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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr
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ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
more
This Cardiac Rehabilitation Change Package was completed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) with the purpose of helping cardiac rehabilitation programs, hospital quality improv
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ement teams, and public health professionals who partner with these groups to implement systems and strategies that improve care for patients who are eligible for cardiac rehabilitation. AACVPR is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation.
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin
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g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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Noncommunicable diseases (NCDs) are the principal cause of morbidity, disability and premature mortality in Azerbaijan. The most effective way to reduce the NCD burden is to prevent NCD development, by addressing thebehavioural risk factors underlying NCDs at the population and individual leve
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ls: smoking, alcohol use, excessive salt intake, low physical activity, overweight and obesity, and unhealthy diets. In Azerbaijan, a national survey of the prevalence of major NCD risk factors, aligned with the WHO-endorsed STEPwise approach to surveillance (STEPS) methodology, was conducted in 2017.
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Job satisfaction among healthcare workers in Ghana and Kenya during the COVID-19 pandemic: Role of perceived preparedness, stress, and burnout
Afulani PA, Nutor JJ, Agbadi P, Gyamerah AO, Musana J, Aborigo RA, et al.
PLOS Global Public Health
(2021)
CC
The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W
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e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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Against the backdrop of the COVID-19 pandemic, health is receiving unprecedented public and political attention. Yet the fact that climate change also presents us with a health crisis deserves further recognition. From more deaths due to heat stress to increased transmission of infectious diseases,
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climate change affects the social and environmental determinants of health in ways that are profound and far-reaching. The fundamental interdependency of human health and the health of the environment is encapsulated in the concept of planetary health, a scientific field and social movement that has been gaining force since the 2015 publication of the Rockefeller Foundation-Lancet Commission report “Safeguarding human health in the Anthropocene epoch”.
We see an urgent need for strategic communication to raise awareness of climate-health synergies in order to overcome the misperception that climate and health are two independent agendas. The fragmented and sector-focused nature of thinking and action remains a significant barrier to integrating health considerations into climate planning and project development. Inevitably, collaboration across sectors requires a community of practice. Despite recent efforts focused on the climate-health nexus, much work remains to be done to translate scientific findings for policymakers, mobilise climate financing resources in support of health co-benefits, and promote genderjust solutions within climate change projects.
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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe
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rent interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
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Guidance module.
The QualityRights training and orientation modules have been developed to enhance the knowledge, skills and understanding of key stakeholders on how to promote the rights of people with psychosocial, intellectual or cognitive disabilities, improve the quality of services and suppo
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rt provided in the field of mental health and related areas, in line with international human rights standards, in particular the UN Convention on the Rights of Persons with Disabilities and the recovery approach.
mental health and related fields, in accordance with international human rights standards, in particular the UN Convention on the Rights of Persons with Disabilities and the recovery approach.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u
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se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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This report seeks to uncover the extent to which global goals crowd in international financing, inform domestic policy priorities, and navigate progress toward development outcomes in low- and middle-income countries (LICs and MICs). Our report:
Provides a historical perspective on how ODA financin
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g was aligned with the MDGs, and the perceived influence of global goals in shaping domestic priorities
Offers a baseline of ODA financing to the SDGs and a forward-looking perspective in translating past lessons learned from the MDGs era into actionable insights
Using a pilot methodology developed by AidData, we analyze ODA flows during the MDGs era (2000-2013) and approximate baseline financing for each goal prior to the adoption of Agenda 2030 in September 2015. The dataset used in the report, Financing to the SDGs, Version 1.0, provides project-level data on estimated Official Development Assistance (ODA) commitments to the 17 Sustainable Development Goals (SDGs) from 2000 to 2013. In this report, we also draw upon the responses of nearly 7,000 public, private, and civil society leaders from AidData’s novel 2014 Reform Efforts Survey to assess how national-level policymakers perceive the MDGs in light of their domestic reform priorities, and what this may mean for the SDGs.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP
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C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing
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and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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After the earthquake in Türkiye-Syria in February 2023 an emergency response was provided to the affected population. Young persons with disabilities were one of the social groups most affected by the crisis. These were either young persons who acquired a disability due to the earthquake, or young
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persons with disabilities who were further isolated after the crisis due to compounded and structural barriers.
