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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Modu
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le 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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India contributes to 16% of the global maternal deaths and around 27% of global newborn deaths. Reducing the burden of maternal and newborn mortality and morbidity in urban poor settings today requires an expansion of effective Maternal and Newborn Health (MNH)
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care services and lowering the barriers to the use of such services, especially availability and accessibility.
For designing sensitive, responsive and relevant urban health policy and action, it is important for planners and programme managers to understand the context with regard to current systems and mechanisms, potential organisations and best practices.
In order to adres this need, Save the Children’s Saving Newborn Lives programme commissioned a study that reviewed the literature and looked at available secondary data on MNH in urban poor settings.
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The Kenyan Health Sector has been playing a critical role in
providing health care services in response to the population
needs in line with the Kenya Health Policy, 2014-2030’s goal
of attaini
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ng the highest possible health standards in a manner
responsive to the population needs.
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The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Health Sector Transformation Plan (HSTP). Th
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e EHSTG, which is consistent with the national focus on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
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Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and
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recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP), which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more
Tuberculosis (TB) is an infectious disease that usually affects the lungs, though it can affect any organ in the body. It can develop when bacteria spread through droplets in the air. TB can be fata
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l, but in many cases, TB is preventable and treatable. This report examines the human rights impact of the prevalence of Tuberculosis (TB) and Multi-drug-resistant tuberculosis (MDR-TB) among the Indigenous San peoples of Namibia. Combining political economy and root-cause methodology, the report explores the socioeconomic factors that make the San vulnerable to TB and limit their access to adequate health services.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control
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in these communities, it is necessary to respond to communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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The report explores strategies for sustaining the country’s responses to the three diseases and eventually transitioning away from external funding and programmatic support. It takes stock of Kenya’s health financing landscape and identifies opportunities and challenges for sustaining effective
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coverage of HIV, TB, and malaria services in the long run, mindful of macro-fiscal and institutional constraints. The report informs ongoing dialogue within government, including among the Ministry of Health, National Treasury, Council of Governors, and National AIDS Control Council, as well as between government and development partners.
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July 2023 version .The 2023 ART guideline introduces simplified ART provision and harmonised methods of management of children, adolescents and adults, as well as pregnant women living with HIV/AIDS, TB and other common opportunistic infections.
T
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he guidelines also provide guidance on the use of Dolutegravir (DTG) dispersible tablets for children from 3kg and 4 weeks old.
These guidelines have been revised with the Differentiated Models of Care SOPs to ensure simultaneous consideration and alignment of clinical, adherence and service delivery updates.
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The health of the people and health services are in crisis, and together as partners this plan commits us to strategies aimed at achieving our goal of:
Strengthened primary health care for all, ... and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB more
Strengthened primary health care for all, ... and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB more
This policy brief presents a summary of current evidence on vulnerability to TB and proposes interventions for equitable, person-centred, and human rights-based TB prevention and
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care. It aligns with WHO policies and guidance on TB prevention and screening, management of TB and comorbidities, access to health care, universal health coverage, determinants of TB, TB-associated impairment and disability, social protection, as well as ethics, equity and human rights.
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Standard operating procedures (SOP) for the management of tuberculosis in children
National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program), Kenya
Ministry of Health, Kenya
(2017)
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2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing
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TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and they have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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In 2008 the Ministry of Health and Social Services (MOHSS) commissioned a national health and social service system review which found that although some progress has been made in primary health care
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, provision of health services did not go beyond the health facilities, irrespective of the fast distances between the Health facilities and community. The review then recommended that health services should be extended in a structured manner to communities through the establishment of paid health workers.
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This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national
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TB response in accelerating efforts towards elimination. The document will also be informative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
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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 and the quality of
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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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Ukrainian decentralization reform has increased and democratized local government responsibility for health care at the level of local government closest to communities and has increased regional and local government responsibility for public health
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. Decentralization affects health system reform in three important areas: health financing, individual health services and public health.
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The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria are part of a group of agencies working together to accelerate progress towards the health-related SDGs through the Global Action Plan for Healthy Lives and Well-being for All. Understanding patterns of inequal
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ities in these diseases is essential for taking strategic, evidence-informed action to realize our shared vision of ending the epidemics of HIV, TB and malaria.
This report presents the first comprehensive analysis of the magnitude and patterns of socioeconomic, demographic and geographic inequalities in disease burden and access to services for prevention and treatment.
The results confirm there have been improvements in service coverage and decreased disease burden at the national level over the past decade. But they also reveal an uncomfortable reality: unfair inequalities between population subgroups within countries are widespread and have remained largely unchanged over the past decade. For some disease indicators, inequalities are even worsening.
Moreover, the report points to the persistent lack of available data to fully understand inequality patterns in HIV, TB and malaria. Collecting data to improve the monitoring of inequalities in these diseases is vital to develop targeted responses for impact.
There are, encouragingly, isolated successes in reducing inequities. Change is possible when deliberate action is taken to reach disadvantaged populations.
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The EHSP in Botswana seeks to attain universal coverage of high-quality package of essential health services. The EHSP is an integrated collection of cost-effective interventions, promotive, preventive, curative, and rehabilitative, that address the
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main diseases, injuries and risk factors that affect the population. The EHSP has two key purposes:
1) Provide a standardized package of basic services which forms the core of service delivery in all primary health care facilities
2) Promote a redistribution of health services by providing equitable access, especially in underserved areas, population, etc.
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