Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
more
39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response. The report shows that deliberate and proactive action is required to ensure that persons with disabilities from all constituencies are systematically included and meaningfully participate in DRR... and humanitarian preparedness, response and recovery. It draws lessons from field practices, but does not provide technical guidance. The newly published IASC Guidelines are the reference document to seek in-depth theoretical and technical information.
more
Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal health indicators in this study, while other highpriority counties consist...ently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care.
more
Personne ne va dans un établissement de soins de santé pour tomber malade. On s’y rend pour se faire soigner, pour accoucher
ou pour se faire vacciner. Cependant, des centaines de millions de personnes s’exposent à un risque accru d’infection en cherchant à obtenir des soins dans des éta...blissements de santé dépourvus de produits de première nécessité, notamment de services d’approvisionnement en eau, d’assainissement et d’hygiène, de gestion des déchets biomédicaux et de nettoyage (services WASH). L’absence de services WASH dans les établissements de santé compromet la sécurité et la dignité des patients, tout en menaçant d’exacerber la propagation d’infections résistantes aux agents antimicrobiens et en fragilisant les efforts déployés pour améliorer la santé des enfants et des mères.
more
En 2015, 26 % des décès de 5,9 millions d'enfants de moins de cinq ans auraient pu être évités si les facteurs de risque
environnementaux avaient été pris en compte – cette possibilité manquée de sauver des vies est révoltante. La période prénatale
et de la petite enfance constitue u...ne source de vulnérabilité particulière, les menaces environnementales pouvant provoquer une
naissance prématurée et d'autres complications, et accroître le risque de maladies chroniques, et notamment de troubles respiratoires, de maladie cardiovasculaire et de cancer. L'environnement est donc un facteur majeur de la santé des enfants et offre d'importantes possibilités d'amélioration dont les effets se manifestent dans toutes les régions du monde.
more
Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate and high priority needs of an affected population and is often the first type of response activated and/or requested by authorities and affected c...ommunities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
more
L'objectif de cette publication est de fournir une approche pratique et progressive pour la mise en œuvre des plans d'action nationaux sur la RAM dans le secteur de la santé humaine ; et de fournir un processus et une compilation des outils existants de l'OMS pour prioriser, chiffrer, mettre en œ...uvre, suivre et évaluer les activités des plans d'action nationaux. Le public cible de cette publication est constitué des parties prenantes nationales/subnationales travaillant sur la RAM dans le secteur de la santé humaine. Il s'agit notamment des autorités sanitaires nationales, des groupes nationaux de coordination multisectorielle, des experts techniques de haut niveau et des décideurs impliqués dans la mise en œuvre des activités liées à la RAM à tous les niveaux du système de santé, ainsi que des partenaires de mise en œuvre afin d'accélérer la mise en œuvre, le suivi et l'évaluation durables des plans d'action nationaux sur la RAM.
more
Modern healthcare has given rise to extremely complex and multifaceted ethical dilemmas. All too often physicians are unprepared to manage these competently. This publication is specifically structured to reinforce and strengthen the ethical mindset and prac...tice of physicians and provide tools to find ethical solutions to these dilemmas. It is not a list of “rights and wrongs” but an attempt to sensitise the conscience of the physician, which is the basis for all sound and ethical decision-making. To this end, you will find several case studies in the book, which are intended to foster individual ethical reflection as well as discussion within team settings.
more
This report challenges policy-makers and political leaders to tackle fossil fuel production and consumption as a health control issue, in the same way that smoking has been reduced and regulated. Fossil fuel combustion is a major source of toxic air pollution that kills 7 million people every year, ...almost the same as the number of deaths caused by tobacco smoking.
In 2018, the World Health Organization (WHO) recognised air pollution as a major health risk factor. There is widespread public discussion about the effects of fossil fuel combustion and emissions on climate change… but what about the effect on our health? Climate change poses a threat not only to the health of the planet, but also to humans.
The case studies evaluated in this report offer examples of mechanisms that can be used to restrict the production and consumption of unhealthy commodities, so that the health, air pollution and climate communities can learn from one another, using shared approaches and language. These case studies show that the connection with health is a strong argument to support sustainable change.
more
Le succès de la mise en œuvre du PNAPF 2017-2020 dépendra de l’engagement de chaque entité à tous les niveaux à travers des arrangements institutionnels clairs. Il s’agit d’un document dynamique qui requerra une forte coordination des différentes parties prenantes multisectorielles. La ...mise en œuvre sera conduite par le Ministère de la Santé à travers la Direction de la Santé de la Famille (DSF). Les autres secteurs tels que les ministères connexes contribueront à favoriser l’environnement juridique et politique de la PF pour garantir l’accès de tous, notamment des jeunes aux services de PF. Les organisations de la société civile (OSC) et les PTF apporteront leur contribution à la mise en œuvre du plan, au renforcement des
capacités des acteurs en PF, au plaidoyer et à la mobilisation des ressources pour la pérennité du programme.