In response to this situation the Compact for Young People in Humanitarian Action reached out to the Youth2030 Disability Task Team with the aim of supporting humanitarian teams in the field. The current version of this checklist has been developed for a broader context not only for the Türkiye-Syria case, but also for other humanitarian crises. This checklist aims to provide guidance on how to ensure meaningful participation of young persons with disabilities in local humanitarian response. The expected users are humanitarian actors, especially those working in the field.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t
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hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Community led-monitoring is based on the principle that «Nothing that is done for us should
be done without us”. The combination of this principle with evidence shows that community-led
monitoring is an important driver of improved service delivery and health outcomes that needs to
be re-empha
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sized. Thus, the community must participate at all stages of the fight against malaria.
This guide will be useful to CSOs working in the field of malaria in the conduct of community-led
monitoring of activities efficiently and allow these CSOs to know their role and responsibilities in this
exercise at each key stage. This guide will also provide CSOs and communities affected by malaria
with templates of monitoring tools adapted to key malaria programs.
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The Global Aids Strategy 2026-2031
recommended
United- Towards Ending AIDS. The Global AIDS Strategy 2026-2031 focuses global efforts for the future of the AIDS response to end AIDS as a public health threat by 2030 and sustain the HIV response after 2030. This is a strategy uniting the world.
The Strategy will shape the June 2026 United Natio
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ns General Assembly High-Level Meeting on Ending AIDS and its political declaration. It provides all actors in the field with guidance to overcome the challenges and to ensure effective country-led AIDS responses. The Global AIDS Strategy 2026-2031 includes new global targets for 2030 and resource needs estimates.
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All young people, including those with special needs and from the most vulnerable groups, have the right to quality health care services. Unfortunately, this right is not a reality, particularly in the case of sexual and reproductive health services. Many youth in need of sexual and reproductive hea
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lth care may either decline or be denied access to health services for a variety of reasons: Providers are often biased and do not feel comfortable serving youth who are sexually active; youth do not feel comfortable accessing existing services because they are not "youth-friendly" and may not meet their needs; and, often, community members do not feel that youth should have access to sexual and reproductive health services.
To address provider and site bias toward serving youth, EngenderHealth created a training curriculum intended to sensitize all staff at a health care facility on the provision of youth-friendly services. The curriculum was created as a result of the participatory work that we have been doing with youth in Nepal to address the needs of all levels of providers at different service-delivery settings. The curriculum has been field-tested and used in Nepal, Russia, Mongolia, and the United States.
Youth-Friendly Services allows staff to reflect upon and assess their own beliefs about adolescent sexuality while ensuring that those values and attitudes do not compromise the basic sexual and reproductive health rights to which youth are entitled. The curriculum also helps providers understand cross-cultural principles of adolescent development and health needs specific to youth. Once participant knowledge, attitudes, and skills are improved, sites conduct a self-assessment on the youth-friendliness of their services and create an action plan for specific improvements.
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This report complements the previous poverty analysis studies by presenting a series of poverty maps of Rwanda at cell and sector levels, based on data from EICV4 and the 2012 Population and Housing Census. A poverty map is simply a map that shows the incidence of poverty in different areas of the c
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ountry. It allows the viewer to appreciate, at a glance, the geographic dimensions of poverty. Apart from their intrinsic interest, poverty maps may be used to help guide the allocation of resources across local agencies or governmental units, in an effort to better target efforts to reach the poor by pinpointing the small areas of most need.
In 2015, the National Institute of Statistics of Rwanda (NISR) published the Rwanda Poverty Profile Report which provided a detailed portrait of the extent and nature of poverty in the country, while in 2016 a Poverty Trends Analysis Report which complements the Profile study by looking at the trends in poverty between 2010/11 and 2013/14 was also published. Both reports were based on information collected by an integrated household living conditions survey (EICV4) undertaken between October 2013 and September 2014.
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April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t
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he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
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3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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