Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic p...alliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
more
Adapting community-led approaches . Three out of 10 people in urban areas do not use improved sanitation facilities, and one out of 10 people are forced to practise open defecation. Still higher proportions do not have access to safely managed sanitation facilities, where the fecal sludge
is contai...ned and either left in situ or safely emptied, transported, and delivered to a treatment plant.
more
WHO Recommendations 2018 Update
The primary audience for these recommendations includes health professionals who are responsible for developing national and local health care guidelines and protocols (particularly those related to PPH prevention and treatment) and those involved in the provision of... care to women and their newborns during labour and childbirth, including midwives, nurses, general medical practitioners and obstetricians, as well as managers of maternal and child health programmes, and relevant staff in ministries of health and training institutions, in all settings.
more
Assurer des prestations optimales dans la chaîne de soins destinés aux patients tuberculeux
Deuxième édition - Juin 2018
Ensuring reproductive rights for all
Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
more
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.
more
Reflections and a call for action after a two-year exploration of emergency response in acute conflicts
There is general consensus that the humanitarian sector is failing to mount timely and adequate responses in the acute phase of conflict-related emergencies, according to the two-year Emergen...cy Gap Project by Médecins Sans Frontières (MSF).
The Project has explored what works for or against effective emergency responses. Its final report, Bridging the emergency gap, draws on the Project’s thematic papers and case studies, and consultations with more than 150 senior-level representatives from 60 key organisations across the humanitarian sector.
more
Guide to national implementation of the Shanghai Declaration describes policy orientations and approaches that can unlock the transformative potential of health promotion for sustainable development. This guide was developed to support country level implementation of the commitments and recommendati...ons in the Shanghai Declaration.
more
The UNICEF-GAIN Partnership Project
The report notes that iodine deficiency is a leading cause of preventable brain damage worldwide. Insufficient iodine during pregnancy and infancy results in neurological and psychological deficits, reducing a child’s IQ by 8 to 10 points. This translates ...into major losses in the cognitive capital of entire nations and thus their socio-economic development.
The report outlines urgent steps to reduce the risk of mental impairment to babies’ growing brains:
• Integrate salt iodization into national plans to support children’s nutrition and brain development in early childhood;
• Align salt iodization and salt reduction agendas;
• Establish surveillance systems to identify unreached populations;
• Strengthen regulatory systems to enforce existing legislation on salt iodization;
• Recognize the growing importance of fortified foods as potential sources of iodized salt.
more
The Global Vaccine Action Plan (GVAP) 2011-2020, endorsed by Member States during the May 2012 World Health Assembly, has set ambitious targets to improve access to immunization and tackle vaccine-preventable diseases. This responsibility has been translated into firm commitments in February 2016, t...hrough the signature of the Addis Declaration on Immunization (ADI) by African Ministers and subsequently endorsed by the Heads of States from across Africa at the 28th African Union Summit held in January 2017. This commitment from the highest level of government comes as a catalyst to immunization efforts on the continent to deliver on the promise of universal immunization
more
Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal health indicators in this study, while other highpriority counties consist...ently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care.
more
In where under-five mortality is high and vitamin A deficiency is a public health problem, two high-dose supplements of vitamin A per year, spaced four to six months apart, can strengthen children’s immune systems and improve their chances of survival.
During much of early childhood – from... 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive.
more
Yemen’s war has become one of the world’s worst humanitarian catastrophes . In September 2014, the Ansarallah (Houthi) movement allied with former President Ali Abdullah Saleh to seize control over the capital city Sana’a and renegotiate Yemen’s fragile power-sharing agreement, and then seve...ral months later pursued President Abed Rabbo Mansour Hadi south to Aden . In March 2015, Saudi Arabia and the United Arab Emirates launched a military intervention, ostensibly to restore Hadi to power . More than 1,000 days later, that war has settled into a brutal stalemate . Officially, the Houthis remain in control of Sana’a and much of the north, while the Saudi-UAE coalition controls much of the south . A comprehensive Saudi-UAE blockade and air campaign has caused incipient famine conditions, the spread of communicable diseases such as cholera and diphtheria, and a wave of internal displacement .
more
Background document to the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA: definition of skilled health personnel providing care during childbirth
DHS Further Analysis Reports No. 108 - This report examines levels, trends, and inequalities in maternal health in Rwanda from 2010 to 2014-15 among women age 15-49 with a recent birth. The analysis uses Demographic and Health Survey (DHS) data for 15 key indicators of maternal health: 6 for antenat...al care, 3 for delivery, 1 for postnatal care, and 5 for barriers to accessing medical care. Levels and trends in these indicators were analyzed overall and by three background characteristics: women’s education, household wealth quintile, and region.
more