Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Hand hygiene is vital for safe health care delivery, yet practices at the point of care remain suboptimal worldwide. A comprehensive research agenda is therefore necessary to improve our understanding of factors influencing hand hygiene behaviour and to strengthen appropriate interventions. This age...nda will provide insightful ideas for researchers to focus their projects and funding proposals and will direct donors towards the areas of hand hygiene evidence that require urgent support and innovation. It will also guide decision-makers and stakeholders at the national and international level and support country efforts in updating and strengthening hand hygiene promotion programmes. Global collaboration and investment in hand hygiene research remain essential to promote safe and effective care worldwide.
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The report showed commitments made three decades ago to protect the rights of children remain unfulfilled for millions. Violence still affects countless children. Discrimination based on age, gender, disability, sexual orientation and religion harms children worldwide.
Key factors include a lack ...of investment in critically important services. Most countries fall well short of spending the 5-6% of GDP needed to ensure universal coverage of essential health care. And foreign aid, which many lower income countries rely on, is falling short in areas such as health, education, protection and child care.
Another factor, the report said, is the lack of quality data. Governments tend to rely on data that reflects national averages, making it difficult to identify the needs of specific children and to monitor progress. Comprehensive data collection and disaggregation of data by gender, age, disability and locality, are increasingly important as rights violations disproportionately affect disadvantaged children.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapte...rs (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile popul...ations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Across the Western Pacific Region COVID-19 is placing enormous strain on health and economic systems apart from direct threats to personal health safety and livelihood the pandemic also has significant implications on mental health and psychosocial well being adversity is an established risk factor ...for mental health problems thus the impact of COVID-19 on mental health is expected to be large diverse and far reaching mental health and psychosocial support mhpss are essential components of a public health response to COVID-19 this guidance note provides 10 activities that may be integrated in national COVID-19 response and mitigation plans
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Human African Trypanosomiasis (HAT, sleeping sickness) and Animal African Trypanosomiasis (AAT) are neglected tropical diseases generally caused by the same etiological agent, Trypanosoma brucei. Despite important advances in the reduction or disappearance of HAT cases, AAT represents a risky reserv...oir of the infections. There is a strong need to control AAT, as is claimed by the European Commission in a recent document on the reservation of antimicrobials for human use. Control of AAT is considered part of the One Health approach established by the FAO program against African Trypanosomiasis. Under the umbrella of the One Health concepts, in this work, by analyzing the pharmacological properties of the therapeutic options against Trypanosoma brucei spp., we underline the need for clearer and more defined guidelines in the employment of drugs designed for HAT and AAT. Essential requirements are addressed to meet the challenge of drug use and drug resistance development. This approach shall avoid inter-species cross-resistance phenomena and retain drugs therapeutic activity.
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A global shortage of an estimated 18 million health workers is anticipated by 2030, a record 130 million people are in need of humanitarian assistance, and there is the global threat of pandemics such as COVID-19. At least 400 million people worldwide lack access to the most essential health service...s, and every year 100 million people are plunged into poverty because they have to pay for healthcare out of their own pockets. There is, therefore, an urgent need to find innovative strategies that go beyond the conventional health-sector response.
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According to the United Nations, Yemen has been the "Worst humanitarian crisis in the world," for the past two years. Despite the Hudaydah Agreement signed in December 2018, the fighting continued in many areas of the country, such as Hajjah in the north, Al Dhale' e in the south and Hudaydah along ...the west coast. Within a year, another 400,000 Yemenis were forced to flee their homes, eventually adding up to one-eighth of the entire Yemeni population who had become displaced at least once, over the last five years.
In 2019, unprecedented heavy rain and flooding from May onwards caused catastrophic damage to homes and the families’ livelihoods, adding to their misery. Thousands of families who had already lost their home due to the fighting had yet again, their temporary shelters, beddings and essential kitchen supplies, destroyed.
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A key component of achieving control and elimination of neglected tropical diseases (NTDs) is effective supply chain management of preventive chemotherapy drugs for Mass Drug Administration (MDA) for trachoma, river blindness, lymphatic filariasis, soil-transmitted helminthiasis and schistosomiasis.... This course explains the end-to-end process from planning and submitting donated drug requests through to waste management of expired and unserviceable stock and reverse logistics of unused tablets. It is essential knowledge for all levels of the health system that must work together to implement MDA.
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WHO issued an updated appeal (May 2022) detailing its resource needs for Ukraine and refugee-receiving and hosting countries for March-August for Ukraine and March-December 2022 for other countries.
The needs are an estimated US$ 147.5 million: US$ 80 million for health response in Ukraine and ano...ther US$ 67.5 million is needed to address the health needs of Ukrainian people affected by the conflict in refugee-receiving and hosting countries.
With the funds sought, WHO aims to ensure, until August, that up to 6 million people can access essential health services including trauma care in Ukraine.
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Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential health services, including those that addres...s sexual and reproductive health and rights (SRHR), gender-based violence (GBV) and preventing harmful practices such as child marriage and female genital mutilation.
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The Atlas of Palliative Care in the Eastern Mediterranean Region is the first systematic attempt to assess the status of resources, activities, and needs of palliative care in the region. It provides a comparative picture of the current state of palliative care in simple and clear graphics, utilisin...g texts, tables, figures and maps that reproduce information given by national palliative care leaders in the Eastern Mediterranean. This information is essential for the appropriate planning of the development of palliative care for this region.
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The article "Can we prevent cardiovascular diseases in low- and middle-income countries?" by Claude Lenfant discusses the growing threat of cardiovascular diseases (CVDs) in developing countries. It highlights that while CVD is already the leading cause of death globally, low- and middle-income coun...tries are now facing rising CVD rates due to lifestyle changes associated with urbanization and economic growth. Lenfant advocates for a dual approach: identifying and treating high-risk individuals and promoting broad, population-wide prevention efforts focused on lifestyle changes such as reducing smoking, lowering salt intake, and increasing physical activity. He emphasizes that early, affordable preventive measures are essential to mitigate the impending CVD epidemic in these countries and prevent significant healthcare and economic strain.
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This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards... have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
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This field workbook supports the implementation of the interagency (FAO, UNICEF, WHO) “Communication for Behavioural Impact (COMBI): A toolkit for behavioural and social communication in outbreak response”. It is a handheld guide and notebook for applying the WHO COMBI methodology in 7-steps, du...ring an outbreak. It is primarily intended for risk communication, developmental communication and health promotion/education personnel working in multidisciplinary teams to investigate and respond to disease outbreaks. It contains essential tools, checklists, and information needed to design effective behavioural and communication interventions in support of outbreak prevention and control objectives - to limit loss of life and minimize disruption to families, communities and societies
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No publication year indicated
The cost of newborn and child health interventions were estimated considering several different angles. At the first attempt, the cost of implementing all newborn and child health interventions packaged as antenatal, Intra natal, Essential newborn care, Care of sic...k newborn, Care of premature & LBW, Nutrition, Immunization, Care of sick infants and newborns, ECCD and WASH was estimated. This estimate reflects the cost of entire newborn and child care program thrust in the country. Costs of different intervention sub packages were also determined.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources... and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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