Natural disasters often increase morbidity and mortality rates. Taking appropriate measures to maintain environmental health helps to reduce or eliminate the risks of preventable disease and death. Such measures contribute not only to the health of individuals in and near disaster-stricken areas, bu...t they also contribute to decreasing the high costs of providing emergency health services in the aftermath of disaster.
This document is divided into several parts. The first section primarily addresses the effects of natural disasters on environmental health conditions and services. In the second section, environmental health measures are described that should be undertaken in each of three time frames: the predisaster, disaster, and postdisaster periods.
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under National Program for Prevention and Control of Cancer, Diabetes, CVD & Stroke (NPCDCS) in
12th five year plan (2012-17)
Level of stunting among Bangladeshi children <5years declined from 51% in 2004 to 36% and underweight from 41% in 2007 to 33% (BDHS 2014). But the decrease in wasting rate is not as expected, which is only from 17% to 14.3 % over last decade. Approximately 3.1 % (BDHS 2014) of under-5 children suffe...ring from SAM only by weight-for-length or height z-score (WHZ) <-3 criterion and estimated to be a total of ~ 450,000. Because, there are no national information on prevalence of SAM using mid upper arm circumference (MUAC) and presence of bipedal oedema in under-5 children, thus the actual number of children suffering from SAM could be much higher than the current estimate.
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The overall goal of the programme, to reduce the malaria morbidity and mortality by 75% (using 2012 as baseline) by the year 2020, continued to be pursued in 2014. The following areas were identified as some of the priorities for the year: Malaria Case Management under which we have Malaria in Pregn...ancy (MIP), Home Based Care and Diagnostics.
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March - June 2018
Myanmar introduced Child Death Surveillance and Response (CDSR) in 2015 as an initiative to reduce child (under-5) mortality, an initiative that will contribute to the country’s efforts to meet the Sustainable Development Goals (SDG). Technical Guidelines for CDSR were devel...oped in 2015 followed by the development of Training Package in 2016. An Implementation Plan was made in 2016; and this led to all townships implementing CDSR in early 2017. After one year of implementation an assessment was carried out in early 2018.
The assessment was conducted in 3 region/states – Ayeyarwaddy, Magway, Shan South, with information gathered from the state/region, district, township and basic health unit levels. In addition a caretaker interview was conducted to see health-seeking behavior. In addition to these three regions/states, information was also gathered from three other regions/states but only at the region/state level – Mandalay, Yangon, Kachin.
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Survey report
Four health surveys were performed in Kutupalong Makeshift Settlment (KMS), Balukhali Makeshift Settlement (BMS), Kutupalong Makeshift Settlement Extension (KMS Extension) and Balukhali Makeshift Settlement Extension (BMS Extension). These sites were chosen to ensure that the health... status and conditions were measured in both the new settlements and the pre-existing settlements. The surveys measured current and retrospective mortality, the main morbidities affecting the population, global and severe acute malnutrition rates, vaccination coverage rates for key antigens and health-seeking behaviour. Simple random sampling was used with a recall period from 25th February 2017 until the date of interview (30th October to 12th November): approximately 260 days.
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he National Institute of statistics of Rwanda (NISR) in collaboration with the worldwide Demographic and Health Surveys Program implemented the 2014-15 Rwanda Demographic and Health Survey (RDHS) to collect data for monitoring progress on health programs and policies in Rwanda. This publication illu...strates the profile of Northern Province.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Senegal is on course to meet the global target for under-five overweight, but is off course to meet the targets for all other indicators analysed with adequate data.
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from ...Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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Sepsis remains a leading cause of mortality and morbidity, especially during the first five days of life and in low and middle-income countries (LMIC) [1]. Hospital infection also remains a major cause of mortality in children despite progress encountered in the last decades.
Tuberculosis (TB) prevention is essential for reaching the End TB targets in the South-East Asia Region (SEAR) of World Health Organization (WHO)1. The targets of 80% reduction in TB incidence rate and 90% reduction in TB mortality by 2030 (compared to 2015 levels) can be achieved only with addition...al interventions aimed at preventing TB, according to epidemiological modelling studies commissioned by the WHO South-East Asia Regional Office (WHO SEARO). Optimal implementation of TB preventive treatment (TPT) is a critical intervention to accelerate reduction in TB burden in the SEA Region, which bears nearly 43% of the global TB burden. TPT by itself has the potential to reduce the overall annual TB incidence rates by 8.3% (95% CrI 6.5–10.8) relative to 2015.
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It estimates that there have been 228,000 additional deaths of children under five in these six countries [Afghanistan, Nepal, Bangladesh, India, Pakistan and Sri Lanka] due to crucial services, ranging from nutrition benefits to immunisation, being halted.
