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CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to b
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e successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further assessment
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The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportionally on low- and middle-income countries. Injury Pr
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evention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year.
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PFA for Red Cross and Red Crescent Societies has several parts that can be used separately or together. It comprises this guide, a small booklet on PFA, and four training modules on PFA. This guide has general information about psychological first aid. It can be used on its own for psycho-
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education and as a reference for the training modules that accompany it. The training modules include instructions, notes, and training resources for the facilitators.
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La PFA pour les Sociétés de la Croix-Rouge et du Croissant-Rouge comprend plusieurs parties qui peuvent être utilisées séparément ou ensemble. Il comprend ce guide, un petit livret sur l'APF et quatre modules de formation sur l'APF. Ce guide contient des informations générales sur les premie
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rs secours psychologiques. Il peut être utilisé seul pour la psycho-éducation et comme référence pour les modules de formation qui l'accompagnent. Les modules de formation comprennent des instructions, des notes et des ressources de formation pour les animateurs.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of
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Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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Guidelines for the Prevention and Contaiment of of Antimicrobial Resistance in South African Hospitals
recommended
These guidelines form part of efforts to institutionalize the prevention and containment of antimicrobial resistance (AMR) in healthcare facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interr
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elated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level. They aim to serve as a practical, step-by-step or ‘how-to’ guide, addressing the infection prevention and AMS components of a robust response in a hospital. They draw on
evidence from various international guidance documents and standards for interventions that have been shown to be successful in infection
prevention and AMS programmes. These interventions have been customised to the South African hospital setting based on local
experiences in the public and private health sectors. This was done through a series of workshops and requests for comment involving
country-level experts.
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Climate change threatens to undermine the past 50 years of gains in public health. In response, theNational Health Service (NHS) in England has been working since 2008 to quantify and reduce its carbon footprint.
This Article presents the latest update to its greenhouse gas accounting, identifying
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interventions for mitigation efforts and describing an approach applicable to other health systems across the world.
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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an
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d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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Cascading risks from rising prices and supply disruptions, April 2022.
Global resource markets are still reeling from the impacts of Russia’s invasion of Ukraine; the two countries are major suppliers of energy, food and fertilizers. Supply disruption and the sudden imposition, in response to the
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crisis, of unprecedented economic sanctions, trade restrictions and policy interventions have caused prices of commodities to skyrocket.
Before the conflict, demand for global resources already exceeded supply and drove up prices as economies rebounded after the COVID-19 pandemic. This gave rise to a global cost-of-living crisis, characterized by increasing levels of energy and food poverty. This situation is likely to become much worse as a consequence of the war in Ukraine, and poses a threat to human security, particularly among low-income and vulnerable populations.
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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe
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rent interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
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Following a long recovery from the economic crisis (2007–2013), young people in the EU proved to be more vulnerable to the effects of the restrictions put in place to slow the spread of the COVID-19 pandemic. Young people were more likely than older groups to experience job loss, financial insecur
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ity and mental health problems. They reported reduced life satisfaction and mental well-being associated with the stay-at-home requirements and school closures. While governments responded quickly to the pandemic, most efforts to mitigate the effects of restrictions were temporary measures aimed at preventing job loss and keeping young people in education. This report explores the effects of the pandemic on young people, particularly in terms of their employment, well-being and trust in institutions, and assesses the various policy measures introduced to alleviate these effects.
Summary available in 22 languages
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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
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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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The recommendations in this guideline are intended to inform development of national and subnational health policies, clinical protocols and programmatic guides. The target audience includes national and subnational public health policy-makers, implementers and managers of maternal, newborn and chil
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d health programmes, health-care facility managers, supervisors/instructors for in-service training, health workers (including midwives, auxiliary nurse-midwives, nurses, paediatricians, neonatologists, general medical practitioners and community health workers), nongovernmental organizations, professional societies involved in the planning and management of maternal, newborn and child health services, academic staff involved in research and in the pre-service education and training of health workers, and those involved in the education of parents.
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The world faces grave consequences from the lack of available mental health services and treatment. Mental illness impacts every country, culture and community, with the World Health Organization (WHO) stating that 10% of the global burden of disease is related to mental, neurological and substance
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use disorders. In low-and middle-income countries, more than 75% of people with mental disorders receive no treatment at all for their disorder. During 2020, as a result of the global pandemic, 93% of countries reported their mental health services were either halted or interrupted (WHO, 2020e). WHO reported a 25% increase in depression and anxiety alone during the pandemic. The Organisation for Economic Co-operation and Development estimates depression and anxiety cost the global economy US $1 trillion dollars a year. All nurses have a health care role in mental health and substance use. ICN strongly advocates for the investment of further education and professional development in this area in order to support individuals and communities achieve the highest attainable standard of health which includes
physical, mental and social wellbeing.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in
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health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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A lot has happened this year. While we continued to tackle the COVID-19 pandemic, we were hit by disease outbreaks and
humanitarian crises. Yet, despite these challenges, we marched on, resolute in resolving critical health systems issues to increase
access to quality healthcare services. To furth
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er our vision and bring concrete actions to reality, under
the leadership of the Government of South Sudan, we developed the Health Sector Strategic Plan to define the strategic
approaches, key interventions, mapping resource needs, and the implementation framework to strengthen the health system
to deliver essential quality health services equitably for 2023 to 2027. For WHO, this Plan will usher in a new reality -- access
to lifesaving or health-promoting interventions is doable and possible, making the health sector fairer, especially for those
unable to pay
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This guideline provides updated, evidence-informed guidance on the percentage of total fat in the diet to reduce the risk of unhealthy weight gain.
This guideline is intended for a wide audience involved in the development, design and implementation of policies and programmes in nutrition and pub
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lic health. This guideline includes a recommended level of total fat intake which can be used by policy-makers and programme managers to address various aspects of dietary fat in their populations through a range of policy actions and public health interventions.
The guidance in this guideline replaces previous WHO guidance on total fat intake, including that from the 1989 WHO Study Group on Diet, Nutrition and the Prevention of Chronic Diseases and the 2002 Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. The guidance in this guideline should be considered in the context of that from other WHO guidelines on healthy diets.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t
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he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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The Commission on Macroeconomics and Health (CMH) was established by World Health Organization Director-General Gro Harlem Brundtland in January 2000 to assess the place of health in global economic development. Although health is widely understood to be both a central goal and an important outcome
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of development, the importance of investing in health to promote economic development and poverty reduction has been much less appreciated. We have found that extending the coverage of crucial health services, including a relatively small number of specific interventions, to the world’s poor could save millions of lives each year, reduce poverty, spur economic development, and promote global security.
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Developmental disabilities are common. Yet, children with developmental disabilities have been neglected in health systems planning and policy provisions for health and continue to experience stigmatization, institutionalization, barriers to access health care and inequalities in health and
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education outcomes.
Using findings from research and practice and guided by the tenets of international human rights conventions, this WHO-UNICEF Global Report on children with developmental disabilities provides principles and approaches to intentionally include the needs and aspirations of children and young people with developmental disabilities in policy, programming and public health monitoring. It makes the case for greater accountability and proposes 10 priority actions to accelerate changes towards inclusive environments and responsive multisectoral care systems for children with developmental disabilities.
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