The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic
has disproportionately affected people with diabetes population, exposing them to a
high risk for severe illness and mortality. Globally, diabetes was responsible for over fourmillion deaths in the year 2019. It was th...e leading cause of end-stage kidney disease, adult-onset blindness and cardiovascular diseases. Further, there was a considerable heterogeneity in the prevalence of complications and deaths associated with diabetes across the countries.
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Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by the presence of hyperglycaemia in the absence of treatment. The heterogeneous aetiopathology includes defects in insulin secretion, insulin action, or both. The long-term specific complications of diabe...tes include retinopathy, nephropathy, and neuropathy. People with diabetes are also at increased risk of other diseases, including cardiac, peripheral arterial and cerebrovascular disease, cataracts, erectile dysfunction, and nonalcoholic fatty liver disease. They are also at an increased risk of some infectious diseases such as tuberculosis, and are likely to experience poorer outcomes.
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Time has seen management for Cystic Fibrosis (CF) advance drastically, most recently in the development of the disease-modifying triple combination therapy ivacaftor/tezacaftor/elexacaftor. There is currently limited evidence regarding both the global epidemiology of CF and access to this transforma...tive therapy - and therefore where needs are not being met. Therefore, this study aims to define gaps in access to CF treatment. The results show that a significant CF patient burden exists in countries where disease-modifying drugs are unavailable, and final figures are likely underestimates. This analysis shows the potential to improve rates of diagnosis and treatment for CF, so a higher percentage of patients receive the most effective triple combination treatment.
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This guideline provides updated, evidence-informed guidance on the percentage of total fat in the diet to reduce the risk of unhealthy weight gain.
This guideline is intended for a wide audience involved in the development, design and implementation of policies and programmes in nutrition and pub...lic health. This guideline includes a recommended level of total fat intake which can be used by policy-makers and programme managers to address various aspects of dietary fat in their populations through a range of policy actions and public health interventions.
The guidance in this guideline replaces previous WHO guidance on total fat intake, including that from the 1989 WHO Study Group on Diet, Nutrition and the Prevention of Chronic Diseases and the 2002 Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. The guidance in this guideline should be considered in the context of that from other WHO guidelines on healthy diets.
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“We must not forget that no matter where we are or how old we are, we can all work for life and take action.” Francisco Vera, 15, UNICEF Child Advocate
The Young Climate Activists toolkit was created by advocates of all ages who, like you, are deeply concerned about our planet's future. Havin...g faced numerous challenges in advocacy and action, our aim is to provide clear, concise and easily understandable information about global, regional and national climate action. This will equip you for meaningful and informed participation. The toolkit booklets are designed to be read sequentially to build a comprehensive understanding of each topic, though they can also be consulted independently based on your needs.
This is the global volume of the Young Climate Activists Toolkit and is designed to complement the regional toolkits for Latin America and the Caribbean, and the Middle East and North Africa Region.
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This purpose of this guide is to inform robust evaluations of the WHO training package – a package aimed at personnel whose primary role in health-care facilities is environmental cleaning, hereafter referred to as cleaners.
The WHO training package – Environmental cleaning and infection prev...ention and control in health-care facilities in low- and middle-income countries – was designed to improve the competencies of cleaners through a practical, educational approach for adult learners in low- and middle-income countries and comprises two volumes: trainer’s guide and modules and resources (1,2). An associated OpenWHO online course describes the essential preparations for trainers to deliver the WHO training package.
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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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Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the
pancreas in sufficient quantities or is not utilized effectively by the body to control blood glucose levels. As a result, blood
glucose levels are abnormally high (hypergl...ycaemia). Chronic uncontrolled hyperglycemia leads to long-term target organ damage, such as: retinopathy, nephropathy and neuropathy (microvascular complications); stroke, coronary heart disease
and peripheral arterial disease (macrovascular complications).
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The risk communication and community engagement (RCCE) competency framework is a resource that details the essential behaviours and activities necessary for effective communication and engagement with communities before, during and after public health emergencies. The purpose of this framework is to... establish and promote a common understanding of behavioural competencies and how they should be applied for high-performing and community-centred health emergency programmes. It is intended to support the development of standardized training programmes, professional development and talent acquisition and to enhance the capabilities of public health professionals involved in RCCE. Its goal is to inform the establishment of a skilled, well-trained RCCE workforce that consistently understands and executes the necessary behaviours and activities required to conduct RCCE activities with competence and professionalism.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in ...reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions... to future response to health emergencies. The final report of EPRC culminates with eight evidence-based recommendations of actions to strengthen future pandemic responses, while building a resilient recovery in the Region. The recommendations by the external team focus on PAHO’s governance and management, on specialized regional mechanisms, diversified funding models, and use of new technologies, among others.
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WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situation in a country, including the state of the health s...ector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
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Adolescence is a critical stage in life for physical, cognitive and emotional development, shaping future health and well-being. Comprehensive measurement of adolescent health is essential to prioritize health issues, guide interventions and track progress. However, global, regional and national ado...lescent health measurement has historically been inconsistent and incomplete.
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An essential component of the return process is counselling, which aims to support counselling beneficiaries to make an informed decision on their future migration pathways. Counselling provides the space for migrants to exert their agency, supports them to prepare for return and positively contr...ibutes to their reintegration in countries of origin. The question of how to prepare and provide return counselling is of significant concern for all actors involved in the return process itself, but until
now very little has been done to offer a standardized approach to return counselling. The Return Counselling Toolkit intends to address this question and proposes a rights-based and migrant-centred approach to return counselling, which builds upon
IOM standards and the Organization’s long-standing experience in providing return and reintegration counselling to thousands of migrants every year, in a multiplicity of countries and contexts.
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As our world changes, so too does the burden of disease. Globalisation, evolving trade and consumption patterns, and increased access to life-saving medical care are just some of the factors that have transformed the global health landscape.
The document "Diabetes in Children and Young People" by NICE (National Institute for Health and Care Excellence) provides quality standards for the diagnosis, management, and support of diabetes in children and adolescents.
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th...e implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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