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1
Cholera is a diarrhoeal disease that is usually contracted when drinking water contaminated with Vibrio cholerae bacteria. The fight against this disease requires a multidisciplinary approach that combines a water, hygiene and sanitation (WaSH) response with a monitoring system, improved water suppl
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y and quality, sanitation and hygiene, and a health response with the treatment of the disease itself.
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This programmatic brief explores how to expand HIV and STI prevention and contraceptive method options in contraceptive services and, thus, to reduce HIV and STI incidence among adolescent girls and women. It focuses on settings with extremely high HIV prevalence and incidence. This brief complement
...
s existing guidance on HIV prevention and sexual and reproductive health and rights (SRHR), amplifies calls for action and outlines more comprehensive approaches to integration of SRHR and HIV services. It also emphasizes the importance of SRHR for women living with HIV. It aligns with updated WHO recommendations for contraceptive eligibility for women at high risk of HIV and other HIV guidance for adolescent girls and young women.
more
Many African countries were amongst the most rapid to respond to the emerging threat of COVID-19, implementing large-scale interventions at very early stages of their epidemic. As demonstrated in this document using very simple models, this rapid mobilization and timeliness of implementing control m
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easures is likely to be an important determinant of their success. Indeed, as these measures were relaxed, subsequent waves of disease have been observed in many countries including South Africa, Kenya, Tunisia, Morocco, Sudan and the Democratic Republic of Congo (DRC) where such waves have severely impacted the health system by straining the supply of oxygen and ICU beds and inflicting a heavy toll on healthcare workers, often necessitating the re-imposition of control measures.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
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miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Evaluation of Community Management of Acute Malnutrition (CMAM)
Sheila Reed, Camille Eric Kouam, Krishna Belbase et al.
United Nations Children’s Fund (UNICEF) Evaluation Office
(2013)
This evaluation is the first systematic effort by UNICEF to generate evidence on how well its global as well as country level Community Management of Acute Malnutrition (CMAM) strategies have worked, including their acceptance and ownership in various contexts and appropriateness of investments in c
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apacity development and supply components. Overall, the evaluation recommends that UNICEF continue to promote and support CMAM as a viable approach to preventing and addressing severe acute malnutrition (SAM), with an emphasis on prevention through strengthening community outreach and integrating CMAM into national health systems and with other intervention
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On 19 August 2016, the former UN Secretary-General announced a new approach to cholera in Haiti, consisting of two tracks. Track 1 focuses on reducing cholera transmission, improving access to care, and addressing water, sanitation, and health syste
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m issues. Track 2 aims to provide material assistance to those most affected by cholera. The Secretary-General urged Member States to show solidarity with Haiti by increasing contributions. The UN General Assembly, in resolution 71/161, recognized the UN's moral responsibility to cholera victims and called for support to eliminate cholera and address its victims' suffering. The Secretary-General was requested to provide an update on the progress of this approach.
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The Facilitator’s Guide for the basic-needs based Response Options Analysis and Planning (ROAP) is a step-by-step guide comprising tools and templates to carry out a multi-sectoral response analysis and planning of response options, in a sudden-onset or chronic crisis.
Being that so, the Guide i
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s conceived to be applied hand in hand with the BNA Guidance and Toolbox, and other assessments methodologies. It is expected to assist in analysing data from different sources - including humanitarian staff’ own
knowledge and experience on the sector, cash, protection matters - to come up with response decisions
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The study analyses the current situation of children with disabilities in relation to realizing their rights and accessing basic services, as well as their life experiences in their communities. It also focuses on identifying the barriers created by society that prevent children with disabilities fr
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om enjoying their human rights. This includes identifying negative attitudes; environmental and communication barriers; gaps in policies or their effective implementation.
The report reveals that children with disabilities in Myanmar are less likely to access services in health or education; rarely have their voices heard in society; and face daily discrimination as objects of pity. It also highlights how inadequate policies and legislation contribute to the challenges these children face.
The information available in this publication should be useful for policy makers, development partners and Disabled Persons Organisations to promote the realization of the rights of all children with disabilities. more
The report reveals that children with disabilities in Myanmar are less likely to access services in health or education; rarely have their voices heard in society; and face daily discrimination as objects of pity. It also highlights how inadequate policies and legislation contribute to the challenges these children face.
The information available in this publication should be useful for policy makers, development partners and Disabled Persons Organisations to promote the realization of the rights of all children with disabilities. more
This brief focuses specifically on the Grand Nord (Great North): the Beni and Lubero territories of northern North Kivu that are the epicentre of the outbreak. Further participatory enquiry should be undertaken with the affected populations, but given ongoing transmission, conveying key consideratio
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ns and immediate recommendations have been prioritised.
