The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t...he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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Las enfermedades no transmisibles (ENT) suelen ser condiciones de salud de larga duración, resultado de determinantes sociales, factores genéticos, fisiológicos, ambientales y conductuales. Debido a la adquisición de hábitos poco saludables y al importante cambio demográfico, que evidencia un ...incremento de la proporción de personas mayores, ha aumentado la prevalencia de ENT y el número de muertes que generan. Por esto, constituyen uno de los principales desafíos sanitarios
del siglo XXI, tanto en los países de mayores ingresos como en aquellos en vías de desarrollo, por su gran impacto a nivel individual, en los sistemas de salud y en la economía nacional.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue...s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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The 2021 COVID-19 Strategic Preparedness and Response Plan (SPRP) for AFR serves as a regional guide for a holistic public health response to COVID‑19 at regional, national and sub-national levels. The 2021
SPRP:
1. Builds upon the lessons learnt from the implementation of the 2020 SPRP and outl...ines a regional preparedness, response and recovery strategy for COVID‑19.
2. Has been adapted to reflect the Regional context including COVID-19 vaccination. It also considers epidemiological changes and recommen-dations emerging from the evaluation report of the 2020 SPRP4.
3. Highlights to Member States strategic preparedness and response actions to be sustained at national and sub-national levels, as well as the critical inter-agency and partner support required.
4. provides the indicative resource requirements to reinforce WHO planned interventions in the African Region to enhance countries’ capacities to suppress transmission, save lives and mitigate the impact of the pandemic on people and health systems.
5. Provides a road map for mitigating potential resurgence in the Region as economies reopen and ensure country level continuity of other essential health services.
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Este artículo analiza un grupo particularmente vulnerable a la pandemia de la COVID-2019: las personas privadas de libertad (PPLs). Con base en el análisis del Censo Carcelario de 2019, presentamos la situación actual de las PPLs y las condiciones de los establecimient...os penitenciarios de Bolivia, con énfasis en los aspectos que impactan en la salud. Posteriormente, identificamos los principales factores estructurales detrás de la mayor vulnerabilidad epidemiológica y sanitaria de las PPLs, no solo a la COVID-2019, sino a epidemias en general. Diferentes instituciones involucradas en el combate de la pandemia desarrollaron recomendaciones para su prevención y tratamiento en contextos carcelarios. Considerando estas recomendaciones y los datos de la situación de las PPLs de Bolivia, desarrollamos propuestas de reformas políticas y legales para reducir la vulnerabilidad epidemiológica de esta población. Argumentamos que, mientras algunas son sencillas de implementar, muchas se enfrentan a obstáculos estructurales para su ejecución, demandando reformas profundas en la política carcelaria y el sistema penal.
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The overall objective of this implementation plan is to define the strategy for implementation of the Xpert MTB/RIF test for rapid detection of TB and rifampicin (RIF) resistance in Tanzania, within the context of the National Tuberculosis and Leprosy Programme (NTLP) strategic plan and other nation...al health guidelines. It is intended to serve as the main guiding document for national, regional and local programme managers, clinicians, coordinators, laboratory staff and other health workers; national and regional reference laboratories; local and international implementing partners; and donors involved in TB control.
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SITUATION ANALYSIS AND RECOMMENDATIONS
National Tuberculosis and Leprosy Conrol Programme
Analysis of survey data looking at 25 years of progress in and the future challenges for tropical medicine and global health
The training focuses on building the capacity of health care workers at the primary and secondary level to address and manage TB in children.
National Tuberculosis Control Program; Mycobacterial Disease Control National AIDS/STD Program
no cover page / publication year available
The process to develop this "National Traditional Medicine Policy" included a detailed situational analysis of traditional medicine in Liberia and a desk review of relevant documents and the regional policy framework on the alignment of WAHO countries ...policy harmonization.
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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis ...B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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The five hepatitis viruses have different epidemiological profiles, and their impact, duration, and transmission route also vary. The most common transmission routes contributing to the spread of hepatitis are exposure to infected blood via blood transfusion or unsafe injection practices, consumptio...n of contaminated food and drinking water, and transmission from mother to child during pregnancy and delivery. Also, unsafe injection practices, including the use of unsterile needles and syringes, serve as a major pathway for the spread of hepatitis B and C, and reducing transmission of both diseases requires addressing these practices.
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The revision of the SRHR Policy is based on the results of the analysis of the implementation process of the past policy, which has provided evidence to
ensure that the revised policy is relevant and effective. The revision has also been done with the participation of all national stakeholders who ...have
also international experience on SRHR issues. The Ministry urges all public and private institutions to use this policy as a guide in the implementation of
SRHR services in the country.
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Silicosis is not a new disease; the impact of silica dust on respiratory function was observed by Hippocrates in 430 B.C. and in the 16th century by Agricol. In 1713, Rammazini described silicotic nodules in post-mortems of stone cutters presenting with respiratory symptoms. In the mid-late 1800s,... the introduction of mechanized tools in the mining sector rapidly increased levels of silica exposure, resulting in an increase in cases and our understanding of silicosis.
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