more
The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly ... certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
more
En 2014, la soixante-septième Assemblée Mondiale de la Santé a exprimé sa préoccupation croissante au sujet de la situation
de la RAM, et elle a exhorté les pays membres à renforcer leurs programmes d’action nationale ainsi que la collaboration
internationale. Dans sa résolution WHA67.25... l’Organisation Mondiale de la Santé (OMS) a recommandé que soit développé
un Plan d’Action Mondial pour lutter contre la RAM. Ce Plan a été adopté en mai 2015 et recommande notamment la mise en
place d’un système mondial de surveillance de la RAM (GLASS, Global Antimicrobial Résistance Surveillance System). L’objectif
de GLASS est de permettre la collecte, l’analyse et l’échange avec les pays de données standardisées, validées, comparables
sur la résistance aux antimicrobiens.
more
La santé mentale fait partie intégrante de notre santé et de notre bien-être en général et constitue un droit humain fondamental. À l'échelle mondiale, les problèmes de santé mentale sont très répandus. Selon les données de l'Organisation mondiale de la Santé (OMS), environ une personn...e sur huit dans le monde vit avec un trouble mental (OMS, 2022a). Les troubles mentaux sont la principale cause d'incapacité, entraînant 1 année sur 6 vécues avec une incapacité (OMS, 2022a).
Les personnes atteintes de troubles mentaux graves meurent en moyenne 10 à 20 ans plus tôt que la population générale, principalement en raison de maladies physiques évitables. Des circonstances défavorables, notamment la pauvreté, inégalités sociales et économiques, urgences de santé publique, guerres et crise climatique, font partie des menaces structurelles mondiales pour la santé mentale, entraînant un risque plus élevé de souffrance de problèmes de santé mentale.
more
This report makes clear that there is a path to end AIDS. Taking that path will help ensure preparedness to address other pandemic challenges, and advance progress across the Sustainable Development Goals. The data and real-world examples in the report make it very clear what that path is. It is not... a mystery. It is a choice. Some leaders are already following the path—and succeeding. It is inspiring to note that Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the 95–95–95 targets, and at least 16 other countries (including eight in sub-Saharan Africa) are close to doing so.
more
Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e220083chgsa, 2022
Two adjectives raise an issue for communicators working on Chagas disease (CD): “invisible and silent”. Two adjectives that can be ascribed to other neglected tropical diseases (NTD), but which are part of the essence of CD. Br...inging CD out of its situation of neglect and oblivion is a mission entrusted mainly to the world of communication as well as of science, politics and financial resources. However, communication has not always been considered among the priorities in the approach to the disease, except in valuable exceptions, some of which we have seen in the preceding article.
more
In March 2020 the IASC Reference Group on Mental Health and Psychosocial Support uniting 57 humanitarian organizations as member issued the Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak. This document has proven to be very useful in the response and has... till now been translated in 24 languages. It covers a set of recommended activities as well as messages for different target groups.
The current document is an annex to the Interim Briefing Note and is meant to support the MHPSS operational response within the various sectors of humanitarian work. Approaches and interventions to MHPSS are not confined to one sector, but need to be integrated within many existing sectors and clusters.This document contains a wealth of operational information and practical approaches that can be used for humanitarian programming in health, SGBV, community-based protection, nutrition, camp management and camp coordination.
more
The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to ...sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
more
Section One
summarizes UNHCR’s mandate of international protecdtion and the aim and principles of emergency
response;
Section Two
deals with emergency management;
Section Three
covers the vital sectors and problem areas in refugee emergencies, including health, food, sanitation
and water, a...s well as key field activities underpinning the operations such as logistics, community
services and registration. The chapters in this section start with a summary so that readers, who
might not need the full level of detail in each of these chapters, can understand the basic principles of
the subject quickly;
Section Four
gives guidance on the support to field operations, primarily administration and staffing;
The Appendices
include a “Toolbox” which gathers, in one location, the standards, indicators and useful references
used throughout the handbook;
more
This research is one case in a study commissioned by the World Food Programme to investigate the participation of recipient community in the targeting and management of humanitarian food assistance in complex emergencies. The study involved a substantial desk review of existing documentation, and th...ree weeks of field work in February and March 2008. The purpose of the study was to understand the ways in which participatory or community-based approaches to targeting have been attempted, within the definition of community-based targeting suggested by WFP. The study was not an evaluation of targeting methods, although some critical examination of targeting was necessary in order to understand the constraints on community participation.
Related resources
more
Faciliter l’accès aux soins de santé primaires et assurer une couverture sanitaire universelle à la population reste un défi de grande taille pour les pays en voie de développement. En effet malgré quelques efforts consentis ces dernières décennies, le problème d’accessibilité aux so...ins de santé est loin d’être résolu. Outre le problème épineux des ressources humaines s’ajoutent des difficultés liées à l’organisation et au fonctionnement des systèmes de santé, au financement des systèmes de santé, à la prestations de soins de qualité et à l’accès aux médicaments de base. Tous ceci ayant un impact désastreux sur la population notamment les plus pauvres qui n’arrivent plus à bénéficier de soins de qualité permettant d’obtenir une santé optimale.
more