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The window to 2030, the SDG target year, is closing. Without accelerated and sustained progress, hard-won UHC gains risk being lost. Using revised and improved UHC indicators the report presents the latest available UHC data and concludes with a cal
...
l to shared action.
more
Operational requirements for implementing WHO recommendations in digital systems. 2nd edition.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health
...
and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems.
more
Int. J. Environ. Res. Public Health 2022, 19(4), 2359; https://doi.org/10.3390/ijerph19042359.
With improved access to antiretroviral treatment (ART), adults with HIV live longer to reach older age. The number of older adults living with HIV is increasing steadily, giving rise to
...
a new population of interest in HIV research and for invigorated considerations in health service delivery and policy. We analysed the profile of comorbidities in older people (50 years and older) living with HIV in South Africa.
more
he United Nations Development Programme’s (UNDP) Gender Equality Strategy 2022-2025 has
been created during turbulent times. Multiple crises and risks are threatening the world and
we are witnessing an alarming backlash against women’s rights and gender equality. Since the
COVID-19 pandemic h
...
it, women have been nearly twice as likely to lose their jobs compared to
men. Yet less than 20 percent of policy measures implemented by countries across the world have
addressed women’s economic insecurity. Gender inequality also takes a toll on men and other
affected groups. For men, rigid gender norms can fuel risky behaviours resulting in violence, poor
health, and lower life expectancy.
more
BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022 (2025 interim update)
The purpose of the 2025 interim update of the guidelines was to update our recommendations based on new evidence since the last update, including: (i) incorporating new evidence related to injectable therapy including frequency of viral load monitoring and use of long-acting cabotegravir/rilpivirine
...
in non-virally suppressed people; (ii) removal of abacavir from first-line recommendations for most and a recommendation to switch away from abacavir where clinically appropriate; (iii) removal of the CD4 caveat for first-line dolutegravir/lamivudine use; (iv) updated recommendations for people with NRTI resistance. These changes, with the supporting evidence, are highlighted in green.
more
This 5th Edition of the Malawi Guidelines for Clinical Management of HIV in Children and Adults is implemented from January 2022. It replaces all previous editions of the Malawi Antiretroviral therapy (ART) and Prevention of Mother to Child Transmission (PMTCT) guidelines.This document is written fo
...
r medical doctors, clinical officers, medical assistants, nurses, midwives, laboratorians, health surveillance assistants (HSAs) and medical records clerks who are working in public and private sector health facilities in Malawi. It is designed to be a practical guide for implementation of integrated HIV Services
more
Hygiene Awareness Manual (Arabic) - GIZ
recommended
The "Hygiene Awareness Manual" focuses on promoting improved hygiene practices within communities, emphasizing personal and household hygiene, water safety, and environmental health. It highlights the importance of handwashing, oral hygiene, and maintaining cleanliness of the skin and clothing as ke
...
y aspects of personal and family hygiene. Specific practices such as regular bathing and wearing clean clothes are also emphasized.
For household hygiene, the manual provides guidance on safe food preparation and storage, as well as keeping living spaces, kitchens, and latrines clean to prevent contamination. It also addresses water safety, emphasizing the need to store water in clean containers, treat it for safe consumption, and dispose of wastewater properly to avoid environmental contamination.
The manual underscores the significance of balanced nutrition and food safety, offering guidelines for cooking and preserving food to reduce health risks. It also delves into disease prevention, explaining the causes and transmission of waterborne and hygiene-related diseases, such as cholera and dysentery, and outlining effective methods to prevent them through proper sanitation and hygiene.
This comprehensive guide serves as a practical resource for community health workers and households, aiming to foster better hygiene practices, prevent diseases, and enhance overall health and well-being.
more
In der ALMHAR-App erhalten Betroffene auf Farsi, Englisch oder Arabisch Aufklärung über psychische Symptome, wie Angstzustände, Stresssituationen, Schlafprobleme und Aggressionen.
Die Projektidee entwickelte sich aus der gestiegenen Nachfrage im Zuge der hohen Anzahl belasteter Geflüchteter aus
...
Kriegsgebieten. Es gibt einen großen Bedarf insbesondere an arabischsprachigen psychoedukativen Angeboten. ALMHAR bietet Übungen, die selbständig bearbeitet oder in die laufende therapeutische Arbeit eingebunden werden können
(verfügbar auf: English | العربية / Arabisch | فارسی / Farsi)
ALMHAR is designed for refugees who had to flee from their homes and who are may be living in exile.
Fleeing your home is an incredibly overwhelming, frightening and life-changing experience. Many refugees who had to leave their homes and countries develop some sort of emotional or physical problems due to their experiences. If this is the case for you, it does not mean you are weak or crazy. Such problems are mostly normal reactions of normal people to abnormal experiences!
The app explains the most common emotional problems you might experience as a refugee and offers first support in dealing with them. It offers background information on 12 common problem areas and gives practical and easy to-do tips.
more
Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
...
