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1
This regional report on the situation of tuberculosis (TB) in the Americas contains information from 2019, provided by the countries of the Region through the World Health Organization TB data collection system. These data have been consolidated and
...
analyzed at the regional level. In addition to presenting the epidemiological and programmatic situation of TB in the Americas, the report aims to raise awareness and to motivate and encourage all stakeholders in the prevention and control of this disease, to accelerate efforts towards TB elimination in the Region, and to achieve the targets of the End TB Strategy. The report records the Region's achievements, but also the gaps in the work being carried out in diagnosis, treatment, comorbidities, vulnerable populations, risk factors, and funding, among other issues. Based on the information presented, specific recommendations are provided for further progress.
more
Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel
...
erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
more
The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, water, sanitation and hygiene, logistics, community engagement and risk communication. All efforts must b
...
e well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
more
Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated with a number of conditions, disability, and causes o
...
f death. These include: strokes; myocardial infarction; end-stage renal disease; congestive heart failure; peripheral vascular disease and blindness. According to Stats SA, in 2017, hypertensive disorders resulted in 19 900 deaths with a further 44 357 deaths associated with cerebrovascular diseases and other heart diseases. This means around 30% of all deaths in 2017 were associated with increased blood pressure.
more
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co
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untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
more
Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and
one-fi fth of adolescents are obese, while rates of overweight and obe
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sity among adults approach 60%. Obesity is the major modifi able risk factor for diabetes.
more
Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
CC
Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Met
...
hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
more
Tuberculosis (TB) is among the top ten most common causes of death globally and as a single infectious disease it top among infectious diseases. Furthermore, it is noted as the top causes of death among people infected with the human immunodeficiency virus (HIV). Despite recent decreases in the numb
...
er of notified cases, Namibia still has a high TB burden and is included among the top 30 high-burden TB countries by the World Health Organisation (WHO). In the 2018 Global TB Report, the estimated incidence rate of TB in Namibia was 423/100,000. The same report estimated that 60 people per 100,000 populations died of TB in Namibia, which is a concern, for a disease that is curable and preventable.
more
Insufficient funding is hindering the achievement of malaria elimination targets in Africa, despite the pressing need for increased investment in malaria control. While Western donors attribute their inaction to financial constraints, the global health
...
community has limited knowledge of China’s expanding role in malaria prevention. This knowledge gap arises from the fact that China does not consistently report its foreign development assistance activities to established aid transparency initiatives. Our work focuses on identifying Chinese-funded malaria control projects throughout Africa and linking them to official data on malaria prevalence. By doing so, we aim to shed light on China’s contributions to malaria control efforts, analysing their investments and assessing their impact. This would provide valuable insights into the development of effective financing mechanisms for future malaria control in Africa.
more
The Plan subscribes to the goals and pillars of the WHO Global Technical Strategy against Malaria 2016-2030 (GTS), while presenting key elements to address the specific challenges of the Region.
This Communication Guide for Malaria Control Interventions is aligned with Tanzania’s Malaria Strategic Plan (2015–2020) and provides comprehensive guidance on the implementation of Social and Behaviour Change Communication (SBCC) for the prevention, diagnosis and treatment of malaria. It is int
...
ended for all stakeholders and implementing partners, with the aim of ensuring harmonised messaging and coordinated communication efforts. The guide outlines strategies, key messages, communication channels and target audiences, with a focus on sustaining and improving malaria-related behaviours at the individual, family and community levels. It incorporates malaria stratification and supports the development of tailored SBCC interventions in different risk areas. Developed with contributions from the Ministry of Health and Social Welfare, the National Malaria Control Programme and various partner organisations, the guide aims to reduce the malaria burden and promote a malaria-free Tanzania. Supplemented by Standard Operating Procedures (SOPs), the guide serves as a practical tool for consistent and effective malaria communication nationwide.
more
The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering quality care services to patients over a long time
...
. The new National Guidelines for Prevention and Management of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
more
Guidelines for Management of ST-Elevated Myocardial Infarction
Directorate General of Health Services
Ministry of Health & Family Welfare Government of India
(2022)
CC
Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi
...
on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
more
Combination file of all the documents related to the national guidelines for accreditation, supervision and regulation of ART clinics in India. Documents included:
National Guidelines for Accreditation, Supervision & Regulation of ART Clinics in India | Preliminary Pages | Corrigendum | Chapter 1
...
- Introduction, Brief history of ART and Requirement of ART Clinics | Chapter 2 - Screening of Patients for ART - Selection Criteria and Possible Complications | Chapter 3 - Code of Practice, Ethical Considerations and Legal Issues | Chapter 4 - Sample Consent Forms | Chapter 5 - Training | Chapter 6 - Future Research Prospects | Chapter 7 - Providing ART Services to the Economically Weaker Sections of the Society | Chapter 8 - Establishing a National Database for Human Infertility | Chapter 9 - Composition of the National Accreditation Committee | Bibliography
| Members of the Expert Group for Formulating the National Guidelines for Accredation, Supervision and Regulation of ART Clinics
more
