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The Knowledge Guide provides guidance on how health workers can apply the Standards to their own practice. For each of the nine competencies and their specific behaviours in the Standards, the Knowledge Guide examines in detail how a
...
health worker's knowledge, skills and attitudes can reach the stated benchmark for providing people-centred health services to refugees and migrants. The Knowledge Guide also details the learning outcomes that reflect the behaviours that a health worker will demonstrate once they have achieved the Competency Standards.
The Knowledge Guide is designed for educators and health workers to assist in designing or integrating learning content to enable attainment of the identified knowledge, skills and attitudes.
more
This publication presents a comprehensive methodology to support the Member States of the Pan American Health Organization (PAHO) in preparing for and responding to heat-health risks in the Region o
...
f the Americas. It builds on World Health Organization and the World Meteorological Organization global documents, as well as on the disaster preparedness methodologies employed throughout the countries of the Region. This publication is part of an effort coordinated by PAHO to support Member States in multihazard preparedness, and includes: early warning system strengthening; threat characterization; activation and deactivation procedure definition; and institutional coordination. It engages different disciplines and recognizes the importance of intersectoral collaboration to respond to heat-health risks. It aims to bring awareness of the impacts of heat on the health of people of the Americas to public health decisionmakers, and thereby strengthen health service provision.
more
This document focus on the direct consequences of the virus (morbidity and mortality) in specific populations and on the results of measures aimed at mitigating the spread of the virus, with indirect impacts on socio-economic conditions. In this complex scenario, the gender approach has not received
...
due attention during the pandemic. Gender is one of the structural determinants of health, but it does not appear in analyses of the direct and indirect effects of the pandemic, despite being essential in the recognition and analysis of the differential impacts on men and women and their interaction with the different determinants of health.
more
Training Modules for climate change and Health - WHO
The Lancet Countdown is an international collaboration that independently monitors the health consequences of a changing climate. Publishing updated, new, and improved indicators each year, the Lancet Countdown represents the
consensus of leading
...
researchers from 43 academic institutions and UN agencies. The 44 indicators of this report expose an unabated rise in the health impacts of
climate change and the current health consequences of the delayed and inconsistent response of countries around the globe—providing a clear imperative for accelerated action that puts the health of people and planet above all else.The 2021 report coincides with the UN Framework Convention on Climate Change 26th Conference of the Parties (COP26), at which countries are facing pressure to realise the ambition of the Paris Agreement to keep the global average temperature rise to 1·5°C and to
mobilise the financial resources required for all countries to have an effective climate response. These negotiations unfold in the context of the COVID-19 pandemic—a global health crisis that has claimed millions of lives, affected livelihoods and communities around the globe, and exposed deep fissures and inequities in the world’s capacity to cope with, and respond to, health emergencies. Yet, in its response to both crises, the world is faced with an unprecedented opportunity to ensure a healthy future for all.
more
The Impacts of Climate Change on Human Health
in the United States: A Scientific Assessment
Climate change is a significant threat to the health of the American people. This scientific assessment
...
examines how climate change is already affecting human health and the changes that may occur in the future.
more
This training guide applies a participatory approach, reflecting the considerable evidence that adults learn best by practicing and reflecting on their experiences. It thus emphasizes exercises to improve skills in counseling that support clients to adopt optimal nutrition practices. Women’s nutri
...
tion and infant feeding in the context of HIV are also addressed. Guidelines to link the prevention of malnutrition with treatment via the Integrated Management of Acute Malnutrition are also included. It can also be conducted with nutrition managers to equip them to provide supportive supervision to health and community workers.
more
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) sta
...
rted implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
more
Preliminary fndings from a global survey of urban young people on the air they breathe and a child health co-benefts analysis of radical decarbonisation of 16 global cities.
Against the backdrop of the COVID-19 pandemic, health is receiving unprecedented public and political attention. Yet the fact that climate change also presents us with a health crisis deserves furth
...
er recognition. From more deaths due to heat stress to increased transmission of infectious diseases, climate change affects the social and environmental determinants of health in ways that are profound and far-reaching. The fundamental interdependency of human health and the health of the environment is encapsulated in the concept of planetary health, a scientific field and social movement that has been gaining force since the 2015 publication of the Rockefeller Foundation-Lancet Commission report “Safeguarding human health in the Anthropocene epoch”.
We see an urgent need for strategic communication to raise awareness of climate-health synergies in order to overcome the misperception that climate and health are two independent agendas. The fragmented and sector-focused nature of thinking and action remains a significant barrier to integrating health considerations into climate planning and project development. Inevitably, collaboration across sectors requires a community of practice. Despite recent efforts focused on the climate-health nexus, much work remains to be done to translate scientific findings for policymakers, mobilise climate financing resources in support of health co-benefits, and promote genderjust solutions within climate change projects.
more
As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality
...
(iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
more
Evidence shows that FGM can cause several physical, mental and sexual health complications in girls and women, and in newborns. Health-care providers play an important role in supporting girls and w
...
omen living with FGM, and improving their health and well-being. They are in a unique position to influence and change the attitudes of their patients about FGM.
WHO is committed to scaling up the health-sector response to address FGM prevention and care. One aspect is to strengthen the quality of FGM prevention and care services by building the capacity of health-care providers. Several guidance materials have been produced to target health-care providers. These include FGM content for training curricula, clinical guidelines and a clinical handbook.
This training manual complements previous publications by building person-centred communication skills specifically for FGM prevention.
more
This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to a
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ddress environmental determinants of health in the Americas. The Pan American Health Organization (PAHO) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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Connecting global priorities: biodiversity and human health: a state of knowledge review
Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses th
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ree key functions: management (ensuring performance), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to b
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e successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further assessment
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CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at home immediately after discharge from
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health care centers. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when sti
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gma associated with HIV/AIDS, tuberculosis and now COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Community Health Volunteers' Decision Support System Project
P. Bakibinga, Kamande E. , Kisia L., et al.
African Population and Health Research Centre APHRC
(2018)
C1
This report presents the key findings of the end-of-project assessment of households and
community health volunteers, conducted in 2017 in the Kamukunji and Embakasi sub-counties
of Nairobi, Kenya, for a Community
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Health Volunteers’ Decision Support System (CHV DSS)
intervention project. The report was prepared by the African Population and Health Research
Center (APHRC). The end-line survey was implemented by APHRC. Implementation of the CHV
DSS project is a joint collaboration among several partners, including APHRC, the City County
of Nairobi, sub-county health management teams (Kamukunji and Embakasi), and community
health volunteers. The opinions expressed in this report are those of the authors and do not
necessarily reflect the views of the donor organization, the County Innovation Challenge Fund
for Kenya.
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By almost any measure, human health is better now than at any time in history. Life expectancy has soared from 47 years in 1950–1955, to 69 years in 2005–2010, and death rates in children younger than 5 years of age have decreased substantially,
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from 214 per thousand live births in 1950–1955, to 59 in 2005–2010. But these gains in human health have come at a high price: the degradation of nature’s ecological systems on a scale never seen in human history. A growing body of evidence shows that the health of humanity is intrinsically linked to the health of the environment, but by its actions humanity now threatens to destabilise the Earth’s key life-support systems.
As a Commission, we conclude that the continuing degradation of natural systems threatens to reverse the health gains seen over the last century. In short, we have mortgaged the health of future generations to realise economic and development gains in the present.
Despite present limitations, the Sustainable Development Goals provide a great opportunity to integrate health and sustainability through the judicious selection of relevant indicators relevant to human wellbeing, the enabling infrastructure for development, and the supporting natural systems, together with the need for strong governance.
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