As the Convention of the Rights of Children recognizes, children are human beings with a distinct set of rights, and not the passive objects of care and charity. They deserve to be full participants in society, and to live lives free of poverty. But for children, living in poverty is particularly im...pactful. The foundations for life are built in childhood. In the early part of our lives, our bodies and brains develop their capacities to function and interact with the world. We learn the social skills we need to fit into society, and acquire the human capital necessary to earn a living, support a family, and to fully take part in the life of our community Poverty can stunt this development. So can the onset of a disability. As the World Report on Disability (WHO/World Bank 2011) points out, people with disabilities are all too often excluded from the economic and social lives of their community. And the interaction between disability and poverty has the potential to develop a vicious circle that can greatly limit life opportunities.
Working Paper Series: No. 25
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HIV infection, due to the immunosuppressant that leads, nowadays constitutes an aggravating factor of endemic tuberculosis. Tuberculosis remains a huge burden to human health, even in the early 21st century. The situation is deteriorating in many countries, particularly because of the synergy with t...he HIV epidemic and the emergence of multidrug-resistant (MDR) and extensively drug resistant (XDR) tuberculosis. The urgent development of new tools that can improve the diagnosis, prevention and/or treatment of tuberculosis and other major mycobacterium diseases depends largely on the progress of basic and applied research. Faced with this situation, there is an urgent need for effective strategies and actions to permanently solve the problem of this endemic disease whose impact is too negative on people’s lives.
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From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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The full range and scale of all forms of violence against children are only now becoming visible, as is the evidence of the harm it does. This book documents the outcomes and recommendations of the process of the United Nations Secretary-General’s Study on Violence against Children. ‘The Study... is the first comprehensive, global study on all forms of violence against children.
It builds on the model of the study on the impact of armed conflict on children, prepared by Graça Machel and presented to the General Assembly in 1996, and follows the World Health Organization’s 2002 World Report on Violence and Health.1
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Original text from 2008, updated in 2012. This document marks the beginning of a structured approach to safety assessment of GE foods, which are yet to be approved in our country. It is understood that many changes will become necessary and will be incorporated as we progress. This document will ho...wever, remain an important milestone in the process towards safety evaluation of food derived from GE plants in India.
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En la era del cambio digital, democrático, social y político, la comunicación se ha convertido en un medio esencial para expresar ideas y desarrollar iniciativas revolucionarias, capaces de crear comunidades más fuertes, mejor informadas y más comprometidas que nunca. El surgimiento del periodi...smo ético se ha vuelto fundamental para las salas de prensa y es el pilar de las noticias periodísticas que favorecen el desarrollo de la sociedad. Al comenzar estos cambios, la cuestión del género se vuelve inseparable del tema del progreso y del periodismo ético.
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Accessed on 20.10.2020
L͛analyse des tendances récentes montre que le Burkina Faso a enregistré une réduction significative de la mortalité infanto-juvénile. Même si aucune des cibles des OMD 4 et 5 n͛a été atteinte par le pays, le taux de mortalité infanto-juvénile est passé de 129 ...pour mille naissances vivantes en 2010 à 82 pour mille naissances
vivantes en 2015, soit une baisse de 7.3% par an. Ceci est en grande partie dû aux progrès enregistrés en matière de lutte contre la mortalité au bénéfice de la tranche juvénile (de 1 à 4 ans). Cependant, comme près de la moitié des enfants âgés de moins de cinq ans continuent de mourir au cours de leur première
année de vie, il reste beaucoup à faire pour l͛atteinte de la vision globale d͛élimination de la mortalité infanto-juvénile évitable et de réduction de la mortalité des mères comme partie prenante des Objectifs de Développement Durable (ODD).
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Le Bénin en registre chaque année environ 1500 décès maternels et plus de 12 000 décès de nouveau-nés. Face à cette situation, il estélaboré le plan opérationnel de réduction de la mortalité maternelle et néonatale 2018 –2022. Il s’agit du document par lequel le Minist...re de la Santé fixe les objectifs, détermine les stratégies permettant de les atteindre, ainsi que les interventions cliniques, managériales, politiques, législatives et autres requises pour infléchir les indicateurs de mortalité maternelle et néonatale. Le document comporte six (6) parties:-la méthodologie d’élaboration;-l’analyse des progrès en matière de réduction de la mortalité maternelle et néonatale; -le cadre stratégique;-le cadre de mise en œuvre;-les plans d’actions budgétisés par niveau de la pyramide sanitaire; -le cadre de coordination, et de suivi / évaluation.
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La publication des résultats de l’EDSC-V intervient quelques années seulement après l’échéance en 2015 des Objectifs du millénaire pour le développement (OMD), le lancement de l’Agenda 2065 de l’Union Africaine, de l’Agenda 2030 des Nations Unies pour le Développement Durable, et a...u moment de la finalisation de la
Stratégie nationale de développement de la deuxième génération (2020-2027) dans le cadre de la Vison 2035.Nul doute qu’ils serviront à établir la situation finale ou la situation de référence pour le suivi évaluation des progrès accomplis dans le cadre de ces agendas nationaux et internationaux.
