WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of equity and evidence-based policies, strategies and interventions to accelerate equitable progress in ...the health of women, children and adolescents. Although progress has been made, great inequities persist. Women from the LAC region’s poorest countries are almost four times more likely to die due to complications during childbirth than those living in the wealthiest countries. Through the years, several tools, instruments and methods (TIMs) have been developed by global, regional and country partners that can be used to conduct systematic equity-based analyses and/or re-designs of health systems, programs, strategies and interventions. The main purpose of this document is to present an overview of existing TIMs that can be used by policymakers, program managers, development partners, nongovernmental organizations, academia and civil society partners to strengthen systematic identification, analysis and responding to social inequities in the health of women, children and adolescents in LAC. The TIMs included were identified through a systematic search process
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Since the last situation report on the multi-country outbreak of cholera was published on 1 June 2023 (covering data reported until 15 of May), no new country reported a cholera outbreak. In total, 24 countries have reported cases since the beginning of 2023. The WHO African Region remains the most ...affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high.
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Overview
Learning objectives
• Name the general principles of essential care and practice.
• Name management principles of priority MNS conditions.
• Use effective communication skills in interactions with people with MNS conditions.
• Perform assessments for priority MNS conditions.
... Assess and manage physical health in MNS conditions.
• Know the impact of violence and gender-based violence on mental health.
• Provide psychosocial interventions to a person with a priority MNS condition and their
carer.
• Deliver pharmacological interventions as needed and appropriate in priority MNS
conditions considering special populations.
• Plan and perform follow-up for MNS conditions.
• Refer to specialists and links with outside agencies for MNS conditions as appropriate and
available.
• Promote respect and dignity for people with priority MNS conditions.
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The chapter Fostering Health Systems’ Monitoring to Better Serve Older Populations is part of the publication series entitled Decade of Healthy Aging: Situation and Challenges. The publications are designed to favor the prioritization of effective actions at the local level as well as the monitori...ng of data and public health policies, and providing evidence-based information. Along with the objective of presenting the available updated knowledge about the situation of health and aging at the beginning of the Decade of Healthy Aging in the Americas, this publication gives information about health systems’ monitoring to better serve the needs of older adults and emphasizes the need for societies and health systems to better adapt to an aging population. It introduces the 360-tool as a guide to adapt health systems through monitoring tracers/indicators and highlighting the data and information that is readily available, disaggregated by age. This information can aid in decision-making and resource allocation to support older adults’ needs. Concerning the 360-tool development, a consensus has been reached on seven tracer indicators with high relevance to informing policy, and case studies in selected countries have assessed the feasibility of this approach. The list of indicators and the process related to the development of the tool are presented in this publication. The Decade of Healthy Aging 2021-2030 is a period to guide action towards the transformation of societies by fostering the inclusion of older people in every decision. This publication intends to contribute to this strategy and highlight the upcoming challenges and opportunities on healthy aging.
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Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve universal health coverage and the Sustainable Development Goals, t...he beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
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WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly re...sults from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.
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Annals of Global Health, 87(1), p.43. DOI: http://doi.org/10.5334/aogh.3269;
The aim of this study was to examine the prevalence of mental health symptoms (anxiety, depression, and stress) in Bangladesh and the factors associated with these symptoms during the COVID-19 pandemic.
They found that ...about 64%, 87%, and 61% of the respondents in Bangladesh reported high levels of depression, anxiety, and stress, respectively and this varied between divisions (regions), more in women, those who self-quarantined, and those that experienced classical symptoms of COVID-19. We think there is a need for mental health support in this population to minimise the long term effects.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, ...coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and proven interventions in Latin American and Caribbean countries. Four areas of work are identified with the respective guidelines or suggestions for actio...n, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
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In Israel, as in other countries, the COVID-19 outbreak highlights existing structural inequities,which compromise the health of some migrant groups. The Israeli case also demonstrate show strong NGOs successfully advocate for the protection of migrants‘health amidst the crisis, madepossible bya c...ertain level ofcooperation withthe Israeli Ministry of Health.Hence,measures for COVID-19preparedness in Israel‘s marginalized migrant communities mostly result from pressure from civil society, against thebackdrop of a generally exclusionary approach toward migrants.4Over time, the Israeli Ministry of Health thus shifted from acknowledging the need to include migrants in preparedness measures toward the realization that particular needs and circumstances amongmigrant communities in some instances require special responses. Givena legacy of neglect and exclusion, this creates challenges for both the authorities and the migrant communities.
