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...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.
more
Climate-induced water insecurity poses one of the biggest threats to humanity and will lead to more hunger, disease and displacement
Oxfam water engineers are having to drill deeper, more expensive and harder-to-maintain water boreholes used by some of the poorest communities around the world, mo...re often now only to find dry, depleted or polluted reservoirs.
Today, during World Water Week, Oxfam publishes the first of its series of reports, “Water Dilemmas”, about the growing water crisis, in large part driven by global heating from greenhouse gas emissions. The report describes how climate change will impact water security in different regions, leading to more hunger, disease and displacement.
Carlos Calderon, Humanitarian Advocacy and Partnerships Lead for Oxfam Aotearoa said, “This new Oxfam research is focused on the global Water, Sanitation and Hygiene (WaSH) situation, but it paints a picture that illustrates the complexity of elements that, combined, will continue to increasingly affect women, girls, boys and men in the decades to come. Changing weather, poverty, inequality, gender-based violence, political instability and conflicts are impacting the availability and quality of adequate water systems. All governments, particularly those from rich countries, should responsively take action at a global scale. The clock is ticking. Our children will judge us for our actions today, or for the lack of them.”
more
Mortality statistics are fundamental to public health decision making. Mortality varies by time and location, and its measurement is affected by well known biases that have been exacerbated during the COVID-19 pandemic. This paper aims to estimate excess mortality from ...the COVID-19 pandemic in 191 countries and territories, and 252 subnational units for selected countries, from Jan 1, 2020, to Dec 31, 2021.
The Lancet. 10 March 2022. doi: 10.1016/S0140-6736(21)02796-3.
more
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
more
To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
more
Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve...ls of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
more
World Psychiatry. 2010 Jun;9(2):67-77.
The main recommendations are presented in relation to: the need for coordinated policies, plans and programmes, the requirement to scale up services for whole populations, the importance of promoting community awareness about mental illness to increase levels ...of help-seeking, the need to establish effective financial and budgetary provisions to directly support services provided in the community. The paper concludes by setting out a series of lessons learned from the accumulated practice of community mental health care to date worldwide, with a particular focus on the social and governmental measures that are required at the national level, the key steps to take in the organization of the local mental health system, lessons learned by professionals and practitioners, and how to most effectively harness the experience of users, families, and other advocates
more
The Lancet Volume 37100891September 2024. Free Download after registration
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and... population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
more
Wet markets have been implicated in multiple zoonotic outbreaks, including COVID-19. They are also a conduit for legal and illegal trade in wildlife, which threatens thousands of species. Yet wet markets supply food to millions of people around the world, and differ drastically in their physical com...position, the goods they sell, and the subsequent risks they pose. As such, policy makers need to know how to target their actions to efficiently safeguard human health and biodiversity without depriving people of ready access to food.
more
The Lancet Planetary Health Volume 5, ISSUE 7, e466-e478, July 01, 2021
Transmission of many infectious diseases depends on interactions between humans, animals, and the environment. Incorporating these complex processes in transmission dynamic models can help inform policy and disease control int...erventions. We identified 20 diseases involving environmentally persistent pathogens (ie, pathogens that survive for more than 48 h in the environment and can cause subsequent human infections), of which indirect transmission can occur from animals to humans via the environment.
more
Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health
(RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and
the Organisation for Economic Co-operation and Development (OECD) policy marker. We... aimed to compare the
estimates, trends, and methodologies of these initiatives and make recommendations for future aid tracking.
more
Les programmes de planification familiale sont une solution gagnant-gagnant ; le bien-être de chaque femme et des enfants est amélioré, et l'économie nationale et l'environnement en tirentles bénéfices
Lancet Planet Health 2022;6: e760–68
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden. But emerging pandemic threats are just one dimension of the complex relationship between agriculture... and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. This changing relationship is examined through four current disease issues.
more
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.
more
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mo...rtality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
more
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.
more
The rise of the discourse of 'trauma' as a major articulator of suffering within Western culture is a facet of the medicalization of life that has gathered pace in the last century. In recent years, Western mental health professionals have been increasingly involved in services addressing the plight... of war-affected populations - largely non-Western - in war zones or as refugees. Querying the extent to which their experiences can be reduced to a matter of mental health, this article addresses child refugees from war via three questions that go to the heart of the debate about how they are to be understood, the implications for their future maturation as individuals and citizens, and the role of psychological therapies aimed at catharsis of 'traumatic' memory.
more
Aligned to the Lancet Migration Global Statementto include migrants and refugees incountries’response toCOVID-192, this brief focuses onGreece’s challenges and opportunities to build an inclusive response. Asylum seekers and refugees in Greece are currently placed by the Greek governments in Rec...eption and Identification Centres(RICs), apartments, hotels and camps across the Greek islands and the mainland, along with a proportion who are homeless. Currently there are six RICson the Greek islands: Vial on Chios island; Pyli on Kos island; Lepida on Leros island; Moria on Lesvos island; and Vathy on Samos, as well asan unofficial camp on Rhodes. Inaddition there are 18 camps in the northern mainland of Greece; 13 camps in the southern mainland of Greece and one in the southern peninsula (Peloponnese).
more
Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec...t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
more