Technical Note on Antimicrobial Resistance
This document reflects UNICEF’s response to the growing global threat of AMR to child survival, growth and development. It identifies UNICEF’s AMR-specific and AMR-sensitive actions in reducing infections, promoting access to and optimal use of antimic...robials, and increasing AMR awareness and understanding. Of particular relevance to this group, UNICEF country offices are directed to provide technical support for development and implementation of national AMR action plans, linking them as appropriate to maternal, newborn and child health programmes and ensuring these are prioritized in both surveillance and policy changes. The guidance note on AMR is intended to inform UNICEF’s AMR-related internal initiatives, programming and activities, as well as external engagements with governments and other stakeholders.
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This toolkit consists of eight modules which have been prepared as stand-alone documents that can be read by themselves, but they have also been prepared to complement one another. It has been designed as a tool for health professionals and students in the health care and public health sectors who ...want to engage more directly on the issue of climate change as educators with their patients, peers and communities, and/or as advocates for the policies, programs and practices needed to mitigate climate change and/or prepare for climate change in their workplaces and communities
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The scale of West Africa’s Ebola epidemic has been attributed to the weak health systems of affected countries,
their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This briefing for African Affairs argues that these explanations lack important contex...t. The briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. To move past technical discussions of “weak” health systems, it highlights how structural violence has contributed to the epidemic. As part of this, local people – their beliefs, concerns and priorities – have been marginalised. Both the crisis response and post-Ebola ‘reconstruction’ will be strengthened by acknowledgment of its long term structural underpinnings and from a more collaborative inclusion of local people.
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The World Health Organization (WHO) endorses the use of population-based prevalence surveys for estimating the prevalence of trachoma. In general, the prevalence of TF in children aged 1–9 years and the prevalence of TT in adults aged ≥ 15 years are measured at the same time in any district bein...g surveyed. This was the approach of the Global Trachoma Mapping Project, which undertook baseline surveys in > 1500 districts worldwide in order to provide the data required to start interventions where needed.
The survey design recommended by WHO is a two-stage cluster random sample survey, which uses probability proportional to size sampling to select 20–30 villages, and random, systematic or quasi-random sampling to select 25–30 households in each of those villages. In most surveys, everyone aged ≥ 1 year living in selected households is examined.
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Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The quality of prescribing depends mostly on those prescribers belonging to clinical medical specialties... having direct contact with patients. These doctors, who comprise the majority of antibiotic prescribers,undergo long-term undergraduate and postgraduate training that shapes their professional knowledge and behaviour
J Antimicrob Chemother2019;74: 3611–3618doi:10.1093/jac/dkz375 Advance Access publication 3 September 2019
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The COVID-19 pandemic has exposed the inadequacy of investments in public health, the persistence of profound economic and social inequalities and the fragility of many key global systems and approaches.
The growing understanding of how sequence information can contribute to improved public health is driving global investments in sequencing facilities and programmes. The falling cost and complexity of generating GSD provides opportunities for expanding sequencing capacity; however, challenges to wid...espread implementation remain. This document provides policy-makers and stakeholders with guidance on how to maximize the public health benefit of SARS-CoV-2 genomic sequencing activities in the short and long term as the pandemic continues to unfold. Practical considerations for the implementation of a virus genomic sequencing programme and an overview of the public health objectives of genomic sequencing are covered. This guidance focuses on SARS-CoV-2 but is applicable to other pathogens of public health concern.
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The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis in health systems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed ...in light of the increasing evidence of climate change and its associated health risks (1); global, regional and national policy mandates to protect population health (2); and a rapidly emerging body of practical experience in building health resilience to climate change (3).
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Burns are a global public health problem, accounting for close to 200,000 deaths annually. The majority of these occur in low- and middle-income countries, where a number of constraints complicate the public health task of addressing burns. While the primary prevention of burns in low- and middle-in...come countries is a pressing need, the World Health Organization (WHO) also actively encourages further development of burn-care systems, including the training of health-care providers in the appropriate triage and management of people with burns.
