Climate-related disasters, heatwaves, climate-sensitive diseases, and severe droughts and floods are taking lives and harming health, livelihoods, and ecosystems across the countries of the Caribbean, as in other Small Island Developing States (SIDS) around the world. In recognition of the high vuln...erability of those countries, the World Health Organization launched in 2017 the Special Initiative on Climate Change and Health in Small Island Developing States, aiming to increase the resilience of these countries and territories to climate variability and climate change
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Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as h...igh as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
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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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The aim of this guidance is to enhance the capacity of health care facilities to protect and improve the health of their target communities in an unstable and changing climate; and to empower health care facilities to be environmentally sustainable, by optimizing the use of resources and minimizing ...the release of waste into the environment. Climate resilient and environmentally sustainable health care facilities contribute to high quality of care and accessibility of services, and by helping reduce facility costs also ensure better affordability. They are, therefore, an important component of universal health coverage (UHC).
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Under the theme Equity at the Heart of Health, this Plan seeks to catalyze efforts in Member States to reduce inequities in health within and between countries and territories in order to improve health outcomes. The Plan identifies specific actions to tackle health inequality, including those recom...mended by the Commission on Equity and Health Inequalities in the Americas, with guidance from the High-level Commission for Universal Health. Four cross-cutting themes are central to this Plan’s approach to addressing the determinants of health: equity, gender, ethnicity, and human rights
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Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including ...disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
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14 January 2021
This practical guide can be used to help countries monitor and analyse the impact of COVID-19 on essential health services to inform planning and decision-making. It provides practical recommendations on how to use key performance indicators to analyse changes in access to and deliv...ery of essential health services within the context of the COVID-19 pandemic; how to visualize and interpret these data; and how to use the findings to guide modifications for safe delivery of services and transitioning towards restoration and recovery. The guide focuses on existing indicators and data that are captured in routine reporting systems and how they can be used by national and subnational authorities to understand specific contexts, challenges and bottlenecks. This guide supports Maintaining essential health services: operational guidance for the COVID-19 context, which provides an integrated framework to guide countries in their efforts to reorganize, adapt and maintain safe delivery of high-priority essential health services within the context of the pandemic.
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This global guidance provided the framework for over 100 countries to develop their NDVPs. This updated (second) version supersedes the previous version published in 16 November 2020. New information has been added on the following areas:
the COVID-19 Partners Platform;
the use of COVID...-19 simulation exercises to test deployment strategies;
the indemnity agreement and no-fault compensation programme for vaccines secured through the COVAX Facility in the Advance Market Commitment (AMC) eligible economies;
the availability and use of the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool;
the COVAX Facility’s humanitarian buffer that enables allocation of vaccine to cover high-risk populations in humanitarian settings;
recommendations for vaccination of pregnant and lactating women;
supplementary information on infection prevention and control (IPC) measures to be used to deliver COVID-19 vaccines safely;
the WHO licensed COVID-19 vaccines product-specific information;
use of geospatial data and digital micro plans for equitable access and delivery of COVID-19 vaccines;
lessons learned from the development of NDVPs and early experiences in COVID-19 vaccine deployment in countries; and
updated additional resources at the end of each chapter.
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to... ambient temperature.
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To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries—the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV ...expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
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The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental health conditions. Meanwhile, those with pre-existing mental health conditions may experie...nce a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
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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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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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This document summarizes the findings of the STEPS survey in Ukraine and compares them with the results of STEPS surveys carried out in other countries in the WHO European Region, as well as with selected other surveys in Ukraine. The survey is designed to be repeated approximately every five years ...in each country to allow assessment of trends.
The study revealed very high prevalence of NCDs and their behavioural and biological risk factors in Ukraine. Data on behavioural risk factors include tobacco and alcohol use, diet, and physical activity. Data on biological risk factors include overweight and obesity, blood pressure, blood glucose, and blood lipid levels.
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This report is part of the gender and noncommunicable diseases (NCDs) initiative launched by the WHO Regional Office for Europe, which aims to strengthen the response to NCDs through a gender approach. It is part of a series of country profiles and a synthesis report. The country profile of Ukraine ...presents a gender analysis of the WHO STEPwise survey (STEPS) data to support international commitments to reducing the burden of NCDs with evidence and knowledge exchange. A gender analysis of STEPS NCD risk-factor survey data describes how risk factors for chronic diseases differ between and among men and women by exploring and tracking the direction and magnitude of trends in risk factors and accessing services by sociodemographic variables. Important differences hide even in sex-disaggregated data that need to be unpacked through sociodemographic characteristics, because men and women are not homogenous groups. The report also recognizes gaps in evidence and calls for further analysis of the impact of gender-based inequalities.
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The threats posed by climate change to agriculture are now well known. Climate change has already resulted in a negative trend in mean crop yield per decade, and this is likely to continue as the century unfolds. In Africa, 650 million people are currently dependent on rain- fed agriculture and, des...pite progress in the Millennium Development Goals, food and nutrition insecurity remainunacceptably high.
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It outlines key achievements, needs and opportunities for intervention in the field of rehabilitation in Ukraine. The content of this document is a snapshot in time – not an in-depth analysis of the entire rehabilitation sector. The analysis focuses on rehabilitation policy and governance, service... provision, financing, information management and human resources, with the aim of improving access to high-quality rehabilitation services in Ukraine.
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Background: Healthcare workers’ mental health was affected by SARS-CoV-2 pandemic.
Aim: To evaluate healthcare workers’ mental health and its associated factors during the pandemic in Chile. Material and Methods: An online self-reported questionnaire was designed including the Goldberg Healt...h Questionnaire, the Patient Health
Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers.
Results: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one
percent reported the need for mental health support, and 38% of them received it.
Conclusions: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it.
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The report notes that the number of people in need of one or more assistive products is likely to rise to 3.5 billion by 2050, due to populations ageing and the prevalence of noncommunicable diseases rising across the world. The report also highlights the vast gap in access between low- and high-inc...ome countries. An analysis of 35 countries reveals that access varies from 3% in poorer nations to 90% in wealthy countries.
Affordability is a major barrier to access, the report notes. Around two thirds of people with assistive products reported out-of-pocket payments for them. Others reported relying on family and friends to financially support their needs.
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