The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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Depuis plus de trois décennies, le Bénin a souscrit à l’approche des soins de santé primaires
telle que définie à la conférence d’Alma-Ata (1978) et renforcée par l’Initiative de Bamako
(1987). Le pays a mis en oeuvre diverses expériences de soins de santé au niveau
communautaire ...avec l’appui des Partenaires Techniques et Financiers (PTF) et la
participation des Organisations Non Gouvernementales (ONG) et les Organisations
Communautaires de Base (OCB). Celles-ci ont contribué à l’amélioration de l’offre des
services de santé, malgré l’absence d’une politique coordonnée devant servir de cadre
institutionnel à la santé communautaire.
A l’étape actuelle du processus de mise en oeuvre de diverses expériences pilotes d’actions
communautaires, le Ministère de la Santé s’est engagé dans une réflexion visant l’élaboration
d’une politique nationale de santé communautaire. Celle-ci devra servir à encadrer la mise à
l’échelle des interventions communautaires qui ont démontré leur efficacité et leur impact
sur les populations cibles. Cette réflexion a entraîné la tenue du forum national sur la santé
communautaire en Novembre 2013 à Cotonou.
Le document de Politique de Santé Communautaire s’arrime au Plan National de
Développement Sanitaire à travers lequel le Bénin ambitionne de « disposer en 2025 d’un
système de santé performant basé sur des initiatives publiques et privées, individuelles et
collectives, pour l’offre et la disponibilité permanente de soins de qualité, équitable et
accessible aux populations de toutes catégories, fondées sur les valeurs de solidarité et de
partage du risque pour répondre à l’ensemble des besoins de santé du peuple béninois » Dans
le présent document, il est défini une vision, des priorités et des stratégies pour les dix
prochaines années en santé communautaire. La principale innovation réside dans la
conception et la mise en place au niveau de chaque village et quartier de ville de la
composante locale du système national de santé (CoLoSS) en partenariat avec toutes les
parties prenantes. Le document précise les conditions requises et les mesures
d’accompagnement pour la réussite de la nouvelle politique dans le sens de l’autonomisation
(empowerment) progressive des populations.
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N Engl J Med. 2016 Jan 13. [Epub ahead of print] Free full text
The explosive pandemic of Zika virus infection occurring throughout South America, Central America, and the Caribbean (see map) and potentially threatening the United States is the most recent of four unexpected arrivals of important a...rthropod-borne viral diseases in the Western Hemisphere over the past 20 years. It follows dengue, which entered this hemisphere stealthily over decades and then more aggressively in the 1990s; West Nile virus, which emerged in 1999; and chikungunya, which emerged in 2013. Are the successive migrations of these viruses unrelated, or do they reflect important new patterns of disease emergence?
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Agodokpessi et al. Journal of Pharmaceutical Policy and Practice (2015) 8:12DOI 10.1186/s40545-015-0033-7
Benin established a revolving drug fund (RDF) for essential asthma medicines in 2008. We evaluated
the operation of the RDF and assessed whether there was interruption of supply of asthma me...dicine from 2008 to
2013.
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This document outlines Rwanda's policy on non-communicable diseases. The overall goal of NCDs Policy is to alleviate the burden of NCDs and their risk factors and protect Rwandan population from premature morbidity and mortality related to NCDs. This policy was developed through a series of consulta...tive meetings and workshops of NCDs' core team members of MOH and RBC, National Technical Working Group (TWG), all implementing and non implementing partners and other development partners. This policy was developed in line with the Millennium Development Goals (MDGs), Vision 2020, Rwanda Economic Development Poverty Reduction Strategy (EDPRS II) of 2013-18 and NCDs Global Action Plan 2013-2020 and national Health Policy. This policy focuses on of the following NCDs: Cardiovascular diseases, Chronic Pulmonary Diseases (CPD), Cancers, Diabetes, injuries and disabilities, oral, eye and kidney diseases.
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The Rwandan Ministry of Health recognizes the threat that Non-Communicable Diseases (NCDs) pose to health and development in Rwanda and in 2009 articulates strategies to respond to them in the Health Sector Strategic Plan 2012 - 2018 (HSSP3). Among other things, the plan calls for a national prevale...nce survey on NCD risk factors. This report responds to that call and summarizes the findings of the first NCD risk factor survey in Rwanda conducted from November 2012 to March 2013.
