n recent decades, a significant improvement in people’s general health conditions has occurred, leading to an increase in life expectancy at birth in most countries in the Region of the Americas. This progress has been the result of both health technology advances – antibiotics, vaccines, and ot...her treatments – and improvements in the conditions in which people live, including increased access to improved drinking water and sanitation, and health services. Nevertheless, progress has slowed in recent years, and achievements have varied among countries and territories, as well as within them. In the journey toward universal health, it is essential to have the ability to monitor and assess progress in terms of the ultimate goal of health systems: improving the health and well-being of populations. To this end, this edition of Health in the Americas analyzes the standardized rate of potentially avoidable premature mortality as an indicator of health system performance, considering both its preventable component through public and intersectoral health interventions, as well as the treatable component, related to the effectiveness of health services, that is, the quality of health care. The analysis of potentially avoidable premature mortality provides a metric for comparing and tracking performance over time.
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LEAVING NO-ONE BEHIND | “A Journey to End NTDs – Elimination and Care” records what we have achieved over the last year and where we are now. It presents our plan of action for the coming years, bringing our ‘traditional’ NTD work together with ‘Disease Management Disability and Inclusio...n’ (DMDI), Community Based Inclusive Development (CBID) and Livelihoods. We care for those affected and we’re working to enhance community and government ownership through national
health system strengthening, community engagement and cross-sectoral action. Ultimately, we are working to free future generations from these menacing diseases, improving prevention and treatment, without forgetting those for whom prevention and treatment are too late because they already have a disability.
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A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal health system evaluations continue to identify major gaps in capacity ... to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
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Background: Primary health care (PHC) is a driving force for advancing towards universal health coverage (UHC). PHC-oriented health systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments and project the associated resource ...needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs.
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Given an increase in outbreaks caused by resistant microorganisms associated with medical tourism, the Pan American Health Organization / World Health Organization (PAHO/WHO) encourages Member States to strengthen their capacity to detect and manage infections caused by resis...tant microorganismsin patients who traveled outside of their country of residence to receive healthcare. Furthermore, PAHO/WHO stresses the importance to implement preventive measures to reduce healthcare-associated infections at all levels of the health system.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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To assess national-level responses to NCDs, WHO has implemented NCD country capacity surveys periodically since 2001. This report is the latest in that series. Since the first survey round, the NCD Country Capacity Survey (NCD CCS) has been conducted a further seven times, most recently in 2021. In ...the survey, completed by the NCD focal point within each country’s ministry of health or similar agency, countries are asked to report on the following topics relating to NCDs: (i) public health infrastructure, partnerships and multisectoral collaboration; (ii) policies, strategies and action plans; (iii) health information systems and surveillance; (iv) health system capacity for detection, treatment and care; and, added for 2021, (v) the impact of the COVID-19 pandemic on NCD-related resources and activities. The questionnaire is web-based and requires supporting documentation wherever possible. In the 2021 round, data were collected from May onwards, with the last survey responses arriving in September. Validation was carried out by WHO regional offices and WHO headquarters. Country responses to previous rounds of the survey were incorporated into the analysis to assess progress since 2010. Although all 194 Member States responded to the survey, data comparisons were restricted to the 160 countries that had responded to all rounds of the survey since 2010.
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The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on... aid targeting reproductive, maternal, newborn, and child health (RMNCH). We take a multi-sectoral approach and extend the estimation to the four sectors that determine child survival: health (RMNCH and non-RMNCH), education, water and sanitation, and food and humanitarian assistance (Food/HA). Methods and findings: Using donor reported data, obtained mainly from the OECD Creditor Reporting System and Development Assistance Committee, we tracked the level and trends of aid (in grants or loans) disbursed to each of the four sectors at the global, regional, and country levels. We performed detailed analyses on missing data and conducted imputation with various methods. To identify aid projects for RMNCH, we developed an identification strategy that combined keyword searches and manual coding. To quantify aid for RMNCH in projects with multiple purposes, we adopted an integrated approach and produced the lower and upper bounds of estimates for RMNCH, so as to avoid making assumptions or using weak evidence for allocation. We checked the sensitivity of trends to the estimation methods and compared our estimates to that produced by other studies. Our study yielded time-series and recipient-specific annual estimates of aid disbursed to each sector, as well as their lower- and upper-bounds in 134 countries between 2000 and 2014, with a specific focus on Countdown countries. We found that the upper-bound estimates of total aid disbursed to the four sectors in 134 countries rose from US$ 22.62 billion in 2000 to US$ 59.29 billion in
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A module from the suite of health service capacity assessments in the context of the COVID-19 pandemicINTERIM GUIDANCE5 February2021
The Community needs, perceptions and demand: community assessment toolcan be used by countries to conduct a rapid pulse survey of community health needs and perceptio...ns around effective use of essential health services during the COVID-19 outbreak. The assessment helps to establish an early warning system on the need to implement coping strategies to continue to respond to communities’ health needs throughout the course of the pandemic. This assessment tool is informed by WHO and partner tools and guidance on community health needs, continuity of essential health services and readiness planning for COVID-19
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The military offensive by the Russian Federation in Ukraine which began February 2022 has triggered one of the world’s fastest-growing displacement and humanitarian crisis, with geopolitical and economic ripples felt across the globe. The ongoing war has caused large-scale disruptions to the deliv...ery of health services and a near-collapse of the health system. But the crisis also saw an extraordinary mobilization and crisis response to a health emergency by WHO and its more than 100 partners.
