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1
The aim of this guidance manual is to introduce the user to project/programme plan- ning in a Red Cross Red Crescent environment. It describes the different stages of the planning phase of the “project/programme cycle” within the context of Results-Based Management (RBM). It also gives an overvi
...
ew of the various components of RBM and explains how to integrate and apply this approach in practice. In addition, the manual summarizes briefly the other key phases of the cycle (assessment, imple- mentation and monitoring, evaluation) and provides references to the key Federation manuals on these phases.
The manual has been developed primarily for use by people managing projects and programmes either in a National Society or the secretariat of the International Federation of Red Cross and Red Crescent Societies (International Federation). Although it is mainly designed for use at the country level, the basic principles can be applied to project and programme planning at any level. The manual draws on two International Red Cross and Red Crescent Movement publications – the International Federation’s Project Planning Process (2002) and the ICRC Economic Security Unit’s Programme/ Project Management: The Results-Based Approach (2008) – reflecting the significant similarity of approach. The International Federation has developed the manual internally to suit the particular needs and uses of project/programme management within the organization.
more
WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situation in a country, including the state of the health s
...
ector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
more
Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – along with mental health, cause nearly three quarters of deaths in the world. Their drivers are social, environmental, commercial and geneti
...
c, and their presence is global. Every year 17 million people under the age of 70 die of NCDs, and 86% of them live in low- and middle-income countries (LMICs).
more
This toolkit is a "how to" guide for developing, implementing and evaluating a multisectoral action plan for prevention and control of NCDs. It is targeted at policy-makers, planners and programme managers, and is intended to help countries, provinces and cities meet the requirements for achieving g
...
lobal and national NCD targets and the Sustainable Development Goals. The toolkit takes the user through a series of actions related to the development of a multisectoral action plan ("MSAP development actions"), and provides forms and a template framework for users to complete as they undertake these actions. Developing a multisectoral action plan involves establishing health needs and engaging relevant stakeholders before determining the actions to take, identifying and prioritizing interventions, deciding on ways to address NCDs while establishing support and resources for prevention and control, and evaluating progress in implementing the plan.
more
Key stakeholders must be involved in the planning, implementation, monitoring and evaluation of NCD plans and programmes. Within a ministry of health there will be different types of stakeholders, such as programme managers and senior managers in departments of prevention, health promotion, and hosp
...
ital and health services. Other stakeholders may come from ministries for transport, economics, agriculture, and education, funding partners, nongovernmental organizations, civil society and community members. It is critical to ensure that there are clear and accurate descriptions of the policies, plans and programmes, so that all interventions, activities and desired outcomes are clearly understood by all involved in their evaluation.
more
World Health Organization. (2022). Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 4: developing an implementation plan.
The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights
...
the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
more
The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub
...
erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
more
Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium
...
term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
more
Public health emergencies, including pandemics, highlight the need for health systems and services that are prepared, resilient and ready to respond to health security threats. Endorsed by Member States in 2023, the Asia Pacific Health Security Action Framework (APHSAF) is designed to engage m
...
ultisectoral actors in health security, and to reflect the complex nature of current and future public health emergencies. The Framework presents six interconnected, multisectoral domains of work that together form a comprehensive, multi-hazard health security system — emphasizing the One Health approach. The Framework also supports progress towards the Sustainable Development Goals and universal health coverage while meeting the responsibilities and obligations of the International Health Regulations (2005).
more
Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions
...
(FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
more
The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key
...
challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
more
Under- and over-diagnosis of COPD: a global perspective
Ho T., Cusack R.P., Chaudhary N. et al.
Breathe, part of the European Respiratory Society (ERS)
(2019)
CC2
The article "Under- and over-diagnosis of COPD: a global perspective" reviews the worldwide variation in the prevalence of chronic obstructive pulmonary disease (COPD) and issues related to its misdiagnosis. It highlights that COPD is under-diagnosed due to factors such as limited access to spiromet
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ry and variable diagnostic criteria, especially in low- and middle-income countries. Conversely, over-diagnosis often results from reliance on non-standard criteria or inadequate spirometry use. The article discusses key risk factors, including age, gender, exposure to pollutants, and comorbidities, and emphasizes the need for standardized diagnostic practices to better address and manage COPD globally.
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There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness and inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for
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COPD care contributes to preventive and management challenges. Thus, the majority of patients with COPD are misdiagnosed, misclassified and mismanaged or undertreated. With the struggling improvement in the quality of healthcare in Africa, studies conducted over the last 10 years indicates the rising trends in both the risk factors and the burden of COPD. The role of new risk factors such as indoor pollution, infections with human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB), in the pathogenesis of COPD in Africa is increasingly being recognized. This literature review attempts to collect and synthesize information that could be useful in improving COPD care and informing the governments to take appropriate actions for prevention, diagnosis and management of COPD in Africa.
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The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir
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ometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
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The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including
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asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obliga
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tion to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE
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CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris
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k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct
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definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
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