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BMJ Glob Health 2017;2:e000345. doi:10.1136/bmjgh-2017-000345. WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients unde
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r care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and chal
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lenges, maps existing international commitments and frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers
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to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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Objectives and scope of the document
This document was developed to provide recommended management strategies for problems and disorders that are specifically related to the occurrence of a major s
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tressful event. The recommended strategies will form the basis of a new module to be added to the WHO (2010) mhGAP Intervention Guide for use in non-specialized specialized health-care settings.
The scope of the problems covered by these guidelines is:
symptoms of acute stress in the first month after a potentially traumatic event, with the following subtypes:
- symptoms of acute traumatic stress (intrusion, avoidance and hyperarousal) in the first month after a potentially traumatic event;
- symptoms of dissociative (conversion) disorders in the first month after a potentially traumatic event;
- non-organic (secondary) enuresis in the first month after a potentially traumatic event (in children);
- hyperventilation in the first month after a potentially traumatic event;
- insomnia in the first month after a potentially traumatic event;
posttraumatic stress disorder (PTSD);
bereavement in the absence of a mental disorder.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
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diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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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 physi
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cal activity occurs may promote physical activity at 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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Ramped-up cancer services could save 7 million lives over the next decade—and addressing huge service gaps between rich and poor countries is key to success, according to this report.
In 2019,
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over 90% of high-income countries reported that comprehensive cancer treatment services were available through the public health system, compared to fewer than 15% of low-income countries, according to WHO.
But poorer countries can make substantial strides with a universal health coverage approach and use of the latest science to meet their particular needs.
The report lays out proven ways to prevent new cancer cases without breaking the bank, including tobacco-control measures and vaccines that protect against common cancers.
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The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study
The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere
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. Before the government implements a payment policy in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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A cross-sectional descriptive study design covering all states and regions was undertaken to:
1) To assess availability, utilization and supply chain management system for RH commodities at dif ... ferent levels of health facilities,
2) To assess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
1) To assess availability, utilization and supply chain management system for RH commodities at dif ... ferent levels of health facilities,
2) To assess quality of RH services with emphasis on family planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities. more
This interim operational guide outlines infection prevention, control, and water, sanitation, and hygiene measures for home care and isolation of mpox in resource-limited settings. It focuses on practical strategies
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to manage and prevent the spread of the virus when persons with mpox are isolated at home in settings with limited resources. This document is intended for health and care workers, caregivers, and public health authorities.
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Improvements in water sanitation and hygiene (WASH) and wastewater management in all sectors are critical elements of preventing infections and reducing the spread of antimicrobial resistance (AMR) as identified in the Global Action Plan to combat A
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MR. Yet, at present, WASH and wastewater management actors and improvement actions are under-represented in AMR multi-stakeholder platforms and national action plans (NAPs). This WHO/FAO/OIE technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR NAPs and sector specific policy to combat AMR. Evidence and actions are presented in the domains of; coordination and leadership, households and communities, health care facilities, animal and plant production, manufacturing of antimicrobials, and surveillance and research.
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The purpose of this interim guidance is to provide information and insight to assist public policy and
health system leaders in preparing for and
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responding to an MCE caused by terrorist use of explosives
(TUE). This document provides practical information to promote comprehensive mass casualty care
in the event of a TUE event and focuses on two areas:
1. leadership in preparing for and responding to a TUE event, and
2. effective care of patients in the prehospital and hospital environments during a TUE event.
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Quantification des intrants de santé : supplément SRMNI - Prévision de la consommation de produits sélectionnés pour la santé reproductive, maternelle, néonatale et infantile
JSI Research & Training Institute, Inc., et Management Sciences for Health
JSI Research & Training Institute, Inc., et Management Sciences for Health
(2016)
C1
Soumis à l’Agence des États-Unis pour le développement international par le programme SIAPS (Systems for Improved Access to Pharmaceuticals and Services ou Programme des systèmes pour l’amé
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lioration de l’accès aux produits et services pharmaceutiques). Arlington, VA : Management Sciences for Health. Soumis à l’UNICEF par JSI, Arlington, VA : JSI Research & Training Institute, Inc.
Ce guide aidera les gestionnaires de programmes, les prestataires de service et les experts techniques lorsqu'ils réaliseront une quantification des besoins en intrants pour les 13 produits indispensables à la santé reproductive, maternelle, néonatale et infantile, dont la priorité a été établie par la Commission des Nations Unies pour les produits qui sauvent la vie des femmes et des enfants. Ce supplément à la quantification ne saurait être utilisé sans son guide principal – Quantification of Health Commodities: A Guide to Forecasting and Supply Planning for Procurement (Quantification des intrants de santé : un guide pour la prévision des achats et la planification des approvisionnements). * Ce supplément décrit les étapes à suivre pour la prévision de la consommation de ces intrants, en l’absence de données sur la consommation ou les services. Ensuite, afin de compléter la quantification, les utilisateurs doivent se référer au guide principal de quantification pour l’étape de planification de l’approvisionnement.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D
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care in LICs is often impacted by challenges in diagnosis and management. These challenges, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
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High prices, hard-to-access human insulin, few insulin producers, and weak health systems are just some of the barriers that people with diabetes f
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ace a century after insulin was discovered, WHO notes in a new report
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Access to health workers who are fit for purpose, motivated and protected is a fundamental force of hea
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lth service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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Conclusion: To ensure that people with disabilities can successfully access the necessary health services, the barriers on the demand side (the ind
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ividuals requiring healthcare) as well as the barriers that are part of the healthcare system, should be attended to.
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International Journal for Quality in Health Care, 2018, 30(9), 724–730
Promoting hand hygiene in a neonatal intensive care unit.
(You need free registration to download the book)
Disasters and public health emergencies can stress health
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care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources
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Palliative Care Toolkits and Training Manual
recommended
This toolkit has been written to empower health workers in resource-poor settings to integrate palliative
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care into the work they are doing by grafting the missing elements of care onto what is already in place. The WHPCA, Hospice UK and Palliative Care Works have led this updating of the Palliative Care Toolkit published in 2008 to reflect new knowledge and practice
The Manual is available in various languages: English, Swahili, Bengali, French, Georgian, Portuguese, Spanish, Vietnamese, Russian,
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