An Indicator-based Approach - This manual presents an indicator-based approach for rapidly assessing pharmaceutical management systems and programs. The manual contains a set of 46 indicators of performance, grouped under eight topics of pharmaceutical management, with each topic being covered by a ...subset of indicators. Thirty-four of the indicators are quantitative, that is, expressed as numbers. Twelve are qualitative, in that they describe the presence or absence of a policy or management system, and in some cases, the degree of implementation.
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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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This manual is a good example of the successful outcomes of the productive mutual cooperation between the United States Agency for International Development (USAID) through the Basic Education Support and Training (BEST – Yemen) Project; funded by the USAID, and the Government of Yemen (GY) throug...h its Ministry of Education (MoE). The BEST Project and the MoE have worked collaboratively to ensure sustainable development where local resources are used wisely and sufficiently by the different Yemeni generations while at the same time building healthy school and community environment. ECOSAN was one area that the project introduced to the MoE as one significant system to reach sustainable environmental development. The Project facilitated a highly quality extensive training on ECOSAN at the Stockholm Environmental Institute – SEI in Stockholm, Sweden.
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La silla de ruedas es uno de los medios de asistencia de uso más frecuente para mejorar la movilidad personal, condición previa para disfrutar de los derechos humanos y una vida digna, y ayuda a las personas con discapacidad a convertirse en miembros más productivos de sus comunidades. Para mucho...s, una silla de ruedas adecuada, bien diseñada y armada puede constituir el primer paso hacia la inclusión y participación en la sociedad.
Este documento ha sido publicado con el fin de ayudar a los Estados Miembros de la OMS a crear y desarrollar un sistema local de suministro de sillas de ruedas y poner así en ejecución los Artículos 4, 20 y 26 de la Convención sobre los Derechos de las Personas con discapacidad.
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El documento ayudará a los países a identificar las áreas de necesidades y determinar cómo se puede reforzar la red de entomología, especialmente en el contexto de un sistema de salud descentralizado. Las recomendaciones también tienen en cuenta los diferentes grados de desarrollo y las difere...ntes investigaciones entomológicas necesarias para dar soporte a las acciones de prevención y control de las enfermedades.
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Antimicrobial resistance has become a serious public health threat for effective treatment of an ever increasing range of infections caused by bacteria, parasites, viruses and fungi. When infections can no longer be treated by first-line antibiotics, other antibiotics must be used, which are both mo...re expensive and more toxic. Treatment and hospitalization is prolonged, and patients undergoing operations and other medical procedures are more vulnerable to infections. All this imposes a huge burden on health care systems and on the economy of countries. This is a major challenge to the health system in Mauritius which provides health care free of user cost to the whole population.
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Given an increase in outbreaks caused by resistant microorganisms associated with medical tourism, the Pan American Health Organization / World Health Organization (PAHO/WHO) encourages Member States to strengthen their capacity to detect and manage infections caused by resis...tant microorganismsin patients who traveled outside of their country of residence to receive healthcare. Furthermore, PAHO/WHO stresses the importance to implement preventive measures to reduce healthcare-associated infections at all levels of the health system.
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As part of our commitment to the fight against NCDs, Nigeria was signatory to the political declaration at the UN General Assembly High Level Meeting on NCDs in September 2011. Thus, the purpose of this document is to develop and ensure the implementation of policies and p...rogrammes that will engender and guarantee a healthy lifestyle and quality health for all Nigerians. The core sections include background, scope of the policy, policy goal, strategic thrusts for implementation, programme management and coordination, roles of stakeholders and partnership coordination. It is expected that with the adoption of this policy, the control and prevention of NCDs and their associated risk factors will be well integrated at all levels of government and health care delivery system in Nigeria. This policy document is therefore a stepping stone towards the development of guidelines for the prevention and management of NCDs.
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El presente informe regional sobre la situación de la tuberculosis en las Américas contiene la información correspondiente al 2019, provista por los países de la Región a través del sistema de recolección de datos de TB de la OMS. Esta información ha sido consolidada y analizada a nivel regi...onal. Su objetivo, además de presentar la situación epidemiológica y programática de la TB en las Américas, es sensibilizar, motivar e incentivar a todas las partes involucradas en la prevención y el control de esta enfermedad, para acelerar los esfuerzos hacia su eliminación en la Región y alcanzar las metas de la Estrategia Fin de la TB. En el informe se consignan los logros, pero también las brechas en el trabajo que se realiza en aspectos de diagnóstico, tratamiento, comorbilidades, poblaciones vulnerables, factores de riesgo y financiación, entre otros asuntos. A partir de la información presentada, se brindan unas recomendaciones concretas para seguir avanzando.
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These guidelines for the prevention and management of cardiovascular diseases are a critical ingredient for streamlining care across the entire health services provision continuum. They are a strategic component in achieving universal health coverage, securing affordable heal...th care and improving the livelihood of all Kenyans which in turn will guarantee a healthy nation working towards sustainable development and prosperity.These guidelines bring to the fore the need for availability of skilled human resource, sustained adequate funding and partnership building at all levels of governance. It provides clear roles for health workers at the different levels of our devolved system which will ensure a harmonized referral system with basic cardiovascular diseases treatment services available closest to the people while decongesting the county and national referral facilities.
