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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The limitation of a single sector approach. HNP Discussion Paper
The following technical report outlines the rationale, process and results of a joint research study, coordinated by the World Health Organization (WHO) and the Pan-American Health Organization (PAHO), co-chaired by the Ministry of Health and Social Protection and the Ministry of Environment and Sus...tainable Development in collaboration with the Climate and Climate Air Coalition, the Stockholm Environment Institute, the Clean Air Institute and leading international and national experts. A rationale section describes the links between greenhouse gas (GHG) emissions, short-lived climate pollutants, air pollution and adverse health outcomes. A summary of the research study describes how scenarios were modelled to examine the health and economic implications of raising ambition in Colombia’s Nationally Determined Contribution (NDC) to the United Nations Framework Convention on Climate Change (UNFCCC)
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Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries
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Miscellaneous
Chapter J.3
Working towards better COVID-19 outcomes in the WHO European Region.From the first COVID-19 cases in Europe reported on
24 January 2020, the pandemic reached 1 million cases
within 3 months, 10 million cases within 8 months, and
100 million cases in Europe alone within 2 years. Over
the course o...f its two years, COVID-19 has claimed over
1.6 million lives across Europe and Central Asia. The
World Health Organization (WHO) European Region has
accounted for close to a third of the cumulative global
COVID-19 cases and deaths.
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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Defending Rights
Breaking Barriers
Reaching People with HIV Services
Global Aids Update 2019
The development of this draft Proposed programme budget 2022–2023 comes at a unique moment for WHO. The world is in the grip of the coronavirus disease (COVID-19) pandemic and faces health, social and economic consequences on an unprecedented scale. Although it is not known when the COVID-19 pande...mic will end, recent encouraging vaccine results, in addition to the examples of countries that have achieved good results through public health measures, hold out the prospect of better days ahead. The full impact of the pandemic cannot yet be determined. But whatever its implications, the Secretariat will rise to the challenge and is ready to adapt so that it is fully equipped to support Member States for any eventuality in the future – to make sure that the world will never again have to face this kind of crisis.
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Externalising disorders
Chapter D.3
Review over the work and challenges of the Nigerian National Agency for Food and Drug Administration and Control (NAFDAC) in combatting counterfeiting of medicines in Nigeria.
Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene. I...n 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
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interim Guidance 1 December 2020. Updated version
This document provides updated guidance on mask use in health care and community settings, and during home care for COVID-19 cases. It is intended for policy makers, public health and infection prevention and control professionals, health care manag...ers and health workers.
The Annex provides advice on how to manufacture non-medical masks. It is intended for those making non-medical masks at home and for mask manufacturers
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The COVID-19 pandemic is having far reaching impacts, well beyond the health crisis and needs, with the most severe impacts experienced in the poorest countries and those most vulnerable to humanitarian crises including natural disasters, such as Nepal.