BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Los avances en el tratamiento del cáncer pediátrico han permitido ampliar las iniciativas más allá de la curación y abarcar aspectos como la detección precoz, la continuidad del tratamiento y la reducción de su toxicidad. Todo ello ha abierto paso a una visión más integral del cuidado de lo...s pacientes, lo que supone mejores oportunidades de curación y una vida más plena, objetivos de la Iniciativa Mundial contra el Cáncer Infantil. Dentro de ese cuidado integral, la atención psicosocial incluye las dimensiones social, psicológica, espiritual y funcional del proceso de enfermedad de los pacientes. Esta serie recoge una serie de orientaciones y normas basadas en la evidencia que garantizan la calidad de dicha atención. Las normas son el resultado de la discusión y la revisión de distintos profesionales de América Latina y el Caribe. El módulo 1 se centra en la evaluación psicosocial como estrategia de apoyo a los objetivos de la Iniciativa Mundial contra el Cáncer Infantil y como herramienta para que los profesionales de la salud recaben la información necesaria para ofrecer a estos pacientes un abordaje integral enfocado en el bienestar, la adaptación al proceso de enfermedad y la adherencia al tratamiento.
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La santé est un droit humain universel et un facteur essentiel de bien-être, de développement économique, de croissance,
de richesse et de prospérité pour tous. Les systèmes de santé jouent un rôle essentiel, car ils protègent, rétablissent et
préservent la santé des patients et des p...opulations. Un personnel de santé bien formé, motivé et soutenu est la clé de
voûte de tout système de santé et, sans lui, il n’y aurait pas de soins de santé
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Dengue is a mosquito-borne viral disease that occurs mainly in the tropics and subtropics but has a high potential to spread to new areas. Dengue infections are climate sensitive, so it is important to better understand how changing climate factors affect the potential for geographic spread and futu...re dengue epidemics. Vectorial capacity (VC) describes a vector's propensity to transmit dengue taking into account human, virus, and vector interactions. VC is highly temperature dependent, but most dengue models only take mean temperature values into account. Recent evidence shows that diurnal temperature range (DTR) plays an important role in influencing the behavior of the primary dengue vector Aedes aegypti. In this study, we used relative VC to estimate dengue epidemic potential (DEP) based on the temperature and DTR dependence of the parameters of A. aegypti. We found a strong temperature dependence of DEP; it peaked at a mean temperature of 29.3°C when DTR was 0°C and at 20°C when DTR was 20°C. Increasing average temperatures up to 29°C led to an increased DEP, but temperatures above 29°C reduced DEP. In tropical areas where the mean temperatures are close to 29°C, a small DTR increased DEP while a large DTR reduced it. In cold to temperate or extremely hot climates where the mean temperatures are far from 29°C, increasing DTR was associated with increasing DEP. Incorporating these findings using historical and predicted temperature and DTR over a two hundred year period (1901-2099), we found an increasing trend of global DEP in temperate regions. Small increases in DEP were observed over the last 100 years and large increases are expected by the end of this century in temperate Northern Hemisphere regions using climate change projections. These findings illustrate the importance of including DTR when mapping DEP based on VC.
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25 August 2021. The earthquake on August 14, 2021 was almost as strong as the severe quake in 2010, which killed about 300,000 people. The current number of victims is more than 2,200 people, and more than 12,000 people have been injured. More than 52,000 houses were destroyed and more than 77,000 ...damaged. Thousands of families were affected! The magnitude 7.2 earthquake struck southwest Haiti at 8:30 a.m. local time at a depth of about 10 km. The epicentre was measured about 12 km northeast of Saint-Louis-du-Sud, about 125 km west of the capital Port-auPrince. The situation on the ground remains chaotic and the extent of the disaster cannot yet be predicted. In addition, heavy rainfall and the unstable security situation are complicating relief efforts. What is needed most now is food and drinking water, tents and primary health care. MEDBOX has already created the Natural Hazard Toolbox after the severe earthquake in 2010 and has collected many essential materials on health care, shelter & reconstruction after an earthquake in English, French and Kreyol there. In this issue brief, we provide a quick
overview of the most important information.
