cervical cancer continues to be a significant public health problem and a major cause of premature mortality among women, disproportionately affecting the socioeconomically disadvantaged population in low- and middle-income countries (LMICs). In the absence of implementing the known evidence-based, ...cost-effective interventions, the number of deaths per year is projected to reach approximately 416 000 globally in 2035. It was estimated in 2020 that 32% of incident cervical cancer cases and 34% of cervical cancer deaths in the world occurred in the 11 Member States of the WHO South-East Asia (SEA) Region. In 2020, 190 874 new cases and 116 015 deaths were estimated due to cervical cancer, which is the third commonest cancer in the Region
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage presents a complete analysis of the resources available for health in 184 countries, with a particular focus on development assistance for health (DAH). DAH was estim...ated to total $37.6 billion in 2016, up 0.1% from 2015. After a decade of rapid growth from 2000 to 2010 (up 11.4% annually), DAH grew at only 1.8% annually between 2010 and 2016. In low-income countries, where much DAH is targeted, DAH made up 34.6% of total health spending in 2016. In upper-middle- and high-income countries, which generally do not receive DAH, DAH accounted for only 0.5% of total health spending. The other 99.5% of health spending – government, prepaid private, and out-of-pocket spending – is the subject of our further analysis.
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