As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma ...and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems
Alliance Report
Participation of community health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount ...of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals.
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This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effectiv...e implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
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Zika virus is primarily transmitted by the Aedes species of mosquito which is also responsible for the spread of dengue, Chikungunya and yellow fever viruses. In most areas, the primary vector of these viruses is Aedes aegypti, with Aedes albopictus a proven or potential vector in some settings. Wel...l-implemented vector control against Aedes using existing tools effectively reduces the transmission of viruses spread by these vectors. Pilot studies are being undertaken on new tools which have potential for future reductions in Aedes populations
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The purpose of this publication is to facilitate the implementation of existing WHO guidelines on nutrition-specific and nutrition-sensitive actions required for improving health and well-being of adolescents. Implementing these actions should explicitly take into account the heterogeneity of adoles...cents in general (for instance, in their state of physical growth and social development), as well as the diversity within their country (for instance, in terms of the expected responsibilities in the family, the number out of school or out of work and existing social norms).
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After five consecutive below-average rains, the humanitarian crisis in the Horn of Africa is expanding and deepening.
Combined with insecurity and macroeconomic volatility, the impact of the drought on food and nutrition security has been devastating. Across Ethiopia, Kenya and Somalia, an estima...ted 22 million people are now acutely food insecure because of the drought. The malnutrition situation is also critical. Some 5.1 million children across drought-affected areas of the three countries are acutely malnourished in 2023, with dire implications for their health, growth and survival. Concerningly, the upcoming March-May 2023 rains are also forecast to be below-average. Should these rains fail, and humanitarian assistance not be delivered at scale, food insecurity will continue to deteriorate.
Regardless of how the 2023 rains perform, extremely high humanitarian needs will persist through 2023 while a full recovery from a drought of this magnitude will take years. To address the devastating drought-induced hunger and malnutrition across the region, WFP is pursuing an integrated dual track approach; meeting immediate life-saving food and nutritional needs while simultaneously building resilience to extreme climate variability.
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The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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CEPI is seeking to raise $3.5 billion to implement CEPI’s next 5-year plan. To mitigate the immediate threat of COVID-19 variants, it is activating key elements of this plan now—and seeking to mobilise a portion of this $3.5 billion in 2021. We have already launched R&D programmes to initiate de...velopment of next-generation vaccines against COVID-19 variants and we are planning studies to answer critical scientific questions related to the durability of immunity, effectiveness of mixed-vaccine regimens, and vaccine effectiveness in vulnerable populations such as pregnant women. We are also bringing forward our plans to develop vaccines that could protect against multiple COVID-19 variants and other coronavirus specie
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –... are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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Despite the continuing war in Ukraine, the Government is preparing for the country’s recovery and reconstruction. Given the magnitude of the attacks on the health infrastructure and consequent disruption to health system functioning, reconstruction of the health system is integral to the country...s recovery. The immediate priorities are to restore essential services, respond to new physical and mental health needs, protect public health, and provide a secure and attractive environment for the return of both health professionals and the general population. This policy note identifies strategic directions for post-war health system recovery in the short and longer terms, while sustaining essential health services during the ongoing invasion
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As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc...tion of safe and quality foods for our daily nourishment. Pests and disease epidemics negatively impact the quality, quantity and safety of our food sources, and cripple economic growth and efficiencies in production. Furthermore, the epidemic and endemic levels of the pathogens and disease vectors can be difficult to control. This is why FAO stresses and promotes the special efforts required for cost-effective preventive measures rather than the more expensive control, disinfestation, treatment and disposal measures. When preventive measures are late or difficult, preparedness and contingency plans must be in place to enable rapid response. Early warning systems, based on close monitoring, surveillance, and timely reporting are fundamental to warn and empower communities to safeguard their livelihoods and assets by enhancing disease and pest prevention measures and for government services to take immediate measures to protect communities and national economies.
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Barbados currently has a rudimentary framework and capacity to address the issue of antimicrobial resistance. There however needs to be coordination of efforts and improvement in areas where gaps have been identified.Actions required include improved antibiotic stewardship in healthcare settings, pr...evention of the spread of drug-resistant organisms//bacteria, elimination of the use of medically-important antibiotics for growth promotion in food animals, and expanded surveillance for drug-resistant bacteria in humans and animals.
The National Action Plan will provide the roadmap to guide Barbados in the effort to address the urgent and serious threat of AMR and will be organized around three goals for collaborative action.
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Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. ...The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during pregnan...cy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutrition in pregnancy.
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Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se...verely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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Financing Global Health 2014 is the sixth edition of this annually produced report on global health financing. As in previous years, this report captures trends in development assistance for health (DAH) and government health expenditure (GHE). Health financing is one of IHME’s core research areas..., and the aim of the series is to provide much-needed information to global health stakeholders. Updated GHE and DAH estimates allow decision-makers to pinpoint funding gaps and investment opportunities vital to improving population health. This year, IHME made a number of improvements to the data collection and methods implemented to produce Financing Global Health estimates. Both government health expenditure and development assistance for health estimates were updated and enhanced in 2013.
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Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d...evelopment needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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Infection 2023 Oct;51(5):1399-1406. doi: 10.1007/s15010-023-01999-9. Epub 2023 Feb 20.
The results indicate a significantly higher rate of infections with S. mansoni in street children compared with orphans. This might be explained by the lack of access to adequate sanitation for street children ...as well as regular contact with the water of Lake Victoria. However, we did not find similar results concerning infection rates with protozoa. The study results show overall inadequate living conditions in this study population, which could be addressed by public health interventions.
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This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health... goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
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