Final Report
Submitted to: Unicef, New Delhi
ORG Centre for Social Research (A Division of AC Nielsen ORG- MARG Private Limited)
Accessed: 30.10.2019
As of 21 March 2019, a total of 250,000 people are reported to be affected by the floods in nine districts. An estimated 48 per cent of the affected population is under 18 years of age.
There is limited road access in the Chimanimani, the worst affected district.
An estimated 60,000 children are ...in need of immediate protection services, and 100,000 children are in need of welfare and civil registration services in nine flood affected districts.
Initial estimates indicate that 54 classrooms from 114 schools have been affected by the floods, impacting about 30,000 learners. Over 5,000 households have been reached with critical WASH Hygiene kits in affected districts.
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Observatory report by Médecins du Monde/Doctors of the World Germany:“Deprived of the right to health. Sick and without medical care in Germany” gives a rare insight into the situation of those who have no or only limited access to the German health system.
The past two decades have witnessed changes in how humans live. Travel and trade, rapid urbanization, limited access to health care as well as environmental degradation and other trends all create the conditions for epidemics to thrive and grow. At the same time, the science and knowledge around inf...ectious hazards are constantly evolving, demanding better response to health emergencies.
This introductory level online course aims to equip frontline responders with the latest know-how to manage outbreaks of known and emerging epidemic-prone diseases in the 21st century. This course focuses on 13 infectious hazards, offering the most relevant scientific, technical and operational knowledge through video presentations and self-tests.
The course will take approximately 6 hours to finish.
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Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combi-
nations of DAAs can cure infection with HCV in 12 weeks, are highly effective and
have limited side-effects. Affordability of DAAs has improved significantly, but access remains lim-
i...ted. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-
income countries alike. Now there is a divide between those countries where, because of intellectual
property barriers, prices have remained (very) high and other countries where generics are, or can be,
available at much lower prices. The result is a dual market
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Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious diseases is greater and exacerbated by limited access to, and availability and affordability of, antimicrobials required to treat infect...ions caused by AMR organisms. With drugs not listed on the essential drugs list (EDL), problems of increased morbidity, costs of extended hospitalisation and mortality are extremely serious. The problem of susceptibility to and spread of infections caused by multidrug-resistant (MDR) infectious agents is fuelled by factors such as limited access to clean water and sanitation to ensure personal hygiene, malnutrition, and the HIV/TB epidemic.
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Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations, refugees,
migrants, and minorities experience the highest degree
of socio-economic marginalization. Marginalized people
become even more vulnerable in emergencies.1 This is due
to factors su...ch as their lack of access to effective surveillance
and early-warning systems, and health services. The
COVID-19 outbreak is predicted to have significant impacts
on various sectors.
The populations most at risk are those that:
• depend heavily on the informal economy;
• occupy areas prone to shocks;
• have inadequate access to social services or political
influence;
• have limited capacities and opportunities to cope and
adapt and;
• limited or no access to technologies.
By understanding these issues, we can support the capacity
of vulnerable populations in emergencies. We can give
them priority assistance, and engage them in decision-making
processes for response, recovery, preparedness, and
risk reduction.
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This document will be continuously updated. Version as of April 27th, 2020
Migrant and displaced children are at heightened risk to the immediate and secondary impacts of COVID-19. They often live in cramped conditions with limited access to water, sanitation, and hygiene (WASH), may be in immig...ration detention or “left behind,” live with disabilities, unaccompanied or separated from their families, and can be hardest to reach with accurate information in a language they understand. Migrant workers and refugees can live in the most disadvantaged urban areas, where access to essential services is already limited. Refugee and migrant children may also be prevented from accessing essential services due to legal, documentation, linguistic or safety barriers. Further, the misinformation on the spread of COVID-19 exacerbates the xenophobia and discrimination that migrant and displaced children and their families already face.
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Previous crises, such as the Ebola virus disease (EVD) in West Africa in 2014, indicate the direct impact movement restrictions and disease containment efforts have on food availability, access, utilization and violence – particularly gender-based violence (GBV). The importance of maintaining and ...upscaling food security interventions for the most vulnerable populations, alongside the health sector’s efforts to avert disease spread, is therefore undeniable. The COVID-19 outbreak in South Sudan threatens to paralyze an already fragile food system and negatively impact more than 6.5 million people in South Sudan who remain vulnerable. At the same time, the core national capacities for prevention, preparedness and response for public health events is limited, and the healthcare system has been weakened by years of conflict, poor governance and low investments.
