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The Lancet Regional Health Americas Volume 37100832 September 2024
Guía de Líderes comunitaros
The humanitarian crisis in Northeast Nigeria, driven by conflict, climate-related shocks, and food insecurity, has created immense challenges for the health sector in Borno, Adamawa, and Yobe (BAY) States. About 1.8 million people remain displaced(1), with inadequate access to healthcare services an
...
d persistent disease outbreaks, malnutrition, and mental health challenges. This strategy outlines a comprehensive localization approach to strengthen the health sector's capacity by empowering local and national actors (L/NAs) include state and local government structures to lead humanitarian responses at respective levels with minimal oversight functions.
The localization strategy aligns with the global commitments of the Grand Bargain 2.0, prioritizing equitable partnerships, capacity sharing, and resource mobilization to enhance sustainable, community-owned health systems(2). Key components include increasing the visibility and meaningful participation of L/NAs in health sector coordination, promoting direct funding to local actors, and addressing systemic barriers such as governance, leadership, capacity, and resource gaps.
The global humanitarian community made a commitment, as reflected in the Grand Bargain 2.0, to localization (3) to improve the efficiency and effectiveness of humanitarian aid. A key priority of this commitment is to empower local actors to take a leading role in delivering assistance, ultimately leading to better outcomes for affected communities. A localized health response, strengthened by partnerships, can achieve several key outcomes, including rapid response and access, community acceptance, cost-effectiveness, links to long-term development, and increased accountability to the community. Localization in health matters because it ensures sustainable and community-owned health responses.
more
The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has
...
developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
more
The document WHA70.16, adopted during the 70th World Health Assembly, outlines a global strategy for an integrated response to vector-borne diseases. It emphasizes the urgent need to strengthen national and global capacities for vector control amid rising threats such as insecticide resistance, clim
...
ate change, and the spread of vectors like mosquitoes. Member States are urged to align their national strategies with WHO’s integrated approach, improve surveillance, promote research, and ensure cross-sector and cross-border collaboration. The WHO Director-General is requested to provide technical support, promote innovation, and monitor progress, with regular updates to future World Health Assemblies.
more
With the COVID-19 pandemic and the ensuing energy and cost-of-living crises, many OECD countries have had to face significant economic and societal challenges over the last five years. The succession of crises has had important implications for health systems and the available resources allocated to
...
health. This policy brief examines the recent trends in health spending and discusses what is driving the latest spending trajectory.
more
This paper was commissioned by N´weti and Wemos as part
of the project “Equitable health financing for a strong health
system in Mozambique”. Its purpose is to contribute to the
debate of the Mozambican Ministry of Health’s draft Health
Sector Financing Strategy (HSFS) 2025 – 2034
Most foreign aid comes in one of two forms: either we pay a person or an institution today in exchange for delivering some beneficial activity in the future, or we observe something bad happen to them and then give them support to recover from it. This kind of aid is simple to design and deliver,
b
...
ut in the former case has limits in how sharply it incentivizes success and effort from a range of actors and in the latter case leads to the inefficient and undignified “begging bowl” approach to humanitarian financing. In what follows, I identify a broad family of alternative approaches, which
can loosely be grouped together as “contractually contingent financing,” and explain why they are still relatively underused.
more
The world is facing a sustainable development crisis. The 2024 Financing for Sustainable Development Report: Financing for Development at a Crossroads finds that financing challenges are at the heart of the crisis and imperil the SDGs and climate action. The window to rescue the SDGs and prevent a c
...
limate catastrophe is still open but closing rapidly. Financing gaps for sustainable development are large and growing – the estimates by international organizations and others are coalescing around $4 trillion additional investment needed annually for developing countries. This represents a more than 50% increase over the pre-pandemic estimates. Meanwhile, the finance divide has not been bridged, with developing countries paying around twice as much on average in interest on their total sovereign debt stock as developed countries. Many countries lack access to affordable finance or are in debt distress. Weak enabling environments are preventing progress. Average global growth has declined, while policy and regulatory frameworks still do not set appropriate incentives. Public budgets and spending is not fully aligned with SDGs. Private investors are not incentivised to invest enough in SDGs and climate action. The world is at a crossroads. This is the last chance to correct course if we want to achieve the SDGs by the 2030 deadline. Only an urgent, large-scale and sustainable investment push can help us achieve our global goals. Next year’s Fourth International Conference on Financing for Development in 2025 will be a once in 80-year opportunity to support coherent transformation of financing.
