Based on research by a team of Nepalese and international experts, this report carries an analysis of the five key elements in the sector - land, basic services, housing finance, building materials and construction technologies, and labour. It gives an assessment
of how these components are governe...d by policy, institutional and legal frameworks, and how they are linked with one another and other urban policies.
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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a...dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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This integrated operational framework provides an overview of the connections between mental health, neurological and substance use (MNS) conditions, and their links to health, well-being and the broader public health and sustainable development agenda. The need for integrated approaches is increasi...ngly recognized as critical to address the complex interactions between mental health, brain health, substance use, and physical health, particularly in light of global threats such as the COVID-19 pandemic. The framework also provides a series of actions for governments and health service planners and advisors to achieve integration across four domains: leadership and governance; care services; promotion and prevention; and health information systems, evidence generation and research.
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This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, preliminary studies and pilot testing, budgeting and accounting, intervention costing and economic analysis, and Phase IV studies. Before new interventions... are released into disease control programmes, it is essential that they are carefully evaluated in ‘field trials’. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. This manual was designed to provide guidance on the practical issues in great detail
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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Nigeria reported its first case of COVID-19 at the end of February 2020 and subsequently experienced
four waves, with peaks in June 2020 and January, August and December 2021. The COVID-19 pandemic
severely impacted the economy of Nigeria and caused disruption of health services nationwide. During... the crisis, many Nigerians failed to access routine health
services due to decreased income and lockdown
restrictions. The most significant service disruptions
were in maternal and newborn health, vaccination,
sick childcare, family planning and noncommunicable
disease treatment services (1). Pregnant women
were anxious about contracting COVID-19 during
2020, and as a result, many avoided attending health
facilities for antenatal (ANC) and postnatal care (PNC).
Disruptions in the medical supply chain and diversion
of resources to COVID-19 management impacted on
essential health services. Health workers were often
unable to go to work because of transport disruptions
or illness
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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An estimated 1.3 billion people globally experience significant disability. This figure has grown over the last decade and will continue to rise due to demographic and epidemiological changes. In 2022, the World Health Organization launched the Global report on health equity for persons with disabil...ities. This report demonstrated that many persons with disabilities are still being left behind. Experiencing persistent health inequities, persons with disabilities die earlier, they have poorer health and functioning, and they are more affected by health emergencies than the general population. These differences are largely associated with unjust factors both inside and beyond the health sector and are avoidable. The Global Report called upon Member States to take actions to make health sector more inclusive for persons with disabilities through the primary health care approach. This will be essential for countries to make health coverage truly universal and to progress towards other health-related targets in the sustainable development goals.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium ...term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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This document presents the World Health Organization Operational framework for building climate resilient and low carbon health systems*. ***The framework's goal is to increase the climate resilience of health systems to protect and improve the health of communities in an unstable and changing clima...te, while optimizing the use of resources and implementing strategies to reduce GHG emissions. It aims to contribute to the design of transformative health systems that can provide safe and quality care in a changing climate.
Implementation of the framework's ten components would help health organizations, authorities, and programmes to be better able to anticipate, prevent, prepare for, and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes. Implementing low carbon health practices would contribute to climate change mitigation while also improving health outcomes. Achieving these aims is an important contribution to universal health coverage (UHC), global health security, and specific targets within the Sustainable Development Goals (SDGs). The document is a useful resource for decision-makers in health systems, including public health agencies, and other specialized institutions, and for decision-makers in health-determining sectors.
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa...cerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
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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 ...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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Mental disorders are one of the top public health challenges in the WHO European Region, affecting about 25% of the population every year. In all countries, mental health problems are much more prevalent among the people who are most deprived. The WHO European Region therefore faces diverse challeng...es affecting both the mental well-being of the population and the provision and quality of care for people with mental health problems.
The European Mental Health Action Plan focuses on seven interlinked objectives and proposes effective action to strengthen mental health and well-being. Investing in mental health is essential for the sustainability of health and socioeconomic policies in the European Region. The Action Plan corresponds to the four priority areas of the European policy framework for health and wellbeing, Health 2020, and will contribute directly to its implementation.
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2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10–19 years, adolescents are both at risk of TB and... represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
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In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population. This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five morta...lity, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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This resource is the third in a series of online guides for promoting positive mental health across the lifespan. This resource provides health and social service providers (“practitioners”) with current evidence-based approaches in the application of mental health promotion concepts and princip...les for refugees. It is intended to support practitioners, caregivers and others in incorporating best practice approaches to mental health promotion initiatives or programs directed toward refugees.
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Current evidence that the climate is changing is overwhelming. Impacts of climate change and variability are being observed: more intense heat-waves, fires and floods; and increased prevalence of food- water- and vector-borne diseases. Climate change will put pressure on environmental and health det...erminants, such as food safety, air pollution and water quantity and quality. A climate-resilient future depends fundamentally on reducing greenhouse gas emissions. Limiting warming to below 2 °C requires transformational technological, institutional, political and behavioural changes: the foundations for this are laid out in the Paris Agreement of December 2015. The health sector can lead by example, shifting to environmentally friendly practices and minimizing its carbon emissions. A climate-resilient future will increasingly depend on managing and reducing climate change risks to protect health. In the near term, this can be enhanced by including climate change in national health programming and creating climate-resilient health systems.
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The National Department of Health and Department of Agriculture, Forestry and Fisheries have collectively engaged to determine the key interventions that will form the basis for this strategy taking into account the recommendations from the WHO and OIE.
The development and implementation of a Natio...nal Antimicrobial Resistance Strategy Framework that complements international efforts is a major step towards containment of the growing threat of antimicrobial resistance in human and animal health. Global partnerships need to be strengthened because the responsibility for reducing resistance is a shared one. This responsibility is not only limited to the health care sector, but calls for collaborative action in all sectors - human, animal and agriculture.
The National Antimicrobial Resistance Strategy Framework will affect South Africa’s response to this looming threat. We already have the tools and expertise to make a difference, now all we need is to work together toward a better future.
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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul...nerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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Cancer centres are a major resource in ensuring a comprehensive approach to cancer treatment and its planning. As part of a new roadmap developed by WHO and IAEA to help countries design national cancer control programmes, this publication proposes a framework to develop a cancer centre and/or to st...rengthen the provision of services in an existing cancer centre. The publication provides the features of multidisciplinary cancer care and details the infrastructure, human resources and equipment for different services. This framework is expected to be used as a guide to implementation, taking into consideration the local context and resources.
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