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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.
more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
...
e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus
EMTCT Global Validation Advisory Committee, Global HIV, Hepatitis and Sexually Transmitted Infections Programmes
World Health Organization WHO
(2021)
C_WHO
Validation of elimination of mother-to-child transmission, or vertical transmission, of HIV, syphilis and hepatitis B virus (HBV), is an attestation that a country has successfully met standard criteria for elimination, or for being at 1 of the 3 levels of achievement on the ‘Path to Elimination
...
while delivering quality services for women, girls and their children, through the life-course, respecting human rights and ensuring gender equality and community engagement.
This document, the third version, adds on EMTCT of hepatitis B virus (HBV), bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.
This document, the third version, adds on EMTCT of hepatitis B virus (HBV), bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.
more
This e-course will guide you through the essentials of latest existing WHO guidelines and policy recommendations on drug-resistant TB. You will also learn more about the rationale behind the WHO recommendations for the management of DR-TB, implementation considerations for different regimens for eli
...
gible patient groups, adjunctive treatment, the active TB drug safety monitoring and management framework, and the analysis and interpretation of performance indicators.
The main focus of the e-course is programmatic; clinical aspects are only discussed when relevant to specific topics.
more
Information note. In 2021, preliminary results of observational studies from the Community Access to Rectal Artesunate for Malaria (CARAMAL) project did not confirm the mortality impact observed in the controlled trial in 2009. Consequently, in January 2022, WHO released an information note on recta
...
l artesunate (RAS), suggesting immediate risk mitigation measures. To provide clarity on the evidence, WHO subsequently convened independent experts to conduct a formal evidence review of the data from the CARAMAL project, as well as data from other studies evaluating the deployment of pre-referral RAS at programmatic level
more
The Department of Health (DOH) has developed a National Integrated Sexual and Reproductive Health and Rights (SRHR) Policy.1 This policy addresses the many cross-cutting issues relating to SRH service provision, drawing together the principles, rights, and guidance for planning and implementation th
...
at underpin the provision of quality, comprehensive, and integrated SRHR services in South Africa. The National Integrated SRHR Policy is supported by several clinical and service delivery guidelines covering related programmatic
areas, including the National Contraception Clinical Guidelines.
more
This regional report on the situation of tuberculosis (TB) in the Americas contains information from 2019, provided by the countries of the Region through the World Health Organization TB data collection system. These data have been consolidated and analyzed at the regional level. In addition to pre
...
senting the epidemiological and programmatic situation of TB in the Americas, the report aims to raise awareness and to motivate and encourage all stakeholders in the prevention and control of this disease, to accelerate efforts towards TB elimination in the Region, and to achieve the targets of the End TB Strategy. The report records the Region's achievements, but also the gaps in the work being carried out in diagnosis, treatment, comorbidities, vulnerable populations, risk factors, and funding, among other issues. Based on the information presented, specific recommendations are provided for further progress.
more
The report also provides country-specific examples showing how direct engagement translated into the adoption of concrete measures, including national legislation and policies. Finally, the report presents key recommendations aimed at intensifying the actions of the international and the humanitaria
...
n communities and strengthening the programmatic response to better target and address the needs and vulnerabilities of all children living in situations of armed conflict.
Full Report and Fact Sheet available in English, French, Spanish and Arabic
more
On September 10, 2022, the Ministry of Health (MOH) announced a cholera outbreak in Aleppo governorate with 15 laboratory confirmed cases reported between August 25 and September 9, 2022. Activities under this plan seek to address the immediate needs stemming from this outbreak and highlight respons
...
e priorities across all areas of the response and key sectors involved. This plan initially focuses on the Health, Water Sanitation and Hygiene (WASH), and Risk Communication and Community Engagement (RCCE) responses for an initial period of 90 days. The activities detailed in this plan are also within the programmatic scope of the 2022-2023 Humanitarian Response Plan (HRP).
more
Getting on track to end AIDS as a public health threat by 2030. This new Road Map charts a way forward for country-level actions to achieve an ambitious set of HIV prevention targets by 2025. Those targets emerged from the 2021 Political Declaration on HIV and AIDS, which the United Nations General
...
Assembly adopted in June 2021 and they are underpinned by the Global AIDS Strategy (2021–2026). The Strategy sets out the principles, approaches, priority action area and programmatic targets for the global HIV response
more
No rumo certo para acabar com a SIDA como ameaca à saúde pública até 2030. This new Road Map charts a way forward for country-level actions to achieve an ambitious set of HIV prevention targets by 2025. Those targets emerged from the 2021 Political Declaration on HIV and AIDS, which the United N
...
ations General Assembly adopted in June 2021 and they are underpinned by the Global AIDS Strategy (2021–2026). The Strategy sets out the principles, approaches, priority action area and programmatic targets for the global HIV response
more
The new WHO guideline for control and elimination of human schistosomiasis: implications for the Schistosomiasis Elimination Programme in Nigeria
Akinola Stephen Oluwole, Uwem Friday Ekpo, Obiageli Josephine Nebe
Infectious Diseases of Poverty
(2022)
CC
Infectious Diseases of Poverty (2022) 11:111; With some 134,073,166 people living in endemic communities at risk of infection, Nigeria is the most endemic country in Africa and requires preventive chemotherapy (PC) for a total of 26.3 million persons. The National Schistosomiasis Elimination Program
...
