Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is... intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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The Third Rwandan Health Sector Strategic Plan (HSSP III) provides strategic guidance to the health sector for six years, between July 2012 and June 2018. HSSP III has been inspired and guided by the VISION 2020, which will make Rwanda a lower-middle-income country by 2020; the Rwandan Health Policy... of 2004; and the priorities set out by the Economic Development and Poverty Reduction Strategy (EDPRS 2008–2012).
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –... are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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The aim of the Technical Brief is to offer guidance to education professionals on how to integrate Mental Health and Psychosocial Support into Education in Emergencies programming. An overview of Mental Health and Psychosocial Support activities that can be implemented in Education in Emergencies co...ntexts is detailed, in line with the MHPSS Minimum Service Package. Country examples and case studies are featured.
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Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co...ncept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
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Benchmarking is a strategic process often used by businesses and institutes to standardize performance in relation to the best practices of their sector. The World Health Organization (WHO) and partners have developed a tool with a list of benchmarks and corresponding suggested actions that can be a...pplied to implement the International Health Regulations 2005 (IHR) and strengthen health emergency prevention, preparedness, response and resilience capacities.
The first edition of the benchmarks was published in 2019 to support countries in developing, implementing and documenting progress of national IHR or health security plans (e.g. national action plan for health security (NAPHS), national action plan for emerging infectious diseases, public health emergencies and health security and other country level plans for health emergencies). The tool has been updated to incorporate lessons from COVID-19 and other health emergencies, to align with the updated IHR monitoring & evaluation framework (IHR MEF) tools and the health systems for health security framework, and to support strengthening health emergency prevention, preparedness, response and resilience (HEPR) capacities and the Preparedness and Resilience for Emerging Threats (PRET) initiative.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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his publication provides an overview of social inequalities in several indicators related to the health of women, children, and adolescents in a region deemed as one with high levels of inequality: Latin America and the Caribbean (LAC). In order for it to serve as a baseline for the 2030 Agenda, emp...hasis is placed on examining these inequalities around the year 2014. The analysis suggests that reducing within-country disparities is a priority, as widespread social inequalities in health are identified among LAC countries.
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding..., knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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The recurrence of severe climate events combined with economic, social, and institutional fragilities leave El Salvador in an utterly critical humanitarian situation and highly vulnerable. Located in a disaster-prone subregion, El Salvador is among the 20 countries at the highest risk of disasters w...orldwide. The successive hydrometeorological hazards that impacted El Salvador over the past two years include tropical storms Amanda and Cristóbal and hurricanes Eta, Iota, and,
more recently, Julia. These storms profoundly affected the lives and livelihoods of almost 900 000 people and significantly disrupted health services, especially at the first level of care. In addition, the country’s exposure to earthquakes, floods, and droughts is also constant. Infrastructural and institutional limitations to deal with emergencies and
low capacity to respond to adverse events are an additional challenge, which leaves the population—particularly the most vulnerable—at even higher risk.
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Hand hygiene is vital for safe health care delivery, yet practices at the point of care remain suboptimal worldwide. A comprehensive research agenda is therefore necessary to improve our understanding of factors influencing hand hygiene behaviour and to strengthen appropriate interventions. This age...nda will provide insightful ideas for researchers to focus their projects and funding proposals and will direct donors towards the areas of hand hygiene evidence that require urgent support and innovation. It will also guide decision-makers and stakeholders at the national and international level and support country efforts in updating and strengthening hand hygiene promotion programmes. Global collaboration and investment in hand hygiene research remain essential to promote safe and effective care worldwide.
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Myanmar continues to experience a severe - and worsening - humanitarian and human rights crisis. Conflict and violence have escalated across the country, impacting children and their families and displacing more than 1.5 million people. Access of conflict-affected populations to services and deliver...y of humanitarian assistance has been further constrained by restrictions imposed on movement of both people and goods.
