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1
Global Health Security (GHS) Index
Nuclear Threat Initiative (NTI) and the Johns Hopkins Center for Health Security (JHU)
The Economist Intelligence Unit (EIU)
(2019)
CC
The GHS Index is intended to be a key resource in the face of increasing risks of high-consequence and globally catastrophic biological events and in light of major gaps in international financing for preparedness. These risks are magnified by a rapidly changing and interconnected world; increasing
...
political instability; urbanization; climate change; and rapid technology advances that make it easier, cheaper, and faster to create and engineer pathogens.
Key findings from the study of 195 countries:
• Out of a possible 100 points, the average GHS Index score across 195 countries was 40.2.
• The majority of high- and middle-income countries do not score above 50.
• Action is urgently needed to improve countries’ readiness for high-consequence infectious disease outbreaks.
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
...
terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
...
echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
more
Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh
...
ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
more
Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management
...
and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
more
Technical package for cardiovascular disease management in primary health care.
Health, rights and drugs - Harm reduction, decriminalization, and zero discrimination for people who use drugs
UNAIDS (Joint United Nations Programme on HIVAIDS)
(2019)
C2
In September, 2018, the first international Medicine Quality and Public Health Conference was held at Oxford University, UK, to discuss opportunities and solutions to ensure that all people have access to affordable and quality-assured medical products. Delegates developed the short Oxford Statement
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, calling for investment, policy change, and action to eliminate substandard and falsified medical products. The statement was born out of discussion between governments, national and international agencies, non-governmental organisations, professional associations, and academic institutions who together examined the latest evidence on the epidemiology and public health implications of substandard and falsified medical products.
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Inequalities in maternal health care utilization in Benin: a population based cross-sectional study
Sanni Yaya , Olalekan A. Uthman, Agbessi Amouzou, Michael Ekholuenetale, Ghose Bishwajit
BMC Pregnancy and Childbirth
(2018)
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Yaya et al. BMC Pregnancy and Childbirth (2018) 18:194
Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services
and fertility control methods, is one of the most critical challenges for public health sector. There are significant
disparities in materna
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l health care indicators across many geographical locations, maternal, economic, sociodemographic
factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization
level of maternal health care, and examined disparities in the determinants of major maternal health outcomes
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The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach for monitoring and evaluation of the global action plan on AMR. This report analyses the results of the second tripartite self-assessment survey
Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious diseases is greater and exacerbated by limited access to, and availability and affordability of, antimicrobials required to treat infect
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ions caused by AMR organisms. With drugs not listed on the essential drugs list (EDL), problems of increased morbidity, costs of extended hospitalisation and mortality are extremely serious. The problem of susceptibility to and spread of infections caused by multidrug-resistant (MDR) infectious agents is fuelled by factors such as limited access to clean water and sanitation to ensure personal hygiene, malnutrition, and the HIV/TB epidemic.
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L’enseignement des soins infirmiers se fait sous la tutelle du ministère de la Santé et de la Prévention médicale.Il est en pleine effervescence,mais seulement avec deux niveaux de formation.
- En premier lieu,il y a la formation initiale qu’une seule institution nationale a assurée de 195
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2 à 1992.Avec la pénurie de la main-d’œuvre et la libéralisation de l’éducation,le Sénégal fait face depuis une quinzaine d’années à l’ouverture effrénée d’écoles privées dont la majorité dispose d’un agrément du ministère de la Santé.Le diplôme requis à l’entrée dans ces institutions de formation est le baccalauréat de l’enseignement général (13 ans de scolarité).La durée des études est de trois années sanctionnées par un diplôme d’État d’infirmier délivré par le ministère de la Santé et de la Prévention médicale,pour les diplômés des secteurs public et privé. - En deuxième lieu,il y a la formation continue spécialisée,dans les huit filières suivantes:enseignement et administration,anesthésie et réanimation,kinésithérapie,biologie,imagerie médicale,odontologie,ophtalmologie et néphrologie.Elle est offerte sur une période de deux ans,par l’École nationale de développement sanitaire et social (ENDSS).Le profil de sortie permet aux soignants d’exercer leur profession spécialisée avec le diplôme de technicien supérieur de santé.
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In resource-limited countries, the number of available antiretroviral (ARV) drugs is relatively limited. Hence, caregivers face some caution and constraints in the changes of ARV treatment (ART) in people living with HIV (PLHIV). Our objective was to calculate the incidence, to describe the main cau
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ses and to identify the predictive factors of the first change of ARV treatment in Senegal.
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The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach for monitoring and evaluation of the global action plan on AMR. This report analyses the results of the second tripartite self-assessment survey. It has
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been developed and run by the three Tripartite organizations (Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE) and World Health Organization (WHO)) and reflects progress in the human, animal (terrestrial and aquatic), plant, food safety and environmental sectors. 154 countries out of 194 WHO Member States responded to this round of the self-assessment survey – a response rate of 79.4%.
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Myanmar continues to present a complex and dynamic operating context where ongoing socio-economic and political challenges, including conflict, displacement, widespread poverty and food insecurity, hinder development efforts. An estimated 24.8 percent of its 54 million population live near or below
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the poverty line. Many struggle with inadequate physical, social and economic access to sufficient, safe and nutritious food, with women, girls, persons with disabilities and minorities affected most.
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Given an increase in outbreaks caused by resistant microorganisms associated with medical tourism, the Pan American Health Organization / World Health Organization (PAHO/WHO) encourages Member States to strengthen their capacity to detect and manage infections caused by resis
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tant microorganismsin patients who traveled outside of their country of residence to receive healthcare. Furthermore, PAHO/WHO stresses the importance to implement preventive measures to reduce healthcare-associated infections at all levels of the health system.
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