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2
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
This document is written for local and international staff running nutrition programmes in emergencies, and for local, regional and national authorities and donors involved in such programmes.
The note explains why nutrition programmes need to inc
...
lude early childhood development (ECD) activities to maximize the child’s development.
It provides practical suggestions as to what simple steps are necessary to create integrated programmes in situations of famine or food insecurity and it gives examples of how such integrated programmes have been established in other situations.
This document is also available in Arabic: http://www.who.int/mental_health/emergencies/ecd_why_what_how_arabic.pdf?ua=1
;and in French: http://www.who.int/mental_health/emergencies/ecd_why_what_how_french.pdf?ua=1
more
this Service Delivery brief provides evidence-based strategies that can help support drug shops and pharmacies in providing a wider variety of family planning methods and information. Evidence shows that with training and support, pharmacy and drug
...
shop staff can facilitate the use of a broad range of modern contraception, especially in areas where the unmet need is high, access to family planning services is poor, and health worker shortages and other barriers prevent women, men, and youth from accessing family planning services
Availabe in English, French, Spanish and Portuguese
more
This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent
...
class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
more
The report showed commitments made three decades ago to protect the rights of children remain unfulfilled for millions. Violence still affects countless children. Discrimination based on age, gender, disability, sexual orientation and religion harms children worldwide.
Key factors include a lack
...
of investment in critically important services. Most countries fall well short of spending the 5-6% of GDP needed to ensure universal coverage of essential health care. And foreign aid, which many lower income countries rely on, is falling short in areas such as health, education, protection and child care.
Another factor, the report said, is the lack of quality data. Governments tend to rely on data that reflects national averages, making it difficult to identify the needs of specific children and to monitor progress. Comprehensive data collection and disaggregation of data by gender, age, disability and locality, are increasingly important as rights violations disproportionately affect disadvantaged children.
more
Three billion people – 40 per cent of the world’s population – do not have a place in their homes to wash their hands with water and soap. Three quarters of those who lack access to water and soap live in the world’s poorest countries and are amongst the most vulnerable: children and familie
...
s living in informal settlements, migrant and refugee camps, or in areas of active conflict. This puts an estimated 1 billion people at immediate risk of COVID-19 simply because they lack basic handwashing facilities.
The Hand Hygiene for All initiative aims to move the world towards this goal: supporting the most vulnerable communities with the means to protect their health and environment. It brings together international partners, national governments, public and private sectors, and civil society to ensure affordable products and services are available, especially in disadvantaged areas, and to enable a culture of hygiene.
more
We will soon be piloting a project titled “Integrating Spirituality into Patient Care” that will form “spiritual care teams” to assess and address patients’ spiritual needs in physician outpatient practices within Adventist Health Sy
...
stem, the largest Protestant healthcare system in the United States.This paper describes the goals, the rationale, and the structure of the spiritual care teams that will soon be implemented, and discusses the barriers to providing spiritual care that health professionals are likely to encounter.Spiritual care teams may operate in an outpatient or an inpatient setting, and their purpose is to provide health professionals with resources necessary to practice whole person healthcare that includes spiritual care.We believe that this project will serve as a model forfaith-based health systems seeking to visibly demonstrate their mission in a way that makes them unique and expresses their values.Not only does this model have the potential to be cost-effective, but also the capacity to increase the quality of patient care and the satisfaction that health professionals derive from providing care.If successful, this model could spread beyond faith-based systems to secular systems as well both in the U.S. and worldwide.
more
Has the world worked together to tackle the coronavirus? July 2021. This research paper assesses how the global community has responded to calls for greater solidarity in tackling the COVID-19 pandemic, and presents the insights of key stakeholders and experts in global
...
health governance, health security, and pandemic preparedness and response. The authors examine the state of solidarity at global, regional and national levels, and present case studies on COVAX and on the EU’s turbulent journey through solidarity.
more
This guidance document is meant to support practitioners working in disaster prone contexts to develop and implement more effective integrated resilience programming. It promotes programming that cuts across different fields of work like rights awareness, food security, emergency preparedness, livel
...
ihoods, education, health etc. whilst at the same time encouraging us to work simultaneously at the individual, household, community and national level. It includes specific recommendations for developing resilience programming for communities prone to floods, cyclone, drought and earthquakes. It also includes recommendations to develop safe school programming to help reduce the impact of disasters on school infrastructure, ensure education continuity and build the resilience of students, teachers and their families.
more
Children with disabilities are particularly vulnerable in humanitarian settings, yet they are often not able to access the services and protection they need. While multiple factors create these barriers, a major cause is how data about children with disabilities is collected and mapped. Data collect
...
ion processes often exclude or underrepresent the views of children with disabilities and thier caretakers. When the experiences of children with disabilities and their caretakers are not defined and collected, they become excluded from mainstreamed protective services, which are meant to serve all children. Children with disabilities also do not get the specialised interventions they need.
