Antimicrobial resistance (AMR) and malaria remain significant public health challenges in the WHO Eastern Mediterranean Region (EMR). In 2021, the region reported 1.7 million sepsis-related deaths, with 373,000 associated with bacterial AMR. High antibiotic consumption, particularly in high-income c...ountries, combined with rising usage in middle-income countries, has accelerated the emergence of drug-resistant infections. Malaria management is further complicated by biological threats, including vector insecticide resistance, PFHRP2/3 gene deletions, and antimalarial drug resistance, alongside insufficient trained personnel and limited molecular surveillance capacity. Effective strategies to address these challenges include strengthening regional and cross-border surveillance networks, designating WHO collaborating centers for molecular monitoring, enforcing national treatment policies, and raising public and healthcare provider awareness about rational antimalarial and antibiotic use. These measures, coupled with sustainable funding and enhanced therapeutic efficacy studies, are essential to reduce the development and spread of drug-resistant malaria and improve overall health outcomes in the EMR.
more
These guidelines have been developed in simple, user-friendly language and they explain the procedures for patients’ access to and the safe management of Schedule I and II drugs that are necessary for the treatment and relief of moderate to severe pain. They provide both procedures for acquisition... and information on records or documents that are necessary to ensure that these medicines are made available and accessible to patients across the entire health care delivery system (i.e. from tertiary institutions to primary level) and ensuring prevention of illicit non-medical use.
more
The African Palliative Care Association is pleased to publish the first edition of Palliative Care Standards for Africa. The development of these standards was achieved through wide consultation with service beneficiaries and providers, and they have been developed to suit different levels of ... service delivery, from primary to tertiary. These standards are underpinned by the World Health Organization’s definition of palliative care, and recognise that scaling up palliative care requires a public health approach with four pillars: policy, education, drug availability and implementation. In addition, the increasing need to establish specific indicators of quality and effectiveness for palliative care has been a big driving force behind these comprehensive standards. It is APCA’s wish that they will provide a framework for the development of evaluation
and performance indicators that can facilitate programme improvement and development. The standards are designed to allow the development or improvement of palliative care across the different services levels, within the organisational capacity of various service providers. They describe a relationship between primary, intermediary and tertiary level service providers, with expectations for all providers articulated through detailed criteria for each standard. It is therefore expected that these standards will influence the planning and delivery of palliative care services at all levels of health care service delivery.
more
In this guide, the African Palliative Care Association (APCA) has put together evidence‑based information on the use of specific opioids commonly used in the management of moderate‑to‑severe pain to manage both cancer and non‑cancer pain. APCA hopes that this guide will be a useful tool i...n aiding health professionals at all levels of healthcare delivery to assess and manage pain using opioids. All opioids included in this guide are listed on the WHO model list of essential medicines but we remind readers that oral morphine is the standard opioid of choice for managing moderate‑to‑severe pain and we recommend that it should be made available at all times.
more
Technical Note: Cholera treatment facilities provide inpatient care for cholera patients during outbreaks. Proper case management and isolation of cholera patients is essential to prevent deaths and help control the spread of
the disease. Traditionally, these structures have been referred to as ch...olera treatment centres (CTCs) and
cholera treatment units (CTUs). CTCs are usually large structures set up at central level (e.g. urban areas),
while CTUs are smaller structures set up in the periphery (e.g. peri-urban or rural areas). CTCs/CTUs can
be set up as independent structures in tents or within existing buildings or wards of health structures.
Whatever the structure, the principles described in this document should be respected
more
This literature review summarizes the link between psychological well-being and entrepreneurial outcomes for small and medium-size enterprises in fragile, conflict, and violence–affected contexts. It identifies potentially promising, scalable psychosocial training interventions, based on cognitive...-behavioral therapy approaches, that can be adapted and implemented to improve psychological health at the individual level, that could lead to better business performance at the firm level.
more
Ocean plastic pollution has reached crisis level: every minute, more than an entire garbage truck of plastic makes its way into the world’s oceans—roughly 11 million metric tons annually. While plastic waste presents an immediate threat to marine wildlife and ecosystems, this global challenge al...so has implications for major industries such as fishing and tourism, impacting the livelihoods of millions of people. The drivers and impacts of ocean plastic pollution also contribute to global challenges in food security, human health, and climate change.
more
The WHO estimates that 19 million children aged 15 years or younger are visually impaired. Of these, 1.4 million are irreversibly blind and need visual rehabilitation interventions for full psychological and personal development. The remainder have visual problems that could be prevented or treated.... Identifying children with visual problems early in life so that they can benefit from medical and optical interventions remains a key challenge for most child eye health programmes. Reports from various low-and middle-income countries indicate that the age of children undergoing operation for cataract is frequently too high to achieve maximum benefit.
more
While the full extent of Cyclone Ida’s impact is still being assessed, early reports indicate significant damage to infrastructure and livelihoods, with an estimated 3,000km2 of land submerged. Preliminary government reports as of 24 March indicate that more than 58,600 houses have been damaged, i...ncluding 36,747 totally destroyed, 19,733 partially destroyed and 2,184 flooded. More than 500,000 hectares of crops have been damaged, which is expected to significantly increase food insecurity given that the flooding has coincided with the annual harvest season. More than 3,100 schools have been damaged, along with at least 45 health centres.
