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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredic
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table resourcing issues, and vulnerability to multiple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicte
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d trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Cancer in sub-Saharan Africa
recommended
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer in
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cidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
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UNICEF Child Alert | February 2018
Back in Myanmar, an estimated half million Rohingya remain largely sealed off in their communities and displacement camps, fearful that the violence and horr ... or that had driven so many of their relatives and neighbours to fl ee would engulf them too. Today, there are an estimated 720,000 Rohingya children in southern Bangladesh and Myanmar’s Rakhine State, in dire need of humanitarian assistance and protection – and looking to the outside world for help. more
Back in Myanmar, an estimated half million Rohingya remain largely sealed off in their communities and displacement camps, fearful that the violence and horr ... or that had driven so many of their relatives and neighbours to fl ee would engulf them too. Today, there are an estimated 720,000 Rohingya children in southern Bangladesh and Myanmar’s Rakhine State, in dire need of humanitarian assistance and protection – and looking to the outside world for help. more
Disability-inclusive social protection research in Nepal
Banks, Lena M., Walsham, Matthew and others
International Centre for Evidence in Disability
(2018)
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A national overview with a case study from Tanahun district. The overall aims of this study are (1) to assess the extent to which social protection systems in Nepal address the needs of people with
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disabilities; and (2) to identify and document elements of good practice, as well as challenges, in the design and delivery of social protection for people with disabilities. As most social protection programmes in Nepal are targeted to various groups considered to be a high risk of poverty or marginalisation (e.g. orphans, widows), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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In disaster preparedness, the participation of women, children, older people, persons with disabilities (PWDs), and other minority groups and sectors is important because they are the most vulnerabl
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e against disasters. Inclusive disaster preparedness provides technical and logical frameworks that assimilate the most vulnerable sectors in a community and enhances their capacity against future disasters.
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Social Science in Humanitarian Action Key considerations: Ebola preparedness and readiness in Goma, DRC
Peyton, D.; I. Gercama and J. Bedford
Social Science in Humanitarian Action: A Communication for Development Platform
(2019)
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This brief summarises key considerations about the social, political and economic context of Goma in relation to the outbreak of Ebola in the DRC as of March 2019. Goma is the administrative capital
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of North Kivu province and a major urban centre in the Great Lakes Region. The city is home to an estimated 1.5 million people and serves as an important economic and transportation hub that links eastern Congo to the broader East African sub-region. The arrival of Ebola in Goma would substantially increase the at-risk population and heighten the potential for cross-border transmission to neighbouring countries, particularly Rwanda. This brief therefore focuses on local social and political structures that can be leveraged to promote preparedness and readiness actions.
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike.
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People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population was very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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Doing what matters in times of stress
recommended
Doing What Matters in Times of Stress: An Illustrated Guide is a stress management guide for coping with adversity. The guide aims to equip people with practical skills to help cope with stress. A f
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ew minutes each day are enough to practice the self-help techniques. The guide can be used alone or with the accompanying audio exercises.
Informed by evidence and extensive field testing, the guide is for anyone who experiences stress, wherever they live and whatever their circumstances.
Different languages available: https://www.who.int/publications/i/item/9789240003927
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The present book deals not only with emergency response, but also with measures designed to reduce the impact of disasters on environmental health infrastructure, such as water supply and sanitation facilities. It also aims to strengthen the ability of peo
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ple to withstand the disruption of their accustomed infrastructure and systems for environmental health (e.g. shelter, water supply, sanitation, vector control etc.) and to recover rapidly.
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The transformation of the humanitarian landscape has already made a significant impact on the operational security of INGOs and other humanitarian actors. This report serves to inform strategic policy priorities and approaches to security planning and coordination, and addresses three main questions
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: 1. What are the emerging trends, developments and drivers of change that are likely to affect or change security issues and considerations in the humanitarian environment of the future? 2. How will the humanitarian sector need to adapt in order to continue to deliver programmes within this changing operational context? 3. How prepared are organisations for this future, and what might they need to do differently in order to be prepared?
