Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system, and findings were further validated during a oneda...y
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
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Since 25 August 2017, 688 000 Rohingya refugees escaping violence and persecution in Myanmar have settled in camps, settlements and within host communities in Cox’s Bazar district, Bangladesh, bringing the total number of refugees in the area to more than 900 300.
Climate change (CC) impacts on health outcomes, both direct and indirect, are sufficient to jeopardize achieving the World Bank Group’s visions and agendas in poverty reduction, population resilience, and health, nutrition and population (HNP). In the last 5 years, the number of voices calling for... stronger international action on climate change and health has increased, as have the scale and depth of activities. But current global efforts in climate and health are inadequately integrated. As a result, actions to address climate change, including World Bank Group (WBG) investment and lending, are missing opportunities to simultaneously promote better health outcomes and more resilient populations and health sectors. Accordingly, with the financial support of the Nordic Development Fund (NDF), the World Bank Group set out to develop an approach and a 4-year action plan, outlined in this paper, to integrate health-related climate considerations into selected WBG sector plans and investments.
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This document addresses preparedness as an important investment against natural and man-made disasters. Through good practices, it urges the humanitarian community, governments and regional bodies to use preparedness thinking to be aware of risks, to reduce them and to plan ahead to combat them in o...rder to respond more effectively and reduce the threat of hunger, disease, poverty and conflicts. It uses examples from Bangladesh, Bhutan, Bolivia, Colombia, Cook Islands, Ghana, Haiti, Indonesia, Kazakhstan, Korea, Democratic People’s Republic of Korea, Kyrgyzstan, Madagascar, Malawi, Mozambique, Namibia, Niger, Panama, Philippines, Samoa, Solomon Islands, South Africa, Sudan, Tanzania, Tonga, Turkmenistan, Uzbekistan, Vanuatu, Zambia and Zimbabwe
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Findings from this report reveal that, rates of early marriage are high, a significant percentage of children contribute to the household’s income or are its main source of income, and restrictions on the mobility of women and girls constrain their participation in social and economic activities a...nd their access to basic services. As the overwhelming majority of refugees do not have paid employment and rely mainly on aid and dwindling family resources, the more the situation of displacement is prolonged the greater the likelihood of higher rates of child labour for boys and early marriage for girls.
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The Rwandan Health Sector Research Policy (HSRP) policy defines the scope of research in the Rwandan health sector and presents the strategic principles to ensure that the research done in Rwandan health sector will be conducted in a more coordinated manner, promoting research for equity and social ...justice and to benefit the Rwandan community as well as the global community in general. The health sector research policy provides solutions to the challenges which have been identified in health research. It will support and improve Rwanda’s health research environment and create a space and framework in which health research will grow and support improved health outcomes in Rwanda. It gives a clear orientation for dissemination and use of results. For sustainability of health research in Rwanda, foreign researchers are called upon to collaborate with Rwandans with clear capacity building plans.
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The audit was undertaken in order to ascertain whether allocations and donations received directly by the Government of Sierra Leone, in the fight against the Ebola Virus Disease were utilised with due regard to economy and efficiency and that internal controls were observed accordingly. The audit f...ound that more than US$ 10 million in spending was inadequately documented and US$ 6 million may have been diverted to non-existent or “ghost” workers. The Quote: “It makes one wonder how a serious humanitarian crisis was used as money-making machine,” said Ibrahim Tommy, coordinator for Sierra Leone’s Centre for Accountability and Rule of Law
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R4D conducted a thorough desk review and qualitative fiscal space analysis, 19 interviews about financing for the three diseases and the extent of alignment between public financial management systems and health policy objectives, and a validation workshop with government officials.
Tanzania’...s disease response faces a triple transition challenge: replacing donor funding, closing the resource gap that would exist even with donor funding, and more efficiently delivering on disease response objectives.
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This report provides an update on the level of poverty based on 2013/14 Integrated Household Living Conditions Survey (EICV4) focusing on poverty as measured in consumption terms. The report also highlights other trend dimensions of living conditions captured in other surveys that complement and pro...vide a holistic understanding of poverty and living conditions.
Rwanda’s economy has been growing steadily at about 8% since 2001 with GDP per capita more than tripling from US$ 211 in 2001 to US$ 718 in 2014. Food crop production growth was more than twice that of population growth between 2007 and 2014.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv...ices closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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In the last quarter of 2009, tropical storms Ketsana, Pharma and Santi poured the heaviest rainfall on Metro Manila in more than 40 years. This caused massive flooding in the National Capital Region and Region IVA. A few weeks later, the world's biggest leptospirosis outbreak reported more than 200 ...deaths and 3 000 cases in various hospitals around the country.
The Global Outbreak Alert Response (GOARN) investigated the outbreak, and recommended that an integrated information system in emergencies be established, for it would provide early warning for potential disease outbreaks.
Surveillance in Post Extreme Emergencies and Disasters or SPEED was conceptualized to provide real time health information reporting after a disaster.
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This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to ...air pollution.
Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines (see the full report, Air pollution and child health: prescribing clean air. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under the age of 5 years in 2016.