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El Análisis de la Situación de la Niñez y la Adolescencia (SITAN, por sus siglas en inglés), desarrollado por el Fondo de Naciones Unidas para la Infancia (UNICEF), presenta y analiza la situación de la infancia. El objetivo del SITAN es examinar los desafíos y las oportunidades para lograr qu...e se respeten los derechos de los niños, niñas y adolescentes (NNyA), así como señalar los progresos en ese camino y los patrones de privación y desigualdad que impiden el ejercicio de esos derechos y el desarrollo humano.
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Ainsi, le présent profil peint le faciès épidémiologique du pays pour l’année 2015
avec un clin d’œil sur le niveau de réalisation des Objectifs du millénaire pour le
développement (OMD) et un focus particulier sur l’appropriation des Objectifs de
développement durable (ODD). Il e...st composé de six chapitres que sont (i)
Introduction au contexte du pays ; (ii) Etat et tendance des indicateurs de santé ; (iii)
Système de santé ; (iv) Progrès des objectifs de développement durable ; (v)
Programmes et services spécifiques ; (vi) Déterminants clés de la santé.
C’est un outil recommandé par l’OMS et est indispensable pour le pays en prélude à
la mise en place de l’Observatoire national de la santé. Son élaboration a connu un
processus participatif avec l’implication des différents acteurs intervenant dans le
domaine de la santé.
Profil sanitaire complet du Burkina Faso 2015 Page 8
Le document du profil pays a été organisé en 4 modules à savoir :
Module 1 : La situation socio-sanitaire du Burkina Faso et mise en œuvre des ODD ;
Module 2 : Le Système de santé au Burkina Faso ;
Module 3 : Les programmes et services spécifiques de santé au Burkina Faso ;
Module 4 : Les déterminants clés de la santé.
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Ainsi, le présent profil peint le faciès épidémiologique du pays pour l’année 2015
avec un clin d’œil sur le niveau de réalisation des Objectifs du millénaire pour le
développement (OMD) et un focus particulier sur l’appropriation des Objectifs de
développement durable (ODD). Il e...st composé de six chapitres que sont (i)
Introduction au contexte du pays ; (ii) Etat et tendance des indicateurs de santé ; (iii)
Système de santé ; (iv) Progrès des objectifs de développement durable ; (v)
Programmes et services spécifiques ; (vi) Déterminants clés de la santé.
C’est un outil recommandé par l’OMS et est indispensable pour le pays en prélude à
la mise en place de l’Observatoire national de la santé. Son élaboration a connu un
processus participatif avec l’implication des différents acteurs intervenant dans le
domaine de la santé.
Profil sanitaire complet du Burkina Faso 2015 Page 8
Le document du profil pays a été organisé en 4 modules à savoir :
Module 1 : La situation socio-sanitaire du Burkina Faso et mise en œuvre des ODD ;
Module 2 : Le système de santé au Burkina Faso ;
Module 3 : Les programmes et services spécifiques de santé au Burkina Faso ;
Module 4 : Les déterminants clés de la santé.
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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.
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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...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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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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The Event-based Surveillance Framework is intended to be used by authorities and agencies responsible for
surveillance and response. This framework serves as an outline to guide stakeholders interested in implementing
event-based surveillance (EBS) using a multisectoral, One Health approach. To ...that end, the document is arranged
in interlinked chapters and annexes that can be modified and adapted, as needed, by users.
This is a revised version of the original “Framework for Event-based Surveillance” that was published in 2018. This
framework does not replace any other available EBS materials, but rather builds on existing relevant or related
documents and serves as a practical guide for the implementation of EBS in Africa. This framework is aligned with
the third edition of the WHO Joint External Evaluation for the following indicators: strengthened early warning
surveillance systems that are able to detect events of significance for public health and health security (Indicator
D2.1); improved communication and collaboration across sectors and between National, intermediate and local
public health response levels of authority regarding surveillance of events of public health significance (Indicator
D2.2); and improved national and intermediate-level capacity to analyse data (Indicator D2.3). As countries begin
to implement and demonstrate EBS functionality they will ensure an increase in JEE scores and progress towards
meeting the requirements outlined in the IHR3F
Additionally, in African Union Member States that have adopted the Integrated Disease Surveillance and
Response (IDSR) strategy, this document is a complement to and can enhance the implementation of IDSR,
especially for the 3rd edition (2019) that includes components related to EBS.
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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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Biweekly situation reports
On Sunday 16th December 2018, some villages in the Province of Mai-Nambiar, Democratic Republic of Congo, neighboring the district of Makotimpoko in the Republic of Congo (CongoBrazzaville) were affected by inter-ethnic conflict between the Banunu and the Batende. The fighting has resulted in 400 fa...talities and the destruction of property. A large number of the population of the conflict affected areas were forced to cross the river Congo and find refuge in several localities in the Cuvette (Konda and Youmba) and Plateaux (Makotimpoko, Bouemba, Patrick) areas in Congo-Brazzaville.
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