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The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violence against children. The report signals a clear need... in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.
The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and challenges, maps existing international commitments and... frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations, refugees,
migrants, and minorities experience the highest degree
of socio-economic marginalization. Marginalized people
become even more vulnerable in emergencies.1 This is due
to factors su...ch as their lack of access to effective surveillance
and early-warning systems, and health services. The
COVID-19 outbreak is predicted to have significant impacts
on various sectors.
The populations most at risk are those that:
• depend heavily on the informal economy;
• occupy areas prone to shocks;
• have inadequate access to social services or political
influence;
• have limited capacities and opportunities to cope and
adapt and;
• limited or no access to technologies.
By understanding these issues, we can support the capacity
of vulnerable populations in emergencies. We can give
them priority assistance, and engage them in decision-making
processes for response, recovery, preparedness, and
risk reduction.
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Risk Communication and Community Engagement (RCCE) is an essential component of your health emergency preparedness and response action plan. This tool is designed to support risk communication, community engagement staff and responders working with national health authorities, and other partners to ...develop, implement and monitor an effective action plan for communicating effectively with the public, engaging with communities, local partners and other stakeholders to help prepare and protect individuals, families and the public’s health during early response to COVID-19.
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Int J Health Policy Manag 2017, 6(10), 587–600
Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin ha...ve failed to produce better quality of care for the population and cost-effectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems.
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This case study examines the humanitarian response to the conflict-related crisis in the North-East of Nigeria, focusing primarily on the period from 2015 to the end of 2016. The aim is test the central hypotheses of the Emergency Gap project: that the current structure, conceptual underpinning and... prevalent mindset of the international humanitarian system limits its capacity to be effective in response to conflict-related emergencies.
As with many conflict-related crises, the emergency in north-east Nigeria has deep and complex roots in the history of the region. The conflict began in 2009 and quickly developed beyond the control of the authorities. It unfolded in the midst of pre-existing political, social and economic tensions, making an effective humanitarian response exceedingly difficult. Despite this complexity, what is clear is that the crisis has resulted in a sprawling humanitarian disaster that has killed over 25,000 people as a direct result of the violence, and continues to devastate many more lives through hunger, psychological trauma and lack of access to healthcare.
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The report reveals weak national mental health services overburdened by the demands placed on them by the Syria crisis. Health facilities which previously provided integrated mental health services in Syria have themselves become casualties of war, with most either destroyed, damaged or not function...ing. The shortage of trained mental health care providers is viewed as critical, both in Syria and in the neighboring countries where refugees now reside. Strengthening and expanding these services is crucial for Syria’s longer term recovery because the need for treatment will last for years after the war ends.
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This Communications Toolkit is intended to provide practical guidance and support to staff and partners who are looking to increase their communications capacity. It has been developed as a resource for project staff who work at field-level, to help them communicate responsibly, creatively, and effe...ctively about their work
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Water, sanitation and hygiene education in schools – WASH in Schools – provides safe drinking water, improves sanitation facilities and promotes lifelong health. WASH in Schools enhances the well-being of children and their families, and paves the way for new generations of healthy children.
f...rom Schools offers a snapshot of WASH in Schools experiences across the globe. These stories have been gathered through a retrospective search of UNICEF’s global and country office websites. They represent a myriad of activities undertaken by UNICEF and partners in 2010 and 2011.
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