5 May 2021
This Information Note is intended to assist national TB programmes and health personnel worldwide to maintain essential tuberculosis (TB) services during the COVID-19 pandemic and in the recovery phase. It is important that recent progress made in TB prevention and care is not reversed b...y COVID-19. The WHO Global TB Programme, along with WHO regional and country offices, developed this note in response to questions received from Member States and other partners since the start of the pandemic. The note includes references to other published WHO information products relevant to TB practitioners. WHO continues to monitor the situation closely for any changes that may influence this note and will issue updates should any factors change.
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This guidance is targeted to primary health care policy-makers and only addresses issues relevant for primary health care providers. It has been prepared on the basis of a systematic review of the best available evidence and emergent country practices in response to the COVID-19 outbreak in the WHO ...European Region. It will be updated on a regular basis as new information becomes available.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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La lutte contre la tuberculose est une des priorités du ministère de la santé. C’est ainsi que le Plan Stratégique National de lutte contre la Tuberculose 2013-2017 du Sénégal a inscrit dans son programme d’actions la préoccupation de mieux d’améliorer la prise en charge des personnes ...vulnérables, dont les prisonniers. L’état de santé est un indicateur clef du bien être de la société, et les prisons servent de miroir. Une bonne compréhension des conditions sanitaires des détenus pourrait contribuer à améliorer le système de santé publique d’un pays. L’environnement carcéral est bien reconnu comme un lieu où les conditions de vie sont propices à la concentration de l’ensemble des maladies de la société, en premier lieu, les morbidités infectieuses.
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The toolkit's purpose is to:
improve the primary health care response for older persons.
sensitize and educate primary health care workers about the specific needs of their older clients.
provide primary care health workers with a set of tools/instruments to assess older people's hea...lth.
raise awareness among primary care health workers of the accumulation of minor/major disabilities experienced by older people.
provide guidance on how to make primary health care management procedures more responsive to the needs of older people's needs.
offer direction on how to do environmental audits to test primary health care centres for their age-friendliness.
The toolkit comprises a number of instruments (evaluation forms, slides, figures, graphs, diagrams, scale tables, country guidelines, exam sheets, screening tools, cards, checklists, etc.) that can be used by primary health care workers to assess and address older persons' health. These resources are meant to supplement and not to replace local and national materials and guidelines
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Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and... population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
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The International Rescue Committee (IRC) is a leading humanitarian agency dedicated to helping people whose lives have been shattered by conflict and disaster to survive, recover, and gain control of their future. Health comprises nearly half of IRC’s program portfolio globally and encompasses thr...ee sectors: 1) Primary Health (including child health, sexual and reproductive health and rights, and mental health); 2) Nutrition; and 3) Environmental Health. IRC health programming across its portfolio, in terms of the size and breadth, responds to significant needs in crisis affected settings, improving health and wellbeing while reducing causes of ill-health.
This five-year Health Strategy sharpens our focus on where we can have the most impact. It guides our efforts in planning, technical assistance, business development, advocacy, and internal and external collaboration. Through this strategy, we will invest and grow in areas that will help us achieve high impact at scale for our clients. For the next five years these priorities will include: Nutrition; Immunization: Infectious Disease Prevention and Control; Last Mile Delivery of Primary Health Care: Clean Water.
Our strategy aligns with Strategy 100 (S100) and Strategy Action Plans (SAPs). It lays out how IRC, through health, nutrition, and Environmental Health (EH) programming, will advance the IRC’s S100 ambitions, respond to global trends, and capitalize on our value add. The strategy will be complemented by delivery plans that detail investments, actions, and roles and responsibilities to advance our priorities. At the end of FY24, we will take stock of the implementation of the strategy, measure progress towards achieving our goals, and review if it continues to be fit for purpose.
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This document provides guidance on how to implement contact screening and chemoprophylaxis with single-dose rifampicin. The contents are logically ordered: counselling and obtaining consent, identification and listing of index case, listing of contacts, tracing of contacts, screening of contacts, ad...ministration of prophylactic drugs. Managerial aspects to undertake contact screeninig and chemoprophylaxis are also elaborated, including planning , training , supervision and drug management.
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The purpose of this publication is to facilitate the implementation of existing WHO guidelines on nutrition-specific and nutrition-sensitive actions required for improving health and well-being of adolescents. Implementing these actions should explicitly take into account the heterogeneity of adoles...cents in general (for instance, in their state of physical growth and social development), as well as the diversity within their country (for instance, in terms of the expected responsibilities in the family, the number out of school or out of work and existing social norms).
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El presente informe incluye análisis de consultas informales en cinco de las regiones de la OMS: la Región de África, la Región de las Américas (donde se realizaron consultas separadas para el Caribe y América del Norte, y para América Latina), la Región de Asia Sudoriental, la Región de Eu...ropa y la Región del Mediterráneo Oriental, junto con tres foros en la Región del Pacífico Occidental. Se analizan las similitudes generales, los matices regionales y las prioridades planteadas en las seis regiones de la OMS para la participación significativa de las personas con experiencias vividas.
El presente informe es la segunda publicación de la serie «De la intención a la acción», un conjunto de recursos destinados a mejorar la limitada base de evidencia sobre el impacto de la participación significativa y abordar la falta de enfoques normalizados sobre cómo hacer operativa esta participación. La serie «De la intención a la acción» pretende llevar esto a cabo proporcionando una plataforma desde la que las personas con experiencias vividas, y los defensores de organizaciones e instituciones, puedan compartir soluciones, retos y prácticas prometedoras relacionadas con esta agenda transversal. La serie «De la intención a la acción» también tiene como objetivo proporcionar poderosas historias, inspiración y evidencia para la 4.ª Reunión de Alto Nivel de las Naciones Unidas sobre las ENT que se celebrará en 2025 y la consecución de los Objetivos de Desarrollo Sostenible (ODS) de las Naciones Unidas para 2030.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Nigeria reported its first case of COVID-19 at the end of February 2020 and subsequently experienced
four waves, with peaks in June 2020 and January, August and December 2021. The COVID-19 pandemic
severely impacted the economy of Nigeria and caused disruption of health services nationwide. During... the crisis, many Nigerians failed to access routine health
services due to decreased income and lockdown
restrictions. The most significant service disruptions
were in maternal and newborn health, vaccination,
sick childcare, family planning and noncommunicable
disease treatment services (1). Pregnant women
were anxious about contracting COVID-19 during
2020, and as a result, many avoided attending health
facilities for antenatal (ANC) and postnatal care (PNC).
Disruptions in the medical supply chain and diversion
of resources to COVID-19 management impacted on
essential health services. Health workers were often
unable to go to work because of transport disruptions
or illness
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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The report focuses on antibacterial resistance (ABR) in common bacterial pathogens. There is a major gap in knowledge about the magnitude of this problem. Antimicrobial resistance (AMR) threatens the effective revention and treatment of an ever-increasing range of infections caused by bacteria, para...sites, viruses and fungi. This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally. It examines the information on AMR, in particular antibacterial resistance (ABR), at country level worldwide.
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This report has been developed, based on data provided by the TB & ORD surveillance system from across Rwanda. It provides a comprehensive picture of the occurrence and management of TB & ORD and Leprosy in Rwanda. It is structured based on the 2013-2018 Rwanda TB national strategic plan (2013-2018 ...TB NSP) and on the 2014-2018 Rwanda Leprosy national strategic plan (2014-2018 Leprosy NSP).
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of transmission, co...ntext and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease burden and control in the WHO African region. It tra...cks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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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.
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding..., knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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