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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal
...
of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
More than 700 000 people lose their life to suicide every year. A core foundation of suicide prevention is the timely registration and regular monitoring of suicide and self-harm. Surveillance data
...
can be used to show important progress towards reaching global targets, such as reducing the suicide rate by one third by 2030 as articulated in the UN SDGs and in the WHO Mental Health Action Plan 2013-2030. However, there are considerable discrepancies in the quality of data on suicide and self-harm globally. The aim of this training manual is to equip fieldworkers and supervisors with the skills to collect and manage data on suicide and self-harm in the community via key informants, health-care facilities and police records. In doing so, the value and overall goal is to strengthen the surveillance of suicide and self-harm in communities, particularly in LMICs and hard-to-reach communities where CRVS systems are weak or absent.
more
This practical manual is designed to support implementation of the World Health Organization (WHO) Guidelines on core components of infection prevention and control programmes at the national level,
...
with special focus on countries with limited resources.
The Guidelines describe what is necessary (that is, recommendations) to effectively improve infection prevention and control (IPC). This practical manual outlines how to do this (that is, how to implement the Guidelines). It focuses on the development of a sustainable action plan informed by the local context to put into operation the Guideline recommendation
more
Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
CC
Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development
...
of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Methods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
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Today, the World Health Organization (WHO) is advancing the global fight against acute malnutrition in children under 5 with the launch of its new guideline on the prevention and management of wasti
...
ng and nutritional oedema (acute malnutrition). This milestone is a crucial response to the persistent global issue of acute malnutrition, which affects millions of children worldwide.
In 2015, the world committed to achieving the Sustainable Development Goals (SDGs), including the ambitious target of eliminating malnutrition in all of its forms by 2030. However, despite these commitments, the proportion of children with acute malnutrition has persisted at a worrying level, affecting an estimated 45 million children under five worldwide in 2022.
In 2022, approximately 7.3 million children received treatment for severe acute malnutrition (SAM). Although treatment coverage has increased, children with SAM in many of the worst affected countries are still unable to access the full necessary care for them to recover.
The Global Action Plan (GAP) on child wasting recognized the need for updated normative guidance to support governments in the prevention and management of acute malnutrition. WHO answered this call to action and developed a comprehensive guideline that provides evidence-based recommendations and good practice statements and will be followed by guidance and tools for implementation.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start
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of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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Improvements in water sanitation and hygiene (WASH) and wastewater management in all sectors are critical elements of preventing infections and reducing the spread of antimicrobial resistance (AMR)
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as identified in the Global Action Plan to combat AMR. Yet, at present, WASH and wastewater management actors and improvement actions are under-represented in AMR multi-stakeholder platforms and national action plans (NAPs). This WHO/FAO/OIE technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR NAPs and sector specific policy to combat AMR. Evidence and actions are presented in the domains of; coordination and leadership, households and communities, health care facilities, animal and plant production, manufacturing of antimicrobials, and surveillance and research.
more
In December 2013, UNICEF published its first comprehensive evaluation assessing how well its global and country strategies and programmes have worked to protect children in emergencies.
The ‘Evaluation of UNICEF Programmes to Protect Children i
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n Emergencies’ was undertaken to identify key successes and gaps in child protection programming over the period 2009-2012 and to draw out lessons learned ahead of the roll-out of the new Strategic Plan, 2014-2017. The evaluation investigates achievements and gaps against the Core Commitments for Children in Humanitarian Action (CCCs), UNICEF’s Child Protection Strategy and the previous Strategic Plan, 2006-2013. It assesses the extent to which interventions in longer term
child protection systems-strengthening and preparedness have led to a more effective response in crises.
more
In 2015, Member States and the global health community committed to reduce premature mortality from
noncommunicable diseases (NCDs) by one third by 2030 (SDG target 3.4). Despite growing efforts, the pace of change in
most countries, and the polic
...
ies and regulations required to achieve this goal, are too slow, inadequate or insufficient.
Recognizing that public sector efforts alone are insufficient to address the prevention and control of NCDs, the Global
NCD Action Plan emphasizes the need for coordinated multisectoral and multistakeholder engagement, acknowledging
the role of nongovernmental organizations – including civil society groups, individuals with lived experience, academic
institutions and private sector entities. However, WHO notes that some Member States still have limited or no capacity
to establish or manage the implementation of engagement with private sector entities for the prevention and control of
noncommunicable diseases
more
Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management
...
and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
more
Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis
...
ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
more
“All sectors of humanitarian response are critical to providing an adequate and holistic response for children who have survived different types of violence, exploitation, abuse and neglect. Follo
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wing the immediate humanitarian response, all humanitarian sectors have an important contribution to make to the effective rehabilitation and reintegration of child survivors. ‘Mainstreaming’ child protection, or ensuring that child protection considerations inform all aspects of humanitarian action, helps to maximize the child protection impacts of the work that all humanitarians do. ”
How to Use This briefing paper: This briefing paper is a quick reference for Plan International Child Protection in Emergencies (CPiE) staff on how to engage with other sectors operating in the emergency to ensure that child protection principles and considerations inform all aspects of humanitarian programming in other sectors. While there is child protection mainstreaming guidance for how to work with specific sectors (e.g. WASH, nutrition, distribution) this “All Sectors” briefing note can give CPiE staff the big picture of shared child protection mainstreaming messages that should be conveyed to all sectors. This briefing is aligned with the Minimum Standards for Child Protection in Humanitarian Action and the Sphere Standards, as well as Plan International staff feedback on what actions are the most vital for child protection mainstreaming in other sectors.
