Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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13 July 2021
The module provides an overview of factors to consider when monitoring the safety of COVID-19 vaccines administered to pregnant and breastfeeding women. It describes how national routine AEFI surveillance should be adapted to cater for this specific group of population using both pass...ive and active surveillance methods. Specific considerations and limitations of each method are provided as well as tools for implementation.
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Desde hace muchas décadas, los microbios, en particular las bacterias, se han vuelto cada vez más resistentes a diversos antimicrobianos. El aval de la Asamblea Mundial de la Salud al Plan de Acción Mundial sobre la resistencia a los antimicrobianos, en mayo de 2015, y la Declaración política d...e la reunión de alto nivel de la Asamblea General sobre la resistencia a los antimicrobianos, en septiembre de 2016, reconocen que la resistencia a los antimicrobianos es una amenaza para la salud pública mundial. Estas iniciativas políticas reconocen el uso excesivo e inapropiado de los antimicrobianos como el principal factor que favorece dicha resistencia, así
como la necesidad de optimizar el uso de estos medicamentos.
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As this report shows,
reports of child abuse and of children
witnessing violence between their
parents and caregivers have increased.
Ending violence against children is
increasingly within our reach. D
BMJ Global Health2020;5:e002914. doi:10.1136/bmjgh-2020-002914
The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and in...fluenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider lessons for COVID-19. We show how models detach from their implementation contexts through their connections with global narratives of pandemic response, and how sociological and anthropological research can help to locate models differently. This potentiates multiple models of pandemic response attuned to their emerging situations in an iterative and adaptive science. We propose a more open approach to the modelling of pandemics which envisages the model as an intervention of deliberation in situations of evolving uncertainty. This challenges the ‘business-as-usual’ of evidence-based approaches in global health by accentuating all science, within and beyond pandemics, as ‘emergent’ and ‘adaptive’.
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High levels of storage iron may increase malaria susceptibility. This risk has not been investigated in semi-immune adolescents. We investigated whether baseline iron status of nonpregnant adolescent girls living in a high malaria transmission area in Burkina Faso affected malaria risk during the fo...llowing rainy season. For this prospective study, we analysed data from an interim safety survey, conducted six months into a randomised iron supplementation trial. We used logistic regression to model the risk of P. falciparum infection prevalence by microscopy, the pre-specified interim safety outcome, in relation to iron status, nutritional indicators and menarche assessed at recruitment.
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La higiene de manos es la más eficaz de todas las medidas para reducir la propagación de infecciones mediante estrategias multimodales que incluyen el acceso a los suministros correspondientes. Por tanto, las presentes orientaciones son pertinentes para todos los p...aíses, y se recomiendan en particular para aquellas zonas donde no sea fácil acceder a instalaciones para la higiene de manos.
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This document is to support local authorities, leaders and policy-makers in cities and other urban settlements in identifying effective approaches and implementing recommended actions that enhance the prevention, preparedness and readiness for COVID-19 in urban settings, to ensure a robust response ...and eventual recovery. It covers factors unique to cities and urban settings, considerations in urban preparedness, key areas of focus and preparing for future emergencies.
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Debido a la actual crisis socio-económica, política y de derechos humanos en Venezuela, cerca de 4.5 millones de personas han salido de su país; convirtiéndose en la segunda peor crisis migratoria del mundo, después de Siria. Se estima que más del 20% de los refugiados y migrantes son niños y... adolescentes. Cerca del 57% de los venezolanos en el exterior se encuentran en Ecuador, Colombia y Perú, según Naciones Unidas.
En 2018, Plan International decidió implementar una estrategia regional en Colombia, Ecuador y Perú para mejorar las condiciones de vida de los refugiados y migrantes venezolanos, durante sus etapas de tránsito y asentamiento.
Durante los meses de junio y julio de 2019, el equipo de la oficina regional visitó más de siete ciudades entre Colombia, Ecuador y Perú para escuchar los testimonios de los refugiados y migrantes, así como para analizar sus necesidades en materia de mecanismos de protección, prevención de la violencia y salud sexual y reproductiva.
El presente documento refleja algunas de las situaciones de riesgo y violencia a las que millones de venezolanos se enfrentan cada día, desde los testimonios y experiencias de 17 refugiados y migrantes.
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BUKO Pharma-Kampagne has investigated the causes and consequences of antibiotic resistance in India, South Africa, Tanzania and Germany. Together with our partners we collected data and did interviews with numerous stakeholders. The outcome is presented in a brochure that is now available in English...
Resistant bacteria are spreading worldwide. In collaboration with partners in India, Tanzania, South Africa and Germany, we have investigated the causes and consequences of this spread.2 This Pharma-Brief Special presents the results. It examines the risks for humans, animals and the environment. It focuses on local problems and approaches, international interactions and the re-sponsibility of doctors, farmers and consumers.
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June 2020In die Skriflig/In Luce Verbi 54(1)
DOI: 10.4102/ids.v54i1.2562
This guideline provides global, evidence-informed recommendations on the use of indicators for assessing a population’s
iron status and application of the use of ferritin concentrations for monitoring and evaluating iron interventions.
Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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Objectifs 2020 : des avancées disparates. Le rapport de l’ONUSIDA sur l’épidémie mondiale de sida fait état d’un échec accentué par la COVID-19. Depuis 2015, 3,5 millions d’infections au VIH et 820 000 morts supplémentaires liés au sida sont imputables à des objectifs non atteints. ...Elles auraient été évitées si les objectifs 2020 avaient été réalisés. La riposte pourrait également revenir dix ans en arrière au moins, si la pandémie de COVID-19 interrompt gravement les services de lutte contre le VIH.
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As of 21 May 2020, 4.8 million confirmed cases of Coronavirus disease 2019 (COVID-19) have been reported globally. In South America, COVID-19 was first detected on 26 February 2020, when Brazil confirmed a case in São Paulo.
En diciembre de 2019 se identificaron los primeros casos del nuevo coronavirus -COVID-19 a nivel global en Wuhan, China. El 11 de marzo de 2020, la Organización Mundial de la Salud -OMS declaró al COVID-19 como pandemia mundial. Si bien la enfermedad se extendió lentamente a los países de Améri...ca Latina y el Caribe -ALC al principio, desde finales del mes de febrero el número de casos confirmados ha aumentado exponencialmente, acercándonos a 2,0 millones de casos confirmados y 124.667 muertos (al 19 de mayo de 2020).
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This interim guidance has been updated with advice on safe and appropriate home care for patients with coronavirus disease 2019 (COVID-19) and on the public health measures related to the management of their contacts.
Lignes directrices provisoires, 13 août 2020
L’OMS a établi cette brève note d’information pour répondre au besoin de recommandations sur la prestation sûre de soins à domicile aux patients présumés atteints de l’infection par le nouveau coronavirus (2019-nCoV) présentant des symptô...mes bénins, et sur les mesures de santé publique liées à la prise en charge des contacts asymptomatiques.
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