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This training guide applies a participatory approach, reflecting the considerable evidence that adults learn best by practicing and reflecting on their experiences. It thus emphasizes exercises to improve skills in counseling that support clients to adopt optimal nutrition practices. Women’s nutri
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tion and infant feeding in the context of HIV are also addressed. Guidelines to link the prevention of malnutrition with treatment via the Integrated Management of Acute Malnutrition are also included. It can also be conducted with nutrition managers to equip them to provide supportive supervision to health and community workers.
more
Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/
...
AIDS, tuberculosis and now COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
more
International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines
recommended
ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with
...
authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
more
The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama
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nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
more
The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o
...
f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
more
La néphrologie pédiatrique (NP) a connu ces dernières années des progrès impressionnants en matière de soins. Cependant, le plus grand défi dans notre continent africain est de fournir aux enfants atteints de maladie rénale l’accès à une prise en
charge spécialisée par des néphrologu
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es pédiatriques ayant une bonne formation, ainsi que la possibilité d’avoir un accès abordable aux techniques modernes, aux médicaments efficaces et à des stratégies de prévention. En Afrique, le développement de la NP a été très lent et sans collaboration réelle entre les pays concernés, ce qui a renforcé ma conviction sur la nécessité d’amener les néphrologues pédiatres africains à œuvrer ensemble, par le biais d’un ouvrage commun, à mettre en lumière les données spécifiques de notre continent dans ce domaine.
more
Recency assays use one or more biomarkers to identify whether HIV infection in a person is recent (usually within a year or less) or longstanding. Recency assays have been used to estimate incidence in representative cross-sectional surveys and in epidemiological studies to better understand the pat
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terns and distributions of new and longstanding HIV infections.
This technical guidance outlines best practices regarding the appropriate use of HIV recency assays for surveillance purposes and updates 2011 technical guidance from the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) on the use of HIV recency assays.
more
Violence against women and girls is widespread in the Region of the Americas, resulting in enormous consequences for the health and wellbeing of women and girls, their families and communities. These costs are unacceptable and they can be prevented through evidence-based action, including the health
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sector through its policies and protocols, as well as in collaboration with other sectors. This report remains the first of its kind and is a major milestone for the Region. It is specifically informed by the commitments of Member States in the regional Strategy and Plan of Action on Strengthening the Health System to Address Violence against Women. The report provides an analysis of efforts to advance the prevention of violence against women through health policies, clinical protocols, multisectoral plans and related approaches across the Americas. Attention to this topic is timely, as the COVID-19 pandemic has created new visibility for this area of work. This report offers critical information on efforts in the Region that can be learned from and used to build upon in the future to prevent and respond to violence against all women and girls everywhere.
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I examine the effectiveness of donors in targeting the highest burden of malaria in the Democratic Republic of Congo when health information structure is fragmented. I exploit local variations in the burden of malaria induced by mining activities as well as financial and epidemiological data from he
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alth facilities to estimate how local aid is matching local health needs. Using a regression discontinuity design, I find significant but quantitatively small variations in aid to health facilities located within mining areas. Comparing local aid with the additional cost of treatment and prevention associated with the increased risk of malaria transmission, I find suggestive evidence that local populations with the highest burden of the disease receive a proportionately lower share of aid compared to neighbouring areas with reduced exposure to malaria infection. The evidence of disparities in the allocation of aid for malaria supports the view that donors may have inaccurate information about local population needs.
more
Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi
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scal cutbacks in many developed countries, total assistance remained steady, reaching an all-time high of $31.3 billion in 2013. While annual increases have leveled off since 2010, continued international funding is a sign of the international development community’s enduring support for global health.
The report also shows shifts in sources of financing. As funding from many bilateral donors and development banks has declined, growth in funding from the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, non-governmental organizations, and the UK government is counteracting these cuts. Development assistance for different health issues is tracked up to 2011, revealing that the greatest increase in funding was for maternal, newborn, and child health.
more
Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig
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h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
more
This report provides an analysis of donor government funding to address the HIV response in low- and
middle-income countries in 2022, the latest year available, as well as trends over time. It includes both
bilateral funding from donors and their contributions to the Global Fund to Fight
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AIDS, Tuberculosis and
Malaria (Global Fund), UNITAID, and UNAIDS. Overall, the analysis shows that while donor government
funding for HIV increased between 2021 and 2022, this was primarily due to the timing of payments from
the U.S. government and not actual increases in commitments.
more
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to
...
accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
more
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
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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.
more
Insufficient funding is hindering the achievement of malaria elimination targets in Africa, despite the pressing need for increased investment in malaria control. While Western donors attribute their inaction to financial constraints, the global health community has limited knowledge of China’s ex
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panding role in malaria prevention. This knowledge gap arises from the fact that China does not consistently report its foreign development assistance activities to established aid transparency initiatives. Our work focuses on identifying Chinese-funded malaria control projects throughout Africa and linking them to official data on malaria prevalence. By doing so, we aim to shed light on China’s contributions to malaria control efforts, analysing their investments and assessing their impact. This would provide valuable insights into the development of effective financing mechanisms for future malaria control in Africa.
more
Drawing on the World Health Organization’s package of NCD best buys, the report demonstrates how these evidence-based measures can help countries reduce premature deaths, strengthen health systems, and advance progress towards the Sustainable Development Goals. It provides policymakers, donors, ad
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vocates, and partners with a clear economic and social rationale for scaling up implementation of proven solutions. By framing NCD prevention and control as both a health and development priority, the report offers a roadmap for action that delivers benefits across populations, economies, and generations. The evidence is clear: investing in WHO’s best buys is not only possible—it is imperative. The time to act is now.
more
Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea
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lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou
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gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
more
WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de
...
aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
more
In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
...
miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
more