more
The Regional Child Protection Operational Note has been developed by IOM and UNICEF’s Regional and Country Offices in North, West and Central Africa as a collaborative inter-agency and cross-regional endeavour within the framework of the sixth phase of the IOM Regional Development and Protection P
...
rogramme (RDPP) for North Africa, a regional initiative funded by the European Union through the Directorate‑General for Migration and Home Affairs and the Italian Ministry of Interior.
more
Tuberculosis (TB) remains a significant global health challenge, with an estimated annual death rate of approximately one per 100,000 people in countries with low TB prevalence. Rapid reductions in TB cases and deaths worldwide depend on research breakthroughs, including the development of new vac
...
cines. There has recently been an increase in political commitment, as evidenced by two UN high-level meetings on TB in 2018 and 2023. The 2023 political declaration reaffirmed the goals set out in the UN Sustainable Development Goals and the WHO's End TB Strategy, and established new targets for the period 2023–2027
more
This practical document is available to support programmes and partners to design and implement risk communication strategies to achieve high uptake of malaria vaccination.
Evidence-based Malaria BCC Module 4 e-learning series.
Accessed July 2025
This guidance covers different options for banning or phasing out a pesticide and suggests related risk reduction measures to be taken during the phase-out period. A key focus of this guidance is how to take action to manage, prevent, minimize, and communicate about identified risks during the imple
...
mentation of a phase-out strategy. It contains a description of legal aspects to consider when phasing out a product and illustrates how a risk communication plan can be structured and implemented. How different stakeholders may be involved when a pesticide is going to be phased out is also described.
more
STANDARD OPERATING PROCEDURES - PREVENTION AND CARE FOR CHILD SURVIVORS
The Gaza Strip is experiencing one of the most severe food security crises globally, with the entire population of approximately 2.1 million people now facing crisis-level food insecurity or worse (IPC Phase 3+). As of May 2025, more than one in five Gazans—about
470,000 people—are at risk of s
...
tarvation (IPC Phase 5: Catastrophe), while over half are classified in Emergency (IPC Phase 4). This marks a significant deterioration compared to just one month earlier and reflects the impact of a comprehensive blockade that has
restricted all humanitarian and commercial supplies since early March. Vital goods have been depleted, food prices have skyrocketed by over 3,000 percent in some areas, and coping mechanisms have all but collapsed, forcing many to scavenge for food or go without entirely. Acute malnutrition has reached serious levels and is projected to worsen, particularly in North Gaza, Gaza, and Rafah, where critical levels are expected between May and September 2025.
more
The Gaza Strip is experiencing one of the most severe food security crises globally, with the entire population of approximately 2.1 million people now facing crisis-level food insecurity or worse (IPC Phase 3+). As of May 2025, more than one in five Gazans—about
470,000 people—are at risk of s
...
tarvation (IPC Phase 5: Catastrophe), while over half are classified in Emergency (IPC Phase 4). This marks a significant deterioration compared to just one month earlier and reflects the impact of a comprehensive blockade that has restricted all humanitarian and commercial supplies since early March. Vital goods have been depleted, food prices have skyrocketed by over 3,000 percent in some areas, and coping mechanisms have all but collapsed, forcing many to scavenge for food or go without entirely. Acute malnutrition has reached serious levels and is projected to worsen, particularly in North Gaza, Gaza, and Rafah, where critical levels are expected between May and September 2025.
more
Universal health coverage (UHC) has a central place in achieving the Sustainable Development Goals (SDGs) by 2030, as
it is a major target (3.8) under SDG 3 (Ensuring healthy lives and promote well-being for all at all ages). The World Health
Organization defines Universal Health Coverage (UHC)
...
as a means through which all people and communities can use the
promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective,
while also ensuring that the use of these services does not expose the user to financial hardship. UHC brings hope of better
health and protection for the world’s poorest.
more
he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian responses to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH servic
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es. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
more
AIDS Behav. 2022 Feb;26(2):375-384.doi: 10.1007/s10461-021-03391.
A community health worker (CHW) model can promote HIV prevention and treatment behaviors,
especially in highly mobile populations. In a fishing community in Rakai, Uganda, the Rakai
Health Sciences Program implemented a communit
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y health worker HIV intervention called Health
Scouts. The situated Information, Motivation, and Behavioral Skills (sIMB) framework informed
the design and a qualitative evaluation of the intervention. We interviewed 51 intervention
clients and coded transcripts informed by sIMB framework dimensions.
more