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Drug Policy and the Sustainable Development Goals
Health Poverty Action, International Drug Policy Consortium
(2015)
C2
The Sustainable Development Goals (SDGs) were launched in September 2015, made up of 17 Goals and 169 Targets that set out a plan of
...
action that will shape the mainstream development agenda for the next 15 years1. There has already been much debate about how these Goals will be achieved, but the significant issue of drug policy reform has so far been ignored. This briefing aims to address this gap, to support discussions and demonstrate how global drug control policies are a cross-cutting development issue that impact upon a number of the SDGs.
more
Policy Guidance Brief 1
• Climate change has already challenged the agriculture sector in Myanmar by afecting rice yields and livestock production, while disasters such as foods and cyclones have caused massive destruction in rural areas.
• Without adaptation, the long-term consequenc ... es of climate change will likely include reduced productivity and huge economic losses, food insecurity, poverty and migration.
• According to the Climate Change Action Plan for the Agriculture, Fisheries and Livestock sector, by 2030 Myanmar should achieve climate-resilient productivity and promote climate-smart responses to support food security and livelihood strategies while also introducing resource-efficient and lowcarbon practices. more
• Climate change has already challenged the agriculture sector in Myanmar by afecting rice yields and livestock production, while disasters such as foods and cyclones have caused massive destruction in rural areas.
• Without adaptation, the long-term consequenc ... es of climate change will likely include reduced productivity and huge economic losses, food insecurity, poverty and migration.
• According to the Climate Change Action Plan for the Agriculture, Fisheries and Livestock sector, by 2030 Myanmar should achieve climate-resilient productivity and promote climate-smart responses to support food security and livelihood strategies while also introducing resource-efficient and lowcarbon practices. more
A manual for developing national action plans.This manual for developing national action plans to address antimicrobial resistance has been developed at the request
...
of the World Health Assembly to assist countries in the initial phase of developing new, or refining existing national action plans in line with the strategic objectives of the Global Action Plan. It proposes an incremental approach that countries can adapt to the specific needs, circumstances and available resources of each individual country. Details of actions to be taken will vary according to national contexts
more
Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan
...
(GAP). With a limited number of new antibiotics in the developmental pipeline, many countries are in the process of establishing strategies for antimicrobial stewardship (AMS). Within each country, different healthcare challenges have
contributed to AMR. This has also shaped individual AMS strategies and policies. In South Africa (SA), there is a high burden of infectious diseases, mainly of bacterial origin. In addition, SA also has the highest number of people living with
human immunodeficiency virus (HIV) globally. According to the 2019 statistics, there are approximately 7.97 million people living with HIV in SA. Together with this, SA has the fourth largest tuberculosis population globally.
Other important challenges include poverty, malnutrition, a high burden of non-communicable diseases, and a dire shortage of trained healthcare professionals (e.g. clinicians, pharmacists, and nurses).
more
The course is aimed at those designing, implementing and evaluating strategies to address AMR. For example, the course would be relevant for members of National Action
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Plan committees, policy and practice professionals who are required to address and support AMR initiatives, mid-career scientists and postgraduate students, and clinicians who would benefit from an understanding of the public health importance of AMR and actions to tackle the problem. The course will have a specific focus on AMR in low- and middle-income countries. Applicants should have a good command of English, as all teaching will be in English.
more
This document outlines Rwanda's policy on non-communicable diseases. The overall goal of NCDs Policy is to alleviate the burden of NCDs and their risk factors and protect Rwandan population from pre
...
mature morbidity and mortality related to NCDs. This policy was developed through a series of consultative meetings and workshops of NCDs' core team members of MOH and RBC, National Technical Working Group (TWG), all implementing and non implementing partners and other development partners. This policy was developed in line with the Millennium Development Goals (MDGs), Vision 2020, Rwanda Economic Development Poverty Reduction Strategy (EDPRS II) of 2013-18 and NCDs Global Action Plan 2013-2020 and national Health Policy. This policy focuses on of the following NCDs: Cardiovascular diseases, Chronic Pulmonary Diseases (CPD), Cancers, Diabetes, injuries and disabilities, oral, eye and kidney diseases.
more
Available in Russian
A detailed overview is provided of the implementation of alcohol policies described in the 10 action areas
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of the European Action Plan to Reduce the Harmful Use of Alcohol 2012–2020 (EAPA), including the current status of implementation of the five action areas of the WHO-led SAFER initiative:
Strengthen restrictions on alcohol availability;
Advance and enforce drink–driving countermeasures;
Facilitate access to screening, brief interventions and treatment;
Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship and promotion; and
Raise prices on alcohol through excise taxes and pricing policies.
more
