Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
Health care-associated infections (HAIs) affect patients and health systems every day, causing immense suffering, driving higher health-care costs and hampering efforts to achieve high-quality care for all. HAIs are often difficult to treat, are the major driver of antimicrobial resistance (AMR) and... cause premature deaths and disability. The COVID-19 pandemic, as well as outbreaks of Ebola, Marburg and mpox are the most dramatic demonstrations of how pathogens can spread rapidly and be amplified in health care settings. But HAIs are a daily threat in every hospital and clinic, not only during epidemics and pandemics. Lack of water, sanitation and hygiene (WASH) in health care settings not only affects the application of infection prevention and control (IPC) best practices but also equity and dignity among both those providing and receiving care.
more
Relevance and effectiveness of World Bank support for public sector capacity building in Sub-Saharan Africa from 1995 to 2004. Benin is part of a six country case study.
The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Frame...work 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.
more
This updated step by step guide aims to assist the ministries of health (MoHs) in developing the national action plans for noma prevention and control, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national heal...th planning, strengthening of primary health care (PHC) and attainment of universal health coverage (UHC).
more
Cities are uniquely positioned to understand local needs and respond rapidly to changing conditions to safeguard health. These changes require strong city leadership to implement multisectoral, health-relevant policies and public services that engage communities. The response to malaria must be an i...ntegral part of such policies and processes.
This framework supports the control and elimination of malaria in urban environments. It provides guidance for city leaders, health programmes and urban planners as they respond to the challenges of rapid urbanization in a targeted way. For each urban context, the strategic use of data can inform effective, tailored responses and help build resilience against the threat of malaria and other vector-borne diseases.
more
It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral care, but can be managed in outpatient settings by an appropriately trained health worker. The guideline seeks to provide programmatic guida...nce on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
more
Joint WHO/ILO guidelines on post-exposure prophylaxis (PEP) to prevent HIV infection.
The use of Delamanid and Bedaquiline for Children with Drug-Resistant Tuberculosis.
Results and Lessons Learned from CapacityPlus 2009-2015
In contrast to bilateral aid, aid disbursed from
multilateral institutions increased significantly at the onset
of the COVID-19 pandemic. Yet, at a time when a coherent
and effective multilateral response is needed most, the
COVID-19 pandemic revealed a shifting landscape of donor
agencies that... struggle with basic functions, such as crossnational coordination. While multilaterals are uniquely
positioned to transcend national priorities and respond
to pandemics, functionally we find official development
assistance (ODA) from these entities may increasingly
mimic the attributes of bilateral aid. We explore three
important, but not comprehensive, attributes of aid leading
up to and during the COVID-19 pandemic: (1) earmarking,
(2) donor concentration and (3) aid modality.
more
This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th...e health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
more