Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many ...infections becoming increasingly limited, expensive, and, in some cases, non-existent.
Conscious of the public health threats of AMR to both humans, animals and the environment, the ministries of health and sanitation, agriculture forestry and food security and the environmental protection agency put together a national multi-sectoral coordinating group tasked with the responsibility of establishing mechanisms to integrate all initiatives into a single concerted action and development of the national AMR strategic plan (2018-2022). The National Strategic Plan on Antimicrobial Resistance is the first approach which addresses AMR specifically.
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This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to ...air pollution.
Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines (see the full report, Air pollution and child health: prescribing clean air. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under the age of 5 years in 2016.
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The United Nations Development Assistance Framework (UNDAF) 2018-2022 sets out the UN partnership aiming to support Nepal as it carves out its development agenda over the next five years. At the core of this new UNDAF are the SDGs, the Government of Nepal’s Fourteenth Plan, and international commi...tments and norms to which Nepal is a party. Leaping off from the lessons learned from the previous UNDAF (2013-2017), this new framework builds upon successes, incorporates emerging issues and agreements, and serves to address Nepal’s larger economic, social, and environmental objectives.
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The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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Myanmar’s transition to a market‐based economy is accompanied by rapid development of the private manufacturing sector, which has large potential for improving economic growth. The overall success of the sector, however, should not be taken for granted. Future advances will greatly depend on th...e policy and business environment in which manufacturing activities take place. It is, therefore, important to better understand the business environment and help inform policies conducive to sustainable economic growth.
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AACAP OFFICIAL ACTION | This Practice Parameter identifies best approaches to the assessment and management of children and adolescents across all phases of a disaster. Delivered within a disaster system of care, many interventions are appropriate for implementation in the weeks and months after a d...isaster. These include psychological first aid, family outreach, psychoeducation, social support, screening, and anxiety reduction techniques. The clinician should assess and monitor risk and protective factors across all phases of a disaster. Schools are a natural site for conducting assessments and delivering services to children. Multimodal approaches using social support, psychoeducation, and cognitive behavioral techniques have the strongest evidence base. Psychopharmacologic interventions are not generally used but may be necessary as an adjunct to other interventions for children with severe reactions or coexisting psychiatric conditions
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The synthesis looked across the evaluations and reviews as mentioned above to draw lessons and conclusions across the different contexts. The synthesis aims to identify:
recurrent issues, patterns and trends, and promising initiatives and lessons learned from existing programming including main...streaming in how UNHCR prevents, mitigates and responds to the risks of SGBV;
institutional management and leadership for SGBV in UNHCR;
factors which are contributing to success, including sustainability of services, and those which are inhibiting it;
the extent to which questions on SGBV are part of UNHCR evaluations of emergency responses;
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Medicina 2019, 55, 553; doi:10.3390/medicina55090553
Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated wit...h external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi...ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards... have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
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(August 28 – October 10, 2017)
A nutrition and mortality assessment using SMART methodology was applied and the survey covered 15 statistical (14 districts plus 1) domains countrywide. The main objective of the survey was to assess the current nutrition status of the population, especially ch...ildren 6-59 months old and women of reproductive age (15-49 years of age). The survey also looked at the major contextual factors contributing to undernutrition such as infant and young child feeding (IYCF) practices; food security indicators; water, sanitation and hygiene indicators; and health situation in Sierra Leone
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This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N...CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
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Global actions to reduce antimicrobial resistance (AMR) include optimising the use of antimicrobial medicines in human and animal health. In countries with weak healthcare regulation, this requires a greater understanding of the drivers of antibiotic use from the perspective of providers and consume...rs. In Bangladesh, there is limited research on household decision-making and healthcare seeking in relation to antibiotic use and consumption for humans and livestock. Knowledge is similarly lacking on factors influencing the supply and demand for antibiotics among qualified and unqualified healthcare providers. The aim of this study is to conduct integrated research on household decision-making for healthcare and antibiotic use, as well as the awareness, behaviours and priorities of healthcare providers and sellers of antibiotics to translate into policy development and implementation
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The steps reassert the sequence of the HPC, with needs analysis directly informing decisions about the response and monitoring, whether for the preparation of new plans or adjustments to existing ones. The steps of the HPC have a rationale and cannot be skipped. However, the depth of work under each... step can and should be adapted to the realities of the operating environment and capacities.
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- Build community resilience to coastal hazards by improving capacity of inclusive disaster management systems.
- Reduce the mortality rate of persons with disabilities in situations of risk.
- Raise awareness about inclusive policies, practices and disaster risk reduction strategies that ...address the accessibility of communication, shelter, transportation and early warning systems.
- Foster collaboration between disaster preparedness organizations, broadcasters and organizations of persons with disabilities to mainstreaming disability issues in disaster risk reduction strategies.
- Build the capacity of disaster management organizations, governments, broadcasters and built environment practitioners by providing technical specifications on accessible communications and the design of accessible shelters and the built environment.
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The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to ...enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
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The objectives of this guidance document are to:
1. Strengthen the capacity of country teams to effectively scale up and manage programmes to address severe acute malnutrition
2. Extend the geographic reach of quality treatment for SAM to all vulnerable communities in need
3. Maximize... access to appropriate and quality treatment for SAM among all eligible children in the community at all times
4. Aid the formulation and implementation of national policies and strategies that support objectives 1 to 3
5. Aid the creation of an enabling environment that supports objectives 1 to 3 through advocacy, documentation of successful practices, support for operational research, mobilization of resources and collaboration with partners
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This guidance should be followed if an unlicensed medicine is prepared in
a registered pharmacy. The preparation of an unlicensed medicine (for
example unlicensed methadone, or menthol in aqueous cream) in a pharmacy is called ‘extemporaneous preparation’.
The guidance should be read alon...gside the standards for registered pharmacies. These aim to create and maintain the right
environment, both organizational and physical, for the safe and effective practice of pharmacy.
By following this guidance, the pharmacy will:
• demonstrate that it meets our standards, and
• provide assurances that the health, safetyand wellbeing of patients and the public are safeguarded
Responsibility for making sure this guidance is followed lies with the pharmacy owner. If the registered pharmacy is owned by a ‘body
corporate’, the directors have responsibility.
Those responsible for the overall safe running of the pharmacy need to take into account the nature of the pharmacy and the range of services
already provided and, most importantly, the needs of patients and members of the public.
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