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The international community sits at the tipping pointof a post-‐antibiotic era, where common bacterial infections are no longer treatable with the antibiotic armamentarium that exists. In South Africa, t...he identification of the first case of pan-‐resistant Klebsiella pneumoniae(Brink et al, J Clin Microbiol. 2013;51(1):369-‐72) marks a watershed moment and highlights ourtip of the antibiotic resistance ‘iceberg’ in this country. Multi-‐drug resistant (MDR)-‐bacterial infections, predominantly in Gram-‐negative bacteria such as Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosaand Acinetobacter baumanniiare now commonplace in South African hospitals. Whilst a number of expensive new antibiotics for Gram-‐positive bacterial infections have been manufactured recently (some of which are licenced for usein South Africa), no new antibiotics active against Gram-‐negative infections are expected in the next 10-‐15years. Hence what we have now, needs conserving
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The Catholic Church has a well-documented tradition of Care for Creation and Stewardship of the Earth.
This resource includes elements of Catholic teaching that highlight this tradition.
This resource is intended to serve as an introduction on this issue; it is not comprehensive.
La guía se basa en las buenas prácticas existentes y se ha elaborado con la colaboración de enfermeras que trabajan en una amplia variedad de ámbitos, pero se enfoca principalmente en las áreas con recursos limitados. Representa el punto de vista del personal técnico ... de La Unión y de la red de Enfermeras y Profesionales Sanitarios entre los miembros de La Unión. Las mejores prácticas se presentan como una serie de pautas que se pueden adaptar a los servicios locales en países de ingresos bajos y medios y que fomentan la evaluación a través del uso de resultados cuantificables. Cada pauta corresponde a un punto importante en el diagnóstico o tratamiento de un paciente con TB, tomando como referencia las estrategias recomendadas por La Unión2, 3 y los regímenes de tratamiento recomendados por la Organización Mundial de la Salud (OMS) para TB susceptible a fármacos y TB resistente a fármacos.4, 5 A lo largo de esta guía, se remitirá a los lectores, a través de notas al pie, a la información relevante publicada en dos guías distintas de La Unión: Manejo de la Tuberculosis: Una guía esencial de buenas prácticas, 6ta edición, 2010 (denominada Guía Naranja)2y Lineamientos para el Manejo Clínico y Operativo de la Tuberculosis Drogorresistente, 2013 (denominada Guía de DR-TB).3 Otros materiales de referencia importantes se indican al final del documento y todos coinciden con las estrategias recomendadas a nivel internacional.
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Food environments are usually defined as the settings with all the different types of
food made available and accessible to people as they go about their daily lives.
That is, the range of food in supermarkets, small retail outlets, wet markets, street
food stalls, coffee shops, tea houses, s...chool canteens, restaurants, and all the other
venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing,
marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate
quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems
and food environments are challenged in supporting consumer choices that are
consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges.
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PlosOne December 10, 2014 https://doi.org/10.1371/journal.pone.0111913
Plastic pollution is ubiquitous throughout the marine environment, yet estimates of the global abundance and weight of floating plastics have lacked data, particularly from the Southern Hemisphere and remote regions. Here we re...port an estimate of the total number of plastic particles and their weight floating in the world's oceans from 24 expeditions (2007–2013) across all five sub-tropical gyres, costal Australia, Bay of Bengal and the Mediterranean Sea conducting surface net tows (N = 680) and visual survey transects of large plastic debris (N = 891). Using an oceanographic model of floating debris dispersal calibrated by our data, and correcting for wind-driven vertical mixing, we estimate a minimum of 5.25 trillion particles weighing 268,940 tons. When comparing between four size classes, two microplastic <4.75 mm and meso- and macroplastic >4.75 mm, a tremendous loss of microplastics is observed from the sea surface compared to expected rates of fragmentation, suggesting there are mechanisms at play that remove <4.75 mm plastic particles from the ocean surface.