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PEN-Plus is an integrated care delivery strategy focused on alleviating the noncommunicable disease (NCD) burden among the poorest children and young adults by increasing the accessibility and quality of chronic care services for severe NCDs—such as type 1 diabetes, rheumatic heart disease, and si...ckle cell disease—in the rural areas of low- and lower-middle-income countries, where more than 90 percent of the world’s poorest people live.
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This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health... goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
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The World Health Organization (WHO) Global Tuberculosis Report 2021 estimated that, in 2020, tuberculosis (TB) was the second most common infectious disease killer after coronavirus disease (COVID-19) and the 13th leading cause of death (1). Twenty-five per cent (25%) of the world’s population has... latent TB infection, which can develop into disease. In 2020, WHO estimated that 9.9 million people fell ill with TB, but only about 5.8 million (60%) were diagnosed, reported and treated, an 18% fall from 7.1 million in 2019. WHO also estimates that, between 2019 and 2020, global TB mortality increased from 1.2 to 1.5 million, a 5.6% increase
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Cardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. The term “cardiovascular disease” is used throughout the report to refer to cardiac disease, vascular diseases of the brain and kidney, and peripheral vascular disease. The report’s main focus is ...on the major contributors to global CVD mortality, coronary heart disease and stroke, and on the major modifiable risk factors for cardiovascular diseases. In fact, as the leading cause of death worldwide, CVD now has a major impact not only on developed nations but also on low and middle income countries, where it accounts for nearly 30 percent of all deaths. The terms “developed” and “high income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as high income economies. The terms “developing” and “low and middle income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as low, lower middle, and upper middle income economies. The increased prevalence of risk factors for CVD and related chronic diseases in developing countries, including tobacco use, unhealthy dietary changes, reduced physical activity, increasing blood lipids, and hypertension, reflects significant global changes in behavior and lifestyle. The term “chronic diseases” is used throughout the report to refer to CVD and the following related chronic diseases that share many common risk factors: diabetes, cancer, and chronic respiratory disease. These changes now threaten once-low-risk regions, a shift that is accelerated by industrialization, urbanization, and globalization. The potentially devastating effects of these trends are magnified by a deleterious economic impact on nations and households, where poverty can be both a contributing cause and a consequence of chronic diseases. The accelerating rates of unrecognized and inadequately addressed CVD and related chronic diseases in both men and women in low and middle income countries are cause for immediate action.
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A sanitary inspection is a simple, on-site evaluation (traditionally using a checklist) to help identify and support the management of priority risk factors that may lead to contamination of a drinking-water supply. Sanitary inspections are a well-established and widely-applied practice. They can su...pport water safety planning, and in some contexts, may be a simplified alternative to water safety plans.
This publication presents the World Health Organization’s (WHO’s) sanitary inspection packages. These packages update the sanitary inspection forms in WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. With more than 25 years of practical experience with the application of sanitary inspections, these packages have been developed from a comprehensive evidence review and established good practices.
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Information on the causes of cancer at specific sites is important to cancer control planners, cancer researchers, cancer patients, and the general public. The International Agency for Research on Cancer (IARC) Monograph series, which has classified human carcinogens for more than 40 years, recently... completed a review to provide up-to-date information on the cancer sites associated with more than 100 carcinogenic agents. Based on IARC’s review, we listed the cancer sites associated with each agent and then rearranged this information to list the known and suspected causes of cancer at each site. We also summarized the rationale for classifications that were based on mechanistic data. This information, based on the forthcoming IARC Monographs Volume 100, offers insights into the current state-of-the-science of carcinogen identification. Use of mechanistic data to identify carcinogens is increasing, and epidemiological research is identifying additional carcinogens and cancer sites or confirming carcinogenic potential under conditions of lower exposure. Nevertheless, some common human cancers still have few (or no) identified causal agents.
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Africa CDC Institute of Pathogen Genomics (IPG) was launched in November 2019 and operates under the Division of Laboratory Systems and Networks.
IPG coordinate the implementation of molecular diagnostics, pathogen genomics and bioinformatics in National Public Health Institutions (NPHIs) and/or Re...fe-
-rence Laboratories (NRLs) across Africa.
Africa CDC and APHF are coordinating a continental initiative to maximize the benefits of molecular approaches and pathogen genomics for more effective
outbreak preparedness, prevention, response, and for the control and elimination of endemic diseases in Africa. One of Africa CDC’s flagship initiative is the Africa
Pathogen Genomics Initiative (Africa PGI), a partnership that aims to strengthen laboratory systems and enhance genomic surveillance by equipping the continent’s
public health institutions with the tools, training, and data infrastructure.
About the Project
In 2023, 166 outbreaks and public health events were reported in Africa. This calls for a resilient laboratory systems for timely detection and reporting of current and future outbreaks. This project aims to scale up molecular diagnostic and genomic sequencing-based detection and characterization of outbreaks.
Africa CDC is working with Member States to develop guidance, diagnostic algorithm, training and capacity building to enable outbreak detection, and reporting to inform public health response.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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