These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
more
Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los
...
años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
more
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin
...
shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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El objetivo de esta nota conceptual y del marco que describe es la eliminación de un grupo de enfermedades transmisibles y los efectos negativos sobre la salud que generan que juntos crean una carga tangible en las personas afectadas, sus familias y comunidades, y en los sistemas de atención de sa
...
lud en toda la Región. Aunque no hay consenso sobre las mejores medidas que se deben usar para la salud de las personas y de acuerdo con la situación epidemiológica de un país, es habitual medir la carga de enfermedad mediante las tasas de enfermedad (incidencia, prevalencia, etc.), las tasas de mortalidad por enfermedad específica, las tasas de morbilidad y mortalidad comparativas, la distribución geográfica y los años de vida ajustados en función de la discapacidad (AVAD)…. Se analiza la situación epidemiológica actual, incluidos los datos sobre tasas de enfermedad o distribución geográfica para las enfermedades del cuadro 1. Hotez et al. (2008) fueron los primeros en examinar y comparar la carga de los AVAD en América Latina y el Caribe para las ETD, la infección por el VIH/sida, la malaria y la tuberculosis como era hace unos diez años atrás. Aunque la carga regional de tuberculosis, malaria y enfermedades infecciosas desatendidas (EID) es algo menor a la de hace diez años, se sigue perdiendo la posibilidad de trabajar (y de asistir a la escuela) debido a la enfermedad y muerte prematura o discapacidad, y la necesidad de acelerar los esfuerzos para eliminar las enfermedades es evidente en todas las comunidades en situación de vulnerabilidad.
more
What is high blood pressure in pregnancy?
Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure
...
in pregnancy:
Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.
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Background: Data on burden of peripheral artery disease (PAD) and its attributable risk factors are valuable for policymaking. We aimed to estimate the burden and risk factors for PAD from 1990 to 2019.
Methods: We extracted the data on prevalence, incidence, death, years lived with disability (YLD
...
s), and years of life lost (YLLs) from the Global Burden of Disease Study 2019 to measure PAD burden. Moreover, the attributable burden to PAD risk factors was also estimated.
Results: Globally, in 2019, 113,443,017 people lived with PAD and 10,504,092 new cases occurred, resulting in 74,063 deaths, 500,893 YLDs, and 1,035,487 YLLs. The absolute numbers of PAD prevalent and incident cases significantly increased between 1990 and 2019, contrasting with the decline trends in age-standardized prevalence and incidence rates. However, no statistically significant changes were detected in the global age-standardized death or YLL rates. The burden of PAD and its temporal trends varied significantly by location, gender, age group, and social-demographic status. Among all potentially modifiable risk factors, age-standardized PAD deaths worldwide were primarily attributable to high fasting plasma glucose, followed by high systolic blood pressure, tobacco, kidney dysfunction, diet high in sodium, and lead exposure.
Conclusion: PAD remained a serious public health problem worldwide. More strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors should be carried out, especially in regions with high or increasing burden.
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance
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r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee
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ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Chi
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ldhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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Malaria and HIV, two of the world’s most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategie
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s of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%–47.5% overall. Prevalence was 0.7%–47.5% in nonpregnant adults, 1.2%–27.8% in children, and 0.94%–37% in pregnant women. MHC was associated with an increased frequency of clinical parasitemia and severe malaria, increased parasite and viral load, and impaired immunity to malaria in nonpregnant adults, children, and pregnant women, increased in placental malaria and related outcomes in pregnant women, and impaired antimalarial drug efficacy in nonpregnant adults and pregnant women. Although a few cases of adverse events have been reported in coinfected patients receiving antimalarial and antiretroviral drugs concurrently, available data are very limited and have not prompted major revision in treatment guidelines for both diseases. Artemisinin-based combination therapy and cotrimoxazole are currently the recommended drugs for treatment and prevention of malaria in HIV-infected children and adults. However, concurrent administration of cotrimoxazole and sulfadoxine–pyrimethamine in HIV-infected pregnant women is not recommended, because of high risk of sulfonamide toxicity. Further research is needed to enhance our understanding of the impact of malaria on HIV, drug–drug interactions in patients receiving antimalarials and antiretroviral drugs concomitantly, and the development of newer, safer, and more cost-effective drugs and vaccines to prevent malaria in HIV-infected pregnant women.
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This course has two main goals. The first is to provide an introduction to key sexual and reproductive health issues of youth, including the relationship between gender norms and health. The second is to present an overview of the best programmatic approaches for improving young people’s sexual an
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d reproductive health - See more at: http://www.globalhealthlearning.org/course/youth-sexual-and-reproductive-health-update#sthash.hWLzTUQt.dpuf
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Counseling d’une cliente souffrant de la fistule traumatique. Supplément
EngenderHealthFistuale Care
(2012)
Un supplément du curriculum de counseling sur la fi
stule obstétricale
