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International Perspectives and Future Directions
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c
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ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Little is known about the patterns of development assistance (DA) for each component of reproductive, maternal, newborn, child and adolescent health (RMNCAH) in conflict-affected countries nor about the DA allocation in relation to the burden of dis
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ease
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Using Theory of Change in the development, implementation and evaluation of complex health interventions. A practical guide
Mary De Silva, Lucy Lee& Grace Ryan
The Centre for Global Mental Health &the Mental Health Innovation Network
(2015)
C1
This guide provides a practical overview of the process of developing a Theory of Change, focusing on using a stakeholder-driven, workshop approach to achieve this.
ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability
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and affordability of CVD medicine, and service delivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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This tool enables a rapid, systematic review of pharmacy curricula at the national or institutional level to evaluate their robustness in delivering the expected content and competencies. It can also assist institutions in designing strategies to strengthen AMR curricular content, and to facilitate
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structured, periodic dialogue on AMR and infection-related competencies among pharmacy faculty and other relevant stakeholders. A pharmacy curriculum that comprehensively integrates AMR content will help ensure that future pharmacists have the knowledge, skills, and attitudes needed to address AMR effectively in both clinical practice and public health.
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Monitoring and Evaluation Toolkit: HIV, TB and Malaria and Health Systems Strenghtening
The Global Fund
(2011)
The TB section of the toolkit presents selected (a) programmatic output and (b) outcome and impact indicators for TB. In addition to recommended monitoring programs and measuring the outcomes and impact of TB programs, indicators for the strengthening of h
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ealth systems, strengthening of community systems and some indicators that measure quality of services are also included.
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The meningitis road map has been designated as a flagship global strategy of the WHO’s Thirteenth General Programme of Work, 2019–2023 and is an essential component in achieving universal health
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coverage.
The road map will reinforce and combine with wider initiatives, such as those aimed at strengthening primary health care and health systems, increasing immunization coverage, improving global health security, fighting antimicrobial resistance and advocating for the rights of persons with disabilities. It will complement other global control strategies, such as those addressing sepsis, pneumonia, tuberculosis and HIV. Implementation will be a challenge for all countries across the world, but especially in resource-poor settings where the burden of meningitis is greatest. The targets for the visionary and strategic goals will be adapted to regional and local contexts.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and
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outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Lancet Glob Health 2022 Published Online May 24, 2022 https://doi.org/10.1016/S2214-109X(22)00185-1
Many commercial actors use a range of coordinated and sophisticated strategies to protect business interests— their corporate playbook—but many
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of these strategies come at the expense of public health. To counter this corporate playbook and advance health and wellbeing, public health actors need to develop, refine, and modernise their own set of strategies, to create a public health playbook. In this Viewpoint, we seek to consolidate thinking around how public health can counter and proactively minimise powerful commercial influences.
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This Mpox SPRP Global Monitoring & Evaluation (M&E) Framework, also referred to as the Framework, aims to monitor and report on global progress towards these objectives, including information about
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country-level response efforts and WHO support to Member States. Regular collection and analysis of data on these objectives, alongside the ongoing tracking of the epidemiological situation, are key to informing decision-making, operational adjustments, as well as ensuring transparency and accountability for achieving the goal to stop the Mpox outbreak. This document suggests reporting indicators for monitoring of the global response to the Mpox PHEIC as articulated in the Mpox SPRP and Operational Planning Guidelines for countries.
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The ninth WHO report on the global tobacco epidemic tracks the progress made by countries in tobacco control since 2008 and, marks 15 years since the introduction of the MPOWER technical package which is designed to help countries implement the dema
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nd-reduction measures of the WHO Framework Convention on Tobacco Control. The report shows that many countries continue to make progress in the fight against tobacco, but efforts must be accelerated to protect people from the harms of tobacco and second-hand smoke.
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In In recent years, China has increased its international engagement in health. Nonetheless, the lack
of data on contributions has limited efforts to examine contributions from China. Existing estimates that track
development assistance for
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health (DAH) from China have relied primarily on one dataset. Furthermore, little is known
about the disbursing agencies especially the multilaterals through which contributions are disbursed and how these
are changing across time. In this study, we generated estimates of DAH from China from 2007 through 2017 and
disaggregated those estimates by disbursing agency and health focus area.
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The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (
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NCDs), as they have a higher risk of severe illness and death from COVID-19. COVID-19 has been associated with an
excess in all-cause and cardiovascular disease (CVD) mortality beyond that related to the infection itself and its immediate consequences. Studies in the
United Kingdom (UK) and United States of America (USA) have clearly shown increasing deaths from ischemic heart disease, stroke and hypertensive disease due to COVID-19. Overall, the impact has been greater in individuals with lower socioeconomic status, even in high income nations.
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The Guidance on global monitoring for diabetes prevention and control by WHO provides a comprehensive framework to support countries in tracking and managing diabetes prevention, care, and outcomes. This document outlines indicators across 4 domains
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: health system determinants, service delivery, risk factors, and outcomes/impacts. The guidance helps countries align their monitoring efforts with WHO’s global diabetes targets, Global Diabetes Compact, and relevant global NCD targets.
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Weekly Epidemiological Record. This report summarizes application of the SAFE strategy against trachoma during 2023. It includes estimates of the global population at risk of trachoma blindness based on district-by-district data submitted to WHO by
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national programmes. Summarizing the epidemiological situation in this way is inherently complex because, for any district, up to 3 serial estimates of prevalence may be valid at different times during a calendar year.
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Drawing on the World Health Organization’s package of NCD best buys, the report demonstrates how these evidence-based measures can help countries reduce premature deaths, strengthen health systems
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, and advance progress towards the Sustainable Development Goals. It provides policymakers, donors, advocates, and partners with a clear economic and social rationale for scaling up implementation of proven solutions. By framing NCD prevention and control as both a health and development priority, the report offers a roadmap for action that delivers benefits across populations, economies, and generations. The evidence is clear: investing in WHO’s best buys is not only possible—it is imperative. The time to act is now.
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