Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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This report is from the National study on living conditions among people
with disabilities carried out in Nepal in 2014-2015. The study was carried
out as a household survey with two-stage stratified sampling, including a screening/listing procedure using the Washington Group on Disability
Statis...tics 6 questions, one Household questionnaire administered to
households with (Case HHs) and without disabled members (Control
HHs), one Individual Case questionnaire administered to individuals who were found to qualify as being disabled in the screening (Case
individuals), and an Individual Control questionnaire administered to
matched non-disabled individuals in the Control HHs (Control individuals). The study covers a range of indicators on level of living, such as socioeconomic indicators, economic activity, income, ownership and infrastructure, health (including reproductive health), access to health information, access to services, education, access to information, social participation, and exposure to discrimination and abuse (see all
questionnaires in Appendix).
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Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs and funding gaps. We develop a country classification framework in t...erms of actual versus expected national domestic funding, considering resource needs and donor financing. With UNAIDS and World Bank data, we examine domestic and donor HIV program funding in relation to need in 84 low- and middle-income countries. We estimate expected domestic contributions per person living with HIV (PLWH) as a function of per capita income, relative size of the health sector, and per capita foreign debt service.
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The wearing of Personal Protective Equipment (PPE) is standard practice for the handling of the deceased and should be carried out in line with standard Health and Safety procedures.
Healthcare and deathcare workers should take precautions when handling the remains of individuals who have died fr...om COVID-19.
This set of four posters provides healthcare and deathcare workers with guidance in the handling of the dead.
The posters cover the following topics:
- How to put on PPE correctly
- During body handling and preparation process
- Removing PPE correctly
- Management of COVID-19 Related Deaths: Key considerations and recommendations for managers
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7 April 2022. Aimed at national policymakers, public health and healthcare planners, staff working in reception centres, and healthcare staff caring for displaced persons, the information note concludes that universal testing of incoming refugees from Ukraine for tuberculosis (TB) infection is not r...ecommended. Specific groups, such as household contacts of bacteriologically confirmed pulmonary cases, or those who are immunocompromised should however be considered for TB infection testing.
Available in Czech, Hungarian, Polish, Romanian, Slovakian, Ukranian
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Environmental Research Volume 151, November 2016, Pages 115-123
Dengue is the world’s most important arboviral disease in terms of number of people affected. Over the past 50 years, incidence increased 30-fold: there were approximately 390 million infections in 2010. Globalization, trade, travel,... demographic trends, and warming temperatures are associated with the recent spread of the primary vectors Aedes aegypti and Aedes albopictus and of dengue. Overall, models project that new geographic areas along the fringe of current geographic ranges for Aedes will become environmentally suitable for the mosquito’s lifecycle, and for dengue transmission. Many endemic countries where dengue is likely to spread further have underdeveloped health systems, increasing the substantial challenges of disease prevention and control. Control focuses on management of Aedes, although these efforts have typically had limited effectiveness in preventing outbreaks. New prevention and control efforts are needed to counter the potential consequences of climate change on the geographic range and incidence of dengue, including novel methods of vector control and dengue vaccines.
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Children with disabilities are particularly vulnerable in humanitarian settings, yet they are often not able to access the services and protection they need. While multiple factors create these barriers, a major cause is how data about children with disabilities is collected and mapped. Data collect...ion processes often exclude or underrepresent the views of children with disabilities and thier caretakers. When the experiences of children with disabilities and their caretakers are not defined and collected, they become excluded from mainstreamed protective services, which are meant to serve all children. Children with disabilities also do not get the specialised interventions they need.
This guidance note explores how to use qualitative methods to create more robust assessment processes to ensure more effective programming and services for children with disabilities. This note provides promising practices for engaging with children with disabilities and includes sample tools that can be tailored to fit the needs of a particular assessment process. The note also explores the importance of thoughtful cross-sectoral responses so that children with disabilities, and their families, are carefully considered in areas like water, sanitation, and hygiene (WASH), education, health, and nutrition, and therefore receive the holistic support they need and deserve.
This note is intended for a broad audience of relevant child protection actors, including practitioners, coordination groups, researchers, and donors. The information is not limited to one type of humanitarian setting, geographic region, or culture. As a result, the practices and guidance should be adapted to each specific context, ideally in partnership with well-informed local actors, such as representatives from local organisations for persons with disabilities.
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In the last five years, i.e. how old turned the Campaign “Indifesa” (Defenceless) in 2016, that was launched by Terre des Hommes in 2012, the world has become smaller. One can actually say that the derangements following the Arab Spring in 2011 reshuffled what is stable and what produces instabi...lity; between those, who live in a peaceful world, and those, who try to survive in areas affected by violence. All that significantly reduced the distance between those, who live there, along the Mediterranean cost, and those, who live here. Such deep disorder made even more acute, visible and tangible also for the so called developed world all the serious violations of the human rights suffered by little girls and girls: on the one hand the widespread political instability and violence made even more precarious the little girls and young women’s conditions on the Mediterranean southern coast, where they were already fragile; and on the other hand the migration flows further worsened them, matching at the same time the conditions of those young and very young migrants to those of the European girls of the same age.