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Asia remained the world’s most disaster-hit region from weather, climate and water-related hazards in 2023. Floods and storms caused the highest number of reported casualties and economic losses, whilst the impact of heatwaves became more severe, according to a new report from the World Meteorolog...ical Organization (WMO).
The State of the Climate in Asia 2023 report highlighted the accelerating rate of key climate change indicators such as surface temperature, glacier retreat and sea level rise, which will have major repercussions for societies, economies and ecosystems in the region.
In 2023, sea-surface temperatures in the north-west Pacific Ocean were the highest on record. Even the Arctic Ocean suffered a marine heatwave.
Asia is warming faster than the global average. The warming trend has nearly doubled since the 1961–1990 period.
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Orientations provisoires, 2 février 2021
e document est une mise à jour des orientations provisoires de l’Organisation mondiale de la Santé (OMS) intitulées Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations... for occupational safety and health,publiées le 18 mars 2020(1). La présente version, qui se fonde sur les données récentes disponibles, fournit des conseils sur les mesures de santé et de sécurité au travail pour les agents de santé et les services de santé au travail dans le contexte de la pandémie de COVID-19. De plus, elle actualise les droits et responsabilités en matière de santé et de sécurité au travail des agents de santé conformément aux normes de l’Organisation internationale du Travail (OIT).
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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...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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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be...come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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Ce manuel donne une vue d’ensemble des connaissances scientifiques actuelles sur l’infection à VIH ainsi que des technologies et des outils utilisés pour prévenir cette infection, pour améliorer la qualité de vie des personnes infectées et pour réduire les effets du VIH sur les enfants et... leur famille. Le manuel présente aussi les stratégies nécessaires pour atteindre les personnes ayant besoin de ces interventions et définit leurs normes.
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Guide de poche pour l’agent de santé en première ligne
Ce guide s’intéresse plus particulièrement à certaines fièvres hémorragiques virales (FHV) Ebola, Marburg, FHCC, fièvre de Lassa [et Lujo] – qui surviennent en Afrique et risquent de donner lieu à une transmission interhumaine. I...l ne traite pas de la prise en charge d’autres infections virales, comme la dengue, la fièvre de la vallée du Rift et la fièvre jaune, qui entraînent également des manifestations hémorragiques, mais pour lesquelles il n’y a pas de transmission directe d’une personne à une autre
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En 1998, la Cinquante-et-Unième Assemblée mondiale de la Santé a adopté la résolution
WHA51.11 qui vise l’élimination mondiale du trachome en tant que problème de santé publique
à l’horizon 2020 (1). La stratégie recommandée pour atteindre cet objectif est récapitulée dans
le sig...le « CHANCE » qui signifie CHirurgie pour les personnes atteintes de trichiasis
trachomateux (TT – le dernier stade cécitant du trachome) ; Antibiothérapie, Nettoyage du
visage et Changements Environnementaux (2). Les interventions relatives aux volets A, N et CE
sont menées dans des districts entiers dans lesquels les cas de trachome évolutif
(inflammatoire) sont courants, dans le but de traiter les infections oculaires dues à Chlamydia
trachomatis, l’agent pathogène à l’origine du trachome, et de réduire durablement sa
transmission.
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Female genital mutilation is a harmful traditional practice that violates girls’ right to health
and overall well-being. Most research cites social acceptance, marriageability, community
belonging, proof of virginity, curbing promiscuity, hygiene, and religion as motivations for the
practice. I...t is generally assumed that individual attitudes of parents and other family mem-
bers have an impact on decisions related to the cutting of girls, and that such attitudes are
influenced by social norms. The aim of this study is to understand how parental attitudes
towards the practice of female genital mutilation influence decision making related to the cut-
ting of girls.
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L'eau potable et les services d'assainissement et d'hygiène (WASH) sont essentiels à la prévention des 17 maladies tropicales négligées (MTN) pour lesquelles une intensification de la lutte ou l'élimination sont prévues à l'horizon 2020.