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The world is not on track to end the AIDS pandemic. New infections are rising and AIDS deaths are continuing in too many communities. This report reveals why: inequalities are holding us back. In frank terms, the report calls the world’s attention to the painful reality that dangerous inequalities... are undermining the AIDS response and jeopardising the health security of everyone. The report highlights three specific areas of inequality for which concrete action is immediately possible—gender
inequalities and harmful masculinities driving HIV; marginalisation and criminalisation of key populations, which our data show is resulting in starkly little progress for those populations and undermining the overall response; and
inequalities for children whose lives must matter more than their market share. But this is not a counsel of despair, it is a call to action. Through bold action to confront these inequalities, we can end AIDS.
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The World Health Organization Regional Office for Africa (WHO AFRO), in accordance with recommendations from various WHO committees, has developed three flagship programmes to support Member States in the African region to prepare for, detect and respond to public health emergencies. They are the re...sult of extensive consultations with more than 30 African government ministers, technical actors, partners across the continent as well as regional institutions such as the Africa Centres for Disease Control and Prevention (Africa CDC), whose contributions have shaped the priority activities. This report provides the second quarterly summary of progress in implementing the flagship programmes.
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Constituting the second part of the World Drug Report 2022, the present booklet contains an overview of the global demand for and supply of drugs.
The first chapter of the booklet begins with the latest estimates of the number of people who use drugs, the distribution of those users by type of drug...s, age and sex, and recent trends in the use of drugs. The chapter also reviews the impact of the coronavirus disease (COVID-19) pandemic on drug use patterns and service provision. Other issues examined in the chapter are the health consequences of drug use, including the number of people in treatment for drug use disorders and the extent of drug injecting and of HIV and hepatitis C among people who inject drugs. The chapter concludes with a review of the extent to which strategies, policies and interventions are in place to respond to the drug use problem.
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A full-scale military attack (invasion) of Ukraine was started by Russia in the night of February 23/24, 2022. Cities, towns and other targets in all regions of Ukraine have been shelled or attacked with rockets, and columns of military vehicles have been invaded the country from three directions (n...orth, east and south). Fighting continues across all regions with Russian forces capturing cities along the south coast but facing tougher resistance in the northern parts of the country. Residential areas in cities such as Kharkiv, Kyiv and Mykolaiv have been shelled and destroyed, with many lives have been lost. Ongoing negotiations between the governments of Ukraine and Russia have yielded no results in bringing a ceasefire or end to the conflict.
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Modelling the health impacts of disruptions to essential health services during COVID-19 Module 1
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVI...D-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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Yemen remains the world’s worst humanitarian crisis with staggering levels of humanitarian need. Eighty per cent of the population – 24.1 million people – need some form of humanitarian assistance. Economic decline, restrictions on imports, shortages of foreign exchange and liquidity, and fluc...tuations in the value of the currency continues to put millions of people at risk of famine. Key assessments remain blocked, complicating efforts to adjust programmes based on the latest evidence. This makes it difficult to know with certainty whether there are large pockets of unmet needs across the country.
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This document, endorsed by the WHO Strategic Advisory Group of Experts on Immunization, provides guiding principles to support countries in their decision-making regarding provision or resumption of immunization services during severe disruptive events such as COVID-19, natural disasters or humanita...rian emergencies. It incorporates the Immunization Agenda 2030 principles of being people-centred, country-owned, partnership-based and data-guided.
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Against the backdrop of the COVID-19 pandemic, health is receiving unprecedented public and political attention. Yet the fact that climate change also presents us with a health crisis deserves further recognition. From more deaths due to heat stress to increased transmission of infectious diseases, ...climate change affects the social and environmental determinants of health in ways that are profound and far-reaching. The fundamental interdependency of human health and the health of the environment is encapsulated in the concept of planetary health, a scientific field and social movement that has been gaining force since the 2015 publication of the Rockefeller Foundation-Lancet Commission report “Safeguarding human health in the Anthropocene epoch”.
We see an urgent need for strategic communication to raise awareness of climate-health synergies in order to overcome the misperception that climate and health are two independent agendas. The fragmented and sector-focused nature of thinking and action remains a significant barrier to integrating health considerations into climate planning and project development. Inevitably, collaboration across sectors requires a community of practice. Despite recent efforts focused on the climate-health nexus, much work remains to be done to translate scientific findings for policymakers, mobilise climate financing resources in support of health co-benefits, and promote genderjust solutions within climate change projects.
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