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Infectious diseases are constantly in transition. New diseases develop, known dis-eases become widespread or reemerge, and occasionally a disease is eradicated.Infectious diseases such as HIV, tuberculosis, and cholera are significant causes ofillness and death in many parts of the world. Health car...e personnel are on thefront lines, helping to protect their clients from infectious diseases and treatingthem when infections occur. During the course of their work, health care person-nel perform clinical procedures or other activities that can expose both them andtheir clients to potentially infectious microorganisms. Many of their clients aresick and thus may be more susceptible to infections or may have infections thatcan be transmitted to others. Fortunately, all staff working at health care facilities can perform simple proce-dures to minimize risk—to themselves and clients—and reduce the spread ofinfections. These practices can be integrated at minimal cost into the routineworkday at clinics and hospitals around the world. This reference booklet isspecifically designed for use at all levels of the health care system, from thelargest hospitals to the smallest dispensaries or health posts, in settings whereresources are scarce. This booklet, which was first published in 1999, has now been updated. Whilemost practices remain the same, there have been a few important changes—forexample, in recommendations related to hand hygiene and standard precautions.Nonetheless, this booklet continues to present practical recommendations forsimple and relatively low-cost procedures that can be implemented anywhere,with basic supplies and little to no high-technology equipment.
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2nd edition. There have been many requests over the past few years for advice about what information should be included in a patient record for leprosy. The patient record should contain the essential information for the clinical management of the patients, for monitoring adherence to MDT, and for r...eporting to the national programmes and to WHO. Patient records vary between countries due to differences in health systems and are modified from time to time. The Model Patient Record is recommended as a reference and as a check list when evaluating programmes and when reviewing existing patient records.
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Nosocomial infections, or hospital-acquired infec-tions (HAI), are among the most significant causesof morbidity and mortality in healthcare settingsthroughout the world.Prevention of HAIs iscentral to providing high quality and safe health-care, even in settings with limited resources.Transmi...ssion of infectious agents between patientsby health workers and irrational use of antibioticsare two important preventable factors involved inmany HAIs.
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Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and ...outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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R4D conducted a thorough desk review and qualitative fiscal space analysis, 19 interviews about financing for the three diseases and the extent of alignment between public financial management systems and health policy objectives, and a validation workshop with government officials.
Tanzania’...s disease response faces a triple transition challenge: replacing donor funding, closing the resource gap that would exist even with donor funding, and more efficiently delivering on disease response objectives.
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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be...come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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This report found that fewer than 15 percent of more than 3,000 school-age asylum-seeking children on the islands were enrolled in public school at the end of the 2017-2018 school year, and that in government-run camps on the islands, only about 100 children, all preschoolers, had access to formal e...ducation. The asylum-seeking children on the islands are denied the educational opportunities they would have on the mainland. Most of those who were able to go to school had been allowed to leave the government-run camps for housing run by local authorities and volunteers
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Recommended practices booklet (April 2020)
The set includes 10 Counselling Cards and a Recommended Practices Booklet. Infant and young child feeding (IYCF) counselling in the context of COVID-19 remains a critical nutrition intervention for the protection and support of pregnant women, caregivers, ...and their young children. WHO and UNICEF advise caregivers and families with suspected or confirmed COVID-19 to continue the recommended IYCF practices with the necessary hygiene precautions. It is therefore vital to ensure that communities and families around the world adopt these recommendations to help prevent the spread of the virus and care for those who are infected.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The quality of prescribing depends mostly on those prescribers belonging to clinical medical specialties... having direct contact with patients. These doctors, who comprise the majority of antibiotic prescribers,undergo long-term undergraduate and postgraduate training that shapes their professional knowledge and behaviour
J Antimicrob Chemother2019;74: 3611–3618doi:10.1093/jac/dkz375 Advance Access publication 3 September 2019
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EU Policies Contribute to Abuse of Migrants in Libya
This report documents severe overcrowding, unsanitary conditions, malnutrition, and lack of adequate health care. Human Rights Watch found violent abuse by guards in four official detention centers in western Libya, including beatings and whippin...gs. Human Rights Watch witnessed large numbers of children, including newborns, detained in grossly unsuitable conditions in three out of the four detention centers. Almost 20 percent of those who reached Europe by sea from Libya in 2018 were children.
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The risks of the use of nuclear, radiological, biological or chemical (NRBC) weapons are heterogeneous. Each risk has its own implications for developing and deploying any capacity to assist victims of an NRBC event and, in parallel, for the health and security of the people bringing this assistance.... At an international level, there are no plans for assisting the victims of an NRBC event which are both adequate and safe. Recognizing
the realities of the contexts associated with each risk throws up numerous challenges; such recognition is also a prerequisite for addressing these challenges. The realities that have to be considered relate to:
1. developing, acquiring, training for and planning an NRBC response capacity;
2. deploying a response capacity in an NRBC event;
3. the mandates and policies of international organizations pertaining to NRBC events. The challenges that will pose the greatest difficulty for a humanitarian organization are those for which the solutions are ‘non-buyable’ and which involve making extremely difficult decisions. Attempting to assist victims of an NRBC event without a reality-based approach might generate ineffective and unacceptably dangerous situations for those involved.
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