La fourniture d’eau potable et de services d’...assainissement et d’hygiène est l’une des cinq interventions clés inscrite dans la feuille de route mondiale contre les MTN. Pourtant, à ce jour, la composante WASH de la stratégie n’a reçu que peu d’attention et le potentiel lié à la mise en commun des efforts WASH et MTN reste largement inexploité.
Des efforts ciblés sur la composante WASH sont nécessaires de toute urgence pour atteindre les cibles de la feuille de route mondiale contre les MTN.
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Orientaciones provisionales
9 de agosto de 2021
El presente documento tiene por objeto describir un conjunto mínimo de actividades de vigilancia recomendadas a nivel nacional para detectar y supervisar la prevalencia relativa de las variantes del SRAS-CoV-2 y esbozar un conjunto de actividades pa...ra la caracterización y evaluación del riesgo que plantean estas variantes. También se ofrece un conjunto de indicadores para normalizar la vigilancia y la notificación pública de la circulación de variantes.
El documento está dirigido principalmente a las autoridades de salud pública nacionales y subnacionales y a los socios que apoyan la aplicación de la vigilancia de las variantes del SRAS-CoV-2
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La OMS ha elaborado una definición de caso clínico de la afección posterior a la COVID-19 mediante la metodología Delphi que incluye 12 dominios, disponible para su uso en todos los entornos. Esta primera versión fue elaborada por pacientes, investigadores y otras personas, en representación d...e todas las regiones de la OMS, en el entendimiento de que la definición puede cambiar a medida que surjan nuevas pruebas y siga evolucionando nuestra comprensión de las consecuencias de la COVID-19.
La afección posterior a la COVID-19 se produce en personas con antecedentes de infección probable o confirmada por el CoV-2 del SRAS, normalmente a los 3 meses de la aparición de la COVID-19 con síntomas y que duran al menos 2 meses y no pueden explicarse por un diagnóstico alternativo. Los síntomas más comunes son la fatiga, la dificultad respiratoria y la disfunción cognitiva, pero también otros, y generalmente tienen un impacto en el funcionamiento diario. Los síntomas pueden ser de nueva aparición tras la recuperación inicial de un episodio agudo de COVID-19 o persistir desde la enfermedad inicial. Los síntomas también pueden fluctuar o recaer con el tiempo.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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Child friendly spaces (CFS) are safe spaces where
communities create nurturing environments in which
children can access free and structured play and
learning activities. CFS, also commonly referred to
as Child Centred Spaces or Safe Spaces for Children,
may provide educational and psychosocial... support
and other activities that restore a sense of normality
and continuity for children whose lives have been
disrupted by war, natural disaster or other emergency
situations.
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Our spiritual health profoundly impacts our physical health, well-being, and quality of life. Just as medical professionals care for our bodies and minds, spiritual care practitioners care for our spirits. The increasing need for spiritual care makes these practitioners even more crucial. However, m...any of us have limited access to quality, professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.Investigators and researchers are creating a growing body of evidence for the innumerable benefits of professional spiritual care, yet many people still do not have a lot of accurate information about these practitioners. To create this publication, the six largest healthcare chaplaincy organizations in North America collaborated to share the facts about spiritual care and practitioners’ roles, training, and standards.By providing evidence and dispelling myths, the thousands of spiritual care practitioners represented by these organizations hope to increase access to spiritual care for the benefit of all.
accessed July 2020
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El propósito de esta guía es brindar orientaciones clínicas actualizadas en TB/VIH con énfasis en aspectos de diagnóstico, incluidas nuevas técnicas, así como de tratamiento vigente, sin perder de vista un enfoque de salud pública. Al recopilar y consolidar en una sola guía las últimas rec...omendaciones de la Organización Mundial de la Salud en el tema, se busca elaborar un documento de referencia y consulta frecuente, que unifique y estandarice el manejo de la coinfección TB/VIH de manera integral en establecimientos de salud con base en el principio de “dos enfermedades, un solo paciente”. También busca sustentar la actualización de normas y guías nacionales sobre la coinfeccion y complementar el trabajo coordinado que debe existir entre los programas de prevencion y control de TB y VIH a todo nivel en el marco las doce actividades de colaboración TB/VIH recomendadas internacionalmente.
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