22nd edition
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health sy...stem, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
In addition, we are pleased to announce that this year's edition includes two innovations. First is the provision of concise summaries of the chapters in the form of 'chapters at a glance'. These are positioned together at the start of the publication for ease of reference and to give a quick overview. The second innovation is the introduction of our Healthcare Workers' Writing Programme (HCWWP), which provides support to first-time authors wanting to publish in the Review.
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22nd edition
The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, which presents a unique collection of perspectives on ...the key challenges in implementing universal health coverage (UHC) in South Africa, as analysed by experts in various fields.
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health system, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
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Antibiotics have been a critical public health tool since the discovery of Penicillin in 1928, saving the lives of millions of people around the world. In developing country like ours, where the burden of treatable disease is very high and access to health facilities and laboratories is difficult, a...ntibiotics have long acted as miracle drugs. Today, however, the emergence of drug
resistance in bacteria is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and in some cases, nonexistent. Diseases previously regarded as relatively easy to manage are much harder to treat as doctors must use “last-resort” drugs that are more costly, take longer to work
and are often unavailable or unaffordable in developing countries. Moreover, regular prescription of antibiotics, random treatment, over the counter sales, inadequate dosage, inclusion of antibiotics in animal feeds and agriculture has contributed equally to emergence of antibiotics resistance as silent epidemic within the country.
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The purpose of this guidance is to assist WHO Member States, and other stakeholders, in the establishment and development of programmes of integrated surveillance of antimicrobial resistance in foodborne bacteria (i.e., bacteria commonly transmitted by food). In this guidance, “integrated surveill...ance of antimicrobial resistance in foodborne bacteria” is defined as the collection, validation, analyses and reporting of relevant microbiological and epidemiological data on antimicrobial resistance in foodborne bacteria from humans, animals, and food, and on relevant antimicrobial use in humans and animals. Integrated surveillance of antimicrobial resistance in foodborne bacteria therefore includes data from relevant food chain sectors (animals, food and humans) and includes data on both antimicrobial resistance and antimicrobial use. Integrated surveillance of antimicrobial resistance for foodborne bacteria expands on traditional public health surveillance to include multiple elements of the food chain, and to include antimicrobial use data, to better understand the sources of infection and transmission routes.
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Antimicrobial resistance (AMR) is a serious public health concern with economic, social and political implications that are global in scope, and cross all environmental and ethnic boundaries. As a global threat, AMR risks the achievements of modern medicine, and has the po...tential to impact overall global development. It is important, therefore, to elevate AMR beyond health as part of a larger development agenda in the context of the Sustainable Development Goals (SDGs). This report provides in-depth technical discussions in areas that have direct implications to the containment of AMR as a development agenda. The report is organized in five chapters which served as the technical background documents for the Biregional Technical Consultation on AMR in Asia, 14-15 April 2016. More information from the meeting is available in the WHO Meeting Report: Biregional Technical Consultation on Antimicrobial Resistance in Asia. The meeting was the first time senior officials from the Ministry of Health and Ministry of Agriculture across Asia came together to tackle AMR
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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Pakistan Global Antibiotic Resistance Partnership (GARP) was formed in the wake of international and national efforts for AMR curtailment. A group of experts from microbiology, infectious diseases and veterinary medicine formed a core group at the organizational meet...ing of GARP in Kathmandu, Nepal in July 2016. In the meeting, this core group was expanded to include other members from different sectors with the selection of the Chair and co-chairs. These were asked to serve on a voluntary basis, in their own individual capacities, with no personal gains, or gains to the institutions to which they are affiliated. The first phase of GARP took place from 2009 to 2011 and involved four countries: India, Kenya, South Africa and Vietnam. Phase one culminated in the 1st Global Forum on Bacterial Infections, held in October 2011 in New Delhi, India. In 2012, phase two of GARP was initiated with the addition of working groups in Mozambique, Tanzania, Nepal and Uganda. Phase three has added Bangladesh, Lao PDR, Nigeria, Pakistan and Zimbabwe to the network to date.
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid, ... diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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In the kingdom of Bahrain, the national antibiotic committee will set the framework for the national response to AMR, especially bacterial resistance to antibiotics. It will be aligned with the World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance, and with standards and... guidelines from the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE).
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Spread of resistance to antimicrobial agents (AMR) does not know national borders and has reached dimensions, which require immediate actions at the national, regional and global levels.
Antibiotic resistance is a natural biological response to improper use of antimicrobial agents (AMA); increasing... number of essential drugs, which become ineffective, contributing to selection, survival and replication of resistant strains of microorganisms. When chosen antimicrobials prove to be ineffective, the second- or third-line drugs need to be used although
in the majority of cases these drugs are more expensive, less safe and not always available.
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The ECA, says over 300,000 Africans could lose their lives due to COVID-19. This, as the pandemic continues to impact on the Continent’s struggling economies whose growth is expected to slow down from 3.2 percent to 1.8 percent in a best-case scenario, pushing close to 27 million people into extr...eme poverty.
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COVID-19 has turned the world upside down. Everything has been impacted. How we live and interact with each other, how we work and communicate, how we move around and travel. Every aspect of our lives has been affected.
While the COVID-19 pandemic threatens all members of society, persons with disabilities are disproportionately impacted due to attitudinal, environmental and institutional barriers that are reproduced in the COVID-19 response.
The “United Nations Framework for the immediate socio-economic response to COVID-19: Shared responsibility, global solidarity and urgent action for people in need” calls for protecting jobs, businesses and livelihoods to set in motion a safe recovery of societies and economies as soon as possibl...e for a more sustainable, gender-equal, and carbon-neutral path—better than the “old normal”.
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1 June 2020
Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidan...ce for the COVID-19 context recommends practical actions that countries can take at national, subregional and local levels to reorganize and safely maintain access to high-quality, essential health services in the pandemic context. It also outlines sample indicators for monitoring essential health services, and describes considerations on when to stop and restart services as COVID-19 transmission recedes and surges. This document expands on the content of pillar 9 of the COVID-19 strategic preparedness and response plan, supersedes the earlier Operational guidance for maintaining essential health services during an outbreak, and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. It is intended for decision-makers and managers at the national and subnational levels.
This is an update to COVID-19: Operational guidance for maintaining essential health services during an outbreak: Interim guidance, 25 March 2020
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Improvements in water sanitation and hygiene (WASH) and wastewater management in all sectors are critical elements of preventing infections and reducing the spread of antimicrobial resistance (AMR) as identified in the Global Action Plan to combat AMR. Yet, at present, WASH and wastewater management... actors and improvement actions are under-represented in AMR multi-stakeholder platforms and national action plans (NAPs). This WHO/FAO/OIE technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR NAPs and sector specific policy to combat AMR. Evidence and actions are presented in the domains of; coordination and leadership, households and communities, health care facilities, animal and plant production, manufacturing of antimicrobials, and surveillance and research.
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This guide is designed to assist UNICEF staff and partners, in establishing and
operating Child Friendly Spaces (CFS) in an emergency. It attempts to provide
readers with the main principles of a CFS and the processes on how to establish
one.
The overall aim is to improve the standards and capac...ity of field staff, by providing
the required knowledge to support the design and operations of child friendly
spaces.
It will facilitate an understanding of how to develop a CFS in contexts in which
children’s well-being are threatened or damaged as a result of conflict or natural
disasters. More specifically, this guide attempts to broaden and strengthen the
knowledge, skills and attitudes of protection officers/field staff so that they are able
to respond to the multi-faceted needs of children.
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of transmission, co...ntext and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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