me (NSCHEP), with the support of international partners, has been implementing PC in Nigeria since 2009 and most recently will need to revise its current strategy (Additional file 1). For example, the new World Health Organization (WHO) guideline has six key recommendations that will dramatically change the implementation of schistosomiasis elimination in endemic countries [3]. However, its impact and programmatic implications will vary from country to country, hence the need for a country-specific analysis. This article discusses these recommendations with specific reference to the challenges and opportunities in Nigeria. We summarise the key pointers in Additional file 1: Box 1 against the six recommendations of the WHO 2022 guideline.
more
Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn
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own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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Keeping communities at the centre of efforts to eliminate lymphatic filariasis: learning from the past to reach a future free of lymphatic filariasis
Krentel, A.; Gyapong, M.; McFarland, D.A.; Ogundahunsi, O.; Titaley, C.R.; Addiss, D.G.
Oxford Academic - International Health
(2021)
CC
Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestations of the disease. To achieve this, millions of c
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ommunity drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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Accessed on 31.03.2023
COUNTDOWN Nigeria has applied a Participatory Action Research (PAR) approach to improve equity of Mass Administration of Medicines (MAM) and inform Neglected Tropical Disease (NTD) policy through an enhanced community engagement strategy. A situational analysis conducted i
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n 2016 identified community engagement as a
bottleneck to achieving equitable coverage of MAM within different and emerging contexts (border, migrant, rural and urban) of Nigeria, related to programmatic, social, political and environmental changes over time See: (Dean et al., 2019), (Oluwole et al., 2019) and (Adekeye et al., 2019)
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The Pandemic Influenza Pandemic (PIP) Framework's Partnership Contribution (PC) High-Level Implementation Plan III (HLIP III) outlines the strategy for strengthening global pandemic influenza preparedness from 2024 to 2030. HLIP III takes into consideration the lessons learned from the response to t
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he COVID-19 pandemic, the gains made over time, including from previous HLIPs, and the broader programmatic and policy context in order to address gaps in pandemic influenza preparedness. Implementation of HLIP III will strengthen global, regional, and country-level pandemic influenza preparedness.
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PH
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C approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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The Seventy-fifth World Health Assembly through a decision on sustainable financing, adopted the recommendations of the Member States Working Group on Sustainable Financing, contained in Appendix 2 of the Working Group’s report to the Seventy-fifth World Health Assembly. As part of the recommendat
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ions, the Secretariat was requested to “explore the feasibility of a replenishment mechanism to broaden further the financing base, in consultation with Member States and taking into consideration the Framework of Engagement with Non-State Actors; and to present a report that includes relevant options for Member States to consider, to the Seventy-sixth World Health Assembly, through the 152nd session of the Executive Board and the thirty-seventh meeting of the Programme, Budget and Administration Committee in January 2023” (paragraph 39(f) of Appendix 2 of the Working Group’s report). In response to this request, the Secretariat reviewed the feasibility of a WHO replenishment mechanism in line with the principles set out by the Working Group on Sustainable Financing. It consulted with Member States through the work of the Agile Member States Task Group on strengthening WHO’s budgetary, programmatic and financing governance and benchmarked a set of replenishment mechanisms within and beyond the global health arena. This report outlines the Secretariat’s review and proposals on key elements of a potential WHO replenishment mechanism.
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The thirty-seventh meeting of the Programme, Budget and Administration Committee was held in Geneva from 25 to 27 January 2023 and chaired by Ms Aishath Rishmee (Maldives). The Committee adopted its agenda and agreed its programme of work. In his opening remarks, the Director-General emphasized the
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crucial work on the financial future of the Organization, most significantly implementation of the Programme budget 2022−2023 and development of the Proposed programme budget 2024−2025, which would be the first to benefit from the agreed increase in assessed contributions. He welcomed the work of the Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance with its recommendations for long-term improvements in reform, prevention of and response to sexual abuse and harassment, new web-based information portals and a new replenishment process for consideration by Member States. Efforts were also under way to improve impact at country level, and he would continue to report to Member States on progress. He was heading an agile, proactive and fast-responding WHO, committed to implementing plans approved by Member States.
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This document outlines the concept and content of the WHO people-centred approach to addressing antimicrobial resistance (AMR) in the human health sector. The proposed approach recognizes and aims to address the challenges and health system barriers people face when accessing health services to prev
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ent, diagnose and treat (drug-resistant) infections. It puts people and their needs at the centre of the AMR response and guides policy-makers in taking programmatic and comprehensive actions to mitigate AMR in line with a proposed package of core interventions. These interventions are based on a review of four pillars and two foundational steps that are critical to overcome barriers faced by people and health systems in addressing AMR.
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