Nearly 110,000 people remained displaced in more than 130 accommodation centres – mostly schools and other public buildings – in Sofala (90), Manica (26), Zambezia (10) and Tete (4), where humanitarian needs are acute and both the risk of communicable disease outbreaks and protection risks – particularly for women and girls – are high
more
1. What do we mean by ‘psychosocial support (PSS)? | 2. What are the basic principles of psychosocial support for UNICEF? | 3. In what types of situations does UNICEF address psychosocial support? | 4. Are there certain psychosocial interventions in which UNICEF should not normally seek to inves...t? | 5. Are there any types of interventions we should discourage? | 6. Should UNICEF support one-to-one counselling? In what situations might this be appropriate? | 7. When should children be referred for professional mental health support? | 8. Should we avoid using the term “traumatised” when referring to children? | 9. How do we assess the type or response needed a) for quick, short term action? b) for medium-long term interventions? | 10. How can caregivers and professionals who have themselves experienced the same crises or exposures provide psychosocial support to children? | 11. What materials and tools are recommended to support and monitor PSS interventions? Where can these be obtained?
more
The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over... 134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. Good control of blood sugar blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India
more
The Lancet. 1 December 2020. doi: 10.1016/S0140-6736(20)32340-0.
To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their ...illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.
more
This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countries of southern Europe, northern Africa, and the Middle East and that there is a need to improv...e leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
more
Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
more
The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights ...the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
more
In April 2018, Refugees International (RI) conducted a mission to Bangladesh, to research the GBV (gender-based violence) response for Rohingya women and girls. RI found that the entire humanitarian system is struggling under tremendous constraints in Bangladesh, and protection and health actors do ...deliver lifesaving services to survivors in an incredibly challenging environment. This report, however, focuses on key gaps and challenges in GBV programming, as communicated by practitioners deployed to Bangladesh at various stages of the emergency, by local organizations, and by the affected women and girls themselves.
In the analyses and recommendations provided in this report, RI draws in part from the framework of the international initiative to safeguard women and girls in emergencies — the Call to Action on Protection from Gender-Based Violence in Emergencies — and urges the donors and humanitarian organizations that are Call to Action partners to implement it more effectively and with urgency during this emergency.
more
Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita...ble. We combined data from six Demographic and Health Surveys conducted in Senegal between 1992/93 and 2014. We examined FP trends over time among WRAU and subgroups, and trends in knowledge of FP and intention to use among women with unmet need for FP. Our results show that percent demand satisfied is lower among rural poor women and adolescents than WRAU, although higher among unmarried women. Marked recent increases have been observed in all subgroups, however fewer than 50% of women in need of FP use modern contraception in Senegal. Knowledge of FP has risen steadily among women with unmet need; however, intention to use FP has remained stable at around 40% since 2005 for all groups except unmarried women (75% of whom intend to use). Significant progress in meeting the need for FP has been achieved in Senegal, but more needs to be done particularly to improve acceptability of FP, and to strategically target interventions toward adolescents and rural poor women.
more
Interim Guidcance March 2020
People affected by humanitarian crises, particularly those displaced and/or living in camps and camp-like settings, are often faced with specific challenges and vulnerabilities that must be taken into consideration when planning for readiness and response operations for... the COVID-19 outbreak. They are frequently neglected, stigmatized, and may face difficulties in accessing health services that are otherwise available to the general population. In the context of this Interim Guidance, the people in humanitarian situations affected by this guidance may include internally displaced persons (IDPs), host communities, asylum seekers, refugees and returnees, and migrants when in similar situations. While further adaptations might be needed for some population groups, including those living in slums this interim guidance is issued to assist field staff to immediately respond to urgent needs.
more
The document outlines the 2017 cholera outbreak in Zambia, mainly in Lusaka, due to poor sanitation and unsafe water. By December, 493 cases were reported, with risks increasing due to the rainy season. The Zambia Red Cross Society (ZRCS), in collaboration with the Ministry of Health, WHO, and UNICE...F, responded by setting up treatment centers, supplying clean water and chlorine, and conducting hygiene education. 1,500 volunteers were mobilized to support 70,000 people directly. The IFRC allocated CHF 222,351 to control the outbreak, but challenges like limited funding and poor infrastructure remained.
more
This topic last updated: Apr 28, 2020.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or condi...tions.
View in: English, Italian, French, German, Japanese, Brazilian Portuguese, Video in Spanish
more