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1
The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la
...
test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
more
Conflicts and disasters, including pandemics, affect women and men in all their diversity differently, and women and girls often suffer the most. Crisis-related hardships combine and compound pre-existing disadvantages, for example, they often cause women’s working conditions to worsen while incre
...
asing their overall workload and care responsibilities. At the same time, crises can give rise to changes that enable women to take up roles that were previously available only to men, and crises can open opportunities to address existing gender-based discrimination and violations of rights.
more
Background: The World Health Organization (WHO) published a clinical case definition of post COVID-19
condition, by a Delphi consensus, on 6 October 2021. That process concluded that a separate definition
may be applicable for children. It is impo
...
rtant to understand the frequency, characteristics and risk factors
that lead to post COVID-19 condition, along with its impact on everyday functioning and development of
children and adolescents. Long-term outcomes of the condition are currently unknown and need to be
studied. For these reasons, a globally standardized clinical case definition is needed.
Aim: To develop a globally relevant standardized clinical case definition for children and adolescents by
building on the WHO clinical case definition for post COVID-19 condition in adults.
more
This is an e-learning module with the objective of providing education for health professionals and pregnant women using published results and studies based on COVID-19 surveillance data, which have indicated an increased risk among pregnant women of presenting with severe forms of COVID-19 and, the
...
refore, of being hospitalized and admitted to intensive care units.
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
...
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
The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health
...
care systems throughout the Region. Though there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
more
Since 24 February 2022, the war in Ukraine has caused widespread suffering to its people and serious damage
to the country’s infrastructure. Attacks on the country’s health system and its power network threaten people, compromise the provision of health
...
care, and complicate the distribution of essential medicines and equipment.
more
Promoting health and preventing disease is a critical component of the effort required to achieve Universal Health Coverage (UHC). to date, efforts to achieve UHC have focused mostly on strengthening health systems and their capacities to provide curative
...
care. However, experience from the COVID-19 pandemic has reaffirmed the need for resilient health systems, emphasizing primary health care, including preventive and promotive health and well-being.
Emerging from the eye of the storm as the global health lead agency during the pandemic, WHO is equipped with the required insights and actions for a holistic approach to “building back fairer and better” after COVID-19.
The Healthier Populations (UHP) Cluster in the African Region is designed to support Pillar 3 of WHO’s 13th Global Programme of Work (GPW13) which aims to make 1 billion people healthier by reducing health inequities, preventing diseases and injuries, addressing health determinants, and promoting partnerships for collaborative actions amongst all stakeholders.
more
During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc
...
e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
more
Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with
...
some even imprisoning patients who cannot afford their bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
more
The WHO COVID-19 Clinical management: living guidance contains the most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients t
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hroughout their entire illness is important.
more
Developmental disabilities are common. Yet, children with developmental disabilities have been neglected in health systems planning and policy provisions for health and continue to experience stigmatization, institutionalization, barriers to access health
...
care and inequalities in health and education outcomes.
Using findings from research and practice and guided by the tenets of international human rights conventions, this WHO-UNICEF Global Report on children with developmental disabilities provides principles and approaches to intentionally include the needs and aspirations of children and young people with developmental disabilities in policy, programming and public health monitoring. It makes the case for greater accountability and proposes 10 priority actions to accelerate changes towards inclusive environments and responsive multisectoral care systems for children with developmental disabilities.
more
Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
The main goal of IPC in the cholera response is to
• To reduce transmission of health
...
care-associated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
more
The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health care. Central to the WASH FIT methodology is
...
training and incremental improvements.
Implementation of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
more
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
...
3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more
A year ago, the second Special Session of the World Health Assembly (WHASS) unanimously agreed to start a diplomatic process for a new binding instrument aimed at ensuring the international community is better prepared for the next health emergencie
...
s. The establishment of an Intergovernmental Negotiating Body (INB) at the WHO paved the terrain for a proper negotiation, which has started to unfold. The INB will be releasing the “conceptual zero draft” of the treaty text in early December 2022.
more
Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a
...
nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
more
The document is part of the briefing package for Ethiopia's Water, Sanitation, and Hygiene (WASH) Cluster, which consists of resources that provide greater clarity and guidance to the cluster partners and other humanitarian actors.
The document is divided into four sections. Each section represen
...
ts the cluster’s coordination system (i) WASH Cluster coordination management, (ii) HPC process, (iii) Response monitoring, (iv) WASH response, and (v) Cluster meeting coordination.
Cluster Overview
The WASH Cluster in Ethiopia is part of and supports the Ministry of Water and Energy (MoWE). MoWE leads the WASH cluster emergency task force (ETF), which is co-led by the WASH Cluster secretariat hosted by UNICEF. In Ethiopia, the WASH Cluster was established with the activation of the cluster approach in 2006, and UNICEF, as the global Cluster Lead Agency, was assigned to appoint the WASH Cluster Coordinator.
The WASH Cluster aims to provide guidance and support to its partners to ensure well-coordinated, quality assistance reaches those in need in accordance with humanitarian standards and principles. Conflict, severe drought conditions, seasonal flooding, and Cholera remain the key drivers of WASH needs in Ethiopia.
In 2024, the WASH Cluster aims to work with 79 partners to preserve life, well-being, and dignity and reduce the risk of WASH-related disease through timely interventions to vulnerable populations and preparedness to respond to shocks. Significant humanitarian WASH needs in 2024 are projected with a rigorous HPC process in Ethiopia.
The Humanitarian Program Cycle
The humanitarian program cycle (HPC) is a coordinated series of actions to help prepare for, manage, and deliver humanitarian response. It consists of five coordinated elements, each step logically building on the previous and leading to the next. Successful implementation of the HPC depends on effective emergency preparedness, effective coordination with national/local authorities and humanitarian actors, and information management. Affected people are central to the response; preparedness, coordination, and information management processes continually occur.
more
Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was
...
the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
more
Due to the heterogeneous distribution of malaria transmission and its determinants, subnational tailoring (SNT) provides an analytical framework to facilitate the targeting of each population with appropriate intervention packages for maximum impact to inform national strategic planning and prioriti
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zation based on resources available. The WHO Global Malaria Programme recommends the use of subnational data on disease epidemiology and other relevant local contextual factors to facilitate the process of SNT. Once the strategies and intervention mixes have been defined, programmes can proceed to the prioritization of
interventions for effective programming, based on available resources
more