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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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Progress in tuberculosis control worldwide, including achievement of 2015 global targets, requires adequate financing sustained for many years. WHO began yearly monitoring of tuberculosis funding in 2002. We used data reported to WHO to analyse tuberculosis funding from governments and international... donors (in real terms, constant 2011 US$) and associated progress in tuberculosis control in low-income and middle-income countries between 2002 and 2011. We then assessed funding needed to 2015 and how this funding could be mobilised.
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La salud mental es de vital importancia para todas las personas, en todas partes. En todo el mundo, las necesidades en materia de salud mental son muchas, pero la respuesta es insuficiente e inadecuada. El Informe mundial sobre la salud mental: Transformar la salud mental para todos ha sido concebid...o para inspirar y fundamentar una mejor salud mental para todas las personas. Al basarse en los datos disponibles más recientes, mostrar ejemplos de buenas prácticas en todo el mundo y transmitir la experiencia de las propias personas, en este informe se pone de relieve por qué es necesario el cambio y dónde, y cuál es la mejor manera de lograrlo. En el informe se insta a todas las partes interesadas a que colaboren para profundizar en el compromiso y el valor que se atribuye a la salud mental, reconfigurar los entornos que influyen en la salud mental y fortalecer los sistemas de atención de la salud mental. La salud mental es mucho más que la ausencia de enfermedad: es una parte intrínseca de nuestra salud y bienestar individual y colectivo. Como se muestra en el presente Informe mundial sobre la salud mental, para alcanzar los objetivos mundiales establecidos en el Plan de acción integral sobre salud mental 2013‑2030 de la OMS y los Objetivos de Desarrollo Sostenible debemos transformar nuestras actitudes, acciones y enfoques para promover y proteger la salud mental, así como para proporcionar cuidados y atención a quienes lo necesitan.
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Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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The "Global NCD action plan" provides a road map and a menu of policy options for countries to take in order to attain the 9 voluntary global targets, including that of a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2...025. The main focus of this action plan is on 4 types of NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes) which make the largest contribution to morbidity and mortality due to NCDs, and on 4 shared behavioural risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol).
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South Africa is a mineral-rich country. Although the mining of these minerals generates wealth for the country, it also causes diseases in the mine workers who are exposed to harmful dust. Pulmonary silicosis, the disease most commonly caused by exposure to crystalline silica dust, was described in ...South African gold miners in the early 1900s not many years after gold-mining commenced. Most studies since then have been cross-sectional, with only one large cohort study being conducted on white miners; long-term trends have not been reported. Currently, South Africa has one of the highest rates of silicosis in the world.
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Asthma is a chronic inflammatory condition characterized by airway hyper-responsiveness to a variety of stimuli largely of allergic origin with reversible airflow limitation. The major clinical features of asthma are wheezing, shortness of breath, and cough. It is a major cause of impaired quality o...f life with impact on work and recreational as well as physical activities and emotions. The goal of treatment is to achieve overall clinical control, which entails the achievement of symptom-free control and to minimize future risks. The goal is the same for all severity of the disease.
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Chronic respiratory diseases (CRDs) are among the leading causes of death worldwide, with asthma rated the most common chronic disease affecting children (1). Globally, about 300 million people have asthma, and current trends suggest that an additional 100 million people may be living with asthma by... 2025.
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Climate change is one of the biggest crises of our time. Climate threats range from higher temperatures, heavy rainfalls and floods, erratic precipitation, droughts, desertification, and land degradation. This has negative implications on the quality and quantity of natural resources, such as land a...nd water, agricultural productivity, rural livelihood options, food prices, and nutrition security, particularly when there is a lack of adaptation capacities and preparedness measures (Pacillo, 2024). Farmers are at the forefront of the climate crisis where their livelihoods are being jeopardized, and they are faced with many challenges to secure water, energy, and agriculture inputs, and maintain agriculture productivity. This heightens the risk of competition over natural resources and aggravates grievances and structural inequalities related to land rights and ownership as well as land access, management, and governance. In Africa, land-related issues are among the triggers of many violent disputes (Medina et al, 2024). For instance, communal violence in Nigeria and Sudan is tied to competition over scarce fertile land and poor resource governance (Bruce and Bourdeaux, 2013).
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