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Key stakeholders must be involved in the planning, implementation, monitoring and evaluation of NCD plans and programmes. Within a ministry of health there will be different types of stakeholders, such as programme managers and senior managers in departments of prevention, health promotion, and hosp
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ital and health services. Other stakeholders may come from ministries for transport, economics, agriculture, and education, funding partners, nongovernmental organizations, civil society and community members. It is critical to ensure that there are clear and accurate descriptions of the policies, plans and programmes, so that all interventions, activities and desired outcomes are clearly understood by all involved in their evaluation.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
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sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im
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munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
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BMC Infectious Diseases (2019) 19:832
Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using
praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children
and does not include neither adult individuals nor
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other public health measures. The Ijinga schistosomiasis project
examines the impact of an intensified treatment protocol with praziquantel MDA in combination with additional
public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly
endemic African setting using an integrated community-based approach.
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This template dossier complements and should be used after fulfilling the criteria and preconditions specified in the Process of validation of elimination of kala-azar as a public health problem in South-East Asia. The national kala-azar programme should be in the consolidation phase of elimination;
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that is, the annual incidence of kala-azar in the implementation unit is maintained below 1 case (new plus relapse) per 10 000 population for a minimum of 3 consecutive years.
The template is designed to help national kala-azar elimination programmes prepare a dossier documenting the essential evidence supporting the request to the World Health Organization (WHO) to validate the status of kala-azar elimination as a public health problem in their country. The information presented in this document will help independent assessors understand the national programme’s specific context, achievements and relevant epidemiological data.
The dossier should be organized according to the following sections:
- Description of the country context and health system capabilities
- Historical data and delineation of endemic areas
- Surveillance and elimination activities
- Epidemiological data
- Vector control strategy and activities
- Post-validation surveillance plan
Once the dossier is prepared, it should be examined and duly endorsed by the National Task Force on kala-azar elimination and/or neglected tropical diseases, or a similar body, before submission to WHO.
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Rwanda’s national health sector is focused on the equitable delivery of high-quality health services. The Government of Rwanda (GoR) recognizes that developing human resources in the health sector is a critical factor to the well-being of the population. Development of the health workforce has bee
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n guided by the Human Resources for Health (HRH) Programme (2012-2019) and its successor, the National Strategy for Health Professions Development (NSHPD) (2020-2030). Rwanda has made significant progress in enhancing its skilled health workforce, with notable improvements in the health professional-to-population ratio over the past decade, attaining 13.4 doctors, nurses, midwives, pharmacists, and dentists per 10 000 people in 2022. Despite such progress, health workforce levels remain below national and global recommendations.
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Social and Behaviour Change Communication (SBCC) is essential for the effective control, prevention and elimination of malaria. The 2018–2030 Strategic Framework for Malaria SBCC guides countries and partners in strengthening capacities, refining strategies and sharing best practices, all of which
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are aligned with the WHO Global Technical Strategy for Malaria. Despite progress, malaria continues to threaten billions of people, and success hinges on access to interventions and behavioural change. This framework emphasises advocacy, technical guidance and tools to ensure that SBCC is prioritised and resourced as an essential element in the global fight against malaria.
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This guidance covers different options for banning or phasing out a pesticide and suggests related risk reduction measures to be taken during the phase-out period. A key focus of this guidance is how to take action to manage, prevent, minimize, and communicate about identified risks during the imple
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mentation of a phase-out strategy. It contains a description of legal aspects to consider when phasing out a product and illustrates how a risk communication plan can be structured and implemented. How different stakeholders may be involved when a pesticide is going to be phased out is also described.
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The World Health Organization recently redefined leprosy elimination as a phased process, with the first milestone being the
interruption of transmission, achieved when no new child cases (defined as younger than 15 years) are reported for five consecutive years.
In Pakistan, the well-functioning
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leprosy programme, with effective case management, context-specific active case-finding strategies and
a robust data management system, has contributed to a decrease in new cases. Between 2001 and 2023, new adult cases dropped by 75%
(from 878 cases to 220 cases annually) and child cases by 83% (from 93 to 16). To support the country’s goal of no new child cases by 2030
and ultimately eliminate the disease, the nongovernmental organizations Marie Adelaide Leprosy Centre and Aid to Leprosy Patients, with
support from the German Leprosy and Tuberculosis Relief Association, have developed a zero leprosy roadmap. As part of this roadmap,
the leprosy elimination strategy emphasizes improving active case-finding and providing post-exposure prophylaxis for contacts of leprosy
cases, who are at the highest risk
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Non-Communicable Diseases (NCDs) have emerged as conditions of great public health concern in Kenya accounting for 39% of deaths annually. The Ministry of Health through the Department of Non-Communicable Diseases has adopted the vision of achieving a nation free from preventable burden of NCDs. Fur
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ther, the mission of this strategy is to halt and reverse the rising burden of NCDs through effective multisectoral collaboration and partnerships by ensuring Kenyans receive the highest attainable standard of NCD continuum of care that is accessible, affordable, quality, equitable and sustainable thus alleviating suffering, disease and death for their well-being and socio-economic development.
