This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be u...sed mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to de...termine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
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Effective malaria case management requires quick access to diagnostics and antimalarial treatments to reduce illness and death. Artemisinin-based combination therapy (ACT) has been essential to malaria treatment since 2001, as it combines artemisinin for rapid parasite reduction with a partner drug ...to ensure complete cure. However, resistance to antimalarial drugs, where parasites survive standard doses, threatens malaria control.
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Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capability for burns care from clinical, human resources a...nd operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
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Globally, 85,000 women and girls were killed intentionally in 2023. 60 per cent of these homicides—51,000—were committed by an intimate partner or other family member. 140 women and girls die every day at the hands of their partner or a close relative, which means one woman or girl is killed eve...ry 10 minutes.
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The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID...-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
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The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, stakeholders, and young adults. Key findings include a... preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
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The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic
has disproportionately affected people with diabetes population, exposing them to a
high risk for severe illness and mortality. Globally, diabetes was responsible for over fourmillion deaths in the year 2019. It was th...e leading cause of end-stage kidney disease, adult-onset blindness and cardiovascular diseases. Further, there was a considerable heterogeneity in the prevalence of complications and deaths associated with diabetes across the countries.
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Climate change is one of the biggest crises of our time. Climate threats range from higher temperatures, heavy rainfalls and floods, erratic precipitation, droughts, desertification, and land degradation. This has negative implications on the quality and quantity of natural resources, such as land a...nd water, agricultural productivity, rural livelihood options, food prices, and nutrition security, particularly when there is a lack of adaptation capacities and preparedness measures (Pacillo, 2024). Farmers are at the forefront of the climate crisis where their livelihoods are being jeopardized, and they are faced with many challenges to secure water, energy, and agriculture inputs, and maintain agriculture productivity. This heightens the risk of competition over natural resources and aggravates grievances and structural inequalities related to land rights and ownership as well as land access, management, and governance. In Africa, land-related issues are among the triggers of many violent disputes (Medina et al, 2024). For instance, communal violence in Nigeria and Sudan is tied to competition over scarce fertile land and poor resource governance (Bruce and Bourdeaux, 2013).
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The far-reaching impacts of the COVID-19 pandemic underscore the critical need for evidence-informed, transparent and inclusive decision-making. Policy-makers have grappled with complex choices amidst uncertainty. They have constantly reassessed response measures while navigating their economic impl...ications and unintended consequences on societal well-being. Effective communication of the basis for these decisions has also posed a challenge, requiring transparency and public trust.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A...Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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Adolescence is a critical stage in life for physical, cognitive and emotional development, shaping future health and well-being. Comprehensive measurement of adolescent health is essential to prioritize health issues, guide interventions and track progress. However, global, regional and national ado...lescent health measurement has historically been inconsistent and incomplete.
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An essential component of the return process is counselling, which aims to support counselling beneficiaries to make an informed decision on their future migration pathways. Counselling provides the space for migrants to exert their agency, supports them to prepare for return and positively contr...ibutes to their reintegration in countries of origin. The question of how to prepare and provide return counselling is of significant concern for all actors involved in the return process itself, but until
now very little has been done to offer a standardized approach to return counselling. The Return Counselling Toolkit intends to address this question and proposes a rights-based and migrant-centred approach to return counselling, which builds upon
IOM standards and the Organization’s long-standing experience in providing return and reintegration counselling to thousands of migrants every year, in a multiplicity of countries and contexts.
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Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th...e implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease burden and control in the WHO African region. It tra...cks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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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).
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This is the 42nd situation report for the multi-country outbreak of mpox, which provides an update on the epidemiological situation of mpox in Africa (including countries in the WHO African Region and some countries in the WHO Eastern Mediterranean Region), with data as of 3 November 2024.