In preparing this paper, the Pharmacovigilance Group of the Pan American Health Organization’s Pan American Network for Drug Regulatory Harmonization (PANDRH) adopted the perspective of PAHO/WHO, which considers Pharmacovigilance, an essential component of public health programs. Its intention was... to facilitate the development of pharmacovigilance systems in the Region of the Americas and improve, strengthen, and promote the adoption of good practices to improve safety for patients and the general population, based on the needs of the Region.
Document also available in Spanish and Portuguese!
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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The WHO Guide on Oral Cholera Vaccines in Mass Immunization Campaigns provides guidance on the planning and implementation of oral cholera vaccine (OCV) campaigns. It covers key aspects such as when and where to use OCVs, vaccine specifications, and recommendations for use in endemic areas, outbreak... settings, and complex emergencies. The document outlines steps for macro- and micro-planning, logistics, budgeting, human resource allocation, and risk communication. It also highlights challenges, including cold chain management, vaccine supply, and community engagement, ensuring that vaccination campaigns are efficient and effective in reducing cholera outbreaks.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ...diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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The document provides quality standards for managing Type 1 diabetes in adults, emphasizing areas like structured education, continuous glucose monitoring (CGM), cardiovascular risk management, and diabetic foot assessment. It aims to improve care processes, reduce complications, and enhance patient... outcomes through evidence-based and patient-centered approaches. The guidelines also focus on supporting inpatient self-management and ensuring equality and accessibility in diabetes care.
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The purpose of the report is to present some first recommendation for the development of Myanmar ecological quality criteria using the system of the EU Water Framework Directive (EU WFD) as baseline, with main focus on the characterization and classification processes. As background for the recommen...dations we first give an overview of the main water use categories in Myanmar. We then provide preliminary suggestions for typology criteria and indices for assessing ecological status in lakes and rivers in Myanmar. The typology factors and physico-chemical parameters are based on common used factors in the EU countries. The biological elements include phytoplankton and aquatic macrophytes for lakes, and benthic invertebrates for rivers.
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The purpose of this guide is to provide updated clinical guidance on TB/HIV, with an emphasis on diagnostic aspects—including new techniques—as well as current treatment, while maintaining a public health approach. By compiling and consolidating the latest World Health Organization recommendatio...ns on the subject into a single guide, the aim is to create a reference and consultation document that is frequently used, and that unifies and standardizes the comprehensive management of TB/HIV co-infection in healthcare facilities based on the principle of “two diseases, one patient.” It also seeks to support the updating of national standards and guidelines on co-infection and to complement the coordinated work that must exist between TB and HIV prevention and control programs at all levels, within the framework of the twelve internationally recommended TB/HIV collaborative activities.
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The Information Management Unit of the Assistance Coordination Unit issued a Panoramic Report on Busra Esh-Sham City located in Dar’a Governorate. The report reflects the living conditions in the city during November and December 2017. The report covers in analysis several sections: Active Civilia...n actors, Demography, Health, Food Security, Education, and the Infrastructure, which incorporates Water sector, Sewage System, Solid Waste, Electricity, and Public Roads Network. This report aims at drawing the attention of the decision-makers to the civil actors in the city of Busra Esh-Sham and to enable them to manage the community and provide necessary infrastructure needs and services to the community people.
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Esta é a primeira edição de orientações sobre estratégias de prevenção e controle de infecção (PCI) para utilizar quando houver suspeita de infecção por um novo coronavírus (2019-nCoV). Foi adaptado do guia da OMS de Prevenção e controle de infecções durante os cuidados de saúde pa...ra casos prováveis ou confirmados da infecção pelo coronavírus que causa a síndrome respiratória do Oriente Médio (MERS--CoV)1, com base no conhecimento atual da situação na China e em outros países onde foram identificados casos e experiências com a síndrome respiratória aguda grave (SARS)-CoV e MERS-CoV. A OMS atualizará essas recomendações assim que novas informações estiverem disponíveis. Esta orientação destina-se a profissionais de saúde, gerentes de saúde e equipes de PCI na atenção básica em saúde, mas também é relevante para os níveis nacional e subnacional. Diretrizes completas estão disponíveis na OMS.
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Esta é a primeira edição da orientação sobre estratégias de prevenção e controle de infecções (PCI) que devem ser aplicadas quando houver suspeita de COVID-19. Ela foi adaptada do documento da OMS sobre prevenção e controle de infecções durante prestação de cuidados de saúde para ca...sos prováveis ou confirmados de infecção da síndrome respiratória do Oriente Médio (MERS-CoV)1, com base no conhecimento atual da situação e experiência com a síndrome respiratória aguda grave (SARS) e MERS2. A OMS atualizará estas recomendações à medida que novas informações forem surgindo. Esta orientação é dirigida a trabalhadores da saúde, administradores em saúde e equipes de PCI nas unidades de saúde, mas também é relevante para os níveis nacionais, estaduais e municipais.