It says the number of children being tr...eated for severe malnutrition fell by more than 80% in Bangladesh and Nepal, and immunisation among children dropped by 35% and 65% in India and Pakistan respectively...
It also estimates that there have been some 3.5 million additional unwanted pregnancies, including 400,000 among teenagers, due to poor or no access to contraception...
The interruption to health services also affected those suffering from other diseases - the report predicts an additional 5,943 deaths across the region among adolescents who couldn't get treated for tuberculosis, malaria, typhoid and HIV/Aids.
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In 2015, 5.9 million children under age five died (1). The major causes of child deaths globally are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhoea, injuries and malaria (2). Most of these diseases and conditions are at least partially cau...sed by the environment. It was estimated in 2012 that 26% of childhood deaths and 25% of the total disease burden in children under five could be prevented through the reduction of environmental risks such as air pollution, unsafe water, sanitation and inadequate hygiene or chemicals.
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Mortality due to enteric infections is projected to increase because of global warming; however, the different temperature sensitivities of major enteric pathogens have not yet been considered in projections on a global scale. We aimed to project global temperature-attributable enteric infection mor...tality under various future scenarios of sociodemographic development and climate change.
The Lancet Planetary Health Volume 5, ISSUE 7, e436-e445, July 01, 2021
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For health care providers.
Sub-Saharan Africa has the highest maternal mortality in the world. According to estimates by the United Nations Maternal Mortality Estimation Inter-Agency Group (UN MMEIG)1 in September 2017, while the African Region had recorded a significant decline in maternal mortali...ty rate (MMR) of 37.8% between 2000 and 2017, 66% of the 295 000 maternal deaths reported globally occurred in sub-Saharan Africa. The African Region is also noted to have an extremely high MMR, estimated at 542 per 100000 livebirths, with an average annual rate of reduction of 2.9%.
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Improving the survival chances and quality of life of women, newborns, and children remains an urgent global challenge. Since 2012, substantial progress has been made in reducing maternal and under-5 deaths, and a only handful of countries are on target to meet the SDG targets in 2030. Yet, 5 millio...n children still die each year under the age of 5, and nearly half of those are newborns less than a month old. Worse still, the global maternal mortality ratio is going in the wrong direction.
A Decade of Progress and Action for the Future will examine the tenacity and innovation that helped us make gains, the lessons learned through monitoring, country-led adaptation and leadership, analysis, and reflection, as well as the approaches we must take to reinvigorate the momentum and global commitment to improving maternal and child survival. Increasing coverage, strengthening the quality of care, and enhancing equity will be tantamount to our global progress.
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As a high-burden neglected tropical disease, soil-transmitted helminth (STH) infections remain a major problem in the world, especially among children under five years of age. Since young children are at high risk of being infected, STH infection can have a long-term negative impact on their life, i...ncluding impaired growth and development. Stunting, a form of malnutrition in young children, has been long assumed as one of the risk factors in acquiring the STH infections. However, the studies on STH infection in children under five with stunting have been lacking, resulting in poor identification of the risk. Accordingly, we collected and reviewed existing related research articles to provide an overview of STH infection in a susceptible population of stunted children under five years of age in terms of prevalence and risk factors. There were 17 studies included in this review related to infection with Ascaris lumbricoides, Trichuris trichiura, hookworm, and Strongyloides stercoralis from various countries. The prevalence of STH infection in stunted children ranged from 12.5% to 56.5%. Increased inflammatory markers and intestinal microbiota dysbiosis might have increased the intensity of STH infection in stunted children that caused impairment in the immune system. While the age from 2 to 5 years along with poor hygiene and sanitation has shown to be the most common risk factors of STH infections in stunted children; currently there are no studies that show direct results of stunting as a risk factor for STH infection. While stunting itself may affect the pathogenesis of STH infection, further research on stunting as a risk factor for STH infection is encouraged.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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Today, the World Health Organization (WHO) is advancing the global fight against acute malnutrition in children under 5 with the launch of its new guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition). This milestone is a crucial response to the persistent... global issue of acute malnutrition, which affects millions of children worldwide.
In 2015, the world committed to achieving the Sustainable Development Goals (SDGs), including the ambitious target of eliminating malnutrition in all of its forms by 2030. However, despite these commitments, the proportion of children with acute malnutrition has persisted at a worrying level, affecting an estimated 45 million children under five worldwide in 2022.
In 2022, approximately 7.3 million children received treatment for severe acute malnutrition (SAM). Although treatment coverage has increased, children with SAM in many of the worst affected countries are still unable to access the full necessary care for them to recover.
The Global Action Plan (GAP) on child wasting recognized the need for updated normative guidance to support governments in the prevention and management of acute malnutrition. WHO answered this call to action and developed a comprehensive guideline that provides evidence-based recommendations and good practice statements and will be followed by guidance and tools for implementation.
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