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.
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This manual was developed based on the recommendations of a global technical consultation on child health in humanitarian emergencies co-organized by WHO and UNICEF at the end of 2003. WHO in collaboration with the Centre for Refugee and Disaster Response, Bloomberg School of Public Health, Johns Ho...pkins University undertook a systematic review in 2004. It demonstrated that existing guidelines, including The Integrated Management of Childhood Illness (IMCI), do not cover all priority conditions in emergencies. The objective of this manual is to provide comprehensive guidance on child care in emergencies.
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In response to the COVID-19 outbreak, this guidance provides information on infection and prevention control (IPC) for older people, their friends and families, carers, and healthcare providers. Anyone who manages, works, volunteers or provides care at any type of facilities where older people recei...ve care at (long-term care facilities, non-acute care facilities, and home care services), should practice strict IPC to prevent and control COVID-19 outbreaks. It has been observed in different countries that older people have higher case-fatality rate compared to other age groups. Therefore, it is especially important to implement and follow IPC measures at facilities, homes, and other venues that older people frequent.
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In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising region...al and national referral hospitals [Figure 3].
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Recognizing the importance of the critical role of community health in disaster management, the Amref health Africa has
developed this operational guide to provide policy direction on COVID-19 response at community level. This guide has
been developed in collaboration with all the implementing cou...ntries in supporting prevention and control of COVID-19.
With a strong community COVID-19 response system at community level, we can all contribute to prevention and control
of COVID-19, and thereby improve health and livelihoods for all people
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Ethiopia has seen high economic growth over the last decade, but remains a poor country with a high burden of disease. It has made considerable health gains in recent years, mainly by having health policies that focus on extending primary healthcare, using health extension workers. It... has made good use of existing resources,but has a low health expenditure (of around US$21 per capita, and totalling 4per centof GDP). It has a federal system with devolved healthcare financing, whereby block grants are allocated to sectors at regional and woreda(district) level. The challenge now,with the epidemiological transition (and a sense that the ‘low-hanging fruits’have already been gathered in relation to public health), is how Ethiopia, still poor, continuesto invest in health improvements?Human resources for health (HRH) are a critical pillar within any health system –the health staff combine inputs to provide the services, thus affecting how all other resources are used, and they make frontline (and back-office) decisions thatare importantdeterminants of servicequality,effectiveness and equity. HRH is usually the most resource-intensive element within the health system –commonly absorbing 50–70per centof public expenditure onhealth, although the proportions are very varied by individual countries and across regions. As they are commonly part of the public administration, reforms to HRH are also part of a complex political economy in most countries.Assessing value for money (VfM) in relation to HRH is correspondingly complex;across the value chain, manyfactors influence the conversion of inputs into outputs and outcomes (see Figure 1).A more detailed description of the HRH value chain can be found in Annex1.
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This section deals with implementing and improving infection control practices in hospitals, health centres and other health services in the outbreak area. It explains the need for, and implementation of, effective triage procedures, and basic requirements for infection control and supporting activi...ties. Further guidance can be found in the MSF Infection Control Guideline
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Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultur...al backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in
a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups.The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition.
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This publication provides recommendations for the management of critically ill adult patients with COVID-19 being treated in intensive care units (ICUs) in the Americas. These clinical practice guidelines provide evidence-informed recommendations for identifying markers and mortality risk factors in... critically ill patients, as well as infection control, sample collection, supportive care (respiratory and hemodynamic), pharmacological treatment, early rehabilitation, diagnostic imaging use, prevention of complications, and discharge requirements. The recommendations are for all health care staff caring for patients in emergency departments and ICUs. These guidelines are also intended for use by decisionmakers and government entities involved in the management of patients with COVID-19 in ICUs in the Region of the Americas.
