This 2011 update of Guidelines for the programmatic management of drug-resistant tuberculosis is intended as a tool for use by public health professionals working in response
to the Sixty-second World Health Assembly’s resolution on prevention and control of multidrug-resistant tuberculosis and e...xtensively drug-resistant tuberculosis.
more
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh...ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
more
Advising principles. The purpose of this document is to support competent authorities in charge of IHR implementation to improve national capacities for the prevention, detection and control of events, by strengthening communications and coordination between points of entry and the national health s...urveillance system
more
Guide for coordinators and data collectors - The WHO Operational Package for Assessing, Monitoring and Evaluating Country Pharmaceutical Situations is intended as a useful tool for researchers, policy-makers, planners and others who need to use standardized measurement tools to gather data and other... information. In addition, the operational package can be used by international agencies and donors, by professional groups and nongovernmental organizations (NGOs).
more
The attainment of Zambia’s goal of being a prosperous and middle-income country by 2030 as stipulated in its Vision 2030 is dependent on among others, a healthy and productive population. Therefore, the Government of the Republic of Zambia (GRZ) has prioritized health as a key socio-economic inves...tment in the Seventh National Development Plan 2017-2021. The government is also committed to achieving the targets under the health goal number three and other health related targets under other goals of the 2030 Sustainable Development agenda. Despite progress which has been made in improving the health of Zambians, the country still faces a high burden of communicable diseases and a growing burden of non-communicable diseases. Structural and social deprivation including poverty, inequalities and marginalisation also remain major threats to health. In order to effectively address all the social determinants of health, all sectors should take into account health and well-being as a key element of policy development.
more
4. Central African Republic
Clashes throughout 2018 in the capital Bangui and a number of major towns illustrate the deadly threat posed by armed groups – a mix of pro-government militias, ex-rebels, bandits and local “self-defence” units – that control much of the countr...y. MINUSCA, the UN peacekeeping force, has failed to neutralise these groups and, as a result, is mistrusted by the general public. Likewise, the national army, slowly being deployed in parts of the country, has been unable to constrain the armed groups’ predatory activities. The humanitarian situation remains dire, with more than one million people internally displaced or fleeing to neighbouring countries and 2.5 million in need of assistance, according to the UN.
more
This document adopts a health determinants framework for examining the evidence related to women’s poor mental health. From this perspective, public policy including economic policy, socio-cultural and environmental factors, community and social support, stressors and life events, personal behavio...ur and skills, and availability and access to health services, are all seen to exercise a role in determining women’s mental health status. Similarly, when considering the differences between women and men, a gender approach has been used. While this does not exclude biological or sex differences, it considers the critical roles that social and cultural factors and unequal power relations between men and women play in promoting or impeding mental health. Such inequalities create, maintain and exacerbate exposure to risk factors that endanger women’s mental health, and are most graphically illustrated in the significantly different rates of depression between men and women, poverty and its impact, and the phenomenal prevalence of violence against women.
more
The audit was undertaken in order to ascertain whether allocations and donations received directly by the Government of Sierra Leone, in the fight against the Ebola Virus Disease were utilised with due regard to economy and efficiency and that internal controls were observed accordingly. The audit f...ound that more than US$ 10 million in spending was inadequately documented and US$ 6 million may have been diverted to non-existent or “ghost” workers. The Quote: “It makes one wonder how a serious humanitarian crisis was used as money-making machine,” said Ibrahim Tommy, coordinator for Sierra Leone’s Centre for Accountability and Rule of Law
more
Comprehensive Reviews in Food Science and Food Safety, Vol.12 (2013) pp.234-248
In 2006, the Institute of Food Technologists (IFT) published an Expert Report entitled “Antimicrobial Resistance: Implications for the Food System” (IFT 2006). That report summarized current scientific knowledge pe...rtaining to the public-health impact of antimicrobial use in the food system and the development and control of antimicrobial resistance. Since that time, intense interest in this topic has continued within the regulatory and scientific communities as well as the general public. This IFT Scientific Status Summary serves to update that 2006 IFT Expert Report by briefly reviewing new scientific evidence relevant to the goals of the initial report and providing a number of key observations and conclusions.
more
This guideline provides updated, evidence-informed guidance on the percentage of total fat in the diet to reduce the risk of unhealthy weight gain.
This guideline is intended for a wide audience involved in the development, design and implementation of policies and programmes in nutrition and pub...lic health. This guideline includes a recommended level of total fat intake which can be used by policy-makers and programme managers to address various aspects of dietary fat in their populations through a range of policy actions and public health interventions.
The guidance in this guideline replaces previous WHO guidance on total fat intake, including that from the 1989 WHO Study Group on Diet, Nutrition and the Prevention of Chronic Diseases and the 2002 Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. The guidance in this guideline should be considered in the context of that from other WHO guidelines on healthy diets.
more
The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this paper explores the impact of this current macro-fisc...al outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
more
Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
more
The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The... Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
more
While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng...es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
more
In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South
American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention
and rehabilitation (CVDPR). In the context of the imple...mentation of a regional and national health policy in Latin American
countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on
Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation
of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline
and adapt it to the national reality.
The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine
clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World
Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025.
more
There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
more
The aim of the present paper is to review capacity building in public health nutrition (PHN), the need for which has been stressed for many years by a range of academics, national and international organisations. Although great strides have been made worldwide in the science of nutrition, there rema...in many problems of undernutrition and increasingly of obesity and related chronic diseases. The main emphasis in capacity building has been on the nutrition and health workforce, but the causes of these health problems are multifactorial and require collaboration across sectors in their solution. This means that PHN capacity building has to go beyond basic nutrition and beyond the immediate health workforce to policy makers in other sectors. The present paper provides examples of capacity building activities by various organisations, including universities, industry and international agencies. Examples of web-based courses are given including an introduction to the e-Nutrition Academy. The scope is international but with a special focus on Africa. In conclusion, there remains a great need for capacity building in PHN but the advent of the internet has revolutionised the possibilities.
more
The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
more
Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
more
PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interagency team has developed a person-centered, district-tailored and Malawi Population-Based HIV Impact Ass...essment (MPHIA)-informed strategy through extensive engagement with Government of Malawi (GoM) and Civil Society Organizations (CSOs) to sustain HIV epidemic control. At the end of COP21, PEPFAR Malawi was commended for contributing to reaching epidemic control in strong collaboration with GoM and stakeholders including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This includes enrollment of 88% of recipients of care on three or more months of antiretroviral treatment (ART), better outcomes for Malawian children through remarkable efforts in Orphans and Vulnerable Children (OVC) programming and progress made towards reaching men with more intentional and focused programming.
more