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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 c
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ountries, 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.
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Ukrainian Title:
УКРАЇНА: Еквівалентність лікарських засобів, зареєстрованих в Україні та інших країнах. Інформація для працівників охорони здоров'я та пацієнтів
To
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support the provision of healthcare and medicines in the host countries, and as part of FIP’s response to the appeals of our member organisation, the All-Ukrainian Pharmaceutical Chamber, FIP has developed the tables of equivalence between medicines registered in Ukraine and those available in other countries, published in this document. This is meant to facilitate the provision of (pharmaceutical) care to refugees and also to support healthcare professionals providing care to them. We are
prioritising medicines for the following chronic non-communicable diseases that require continuation of treatment: asthma & COPD, mental health, cardiovascular diseases and diabetes, but also oral contraceptives. This list may be expanded as necessary.
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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
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charity. They deserve to be full participants in society, and to live lives free of poverty. But for children, living in poverty is particularly impactful. 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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Algorithm for COVID-19 triage and referral
recommended
Efficient triage of patients with COVID-19 at all health facility levels (primary, secondary and tertiary) will help the national response planning and case management system cope with patient influ
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x, direct necessary medical resources to efficiently support the critically ill and protect the safety of health-care workers. The objective of this algorithm is to give overall guidance for the triage and referral of symptomatic COVID-19 patients. Intended for use by ministries of health, hospital administrators and health workers involved in response planning for COVID-19 and/or patient triage, management and referral, this algorithm provides a general framework to be adapted to local health systems in countries.
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The Federal Ministry of Health of Ethiopia (FMOH), the National Disaster Risk Management Commission (NDRMC) and other government actors together with UN agencies (UNICEF, UNHCR, WHO and WFP)
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and nutrition development partners call for all parties involved in the response to emergencies in Ethiopia to provide appropriate, prompt support for the feeding and care of infants, young children and their mothers. This is a critical for supporting child survival, growth and development and preventing malnutrition, illness and death. This joint statement has been issued to help secure immediate, coordinated, multi- sectoral action on infant and young child feeding (IYCF) in emergencies.
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Brazil‘s Social Policy Response to Covid-19: Healthcare and Poverty Alleviation
Massard da Fonseca, E.; Arantes Beatriz, L. B.; Portella, C.
Global Dynamics of Social Policy; Deutsche Forschungsgemeinschaft
(2022)
CC
During the pandemic, Brazil has provided its citizens with support in the areas of long-term care and disability, the labor market, social assistan
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ce, education, and pensions. This report focuses on two social policy areas, health-care and family benefits (including labor policies), as these were the most crucial social policies implemented in Brazil during the Covid-19 pandemic in terms of the resources allocated and the magnitude of social impact. Brazil’s relatively generous social policies were uncoordinated with public health interventions, which contributed to poor compliance with these public health interventions. This suggests that social policy initiatives alone are insufficient in mitigating the social consequences of the pandemic. They need to be accompanied by and coordinated with public health measures, including regulations on testing, social distancing and mask wearing.
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The ‘jigsaw puzzle’ approach to building a diagnostic picture of asthma in primary care over time
Ryan, D.; Kocks, J.; Correia de Sousa, J. et al.
International Primary Care Respiratory Group
(2023)
CC
Since there is no single objective diagnostic test for asthma this study suggests an approach of collecting and assembling pieces of clinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demons
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tration of symptom and airway variability and/or bronchodilator responsiveness over time, to support a clinical diagnosis.
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This guide is intended to promote a global health sector response to FGM for the provision of high-quality prevention and care services to women and
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girls at risk of FGM or living with the consequences of FGM. It also aims to support the systematic development of pre-service and in-service FGM content for midwifery and nursing education curricula which are relevant to context and need. This document could also be used for training materials of other cadres of health-care providers.
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Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation a
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mong established smokers are key for reducing smoking prevalence and the associated negative health consequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.
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Self-care activities are an essential component of patient-centered health care systems. The World Health Organization defines self-care as “the
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ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider.”
accessed 30.07.2021
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The document titled "Classification and Referral Algorithm – iCCM South Sudan", published by Malaria Consortium in 2012, provides a practical tool for community health workers to assess, classify, and
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manage common childhood illnesses in South Sudan. It outlines step-by-step procedures for identifying danger signs and symptoms related to malaria, pneumonia, diarrhoea, and severe acute malnutrition. Based on clinical findings, the algorithm guides health workers in making decisions about immediate treatment, referral to higher-level health facilities, and caregiver counseling. The aim is to support timely and appropriate care at the community level through the Integrated Community Case Management (iCCM) strategy.
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The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Ess
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ential Care and Practice that includes general guidelines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
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Several countries affected by COVID-19, have seen increases in levels of violence occurring in the home, including violence against children, intimate partner violence and violence against older people. Countries also face increasing challenges in m
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aintaining support and care for survivors of violence. This brief compiles key actions that the health sector can undertake within a multisectoral response to prevent or mitigate interpersonal violence based on existing WHO guidance.
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The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to dev
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elop mental health conditions. Meanwhile, those with pre-existing mental health conditions may experience a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
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The Ideal Clinic Realisation and Maintenance (ICRM) programme was initiated by the National Department of Health in July 2013 in order to systematically improve primary health care (PHC) facilities
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and the quality of care they provide. The Ideal Clinic framework/dashboard sets out the standards for PHC facilities to provide good-quality health services. An Ideal Clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicines and supplies, good administrative processes, and sufficient adequate bulk supplies. Applicable clinical policies, protocols and guidelines are adhered to, and it harnesses partner and stakeholder support.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear
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and mistrust about the response activities within the communities affected.
Infection prevention and control (IPC) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health
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programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six Afri
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can countries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Based on scientific evidence, expert consensus and country experiences, the WHO core components for infection prevention and control (IPC) are the foundation for establishing or strengthening effect
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ive programmes at the national and facility level.
These new guidelines on core components of infection prevention and control (IPC) at the national and acute health care facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC.
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