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This guidance note developed by UNICEF helps WASH staff in their preparedness and response to the current COVID-19 pandemic. It provides an overview of Infection Prevention and Control (IPC) and its intersection with water, sanitation and hygiene (WASH). It also provides key actions that staff can i...mplement to help prevent infection and its spread in health-care facilities: from human to human, among health care workers and patients, through droplets, and by touching surfaces contaminated with the virus. WASH, including waste management and environmental cleaning, is essential for IPC
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Report of the WHO/Bill & Melinda Gates Foundation Consultation. The Consultation was organized back-to-back with the first annual meeting of the International Coordinating Group of the BMGF-funded project for human and dog rabies elimination in developing countries, held at WHO headquarters, Geneva,... Switzerland, from 5 to 7 October 2009. This allowed the Consultation to benefit from the participation of the national coordinators and advisers of the BMGF-funded projects in the Philippines, South Africa (KwaZulu-Natal) and the United Republic of Tanzania
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Includes a Special Report on the Financial and Personal Benefits of Early Diagnosis
2018 Alzheimer’s Disease Facts and Figures is a statistical resource for U.S. data related to Alzheimer’s disease,
the most common cause of dementia. Background and context for interpretating the data are con...tained in
the Overview. Additional sections address prevalence, mortality and morbidity, caregiving and use and costs of health care and services. A Special Report discusses the financial and personal benefits of diagnosing earlier in the disease process, in the stage of mild cognitive impairment.
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Malawi is a landlocked country with a surface area of 118,484 km2. Administratively, the country is divided into three regions, namely the Northern, Central and Southern regions. The country has 28 districts, which are further divided into traditional authorities (TA) ruled by chiefs. The TAs are su...b-divided into villages, which form the smallest administrative units. The Village Development Committees (VDCs) under the TAs are responsible for development activities. Politically, each district is divided into constituencies that are represented by Members of Parliament (MPs) in the National Assembly for purposes of legislations. Constituencies are further divided into wards which are represented by a ward councillor at district assembly.
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28 May 2021
Contact tracing is a key component of a public health response to infectious disease outbreaks. The purpose of this guidance is to reinforce the place of community engagement and participation in the contact tracing process. The guidance and related products articulate best practice pri...nciples for community engagement and how they can be operationalized as part of any community-centred contact tracing strategy. The material provided can stand on its own or be used to complement other documents that support strategies, implementation plans or training and capacity building modules.
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Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char...acteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines.
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This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), which is funded by USAID and based at the Johns Hopkins Center for Communication Programs, offers structured guidance for improving social and behavioural change communication (SBCC) strategies relat...ed to malaria in pregnancy (MiP). Designed for programme managers and stakeholders, the toolkit addresses critical communication gaps in MiP programming, particularly among service providers. It provides tools to help users integrate MiP into situation analyses, segment audiences, define behavioural objectives and draft strategic communication plans.
MiP poses a significant public health challenge, contributing to maternal and neonatal mortality and morbidity in sub-Saharan Africa. Although effective interventions exist, such as the use of insecticide-treated nets, intermittent preventive treatment in pregnancy (IPTp) and timely diagnosis and treatment, their implementation remains inconsistent. The I-Kit supports more effective SBCC planning and implementation, with the aim of increasing the uptake and impact of these interventions and ultimately reducing malaria-related deaths and illness among pregnant women and newborns.
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The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly cost-effective and improves effectiveness of core pu...blic health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
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21 August 2020
This guidance provides specific considerations for the use of non-medical masks, also known as fabric masks, by children as a means for source control in the context of the current COVID-19 pandemic. It also advises on the use of medical masks for children under certain conditions.
Prepared as an outcome of ICMR Subcommittee on Colorectal Cancer | Coordinated by Division of Non Communicable Diseases | This Consensus Document on Management of Colorectal Cancer summarizes the modalities of treatment including the site-specific anti-cancer therapies,
supportive and palliative ca...re and molecular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
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WHO published guidance for clinicians and health care decision-makers on the use of corticosteroids in patients with COVID-19.
We recommend systemic corticosteroids for the treatment of patients with severe and critical COVID-19. We suggest not to use corticosteroids in the treatment of patients ...with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful. Treatment should be under supervision of a clinician.
Corticosteroids are listed in the WHO model list of essential medicines, readily available globally at a low cost. WHO encourages countries to maintain sufficient stocks of corticosteroids to treat COVID-19 and the other disease for which they are effective, while not maintaining excessive stocks which could deny other countries access.
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