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This Study presents the key results of a research that analyses the implications of an ambitious agroecological transition across Europe, following the TYFA scenario. Published in 2018, what it proposes by 2050 is fully aligned with the objectives that the European Farm to Fork and Biodiversity stra...tegies aim to achieve by 2030, in particular regarding the decrease in pesticides, nitrogen, and antibiotics on the supply side, and the transition towards more plant-based diets on the demand side. Using a world biomass balance model (GlobAgri-AgT), the impact of the TYFA scenario in the EU on world land use, the EU physical trade balance, the provision of calories and global food security is analysed in addition to key policy levers to spur the transition.
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Guide pratique à l’usage des médecins, infirmiers, techniciens de laboratoire, auxiliaires de santé, techniciens sanitaires et logisticiens.
Le document est un guide complet pour la gestion des épidémies de choléra, fournissant des protocoles détaillés pour la prévention, l’investigat...ion des épidémies, le traitement et les mesures de contrôle. Il couvre des aspects essentiels tels que la thérapie de réhydratation, l’assainissement de l’eau, la promotion de l’hygiène et la mise en place de centres de traitement. Conçu pour le personnel médical et non médical, il vise à soutenir une réponse efficace aux épidémies et à réduire la morbidité et la mortalité liées au choléra.
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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.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –... are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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This is the seventeenth annual publication of the Global Hunger Index (GHI), a report jointly published by Concern Worldwide and Welthungerhilfe.
The 2022 Global Hunger Index (GHI) brings us face to face with a grim reality. The toxic cocktail of conflict, climate change, and the COVID-19 pandemi...c had already left millions exposed to food price shocks and vulnerable to further crises. Now the conflict in Ukraine—with its knock-on effects on global supplies of and prices for food, fertilizer, and fuel—is turning a crisis into a catastrophe. But the speed and severity of the global food crisis reflects the fact that millions of people were already living on the precarious edge of hunger—a legacy of past failures to build more just, sustainable, and resilient food systems. This year’s report therefore focuses on food systems transformation and local governance.
According to the 2022 GHI, Hunger is at alarming levels in 5 countries—Central African Republic, Chad, Democratic Republic of the Congo, Madagascar, and Yemen— and is provisionally considered *alarming *in 4 additional countries— Burundi, Somalia, South Sudan, and Syria. In a further 35 countries, hunger is considered serious, based on 2022 GHI scores and provisional designations.
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Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak health systems and poor infrastructure. Low-carbon appro...ach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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Although Shiga toxin-producing Escherichia coli (STEC) have been isolated from a variety of food production animals, they are most commonly associated with ruminants from which we derive meat and milk. Because of the widespread and diverse nature of ruminant-derived food production, coupled with the... near ubiquity of STEC worldwide, there is no single definitive solution for controlling STEC that will work alone or in all situations. Instead, the introduction of multiple interventions applied in sequence, as a “multiple-hurdle scheme” at several points throughout the food chain (including processing, transport and handling) will be most effective.
This report summarizes the review and evaluation of interventions applied for the control of STEC in cattle, raw beef and raw milk and raw milk cheese manufactured from cows’ milk, and also evaluates available evidence for other small ruminants, swine and other animals. The information is presented from primary production, to the end of processing, providing the reader with information on the currently available interventions based on the latest scientific evidence.
This work was undertaken to support the development of guidelines for the control of STEC in beef, raw milk and cheese produced from raw milk by the Codex Committee on Food Hygiene (CCFH).
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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History has shown that governments tend to deprioritize environmental commitments during times of financial and public crises as they work to mitigate immediate needs—and the age of COVID-19 has been no different. Even though human interaction with wildlife is believed to be the cause of the pande...mic, the focus on COVID’s fallout has deprioritized the importance of reversing the damage humans have done to the planet.
COVID has had a multifaceted and detrimental effect on environmental conservation. Not only has funding been diverted to deal with the pandemic, conservation-oriented organizations are operating with minimal staff or have closed entirely. People whose daily work it is to advance environmental science and protect the land and water have become ill or have been forced to stay home because of travel restrictions. Plastic use is at an all-time high.
The good news is that there is an unprecedented opportunity for philanthropy to recharge the effort to protect the planet. This Giving Smarter Guide examines the state of environmental philanthropy, and provides an overview of potential strategic starting points for philanthropy and impact capital to play a role in saving the planet. In addition to offering recommendations specific to the COVID-19 response, the Center for Strategic Philanthropy also asks the questions that philanthropists should consider at the start of their journey into the field of conservation philanthropy.
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