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The primary audience of these recommendations includes healthcare providers who are responsible for developing national and local health protocols (particularly those related to hypertensive disorders of pregnancy), and those directly providing care
...
to pregnant women and their newborns, including midwives, nurses, general medical practitioners, obstetricians, obstetric physicians, managers of maternal and child health programmes, and relevant staff in ministries of health, in all settings.
more
Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health
...
care resulting in failure to provide adequate, accessible and quality maternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
more
Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and chil
...
d health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how aid flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases. MethodsandFindings:We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development’s Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of ‘‘stillbirth’’ and only nine references were found to ‘‘fetus’’ in any spelling variant or language
more
Programming strategies for Postpartum Family Planning
World Health Organization; USAID; MCHIP
(2013)
This publication is designed to be used by programme planners and managers as a resource when designing interventions to integrate postpartum family planning into national and subnational strategies. Postpartum family planning should not be considered a ‘vertical’ programme, but rather as an int
...
egrated part of existing maternal and child health and family planning efforts. Successful interventions for postpartum family planning require holistic and evidence-based programme strategies that contribute to strengthened health systems and sustained improvements in high-quality services that put people at the centre of health care
more
The main objective of the 2014-15 RDHS was to obtain current information on demographic and health indicators, including family planning; maternal mortality; infant and child mortality; nutrition status of mothers and children; prenatal
...
care, delivery, and postnatal care; childhood diseases; and pediatric immunization. In addition, the survey was designed to measure indicators such as domestic violence, the prevalence of anemia and malaria among women and children, and the prevalence of HIV infection in Rwanda. For the first time, this 2014-15 RDHS also includes indicators to monitor HIV testing among children age 0-14 as well as domestic violence for males age 15-59.
more
The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Health Sector Transformation Plan (HSTP). The EHSTG, which is consistent with the national focu
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s on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
more
Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–
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19 years old in low- and middle-income countries become pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
more
This dataset contains data from WHO's data portal covering the following categories:
Air pollution, Antimicrobial resistance (AMR), Assistive technology, Child mortality, Dementia diagnosis, treatment and care, Dementia policy and legislation, En
...
vironment and health, Foodborne Diseases Estimates, Global Dementia Observatory (GDO), Global Health Estimates: Life expectancy and leading causes of death and disability, Global Information System on Alcohol and Health, Global Patient Safety Observatory, HIV, Health financing, Health systems, Health taxes, Health workforce, Hepatitis, Immunization coverage and vaccine-preventable diseases, Malaria, Maternal and reproductive health, Mental health, Neglected tropical diseases, Noncommunicable diseases, Nutrition, Oral Health, Priority health technologies, Resources for Substance Use Disorders, Road Safety, SDG Target 3.8 | Achieve universal health coverage (UHC), Sexually Transmitted Infections, Tobacco control, Tuberculosis, Vaccine-preventable communicable diseases, Violence against women, Violence prevention, Water, sanitation and hygiene (WASH), World Health Statistics.
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Peru − Progress in health and sciences in 200 years of independence
Carrillo-Larco; R.M.; Guzman-Vilca, W. C.; Leon-Velarde, F.; et al.
The Lancet Regional Health - Americas
(2021)
CC
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and
...
population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
more
Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP)
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, which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more
Integrated Management of Newborn and Childhood Illness, Part 1 Blended Learning Module for the Health Extension Programme
HEAT, UNICEF, Open University, AMREF, WHO
Ministry of Health, Federal Democratic Republic of Ethiopia
(2011)
C1
These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium Development Goals to reduc
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e maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery, postnatal care, the integrated management of newborn and childhood illness, communicable diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases), family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene and environmental health, non-communicable diseases, health education and community mobilisation, and health planning and professional ethics.
more
As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea
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rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
more
Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environme
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ntal factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
more
In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population. This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five morta
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lity, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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 prevent
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able and treatable, PPH results in around 70 000 deaths 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.”
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of lo
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w NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
more
The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing common medical conditions at the primary healthcare level. This document includes treatment protocols
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for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit
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h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
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e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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