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Global Health Science and Practice February 2022, https://doi.org/10.9745/GHSP-D-21-00237
Key Findings: Exposure to vaccination information from faith leaders and health facilities was associated with increased likelihood of vaccination uptake. The significant association between exposure to a... greater number of immunization information sources and increased likelihood of vaccination uptake reinforces the need for multiple sources to provide consistent and accurate immunization information to facilitate positive vaccination behavior.
Key Implications: Social and behavior change communication interventions may optimize the promotion of immunization services through multiple information sources such as health facilities and community-based assets including faith leaders and lay community health workers. Religion and faith play an important role in how people understand health and make health decisions. In Sierra Leone and other similar settings, interventions to improve uptake of immunization services may be enhanced by proactively engaging faith leaders.
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Cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancers, and other non-communicable diseases are among the leading causes of morbidity and mortality in low-income, middle-income, and high-income countries, and The Lancet Taskforce recently made the case for investing in non-...communicable disease prevention. Now, in The Lancet Planetary Health, Benjamin Bowe and colleagues report that exposure to PM2·5 air pollution is indeed a risk factor for diabetes.
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Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change. ...Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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During the first year of the Covid-19 pandemic, the world’s economy slowed. Yet, the global annual average particulate pollution (PM2.5) was largely unchanged from 2019 levels. At the same time, growing evidence shows air pollution—even when experienced at very low levels—hurts human health. T...his recently led the World Health Organization (WHO) to revise its guideline for what it considers a safe level of exposure of particulate pollution, bringing most of the world—97.3 percent of the global population—into the unsafe zone. The AQLI finds that particulate air pollution takes 2.2 years off global average life expectancy, or a combined 17 billion life-years, relative to a world that met the WHO guideline. This impact on life expectancy is comparable to that of smoking, more than three times that of alcohol use and unsafe water, six times that of HIV/AIDS, and 89 times that of conflict and terrorism.
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Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this condition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized ...as a disease by the American Medical Association and World Health Organization,
based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and
control of obesity would have a great impact in our society.
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Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD...) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT ...control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
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Background: One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public... is deficient. This study was therefore designed to assess the current level of awareness and knowledge of the Nigerian public of AMR.
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The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on... aid targeting reproductive, maternal, newborn, and child health (RMNCH). We take a multi-sectoral approach and extend the estimation to the four sectors that determine child survival: health (RMNCH and non-RMNCH), education, water and sanitation, and food and humanitarian assistance (Food/HA). Methods and findings: Using donor reported data, obtained mainly from the OECD Creditor Reporting System and Development Assistance Committee, we tracked the level and trends of aid (in grants or loans) disbursed to each of the four sectors at the global, regional, and country levels. We performed detailed analyses on missing data and conducted imputation with various methods. To identify aid projects for RMNCH, we developed an identification strategy that combined keyword searches and manual coding. To quantify aid for RMNCH in projects with multiple purposes, we adopted an integrated approach and produced the lower and upper bounds of estimates for RMNCH, so as to avoid making assumptions or using weak evidence for allocation. We checked the sensitivity of trends to the estimation methods and compared our estimates to that produced by other studies. Our study yielded time-series and recipient-specific annual estimates of aid disbursed to each sector, as well as their lower- and upper-bounds in 134 countries between 2000 and 2014, with a specific focus on Countdown countries. We found that the upper-bound estimates of total aid disbursed to the four sectors in 134 countries rose from US$ 22.62 billion in 2000 to US$ 59.29 billion in
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Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how a...id flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases. MethodsandFindings:We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development’s Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of ‘‘stillbirth’’ and only nine references were found to ‘‘fetus’’ in any spelling variant or language
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To better adapt current case management practices and address excess mortality in otherwise treatable
cases will require better knowledge of the demographic characteristics of the patients and comorbidities
which can make severe dehydration harder to tolerate physiologically. With this in mind, a ...scoping review
was undertaken, to explore the literature and summarise the existing evidence on cholera mortality and
reported risk factors.
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