Interim Framework for the South-East Asia Region 28 October 2020
Midwifery Capacity Building Strategy for Northern Syria
2017-2021
Available in Arabic
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Children without access to safe water are more likely to die in infancy -- and throughout childhood -- from diseases caused by
water-borne bacteria, to which their small bodies are more vulnerable.
In 2006, the Special Session of African Union Health Ministers adopted the Maputo Plan of Action for implementing the Continental Policy Framework on sexual and reproductive health and rights (SRHR), which expired at the end of 2015. The goal was for all stakeholders and partners to join forces and ...re-double efforts, so that together, the effective implementation of the Continental Policy framework including universal access to sexual and reproductive health by 2015 in all countries in Africa can be achieved. The Revised Maputo Plan of Action (MPoA) 2016 – 2030 was subsequently endorsed by the African Union Heads of State at the 27th AU Summit in July 2016 in Kigali, Rwanda. The plan reinforces the call for universal access to comprehensive sexual and reproductive health services in Africa and lays foundation to the Sustainable Development Goals, particularly Goal 3 and 5, as well as the African Union Agenda 2063.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium ...term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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Ghana's attempt to regulate health care waste management started in 2002 with the development of guidelines on health care waste manage-ment by the Environmental Protection Agency (EPA). In 2006, the Ghana Health Service (GHS) also developed the Health Care Waste Management Policy and Guidelines as ...a single document.
Although awareness on Health Care Waste Management (HCWM) has improved in recent years, there is the need for a systematic approach to improve on effective segregation, safe collection, and storage, as well as ultimate treatment before disposal.
This guideline seeks to ensure that HCW is managed effectively in compliance with existing International Conventions that Ghana is a signatory to, national laws and regulations, and others to be passed in future.
Recommendations for better management of HCW in the nation's health care facilities have been presented in this document. Also, standard operating procedures (SOPs) have been developed to provide
guidance to various levels of the health facilities.
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The Look Back Study (LBS) focuses on the water and sanitation and hygiene (WASH) component of the project but some additional information was collected along side the WASH data. This data has been compared to the baseline survey data that was reported at start of the project (see tables in annex D t...o this report).
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La Convención de los Derechos del Niño (Convención) de las Naciones
Unidas (ONU) y documentos relacionados tienen el potencial de mejorar
enormemente varias dimensiones de la vida de los niños (definidos como
desde el nacimiento hasta la los 18 años, dependiendo de la cultura), ofreciendo
p...rotección ante el abuso, fortaleciendo la relación de los niños con sus familias
y garantizando la realización del potencial individual. Estos documentos van
más allá de implicaciones para los gobiernos y deben considerarse en relación
con todas las actividades profesionales relacionadas con la vida de los niños,
incluyendo la práctica clínica, la investigación, la participación y educación.
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The principle of “the best interest of the child” should guide decisions by politicians whenever
children are affected. This is one of the basic ideas in the UN Convention on the Rights
of the Child. Decision makers should assess the consequences for children before taking
action. Today, this... principle is not fully respected in European countries in relation to migrant
children.
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Promising Approaches to Combination HIV Prevention Programming in Concentrated Epidemics
AIDSTAR-One CASE STUDY SERIES May 2010
Further analysis of the 2011 Nepal Demographic and Health Survey
Sudan has a long history of hosting refugees and asylum seekers with 991,787 individuals, 51 per cent female and 53 per cent children, expected to live in Sudan by the end of 2020.
To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find t...hat patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
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