This guidance note explores how to use qualitative methods to create more robust assessment processes to ensure more effective programming and services for children with disabilities. This note provides promising practices for engaging with children with disabilities and includes sample tools that can be tailored to fit the needs of a particular assessment process. The note also explores the importance of thoughtful cross-sectoral responses so that children with disabilities, and their families, are carefully considered in areas like water, sanitation, and hygiene (WASH), education, health, and nutrition, and therefore receive the holistic support they need and deserve.
This note is intended for a broad audience of relevant child protection actors, including practitioners, coordination groups, researchers, and donors. The information is not limited to one type of humanitarian setting, geographic region, or culture. As a result, the practices and guidance should be adapted to each specific context, ideally in partnership with well-informed local actors, such as representatives from local organisations for persons with disabilities.
more
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
...
SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
more
This document updates the 2009 ECDC guidance on chlamydia control in Europe. It was developed by a technical expert group which conducted a critical review of the scientific evidence on the epidemiology of chlamydia and the effectiveness of screening programmes.
The aim of this guidance is to suppo
...
rt Member States to develop, implement or improve strategies for chlamydia control. This guidance describes the current evidence base behind the proposed options, highlights key gaps in knowledge, and suggests effective options for national chlamydia control strategies. It is directed primarily at policy advisors but should also be useful for programme managers and experts in sexual health.
more
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
...
patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
more
A case study from Albania
June 2016
EHRN is grateful to all who contributed to this document, especially (in alphabetical order): Alena Alba, Program Officer, Eastern Europe and Central Asia Team, Asia, Europe, Latin America and the Caribbean Department, The Global Fund to Fight AIDS, Tuberc
...
ulosis and Malaria, Geneva; Roland Bani, Head, National AIDS Program, Institute of Public Health, Ministry of Health, Tirana; Gazmend Bejtja, Director, Health Care Directory, Ministry of Health, Tirana; Arian Boci, Director, Stop AIDS, Tirana; Bujana Hoti, UNAIDS Focal Point, Tirana; Gyöngyvér Jakab, Fund Portfolio Manager, Eastern Europe and Central Asia, Asia, Europe, Latin America and the Caribbean Department, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva; Manjola Kola, CCM Secretariat, Tirana; Sokol Morina, Coordinator, Control of illicit Drugs and Alcohol Addiction, Ministry of Health, Tirana; Genci Muçollari, Director, Aksion Plus, Tirana; and Dorina Tocaj, National Program Officer, UNFPA, Tirana.
more
Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures—and better, in social terms, than social distancing. Given that a vaccine will eventually be produced,
...
information will be needed to support a potential campaign to promote vaccination.
Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects.
Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile.
Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies.
Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
more
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca
...
l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
more
As slight hints of recovery begin to surface in West Africa, UNICEF is looking at the impact of Ebola on children and the response and work of the affected communities in the report, Ebola: Getting to zero – for communities, for children for the future. The document traces some of the outbreak’s
...
history along with the stories of survivors, health care workers and those working to make things better on the ground. The report also helps map out the actions that urgently must continue to help build resiliency and resuscitate basic services and systems decimated by Ebola.
more
The education sector forms an important part of the child protection response in refugee settings, and UNHCR’s Education Strategy (2012-16) reflects a focus on refugee education as a core component of UNHCR’s protection mandate. The right to education for all children also forms part of the Unit
...
ed Nations Convention on the Rights of the Child. UNHCR’s Education Strategy promotes the importance of schools as safe learning environments, emphasises improving access to quality education for refugee children and maximises the protective benefits of participation in school. It advocates for the integration of refugee children into national education systems.
more
Health in All Policies (HiAP) promotes health and equity. It is based on the recognition that our greatest health challenges for example, non-commu
...
nicable diseases, health inequities and inequalities, climate change, and spiraling health care costs are highly complex and often linked through the social determinants of health (SDH). In this context, promoting healthy communities, and in particular health equity across different population groups, requires that we address the social determinants of health, such as public transportation, education access, access to healthy food, economic opportunities, and more. While many public policies work to achieve this, conflicts of interest may arise. Alternatively, unintended impacts of policies are not measured and addressed. This requires innovative solutions, and structures that build channels for dialogue and decision-making that work across traditional government policy siloes. Hence, HiAP could be adopted to ensure commitment from the highest decision makers within government to address the social determinants of health.
more
Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re
...
fugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
more