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The High-Level Panel on International Financial Accountability, Transparency and Integrity for Achieving the 2030 Agenda (FACTI Panel) was convened by the 74th President of United Nations General Assembly and the 75th President of the Economic and Social Council on 2 March 2020. The objective of the... FACTI Panel is to contribute to the overall efforts undertaken by Member States to implement the ambitious and transformational vision of the 2030 Agenda for Sustainable Development. It is mandated to review current challenges and trends related to financial accountability, transparency and integrity, and to make evidence-based recommendations to close remaining gaps in the international system.
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In this era, grand challenges lies in biodiversity loss, climate change, and global noncommunicable diseases signify that planet and humanity are in crisis. Scholarly evidence from human and animal kingdom suggest that there is an optimism in planetary health which can provide a unique and novel con...cept where efforts toward survival and remediation can be made. With accurate navigation, the current challenges can be mitigated leading to a new reality, one in which the core value is the well‐being of all. This paper discusses the drivers of planetary health and the role of community health workers (CHWs) in making health‐care system more resilient that can produce multiple benefits to community and overall planetary health. A web‐based international database such as Google, Google Scholar, SCOPUS/MEDLINE/PubMed, and JSTOR was searched relevant to a planetary health framework. The study findings suggest that CHWs can offer health care interventions through environmental health cobenefits across the spectrum of health effects of climate change cause and effects. These actions have been divided into four major categories (i. health care promotion and prevention, ii. health care strengthening, iii. advocacy, and iv. education and research) that CHWs perform through a variety of roles and functions they are engaged in protecting planetary health. CHWs contribute toward achieving sustainable development goals such as planetary health and focus on environment sustainability and well‐being of entire mankind.
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The 2022 Financing for Sustainable Development Report identifies a “great finance divide” as a main driver of the divergent recovery. Developed countries were able to borrow record sums at ultra-low interest rates to support their people and economies, but the pandemic response and investment in... recovery of poor countries was limited by fiscal constraints. This joint report, by over 60 agencies of the United Nations system and partner international organizations, provides analysis and puts forward policy recommendations to overcome this “finance divide” and enhance developing countries’ access to financing for recovery and productive and sustainable investment.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE...CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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The scope of the Guidance is primarily the education in rural settings in Myanmar, but it covers some of the issues which have pan Myanmar implication and relevance. Considering the importance, complexity and vastness of the subject, similar type of initiatives on urban school and education system a...nd other issues needs to be taken up in future.
The Guidance has four sections namely Introduction to this Guidance, Rationale for Mainstreaming DRR in the Education Sector, How to Mainstream Disaster Risk Reduction in Reconstruction Process of Education Sector in Myanmar and Creating an Enabling Environment for Safer Education. The Guidance also includes good practices of various agencies involved in Cyclone Nargis education sector recovery as example.
No publication year indicated.
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A septic tank takes raw sewage in, allows the solids to settle (sludge) and allows the remaining liquid to flow into the surrounding soil by means of a soakaway. Scum on the surface is also prevented from leaving the tank. Microorganisms in the anaerobic environment in the tank digest the sludge and... scum. The system consists of several stages, supply to the tank, the tank itself and the soak field.
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This guide is available in English, French, Spanish, Russian, Arabic and Chinese
This guide consolidates COVID-19 guidance for human resources for health managers and policy-makers at national, subnational and facility levels to design, manage and preserve the workforce necessary to manage the COVI...D-19 pandemic and maintain essential health services.
The guide identifies recommendations to protect, support and empower health workers at individual, management, organizational and system levels.
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The Lancet DOI: 10.1016/S2468-2667(20)30101-8
WHO declared COVID-19 to be a pandemic on March 11, 2020. The pandemic eventually reached Yemen, with the first laboratory confirmed case announced on April 10. emen has structural vulnerabilities that have developed over a protracted period of conflic...t and poor governance, and its health system has suffered the most. To prevent a total collapse of Yemen’s fragile health system, the government and the international community should act now more decisively.
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A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists working on this disease, the manual details the exac...t procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), has published global standards for prosthetics and orthotics. Its aim is to ensure that prosthetics and orthotics services are people-centred an...d responsive to every individual’s personal and environmental needs. The standards advocate for the integration of prosthetics and orthotics services into health services, under universal health coverage. Implementation of these standards will support countries to fulfil their obligations under the Convention on the Rights of Persons with Disabilities and towards the Sustainable Development Goals, in particular Goal 3: Ensure healthy lives and promote well-being for all at all ages.
The standards provide guidance on the development of national policies, plans and programmes for prosthetics and orthotics services of the highest standard. The standards are divided into two documents: the standards and an implementation manual. Both documents cover four areas of the health system:
policy (governance, financing and information);
products (prostheses and orthoses);
personnel (workforce);
and provision of services.
The Standards have been developed through consultation with experts from around the globe via a steering group, development group and external review group.
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