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.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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Ensuring mental health and well-being has become a worldwide imperative and an important target
of the Sustainable Development Goals.
But in all countries around the world, our response has been woefully insufficient, and we have made
little progress to advance mental health as a fundamental huma...n right.
One in ten people are affected by a mental health condition, up to 200 million people have an
intellectual disability and an estimated 50 million people have dementia. Many persons with mental
health conditions, or psychosocial, intellectual, or cognitive disabilities lack access to quality mental
health services that respond to their needs and respect their rights and dignity.
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This report presents a framework to link science, policy and practice for a comprehensive assessment of climate mitigation and adaptation investments and their impact on human health.The framework proposes to use weather and climate data to forecast health impacts over time, as well as biophysical a...nd economic models to quantify the outcomes of investments in climate change adaptation and mitigation for relevant sectoral indicators and health co-benefits. It provides guidance on the economic valuation of health co-benefits of climate action, for inclusion in sector-specific cost–benefit analysis (CBA), including the spatial allocation of such costs and benefits.
The framework developed and presented in this study is comprehensive, and provides various entry points for different audiences, including decision-makers in the public and private sectors, researchers and scientists, working in the health sector as well as in other thematic areas and related sectors affected by climate action.
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Diets are changing everywhere, and the burden of disease associated with unhealthy diets is a worldwide concern. Measurement and monitoring of diets across countries and population groups is critical. However, there are no harmonized metrics for tracking how the healthfulness of diets around the wor...ld is evolving.
This report assesses the validity, usefulness and fitness for purpose of existing healthy diet metrics as global and national monitoring indicators, presents a comparative assessment of selected healthy diet metrics and discusses priorities and opportunities to improve diet monitoring. This report is an important first step of the Healthy Diets Monitoring Initiative to respond to the need for developing healthy diets metrics for assessing and monitoring diets at national and global level.
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This report aims to outline the current available knowledge on the health and wellbeing of older persons in the Region of the Americas during the United Nations Decade of Healthy Ageing (2021-2030). It also seeks to guide political actions towards ensuring the human rights of older persons, and desc...ribes the negotiation and drafting process behind the Inter-American Convention on Protecting the Human Rights of Older Persons. It reports on the doctrinal and legal developments that led the Region of the Americas to draft the Convention and describes its action areas and guaranteed rights, as well as the obligations assumed by the States Parties. The Convention is an essential tool to advance the strategies of the Decade of Healthy Ageing. This publication reflects on the importance of having a major legal instrument for this purpose at the international level. The demographic transition in Latin America and the Caribbean will continue to shape the ability of countries and health systems to respond to the needs of the population. Given this reality, international instruments will be needed to guarantee the full enjoyment of the human rights of older persons. In order to design inclusive and sustainable systems, accurate, updated, and effective information is required. The Decade of Healthy Ageing––the initiative that constitutes the framework for this document––is a strategic period in which to focus on data generation and monitoring.
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The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals.
Pharmaceutical and Therapeutics Committees (PTCs) are responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as... well as at higher levels of care.
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La violencia contra las mujeres y las niñas es generalizada en la Región de las Américas, y tiene enormes consecuencias para su salud y bienestar, así como el de sus familias y sus comunidades. Se trata de un costo inaceptable que puede ser prevenido mediante acciones basadas en la evidencia, pr...omovidas por las políticas y los protocolos del sector de la salud, y la colaboración con otros sectores. El presente informe es el primero de su tipo y representa un hito importante para la Región. Se basa específicamente en los compromisos asumidos por los Estados Miembros en la Estrategia y plan de acción sobre el fortalecimiento del sistema de salud para abordar la violencia contra la mujer. El informe ofrece un análisis de los esfuerzos para avanzar en la prevención de la violencia contra las mujeres en la Región por medio de políticas de salud, protocolos clínicos, planes multisectoriales y otros enfoques relevantes. La atención a este tema es oportuna, ya que la pandemia de COVID-19 ha dado más visibilidad a esta esfera de trabajo. En este informe se ofrece información crucial sobre los esfuerzos llevados a cabo en la Región, de los cuales se puede aprender y utilizar el conocimiento extraído en el futuro para prevenir y responder a la violencia contra las mujeres y las niñas en todo el mundo.
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Refugee protection in the country is provided within the framework of these international and national refugee laws as well as the core international human rights treaties that have been ratified by the country. Continued insecurity within neighbouring states has resulted in sustained refugee moveme...nts, either directly as a result of internal conflict and human rights abuses or as a result of conflict related to competition for scare natural resources and drought related food insecurity.
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This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels ...of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
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This document provides guidance for countries on how to implement activities to achieve the interruption of yaws transmission. It is intended for use by national yaws eradication programmes, partners involved in the implementation of yaws eradication activities and WHO technical staff who provide te...chnical support to countries in the eradication of yaws.
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Shaping Health programme on Learning from international experience on approaches to community power, participation and decision-making in health,AMHF, TARSC
The annual Development Co-operation Report brings new evidence, analysis and ideas on
sustainable development to members of the OECD Development Assistance Committee (DAC) and the international community more broadly. The objectives are to promote best practices and innovation in development co-ope...ration and to inform and shape policy reform and behaviour change to realise better lives and the Sustainable Development Goals for all
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa...cerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
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UNAIDS 2016, Reference
HIV care and support taking into account the 2016 WHO consolidated guidelines
he refugee flow to Ethiopia continued during 2018, with 36,1351 persons seeking safety and protection within the country’s borders. At the start of 2019, the nation hosted 905,8312 thousand refugees who were forced to flee their homes as a result of insecurity, political instability, military cons...cription, conflict, famine and other problems in their countries of origin. Ethiopia is one of the largest refugee asylum countries world-wide, and the second largest in Africa, reflecting the ongoing fragility and conflict in the region. Ethiopia provides protection to refugees from some 26 countries. Among the principal factors leading to this situation are predominantly the conflict in South Sudan, the prevailing political environment in Eritrea, together with conflict and draught in Somalia.
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This handbook is for health care providers involved in the care of girls and women who have been subjected to any form of female genital mutilation (FGM). This includes obstetricians and gynaecologists, surgeons, general medical practitioners, midwives, nurses and other country-specific health profe...ssionals. Health-care professionals providing mental health care, and educational and psychosocial support – such as psychiatrists, psychologists, social workers and health educators – will also find this handbook helpful.
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Supplement
HIV testing services
December 2016