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The key areas covered are diagnosis, imaging, pathology, surgery, rehabilitation, palliative care and survivorship. It emphasizes a multi-disciplinary team approach which is paramount for quality cancer care. The specific cancers covered are breast, central nervous system, gastroint...estinal, gynecological, head and neck, hematological, Kaposi’s sarcoma, lung, prostate and pediatric cancers. They also complement the National Guidelines for Cancer Management in Kenya released in 2013.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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La Región de las Américas constituye un territorio extremadamente rico desde el punto de vista de la diversidad cultural, en la cual se presentan una variedad de desafíos relacionados con el reconocimiento y el respeto de los derechos humanos de los miembros de los pueblos indígenas, los afrodes...cendientes, los romaníes, así como de otros grupos étnicos. A lo largo del curso de la vida, estas personas experimentan discriminación estructural y poca representatividad e inclusión en los procesos de toma de decisiones, lo cual dificulta su acceso a los servicios de salud, afecta la calidad de la atención que reciben y tiene un efecto general en sus condiciones de vida. Por tanto, la protección y la promoción de su salud y seguridad socioeconómica es una cuestión no solo de política pública, sino también de protección y ejercicio de los derechos humanos. En esta publicación se presentan los instrumentos internacionales y regionales de derechos humanos y los sistemas de protección de esos derechos instaurados por las Naciones Unidas y el Sistema Interamericano de Derechos Humanos, así como medidas para hacerlos efectivos, con especial hincapié en el derecho a la salud, al medio ambiente sano y otros derechos relacionados con el cuidado del planeta.
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Although Kenyans enjoy comparatively good health, the prevalence of
chronic disease is increasing and our ageing population is placing evergrowing pressures on the finite resources of our health system.
El personal de enfermería desempeña un papel fundamental en la promoción de la salud y la prevención de enfermedades, y es uno de los grandes pilares del sistema de atención de salud. No obstante, la escasez de recursos humanos que afecta al sector en todo el mundo repercute en la calidad de lo...s servicios. Esta hoja informativa hace hincapié en los puntos de acción clave para invertir en la fuerza de trabajo e insta a los Estados Miembros de la OPS a fortalecer el sector a través de medidas basadas en la inversión en formación, la creación de empleo e incentivos, el liderazgo de alto nivel y la regulación de la práctica de enfermería.
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El objetivo de esta publicación es ofrecer un enfoque práctico y gradual para la aplicación de los planes de acción nacionales sobre la RAM en el sector de la salud humana; y proporcionar un proceso y una recopilación de las herramientas existentes de la OMS para priorizar, costear, aplicar, su...pervisar y evaluar las actividades del plan de acción nacional. Los destinatarios de la publicación son las partes interesadas nacionales/subnacionales que trabajan en la RAM dentro del sector de la salud humana. Se trata de las autoridades sanitarias nacionales, los grupos de coordinación multisectorial nacionales, los expertos técnicos de alto nivel y los responsables de la formulación de políticas que participan en la ejecución de las actividades relativas a la RAM en todos los niveles del sistema de salud, y los asociados en la ejecución para acelerar la aplicación sostenible y el seguimiento y la evaluación de los planes de acción nacionales sobre la RAM.
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Cotonou Declaration oBuruli Ulcer
Cotonou, Benin, 30 March 2009
Neglected tropical diseases kill, weaken or incapacitate millions of people every year, causing permanent physical suffering, social stigmatization and reduced productive capacity. Buruli ulcer, one such disease, causes immense suffer...ing and disabilities, especially among children. Delayed schooling and loss of productivity are considerable among the affected populations. These adverse consequences tend to aggravate poverty in affected communities. Globally, the disease has been reported in 30 countries. In WHO’s African Region, Buruli ulcer has been confirmed in 12 countries and is suspected in 10 others.
Significant progress has been made in the past 10 years in knowledge of Buruli
ulcer, investments in related research, control of the disease, and improvement
of tools for case diagnosis and development of treatment protocols. Substantial achievements have been made in diagnosis, treatment, immunology and epidemiology. Despite these achievements, little is known about the exact mode of transmission of the disease, and there is no simple diagnostic test usable in the field.
The use of antibiotics has revolutionized treatment and contributed to reducing the need for surgery by half. However, efforts are still needed to develop simple diagnostic tools usable in the field as well as disability prevention methods. The Global Buruli Ulcer Initiative has adopted the strategy recommended by WHO. The strategy is based on early diagnosis of the disease and the use of antibiotics for treatment upon the onset of the first signs by improving access to screening and case management at the most peripheral level of the health system.
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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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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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This resource presents a comprehensive framework designed to enhance and streamline telemedicine services within health-care systems. It addresses the critical need for accessible and effective telemedicine solutions, especially in the face of global health challenges and the evolving demands on hea...lth-care infrastructures. It outlines a multidimensional strategy that includes an assessment of the current health-care ecosystem, strategic visioning for telemedicine integration, organizational change management, development of telemedicine services, and continuous monitoring, evaluation, and optimization. It emphasizes the importance of considering the unique needs of diverse populations and ensuring equitable access to telemedicine technologies. By leveraging global best practices and empirical evidence, the document aims to guide stakeholders through the lifecycle of telemedicine service implementation—from conceptualization to maturity. Intended for health-care decision-makers, policy-makers, and telemedicine practitioners, the framework supports the development of high-quality telemedicine services at various levels of the health system. It facilitates a collaborative approach, encouraging alignment and coordination among different stakeholders to achieve a common goal: building a resilient, patient-centred, and technologically advanced health-care system.
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