SHOPS and HIA finalized a scope of work with USAID Senegal in April 2015, and a team of five private sector experts conducted the onsite assessments between May and June 2015. The Private Sector Assessment (PSA) team worked closely with Senegalese key stakeholders throughout the process. The PSA tea...m interviewed more than120 individuals from approximately 78 organizations, including the government of Senegal (GOS), donors, USAID implementing partners, private sector umbrella organizations, private insurance companies, faith-based organizations (FBOs), nongovernmental organizations (NGOs), private health care facilities, and private pharmacies.
Through stakeholder interviews and review of government reports and online resources, the assessment team noted the following findings by theme.
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The 65-page report names more than 15 commanders and officials from both the government Sudan People’s Liberation Army (SPLA) and the rebel SPLA-in Opposition and their allies who have used child soldiers. The report is based on interviews with 101 child soldiers who were either forcibly recruited... or joined forces to protect themselves and their communities. They said they lived for months without enough food, far away from family, and were thrown into terrifying gun battles in which they were injured and saw friends killed. Children also expressed deep regret that they had lost time they should have spent in school.
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Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success.
The NTLP is ...poised to attain the ambitious goal pronounced by the government of eliminating TB by 2030, in line with the Sustainable Development Goals (SDGs) and the World Health Organization End TB Strategy. The programme exponentially increased TB notifications from as low as 35,922 people with TB in 2018 to 40,726 in 2020 and in 2021 the TB notifications rose to 50,825 (a 25% increase against 2020 performance). The NTLP also registered incredible success in sustaining high TB Preventive Treatment (TPT) initiations among persons living with HIV and a high TB treatment success rate among drug-susceptible TB cases. New and relapse TB notifications in children below 15 years increased by 43%, from 2,724 in 2020 to 3,890 in 2021. TB notifications ratio between children aged 0-4 and 5-14 was 0.9, an improvement from what we achieved in 2018 (the ratio was 0.7). The proportion of TB patients who are HIV positive continued to decrease, reaching 34% in 2021 from 39% in 2020. Sustained increases in TB notifications, treatment success rate, and TPT initiations have resulted in a rapid decrease in the TB incidence rate that reached 307 per 100,000 population in 2021 against a rate of 391 in 2015.
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Three classess of tests are now recommended in the latest consolidated guideles on tests for tuberculosis infection. It includes for the first-time a new class of Mycobacterium tuberculosis antigen-based skin tests (TBSTs), and the two existing classes of tests: the tuberculin skin test (TST) and t...he interferon-gamma release assays (IGRAs).
IGRAs and TBSTs use Mycobacterium tuberculosis complex specific antigens and represent a significant advancement to TST which has been used for over half a century.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t...o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Masangane Case Study
The Vesper Society commissioned ARHAP to do research on the integrated Masangane HIV/AIDS programme affiliated with the Moravian Church in Eastern Cape, South Africa. Completed in 2006, this study aimed to understand the role of the religious health assets of the Masangane ART ...programme for public health, as a model for a replicable response to HIV/AIDS. A crucial aspect of this research involved teasing out what value is added to this programme by its faith-based nature. Field work for this case study consisted of more than 20 key informant interviews of various stakeholders: Masangane staff and management; church leaders; health seekers; donors and health providers. Health seekers also answered 77 questionnaires and were involved in two focus groups.
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Excessive consumption of salt (more than 5 g per day) raises blood pressure, a major risk factor for cardiovascular diseases such as heart disease and stroke, and is the leading cause of death in the WHO European Region. Many countries in the Region have initiated national salt reduction strategies,... including public awareness campaigns, reformulation, and front-of-pack nutrition labelling. However, despite ongoing efforts, surveillance data indicate that salt intake still far exceeds the limits recommended by WHO to protect health.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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n October 2019, WHO convened the first meeting of the Buruli ulcer laboratory network (BU-LABNET) in Yaoundé, Cameroon, bringing together 11 laboratories from nine countries at the Pasteur Centre of Cameroon (CPC), the network’s Coordinating Centre. The network was formally established at th...is meeting (1) and its members were those present. The objective of BU LABNET is to improve diagnosis of Buruli ulcer based on polymerase chain reaction (PCR) using standardized testing protocols, involving external quality assurance programmes and sharing knowledge among member laboratories.
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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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The 2015-16 MDHS is a national sample survey that provides up-to-date information on fertility levels; marriage; fertility preferences; awareness and use of family planning methods; child feeding practices; nutrition; adult and childhood mortality; awareness and attitudes regarding HIV/AIDS; women...s empowerment; and domestic violence. The target groups were women and men age 15-49 residing in randomly selected households across the country. In addition to national estimates, the report provides estimates of key indicators for both urban and rural areas in Myanmar and also for the 15 states and regions.
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Early Childhood Matters is a journal about early childhood. It looks at specific issues regarding the development of young children, in particular from a psychosocial perspective. It is published twice per year by the Bernard van Leer Foundation.
On Page 54 of this issue the article titled: "Par...enting in times of war: supporting caregivers and children in crisis" can be found. In this article: Humanitarian interventions to support and guide parents and caregivers in times of war can mitigate the negative effects of violence and chaos on children and promote their resilience and development. This article highlights recent findings from the International Rescue Committee’s parenting programmes in Syria, underscoring the importance of such programmes not only in strengthening caregiving practices but also in addressing the psychological needs of parents.
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In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti...on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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The Global Vaccine Action Plan (GVAP) 2011-2020, endorsed by Member States during the May 2012 World Health Assembly, has set ambitious targets to improve access to immunization and tackle vaccine-preventable diseases. This responsibility has been translated into firm commitments in February 2016, t...hrough the signature of the Addis Declaration on Immunization (ADI) by African Ministers and subsequently endorsed by the Heads of States from across Africa at the 28th African Union Summit held in January 2017. This commitment from the highest level of government comes as a catalyst to immunization efforts on the continent to deliver on the promise of universal immunization
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The International Association for Child and Adolescent Psychiatry and
Allied Professions (IACAPAP) aims to promote the mental health and
development of children and adolescents worldwide. It seeks to achieve
this by contributing to the training and professional development of the
child and adole...scent mental health professionals by disseminating up-todate
and high-quality information through its publications, organization
of biennial international congresses, and study groups. IACAPAP has a
long tradition of publishing monographs released to coincide with the
congresses, with the first one published in 1970.
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39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response. The report shows that deliberate and proactive action is required to ensure that persons with disabilities from all constituencies are systematically included and meaningfully participate in DRR... and humanitarian preparedness, response and recovery. It draws lessons from field practices, but does not provide technical guidance. The newly published IASC Guidelines are the reference document to seek in-depth theoretical and technical information.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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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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Project Drawdown (2022) provides evidence of how climate solutions can also be win-win opportunities for meeting development and human well-being needs while boosting prosperity for rural communities in sub-Saharan Africa and South Asia. The report summarizes the co-benefits of five groups of a subs...et of Project Drawdown climate solutions (28 total solutions) for advancing human well-being in rural areas of low- and middle-income countries
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