Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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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.
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This regional report on the situation of tuberculosis (TB) in the Americas contains information from 2019, provided by the countries of the Region through the World Health Organization TB data collection system. These data have been consolidated and analyzed at the regional level. In addition to pre...senting the epidemiological and programmatic situation of TB in the Americas, the report aims to raise awareness and to motivate and encourage all stakeholders in the prevention and control of this disease, to accelerate efforts towards TB elimination in the Region, and to achieve the targets of the End TB Strategy. The report records the Region's achievements, but also the gaps in the work being carried out in diagnosis, treatment, comorbidities, vulnerable populations, risk factors, and funding, among other issues. Based on the information presented, specific recommendations are provided for further progress.
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Resumen para Equipos de Salud Edición 2021-2022
Las presentes recomendaciones se encuentran dirigidas a los miembros del equipo de salud que asisten niñas, niños y adolescentes (NNyA) que viven con VIH. También se dirigen a los responsables jurisdiccionales que participan en el proceso de gesti...ón de acceso a tratamientos antiretrovirales recomendados. El objetivo es brindar directrices para optimizar el cuidado y tratamiento antiretroviral de NNyA, con opciones más seguras y eficaces, basadas en la mejor evidencia disponible.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Phytochem Rev (2023) 22:1691–1806
Plants have a lot of potential and will continue to contribute feasible, effective medicines and/or pesticides; more research is warranted to fully explore their future applications
La mission d’évaluation au Bénin a été coordonnée et organisée par Anne-Sophie Le Dain, nutritionniste à l’UNICEF-Cotonou et Félicien Agossou Sagbadja, nutritionniste à l’UNICEF-Parakou. Elle a inclus la visite du Service National de Nutrition (SNN), de la section Survie UNICEF ainsi ...que de son représentant, la participation à la révision du protocole sur la prise en charge de la malnutrition aiguë et enfin la visite des centres de prise en charge intégrée de la malnutrition aiguë dans le département de l’Alibori dans les zones sanitaires de Malanville Karimama, Kandi-Gogounou-Segbana et Banikoara
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The information provided here can be used to understand the current situation, increase attention to preterm births in Rwanda and to inform dialogue and action among stakeholders. Data can be used to identify the most important risk factors to target and gaps in care in order to identify and impleme...nt solutions for improved outcomes.
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Neurodiversity is associated with people who experience dyslexia, autism, dyspraxia, ADHD, and other similar neurological conditions. They’re known as “spectrum” conditions that cover a wide range of characteristics but share similarities in how people with these conditions learn and process... different kinds of information.
Many organizations fail to support neurodiverse employees. This is party because working with neurodiverse employees can be perceived as challenging.
In this guide, we’ll explore the benefits of a neurodiverse workplace. We’ll look at some of the competitive advantages of neurodiversity and the legislation surrounding it. Finally, we’ll end with advice on making neurodiversity a workplace strength by supporting neurodiverse employees.
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UNICEF Malawi and its partners are prioritizing renewable energy solutions for children and communities across the country to access clean and affordable electricity, with a focus on hard-to-reach, rural communities unable to access the national electricity grid.