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This document provides a guidance on the importance of consulting with children with disabilities. It provides practical suggestions for consulting with children and young people with disabilities in
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a variety of situations. It aims to equip individuals working on child rights with the knowledge and skills necessary to communicate with children with a variety of disabilities.
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The Current State of CHW Training Programs in Sub-Saharan Africa and South Asia
Cindil Redick& annah Sarah Faich Dini
One Million Community Health Workers Campaign | mPowering Frontline Health Workers
(2014)
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What We Know, What We Don’t Know, and What We Need to Do
This brief focuses on disability rights in the ASEAN countries, namely Brunei Darussalam, Cambodia, Indonesia, Lao People’s Democratic
Republic (PDR), Malaysia, Myanmar, the Philippines, Singapor
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e, Thailand and Viet Nam.
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This guide is intended for shelter operators, planners, and staff, as well as emergency managers, public health professionals, and radiation protection professionals who participate in shelter planning and could be called upon to support shelter ope
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rations. This guide provides information on the incident-specific considerations that shelter operators will
need to take into account in a radiation emergency. Shelter operations include other mass care and emergency assistance activities that are required to support a sheltered population, such as feeding, providing essential supplies, and assisting with reunification of family and friends. Guidance to support such activities can be found in other planning resources. The information in this guide is intended to complement, not supplant, existing shelter protocols and responsibilities.
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Tracking aid for the WHA nutrition targets: Global spending in 2015 and a roadmap to better data
Alimonte, Mary D'; Thacher, Emily; LeMier, Ryan; Clift, Jack
Results for Development (R4D)
(2018)
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In 2017, the World Bank and partners created the Global Investment Framework for Nutrition as a roadmap towards achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual a
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dditional investment of $7 billion per year to scale-up nutrition-specific interventions at the level needed to achieve the global targets. However, the world is off-track to meet the global targets. And it is unclear whether additional resources will be mobilized for life-saving and cost-effective nutrition-specific interventions, or whether donor support will be enough to meet the annual resource need established by the framework.
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Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage ... (UHC). In practice, this means that the majority of health care costs have to be met from government revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage ... (UHC). In practice, this means that the majority of health care costs have to be met from government revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
Mental Health in the Asia-Pacific Region: An Overview
Alexander Lourdes Samy, Zahra Fazli Khalaf, & Wah-Yun Low
International Journal of Behavioral Science
(2015)
CC
Mental health problem is one of the growing major public health issues in the Asia Pacific region. It contributes to the high number of Disability Adjusted Life Years (DALYs), morbidity and mortality in
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the region. It is expected that leading mental health problems will occur in the low-and middle-income countries (LMICs) and majority of the countries which comes under this category are in the Asia Pacific region. In addition, mental health problem hamper the achievement of Millennium Development Goals (MDGs), particularly MDG 1, MDG 4 and MDG 5. The most common mental health problems in the region are depression, anxiety, posttraumatic stress disorder, suicidal behaviour and substance abuse disorder. Several modifiable and non-modifiable risk factors were identified for the cause of these major mental health issues. Interventions, programmes and policies need to be designed in order to curb mental health problems at all levels.
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Q7. SCOPING QUESTION: In adults with moderate-severe depressive disorder, what is the effectiveness and safety of antidepressant medication (ADM) in comparison with psychological treatment?
The W
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HO mhGAP programme’s existing guidelines recommend that either structured brief psychological treatments (e.g., interpersonal psychotherapy or cognitive behavioural therapy, including behavioural activation) or antidepressant medication (e.g., SSRIsi and tricyclic antidepressants) be considered in adults with moderate-severe depression. Health care workers need to know whether these treatments have different effects, including side-effects, in treating depressive disorder in the short and long term, in order to improve clinical decision-making.
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