The scope of NCDs covered by this strategy include; cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, mental health conditions, violence and injuries, hemoglobinopathies, haemophilia and other bleeding disorders, auto immune diseases, chronic renal diseases, epilepsy and other neurological disorders, chronic skin conditions and oral diseases and conditions. It equally addresses seven risk factors; tobacco use, harmful use of alcohol, unhealthy diets and toxins, physical inactivity, indoor air pollution, environmental pollutants and toxins and stress.
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This document, with a focus on the built environment and health care facilities, intends to guide the audience in preparing for and responding to SARI pandemics caused by existing and novel pathogens. It provides technical guidance on designing, establishing, and managing health care facilities for
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severe acute respiratory infections (SARI), covering point of entry, treatment centers, entry to health system facilities, quarantine and community facilities, and home care and quarantine.
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Prevention of mother-to-child HIV transmission (PMTCT) has been a success in many respects
but there is still much to do to eliminate mother-to child transmission (MTCT), particularly in low
antiretroviral therapy (ART) coverage areas and in the postnatal phase. The success of PMTCT is
highly dep
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endent on the availability and accessibility of patient-centred care, which enables women
and their families to take informed decisions about their health and the health of their infant. For
this reason, it is recommended to have a patient-centred approach when implementing PMTCT.
PMTCT success is also linked to the partners’ involvement, as well as to community acceptance
of HIV.
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The document “Public Health Surveillance for Cholera – Guidance Document (2024)” provides practical recommendations for countries on how to design, implement, and strengthen cholera surveillance systems. Developed by the Global Task Force on Cholera Control (GTFCC), it outlines the minimum req
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uirements for detecting, confirming, reporting, and monitoring cholera cases and outbreaks.
The guidance explains the core functions of cholera surveillance, including case detection, laboratory testing (such as RDTs, culture, and PCR), routine data collection, outbreak notification, case and field investigation, data analysis, and performance monitoring. It also describes how surveillance strategies should be adapted depending on whether a country is experiencing no outbreak, clustered transmission, or community transmission.
Overall, the document aims to help countries establish adaptive, fit-for-purpose surveillance systems that enable early outbreak detection, guide timely response measures, and support long-term cholera control and elimination efforts.
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The document “Strengthening the global architecture for health emergency prevention, preparedness, response and resilience” presents a report by the Director-General of the World Health Organization (WHO) to the World Health Assembly on global efforts to improve preparedness and response to heal
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th emergencies. It reviews the implementation of the Health Emergency Prevention, Preparedness, Response and Resilience (HEPR) framework and highlights lessons learned from recent crises such as COVID-19. The report describes international initiatives to strengthen global health governance, surveillance systems, laboratory networks, community protection measures, healthcare capacity and access to medical countermeasures like vaccines and diagnostics. It also discusses coordination of emergency responses, support for countries facing outbreaks or humanitarian crises, and the importance of international cooperation. In addition, the report emphasizes the need for sustainable and coordinated financing to strengthen global health security and ensure that countries can better prevent, detect and respond to future health threats.
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WHO's Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections (STIs) has consolidated all existing normative guidance on STIs into a single publication. Structured around 10 chapters that follow the STI prevention and care cascade, the handbook covers primary prevention, synd
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romic management and asymptomatic case identification, diagnostics, treatment, partner management, surveillance, service delivery, and integration within primary health care, community-based clinics, or other platforms (HIV, sexual health, antenatal clinics, etc).
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This document suggests mechanisms that countries can use to respond to emergencies and disasters taking a whole of society and whole of government approach ensuring multisectoral engagement for health actions. It helps to run a participatory process of developing the national health response operati
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ons plan that brings together all relevant sectors, public health experts, civil society and the international community under government leadership and facilitate ownership, adoption, testing through simulation and finally successful implementation in responding to emergencies and disasters from multiple hazards.
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The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t
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he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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Food environments are usually defined as the settings with all the different types of
food made available and accessible to people as they go about their daily lives.
That is, the range of food in supermarkets, small retail outlets, wet markets, street
food stalls, coffee shops, tea houses, s
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chool canteens, restaurants, and all the other
venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing,
marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate
quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems
and food environments are challenged in supporting consumer choices that are
consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim
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ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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