Los datos incluidos en este informe demuestran que en la Región de las Américas existe un desarrollo progresivo en relación con las políticas, leyes, programas y servicios de salud mental. Sin embargo, se necesitan aun grandes esfuerzos, compromisos y recursos para alcanzar los objetivos regiona...les. Los resultados del Atlas 2017 confirman una tendencia ya percibida en ediciones anteriores: los Recursos siguen siendo insuficientes para satisfacer la creciente carga de la enfermedad mental, y su distribución es heterogénea. Además, los servicios existentes requieren una transformación que permita mejorar la cobertura y el acceso a la atención en salud mental, asegurando que salud mental sea a todos los efectos parte de las políticas nacionales de cobertura universal en salud.
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Psoriasis, which can involve the skin, nails and joints, is a chronic, painful, disfiguring and disabling noncommunicable disease (NCD) for which there is no cure. It negatively impacts on quality of life. Some of those who suffer from the disease develop chronic, inflammatory arthritis (psoriatic a...rthritis) that leads to joint deformations and disability. People with psoriasis are also reported to be at increased risk of developing other serious clinical conditions such as cardiovascular and other NCDs
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The "Global NCD action plan" provides a road map and a menu of policy options for countries to take in order to attain the 9 voluntary global targets, including that of a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2...025. The main focus of this action plan is on 4 types of NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes) which make the largest contribution to morbidity and mortality due to NCDs, and on 4 shared behavioural risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol).
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This booklet provides an overview of all findings from the Global Burden of Disease 2017 study. Published in The Lancet in November 2018, GBD 2017 provides for the first time an independent estimation of population, for each of 195 countries and territories and the globe, using a standardized, repli...cable approach, as well as a comprehensive update on fertility. Produced with the input of 3,676 collaborators from 146 countries and territories, GBD 2017 incorporates major data additions and improvements, and methodological refinements. GBD 2017 also includes estimates at the subnational level for selected locations.
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This report aims to improve the assessment of mental health needs in the Americas by providing an updated and nuanced picture of: (a) the disability resulting from mental, substance use, and specific neurological disorders, plus self-harm, alone and in combination with premature mortality; (b) the i...mbalance between mental health spending and its related disease burden; and (c) the inadequate allocation of the meager mental health spending by countries of the Region
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The World Health Organization organized a Consultation of National Leprosy Programme managers, partners and affected persons to discuss the draft Global Leprosy Strategy, 2021--2030. This virtual event took place from 26 to 30 October 2020. It was attended by more than 450 stakeholders. Contribution...s were shared through 70 presentations made by stake holders from all Regions. The presentations covered the key strategic approaches: global context, challenges in countries, contact tracing and post exposure prophylaxis, disability care, interruption of transmission and elimination of disease, stigma and d iscrimination, research. In addition to numerous comments received through the chat box and by email, the conclusions and recommendations of this Consultation will guide finalizing the post 2020 Global Leprosy Strategy.
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The World Health Organization invites clinicians and patients to collect information on COVID-19 in a systematic way and contribute clinical data to the WHO Clinical Platform to expand our knowledge on Post-COVID-19 condition, and support patient care and public health interventions.
WHO’s Post... COVID case report form (CRF) has been designed to report standardized clinical data from individuals after hospital discharge or after the acute illness to examine the medium- and long-term consequences of COVID-19. The forms will be available in multiple languages.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs). This work is described in the NTD ...road map 2021–2030, WHO’s blueprint to drive global efforts in the fight against NTDs in the context of the United Nations Sustainable Development Goals. These goals encompass a vision of a world population for whom equality of opportunity and of health are fundamental.
Within this context, and during the two years since the launch of the road map (2021–2022), progress has been made. Nevertheless, hindrances towards achieving the targets for 2030 have arisen and work to overcome these obstacles continues. These endeavours have also revealed the scale of the task still facing the global NTD community.
Disruption as a result of the COVID-19 pandemic has continued to afflict longstanding and new programmes alike, while other entrenched issues have re-emerged in new and challenging ways. The global NTD community is also confronted with a changing, multi-dimensional funding landscape as donors reassess priorities and adapt to new ways of working, as well as a challenging and unpredictable international context. As a result, progress in controlling, eliminating or eradicating NTDs has not been as far-reaching as expected.
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Ce document présente une politique pour orienter et soutenir les États Membres de l’Organisation panaméricaine de la Santé, ainsi que le Bureau sanitaire panaméricain, dans leur coopération technique visant à améliorer la santé mentale en tant que priorité pour faire progresser le dével...oppement sanitaire, social et économique de la Région dans le contexte de la pandémie de COVID-19, et au-delà.
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Japan has been implementing projects of global extension of medical technologies under an official development assistance policy to improve public health and medicine by promoting Japanese medical technologies worldwide. The current work examines the impact and goals of implementing this new scheme.... The scheme has involved dozens of projects that sent Japanese experts to partner countries and that invited their counterparts to Japan to showcase Japanese medical technologies. Approximately 50 projects have been implemented in 24 countries over 5 years, and 19,638 individuals have been trained. As a result, the introduced technology was adopted in national guidelines in 4 projects and the introduced equipment was procured in the partner country in 17 projects. In total, 912,334 individuals have benefitted from the introduction of these medical technologies. The concept of "creating shared value" (CSV) could help promote project success by both creating economic value and encouraging social progress. However, the sustainability of that business model remains in question in terms of the internationalization of CSV. Several successful projects improved medical care and led to new business opportunities.
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This short guide to the Global Diabetes Compact explains what diabetes is and why action to improve prevention efforts, diagnosis and treatment is so urgent. It outlines the key asks associated with the Compact and emphasizes that increasing access to insulin, strengthening health systems and meanin...gfully engaging with people affected by diabetes are key to success.
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Las necesidades de salud mental insatisfechas en la Región de las Américas son una de las principales causas de morbimortalidad, y tienen enormes consecuencias sociales, económicas y para la salud. La pandemia de COVID-19 ha exacerbado la crisis de la salud mental en la Región, por lo que se nec...esita una acción urgente en los niveles más altos del gobierno y en todos los sectores con el propósito de reconstruir para mejorar los sistemas y servicios de salud mental ahora y en el futuro. En este histórico informe, elaborado por la Comisión de Alto Nivel de la OPS sobre Salud Mental y COVID-19, se presenta un análisis de la situación de la salud mental en las Américas, seguido de una serie de recomendaciones y sus puntos de acción correspondientes, a fin de ayudar a los países a priorizar y promover la salud mental con enfoques basados en los derechos humanos y la equidad.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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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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This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N...CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
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The Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 by the World Health Organization (WHO) outlines a comprehensive strategy to address the global rise in noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, chronic respiratory diseases,... and diabetes.
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This document highlights landmarks and key milestones in the development and implementation of the global agenda for noncommunicable diseases (NCDs) over the last two decades. It summarizes where the world was in 2000, where it is in 2022, and where the world wants to be in terms of NCD prevention a...nd control by 2030. It recalls the commitments made by heads of state and governments, and outlines the technical guidance provided by the World Health Organization (WHO) in support of national efforts to achieve the internationally agreed NCD targets for 2025 and 2030.
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