Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Disease epidemiology has a deeper relationship with the dynamic nature of culture. Health behaviors in general are largely shaped by the cultural norms and customs in a society. A mere identification of a behavior could be only a layer on the outer sphere of a particular disease epidemiology and the... interventional efforts to counteract such behaviors through for example public health measures could be futile and volatile, unless the deeper cultural factors are addressed.
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Developed as part of the UN Women–WHO Global Joint Programme on Violence Against Women Data, this briefing note focuses on the measurement of violence against women with disability and is one in a series of methodological briefing notes for strengthening the measurement and data collection of viol...ence against particular groups of women or specific aspects of violence against women.
The briefing note is meant for researchers, national statistics offices, and others involved in data collection on violence against women. It provides an overview of the challenges in the availability, measurement, and collection of data on violence against women with disability and outlines recommendations for good practice in measurement, with the aim of strengthening ongoing and future data collection efforts and increasing the availability of such data.
The inclusion of women with disability and the issue of disability within population-based surveys and research on violence against women is necessary for an improved understanding of populations of women at specific risk of violence. This knowledge would also allow more tailored prevention strategies and response/services and programmes to be designed in a way that addresses the specific needs of women with disability.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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In spite of the work carried out by the EU institutions, the Member States, many cities and grassroot movements in Europe, the general public is still not engaging enough in air quality policy initiatives and the level of awareness and knowledge of the effects of poor air quality on health is often ...low.
HEAL, within its work with the EU urban air quality partnership has put together a toolkit on ‘Communicating on air quality and health – Inspiring practices, challenges and tips’, providing hands-on examples of how communication on air quality, the health links and (policy and behavioural) changes takes place, as an inspiration particularly for urban authorities wanting to communicate on clean air.
The Partnership on Air Quality was founded in 2016 with the main objective of improving air quality in cities and bringing the ‘healthy city’ higher on the local, national and EU agendas as part of the urban agenda.
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The document is a summary report by the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, focusing on a capacity-building workshop held in Abu Dhabi in 2019. The workshop addressed the management and care of substance use disorders, aiming to improve technical and manage...rial capacities in areas such as policy development, treatment services, prevention, monitoring, and international collaboration. Participants included representatives from 12 countries, WHO collaborating centers, and other UN agencies.
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Social protection, a component of the World Health Organization (WHO)’s End TB strategy, has been upheld by Member States as an essential part of the response to tuberculosis in several political declarations, including the 2017 Moscow Declaration to End TB, and both the political declarations of ...both the 2018 and 2023 United Nations General Assembly (UNGA) high-level meetings on the fight against TB. Furthermore, during the 2023 high-level meeting, member states agreed on a new target to ensure that all people with TB have access to a comprehensive package of health and social benefits by 2027.
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The Global status report on alcohol and health and treatment of substance use disorders presents a comprehensive overview of alcohol consumption, alcohol-related harm and policy responses as well as treatment capacities for alcohol and drug use disorders worldwide. The report is based on data collec...ted by WHO from Member States and organized in accordance with the Sustainable Development Goals health target 3.5 which calls on countries to strengthen “the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”. The chapter on alcohol and health continues the series of WHO global status reports on alcohol and health and presents the latest available data on the status of, and trends in, alcohol consumption, as well as estimates of the alcohol-attributable disease burden and descriptions of policy responses worldwide. On the basis of data collected from countries on the treatment of substance use disorders the report describes the status of key components of treatment responses to alcohol and drug use disorders and proposes a new service capacity index for these disorders as an additional contextual indicator for monitoring progress in this domain of SDG health target 3.5. The report concludes with broad directions for international action to accelerate progress towards achievement of SDG health target 3.5.
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The2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group was coordinated and supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Healt...h. It is designed to improve patient care and support informed decision making about asthma management in the clinical setting. This update addresses six priority topic areas as determined by the state of the science at the time of a needs assessment, and input from multiple stakeholders:
• Fractional Exhaled Nitric Oxide Testing
• Indoor Allergen Mitigation
• Intermittent Inhaled Corticosteroids
• Long-Acting Muscarinic Antagonists
• Immunotherapy in the Treatment of Allergic Asthma
• Bronchial Thermoplasty
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En los últimos decenios se han logrado avances significativos en el control de la esquistosomiasis así como de las geohelmintiasis, y la OMS ha trazado una hoja de ruta para guiar la aplicación de las políticas y las estrategias planteadas en Accelerating work to overcome the global impact of ne...glected tropical diseases
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Parasite Epidemiology and Control Volume 27, November 2024, e00380
The planning and implementation of intervention measures against schistosomiasis, particularly mass administration, require knowledge of the current status of the infection. This is important for monitoring the impact of the interve...ntion on disease indicators such as a decline in infection prevalence, intensity of infection, and urogenital morbidities. Following repeated rounds of mass treatment in northwestern Tanzania, the epidemiology of urogenital schistosomiasis has changed; thus, for the effective planning and allocation of resources, it is important to understand the current status of the disease in the targeted groups
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Este informe presenta los resultados de la colaboración entre la Organización Panamericana de la Salud y sus Estados Miembros para analizar las barreras de acceso a la atención primaria de salud, así como para formular opciones de políticas encaminadas a reducirlas y eliminarlas de manera progr...esiva. El primer capítulo presenta una caracterización de los sistemas de salud de la Región de las Américas y los desafíos para el acceso universal en el contexto de la pandemia de COVID-19. El segundo ofrece un marco metodológico y de análisis para el estudio de las barreras de acceso y la determinación de opciones de políticas. En los capítulos 3 a 6 se presentan estudios de casos centrados en las barreras que enfrentan los grupos en situación de mayor vulnerabilidad en el contexto y la trayectoria de distintas reformas de los sistemas de salud. A modo de conclusión, se presentan recomendaciones generales que permitirán promover la agenda aún inconclusa hacia el acceso universal a la salud y la cobertura universal de salud.
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Strengthening rehabilitation in health emergency preparedness, response, and resilience: policy brief outlines the evidence for rehabilitation in emergencies and the need for greater preparedness of rehabilitation services. It shows how existing guidelines support the integration of rehabilitation i...n emergencies and sets out the steps that decision-makers can take to better integrate rehabilitation into health emergency preparedness and response.
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Le nombre de cas de COVID-19 augmente à nouveau, l’Afrique du Sud comptant pour près de la moitié de tous les cas confirmés de la Région africaine de l’OMS. La menace de nouveaux variants plane, et la faible couverture vaccinale soulève des questions concernant les mesures qui devront êtr...e prises pour lutter contre la COVID-19. Dans la plupart des pays d’Afrique subsaharienne, la prévention reste la stratégie clé. Dans ce document, cinq centres nationaux de la plateforme de l’Observatoire africain de la santé sur les systèmes et politiques de santé (AHOP), basés en Éthiopie, au Kenya, au Nigéria, au Rwanda et au Sénégal analysent les leçons à tirer de leurs mesures d’endiguement respectives lors despremières phases de la pandémie.
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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