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The COVID-19 pandemic has created challenges for forcibly displaced persons and the humanitarian organizations working to support them. With restrictions on movement and limited access to refugees, asylum-seekers, internally displaced persons (IDPs) and stateless persons across the globe, UNHCR is s...upporting displaced communities to take the lead in the prevention of, and the response to, the existing and emerging protection needs of women, men, girls and boys of diverse backgrounds.
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The COVID-19 pandemic poses an additional and critical challenge in a fragile humanitarian context, where the population is already highly vulnerable and lives in often overcrowded settlements where distancing is impossible, and with limited access to basic health services and hygiene. Further sprea...d of COVID-19 in the EHoA region will burden the already complex humanitarian situation with devastating consequences.
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EID Journal , Volume 27, no.12 , Dec. 2021. Early Release
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections may be underestimated because of limited access to testing. We measured SARS-CoV-2 seroprevalence in South Africa every 2 months during July 2020–March 2021 in randoml...y selected household cohorts in 2 communities. We compared seroprevalence to reported laboratory-confirmed infections, hospitalizations, and deaths to calculate infection–case, infection–hospitalization, and infection–fatality ratios in 2 waves of infection. Post–second wave seroprevalence ranged from 18% in the rural community children <5 years of age, to 59% in urban community adults 35–59 years of age. The second wave saw a shift in age distribution of case-patients in the urban community (from persons 35–59 years of age to persons at the extremes of age), higher attack rates in the rural community, and a higher infection–fatality ratio in the urban community. Approximately 95% of SARS-CoV-2 infections were not reported to national surveillance.
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The leishmaniases are a group of diseases caused by Leishmania spp., which occur in cutaneous, mucocutaneous and visceral forms. They are neglected tropical diseases (NTDs), which disproportionately affect marginalized populations who have limited access to health care. HIV co-infected patients with... Leishmania infection are highly infectious to sandflies, and an increase in the coinfection rate in an endemic area is likely to increase the effective infective reservoir.
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The geographical area directly affected by military operations has increased dramatically. Affected areas are not limited as before to a strip along the contact line (which continues to exist) but are scattered across the country. There are many territories outside eastern conflict area are directly... affected for the first time (including urban centres).
Previously accessible areas or unaffected areas are now isolated settlements due to active fighting, not reachable by both humanitarian agencies and public actors. Access to these locations is still not possible, as military activities are ongoing.
Residential buildings are not a direct target, but collateral damages are registered. Civilian infrastructure – such as gas, central heating systems and electricity – is also affected, with an even higher impact on the population due to the cold season and to the impossibility to access markets for solid fuel and state winterization subsidies.
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Mycetoma is a slow-growing bacterial or fungal infection, most often of the foot, that may spread to other parts of the body and can cause severe deformity. It is a debilitating disease that most often affects poor people in rural areas with limited access to health care.
For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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Almost the entire Rwandan population (98.5%) relies on polluting fuels, particularly firewood and charcoal, for cooking. Access to clean energy such as electricity is still limited. In 2022, 70% of the population lived in towns and villages that have electricity – 49% from the national grid and 21...% from off-grid (mainly solar) systems. When access is defined as connection and use of households to electricity, an estimated 47% of households had access in 2020, representing 86% of the urban population but only 38% of the rural population.
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South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing ...and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Time has seen management for Cystic Fibrosis (CF) advance drastically, most recently in the development of the disease-modifying triple combination therapy ivacaftor/tezacaftor/elexacaftor. There is currently limited evidence regarding both the global epidemiology of CF and access to this transforma...tive therapy - and therefore where needs are not being met. Therefore, this study aims to define gaps in access to CF treatment. The results show that a significant CF patient burden exists in countries where disease-modifying drugs are unavailable, and final figures are likely underestimates. This analysis shows the potential to improve rates of diagnosis and treatment for CF, so a higher percentage of patients receive the most effective triple combination treatment.
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