Policy
June 2015
Training Menus, Facilitation Tips, and Participatory Training Modules
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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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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Ade et al. BMC Health Services Research (2016) 16:5
Background: In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about
the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the
possible b...enefits on improving treatment outcomes. This study aimed to determine the contribution of tracing
activities for those who missed scheduled appointments towards a successful treatment outcome.
Methods: A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients
treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment
outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their
scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed
to explore factors associated with missing a scheduled appointment
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The Epidemic Preparedness and Response Plan for Cholera in Syria (November 2015) outlines strategies to prevent, detect, and manage cholera outbreaks in the country, where poor water and sanitation conditions, displacement, and damaged healthcare infrastructure increase the risk of disease spread. T...he plan aims to reduce morbidity and mortality through early detection, rapid response, and coordinated interventions. It is divided into four key phases: the Pre-Epidemic Phase, which includes risk assessment, resource mapping, stockpiling medical supplies, training health workers, and raising community awareness; the Alert Phase, which focuses on surveillance, laboratory confirmation, and mobilization of rapid response teams; the Epidemic Phase, which involves case management, infection control, environmental measures such as water chlorination and improved sanitation, and public awareness campaigns; and the Post-Epidemic Phase, which evaluates the response effectiveness and identifies lessons to improve future preparedness. The plan emphasizes multi-sectoral coordination, strengthening health surveillance, and ensuring timely intervention to control and prevent cholera outbreaks in vulnerable communities.
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The protection of children and educational facilities is particularly important. Precautions are necessary to prevent the potential spread of COVID-19 in school settings; however, care must also be taken to avoid stigmatizing students and staff who may have been exposed to the virus. It is important... to remember that COVID-19 does not differentiate between borders, ethnicities, disability status, age or gender. Education settings should continue to be welcoming, respectful, inclusive, and supportive environments to all. Measures taken by schools can prevent the entry and spread of COVID-19 by students and staff who may have been exposed to the virus, while minimizing disruption and protecting students and staff from discrimination.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based ...approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based ...approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based ...approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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This guide is strongly practice -oriented and intended as an open resource when replicating similar methods of psychosocial care in other projects. It describes the steps in the development of our pilot project
"Low threshold psychosocial support for refugees and asylum seekers’ in... Germany ", from the initial idea of the project to its practical implementation. It is to be understood as apractical report for transferring the working methods of MSF from project countries to the German context. A particular focus is the training and working methods of psychosocial peer counsellors. They are at the heart of our approach to low-
threshold psychosocial care
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"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re...lapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing."
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The NDMS&IP focuses on mainstreaming disability to promote equitable access to services in the six thematic areas of health, education, livelihoods, empowerment, and social inclusion and cross-cutting issues.
The first part of the NDMS&IP outlines incongruences between national and sectoral policie...s and pieces of legislation on one hand, and practice on the other and identifies key priority areas/themes of the strategy,
medium-term outcomes and strategies for each identified priority area/ theme. This process is largely informed by key findings and recommendations from a study on the Situation of Persons with Disabilities
in Malawi (CBMM/NAD, 2011). The study provides background descriptive information on existing national and sectoral policy and legal framework, level of access by children, adult women and males with disabilities to services in the areas of education, health, livelihoods and other social services as well as of participation by persons with disabilities through self-representation in development activities at various levels. A review of relevant documents at the international level further describes the disability situation in Malawi in the global context.
The second part of the NDMS&IP consists of the operational matrix, (Annex 1), a monitoring and evaluation framework (Annex 2) and budget estimates (Annex 3). This part outlines specific actions by various actors both in the public, private and civil society sectors to prioritise disability in their routine policy, programming, resource mobilisation and allocation, monitoring, evaluation and reporting routines. The action plan lays out priority sectors and concrete actions by setting out implementation schedules, defining targets, assigning responsibility to key duty bearers and rights holders for coordination, decision-making, monitoring and reporting, mobilisation and allocation and control of resources.
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Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among... high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of i...nterventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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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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This Plan envisions a future with the elimination of cervical cancer as a public health problem as a result of universal access to sexual health and STI prevention services, HPV vaccines, effective screening and precancer treatment services, treatment of invasive cervical cancer, and palliative care.... It foresees that all women and girls, regardless of age, race, ethnicity, socioeconomic status, HIV status, or disability will have timely access to quality cervical cancer prevention, care, and treatment so that they can live in good health throughout the life course and enjoy the health-related human rights.
The goal is to accelerate progress toward the elimination of cervical cancer as a public health problem in the Americas by reducing incidence and mortality rates by one-third by 2030.
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Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ...ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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Accessed online January 2019 | PTSD: National Center for PTSD | This article provides information regarding what events cause PTSD in children, how many children develop PTSD, risk factors associated with PTSD, what PTSD looks like in children, other effects of trauma on children, and treatments for... PTSD.
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