An IPCC Special Report on climate change, desertification,
land degradation, sustainable land management, food security,
and greenhouse gas fluxes in terrestrial ecosystems.
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Protocol for strategic implementation of mental health in COVID-19 emergencies ( Version 2)
La Región de las Américas constituye un territorio extremadamente rico desde el punto de vista de la diversidad cultural, en la cual se presentan una variedad de desafíos relacionados con el reconocimiento y el respeto de los derechos humanos de los miembros de los pueblos indígenas, los afrodes...cendientes, los romaníes, así como de otros grupos étnicos. A lo largo del curso de la vida, estas personas experimentan discriminación estructural y poca representatividad e inclusión en los procesos de toma de decisiones, lo cual dificulta su acceso a los servicios de salud, afecta la calidad de la atención que reciben y tiene un efecto general en sus condiciones de vida. Por tanto, la protección y la promoción de su salud y seguridad socioeconómica es una cuestión no solo de política pública, sino también de protección y ejercicio de los derechos humanos. En esta publicación se presentan los instrumentos internacionales y regionales de derechos humanos y los sistemas de protección de esos derechos instaurados por las Naciones Unidas y el Sistema Interamericano de Derechos Humanos, así como medidas para hacerlos efectivos, con especial hincapié en el derecho a la salud, al medio ambiente sano y otros derechos relacionados con el cuidado del planeta.
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Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance...), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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In 2018 and early 2019, the WHO Regional Office for Europe’s cultural contexts of health and well-being project worked alongside the University of Exeter’s WHO Collaborating Centre on Culture and Health, the Minsk Regional Centre for Psychiatry and Addiction, and the Institute of Mental Health o...f the Ukrainian Catholic University to engage researchers, practitioners, health-care workers and other relevant stakeholders in a series of workshops on the cultural contexts of early life trauma in Belarus and Ukraine.
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La resistencia a los antimicrobianos es un problema complejo que requiere soluciones únicas adaptadas a cada país. Este conjunto de herramientas de adaptación de los programas de resistencia a los antimicrobianos (TAP, por su sigla en inglés) los ayudará a iniciar y ejecutar proyectos para enfr...entar la propagación de la resistencia a los antimicrobianos en sus territorios. Los ejercicios y recursos presentados corresponden a cada una de las etapas descritas en la Guía rápida: Manual práctico para la adaptación de intervenciones a medida contra la resistencia a los antimicrobianos, y deben ser utilizados por un grupo de trabajo de TAP.
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The extensive use of natural resources threatens to exceed the carrying capacity of the Earth. The concept of a
circular economy offers an avenue to sustainable growth, good health and decent jobs, while saving the environment
and its natural resources. Further, the change from a linear economy (t...ake, make, dispose) to a circular economy (renew, remake, share) is expected to support significantly the attainment of the Sustainable Development Goals
(SDGs), particularly SDG 12 on responsible consumption and production.
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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe...rent interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
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La intención de este documento es describir el perfil y la tendencia de morbilidad y
mortalidad en el país. Es decir quiénes, dónde y de qué se enferma o muere la población en Argentina, así como también mostrar las condiciones de vida en las que se vive y cuáles son los recursos con los ...que cuenta el sistema de salud para dar respuesta a las necesidades.
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MMWR Morbidity and Mortality Weekly Report December 19, 2014 / 63(50);1205-1206
Adapting community-led approaches . Three out of 10 people in urban areas do not use improved sanitation facilities, and one out of 10 people are forced to practise open defecation. Still higher proportions do not have access to safely managed sanitation facilities, where the fecal sludge
is contai...ned and either left in situ or safely emptied, transported, and delivered to a treatment plant.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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This global progress report attempts to lay the groundwork for the kind of accelerated action needed. Section 1 presents key data, trends and developments in women’s, children’s and adolescents’ health and well-being. That is followed in Section 2 by a deeper dive into the impact of the COVID-...19 pandemic, which has created and contributed to many threats and challenges to progress for women, children and adolescents. In Section 3, the report concludes with recommendations for accelerating progress towards the achievement of the 2030 Agenda even in such challenging times, with an emphasis on partnership
and clear-eyed recognition of the consequences of failing to do better.
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Le monde fait face aux conséquences graves du manque de services et de traitements de santé mentale disponibles. Les troubles mentaux touchent tous les pays, toutes les cultures et toutes les collectivités. Selon l’Organisation mondiale de la Santé (OMS), 10% de la charge mondiale de morbidit... est liée aux troubles mentaux, neurologiques et à l’usage de substances psychoactives.
Dans les pays à revenu faible ou intermédiaire, plus de 75% des personnes atteintes de troubles mentaux ne reçoivent aucun traitement. En 2020, en raison de la pandémie mondiale, 93% des pays ont déclaré que leurs services de santé mentale ont été suspendus ou interrompus (OMS, 2020e). L’OMS a signalé une hausse de 25% des cas de dépression et d’anxiété durant la pandémie. L’Organisation de coopération et de développement économiques (OCDE) estime que la dépression et l’anxiété coûtent à l’économie mondiale 1 000 milliards d’USD par an.
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An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, the WHO Global report on health equity for persons w...ith disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. Furthermore, the Sustainable Development Goals and global health priorities will not progress without ensuring health for all.
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Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech...anisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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