This brief is based on a rapid review of existing published and grey literature, professional ethnographic research in DRC, personal communication with administrative and health officials and practitioners in the country, and experience of previous Ebola outbreaks.
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Effective Ebola risk communication requires respect and transparency and remains as vital
as ever. An assessment of changing communication needs and preferences in Beni, North Kivu.
In the second year of the current Ebola outbreak response in the Democratic Republic of Congo (DRC), people at ris
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k still don’t have clear answers to their questions about the disease in a language they understand. Many local health communicators are themselves confused about the disease prevention and treatment measures they promote. The language, content, and form of communication about Ebola affect how far people understand, trust and act upon it.
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The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp
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ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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How should humanitarian organisations prepare and respond to COVID-19 in humanitarian settings in low- and middle-income countries?
This Rapid Learning Review outlines 14 actions, insights and ideas for humanitarian actors to consider in their COVID-19 responses. It summarises and synthesises the
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best available knowledge and guidance for developing a health response to COVID-19 in low- and middle-income settings as at April 2020
The paper, supported by the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock, will be updated throughout 2020 to reflect emerging knowledge and evidence on the most effective approaches to respond to the COVID-19 Pandemic.
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With about 24 million of Yemen’s 30 million people in need of some form of assistance, the United Nations calls Yemen the world’s worst humanitarian crisis. Cholera and other disease outbreaks are common, malnutrition is widespread, water is scarce, and the healthcare system is crumbling, with o
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nly half of the country’s 5,000 or so health facilities fully operational and with massive medical supply and staff shortages. In August 2020, the UN warned the country was again on the brink of full-scale famine.
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These guidelines were developed as part of Kenya's fast-track plan to end AIDS among adolescents and young people. Based on research into adolescent and young key populations in Kenya and elsewhere, they outline a package of HIV prevention services, and emphasize the need to combine biobehavioural i
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nterventions with services in education, job skills training, mental health, and social care and protection.
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Early damage assessments indicate that at least 800,000 people could be directly exposed to minor to severe damages, including communication, access, security, loss of livelihoods, infrastructure, and health services could be impacted.
Technical Note: Cholera treatment facilities provide inpatient care for cholera patients during outbreaks. Proper case management and isolation of cholera patients is essential to prevent deaths and help control the spread of
the disease. Traditionally, these structures have been referred to as ch
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olera treatment centres (CTCs) and
cholera treatment units (CTUs). CTCs are usually large structures set up at central level (e.g. urban areas),
while CTUs are smaller structures set up in the periphery (e.g. peri-urban or rural areas). CTCs/CTUs can
be set up as independent structures in tents or within existing buildings or wards of health structures.
Whatever the structure, the principles described in this document should be respected
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One of the principles underpinning the delivery of all essential services and coordination of those services is the “survivor-centered approach”, which places the human rights, needs, and wishes of women and girl survivors at the centre of service delivery.
A key challenge faced by many entit
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ies working to end violence against women is ensuring that survivors’ voices and inputs are incorporated into policies, practices, and procedures on response. Survivors have diverse needs and face different risks. Not all women and girls experience violence in the same way. An effective intervention takes into account the realities of their unique circumstances, addresses individual needs, and reduces the risk for further harm and suffering.
UN Women, together with Global Rights for Women, have developed “Safe consultations with survivors of violence against women and girls”, which is designed to provide practical steps, safety measures, and actions that government agencies, civil society and survivor organizations, and United Nations’ entities can take to incorporate survivors' voices into systemic reform efforts, through safe and meaningful consultations.
This guidance is intended to help policymakers develop survivor-centered programming on ending violence against women and girls that meets the needs of diverse groups of women and girls, including those who are at higher risk of experiencing violence and discrimination. It is applicable to programming across the health, justice and policing, and social services sectors, as well as coordination of these sectors, and will help improve the standard and delivery of essential services for women and girls who have experienced violence.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
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Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights
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the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
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NUDOR’s first strategic plan (2010-2016) focused on establishing NUDOR as a viable, well-run organisation. Significant progress has been made towards these aims and therefore the strategy and has been reviewed by NUDOR board, secretariat and member organisations. The updated strategic plan now cov
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ers the period 2015 – 2020 for which three strategic aims have been agreed.
1. Representation and accountability: NUDOR will be accountable to and effectively represent members’ interests through the delivery of projects and priorities agreed by member organisations, and by facilitating joint working amongst members.
2. Capacity building and resource mobilization: NUDOR and its member organisations are strengthened to fulfil its mandates by developing its technical skills, research and insight, sustainability and outreach.
3. Advocacy and influencing: NUDOR will work to ensure that the needs and rights of all persons with disabilities are recognised by all, mainstreamed in laws and policies at all levels of government, and in programmes of other institutions focusing on areas of education, health and poverty reduction.
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