The aim of this document is to provide interim guidance for interventions to reduce the risk of maternal Zika virus infection and to manage potential complications during pregnancy. This guidance is based on the best available research evidence and covers areas prioritized by an international, multi...disciplinary group of health care professionals and other stakeholders. Specifically, it presents guidance for preventing Zika virus infection;antenatal care and management of women with infection; and care during pregnancy for all pregnant women living in affected areas, with the aim of optimizing health outcomes for mothers and newborns.
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Suicide is a serious public health problem surrounded by stigma, myths, and taboos. With an annual average of 81,746 suicide deaths in the period 2010–2014 and an age-adjusted suicide rate of 9.3 per 100,000 population (age-unadjusted rate of 9.6), suicide continues to be a public health problem o...f great relevance in the Region of the Americas. Contrary to common belief, suicides are preventable with timely, evidence-based, and often low-cost interventions. It is estimated that for each suicide that occurs, there are more than 20 attempts. Suicide can occur at any age and it is the third highest cause of death among young people between the ages of 20 and 24 in the Region of the Americas.
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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The Early Childhood Development Policy and its Strategic Plan seek to provide a framework to ensure such a holistic and integrated approach to the development of young children. International research has demonstrated the high economic returns on ECD investment and its positive impact on health and ...education outcomes as well as the overall economic development of a nation. The implementation of the ECD Policy will thus provide Rwanda with the basis for achieving the objectives and goals of the EDPRS and Vision 2020.
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The paper provides the rationale for these recommendations, which are based on analyses of data from the TRACT trial.
International Journal of Basic & Clinical Pharmacology 5(6):2290-2294
DOI: 10.18203/2319-2003.ijbcp20164081
The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease, the associated risk factors, and the increasing burden on healthcare systems, particularly in low- a...nd middle-income countries. The report discusses strategies for preventing Type 2 diabetes, managing diabetes effectively, and reducing complications through integrated healthcare approaches. It emphasizes the need for global action, national policies, and collaboration across sectors to address diabetes and improve health outcomes worldwide.
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A Step-by-Step Guide.
It is intended for health planners, dengue or vector control programme managers and individuals, nongovernmental organizations (NGOs) and other agencies with interests and/or expertise in developing biological, chemical, environmental and communication interventions to prevent... and control dengue fever.
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This manual describes some of the strategic, managerial, financial, technical and scientific aspects to be considered in establishing a national EQA programme for clinical laboratories and other testing services at all health care levels
La presente publicación describe la evidencia científica publicada respecto a la hipertensión como factor pronóstico en pacientes con COVID-19. Se identificó una revisión sistemática que evaluó diferentes desenlaces de pronóstico en pacientes con hipertensión y diagnóstico confirmado de C...OVID-19 con evidencia procedente de treinta estudios.
Esta publicación pertenece al compendio Publicaciones Minsa sobre COVID-19.
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Guía para la rehabilitación basada en la comunidad (RBC)
En el 2003, una Consulta Internacional para Revisar a Rehabilitación Basada en la Comunidad, celebrada en Helsinki, hizo un número de recomendaciones. Seguidamente, la rehabilitación basada en la comunidad se volvió a posicionar con una... propuesta de posición conjunta de la OIT, UNESCO y OMS, como una estrategia dentro del desarrollo comunal general para la rehabilitación, la equiparación de oportunidades, la reducción de la pobreza y la inclusión social de las personas con discapacidad.
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Climate change, increasing population densities, and intensified globalisation in trade, travel and migration are among the most important factors shaping the 21st century. Each impacts upon population health and the risk of infectious disease, particularly those originating at the human-animal-envi...ronmental interface. The recognition that many risk drivers of infectious disease fall outside of the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security. In response, the One Health concept has emerged, as have related initiatives addressing Planetary Health and Biodiversity and Human Health. From a public health perspective and operationally speaking, the One Health approach offers great potential, emphasising as it does cooperation and coordination between multiple sectors. Yet despite having been a focal point for discussion for over a decade, numerous challenges facing the implementation of One Health preparedness strategies remain. While some are technical, related to the requirement for innovative early warning systems or new vaccines, for example, others are institutional and cultural in nature, given the transdisciplinary nature of the topic. There have thus been calls to address One Health from multiple perspectives, from ecology to the social sciences. In order to further explore this issue and to identify priority areas for action for strengthening One Health preparedness in Europe, ECDC convened an expert consultation on 11–12 December 2017.
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