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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis
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B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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August 2020.
In December 2018, the President launched the UHC pilot covering four strategically selected counties-Isiolo, Kisumu, Machakos and Nyeri. It isplanned that by the year 2022, all persons in Kenya will be able to use the essential
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services they need for their health and wellbeing through a single unified benefit package, without the risk of financial catastrophe. Essential health products are considered an integral part of UHC andare an indispensable element for delivery ofservices andare also a requirement for qualitycare. Despite this realization, a review of the UHC pilot in September 2019 established that whereas the Kenya Medical Supplies Authority (KEMSA) was able to fill up to 80% of pharmaceutical items, the order fill rate for medical supplies was less than 50%for level 2 and 3 facilities and as low as 30%for level 4 and 5 facilities.
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The National AIDS Control Council recognizes the growing, organized and progressive inter-faith religious voice in the spheres of governance and development in Kenya. Across the country, the Faith Sector has been involved in HIV prevention, treatment, care and support to programmes towards
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the HIV response.On behalf of the board and the NACC family, I want to thank the Faith Sector Working Group (FSWG) and the Faith Religious Leaders for their contribution in HIV prevention by recognizing their comparative advantage in moulding behaviors among the various populations. We pride in your ability of being able to reach millions of Kenyans at any given time. This is the more reason why NACC wishes to sincerely thank you for working closely with us on the HIV response.We appreciate the Faith Sector support to the provision of HIV and health care services provision which has facilitated access to health services even in the remotest parts our country. The role played by the Religious Leaders in addressing stigma and discrimination as the greatest barrier to access of HIV and Health services by PLHIV and other vulnerable populations is well acknowledged.Finally, our gratitude goes to the theologians who participated in the development of the Faith Sector HIV messages booklet, which provides a tool to facilitate the Religious Leaders with knowledge to address the gaps in the HIV response among the congregants.
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This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and proven interventions in Latin American and Caribbean countries. Four areas of work are identified with the respective guidelines or suggestions for actio
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n, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
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This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and proven interventions in Latin American and Caribbean countries. Four areas of work are identified with the respective guidelines or suggestions for actio
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n, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources
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and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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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 servi
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ce provision, drawing together the principles, rights, and guidance for planning and implementation that 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.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control
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in these communities, it is necessary to respond to communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduc
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e clinical variability and, in essence, improve health and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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Noncommunicable diseases (NCDs) are responsible for 81% of all deaths in the region of the Americas, of which 34% befall prematurely in people between 30- 69 years old. The burden of theses diseases and their common risk factors jeopardize the health
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systems to provide adequate management, as well as to implement customized policies and interventions. The PAHO/WHO STEPwise approach to NCD risk factor surveillance (STEPS) is a simple, sequential, standardized method for collecting, analyzing, and disseminating data on key NCD risk factors in countries in adults from 18 to 69 years old. This survey covers key modifiable risk factors: tobacco use, alcohol use, physical inactivity, and unhealthy diet, as well as key biological risk factors: overweight and obesity, raised blood pressure, raised blood glucose, and abnormal blood lipids. STEPS is a household survey that gathers information on the risk factors through a face-to-face interview (step 1), simple physical measurements (step 2), and collection of urine and blood samples for biochemical analysis (step 3). Every step has a core set of questions, measurements, and expanded sets depending on the countries' needs and interests. It also has optional modules. Implementing STEPS allows the comparability of data within and between countries due to its standardized data collection. It also helps health services plan public health priorities and monitors and evaluates population-wide interventions. It is designed to help countries build and strengthen their capacity to conduct surveillance. STEPS captures 11 of the 25 indicators outlined in the NCD Global Monitoring Framework relating to 7 of the nine global targets.
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The purpose of this guide is to provide practical advice for health staff undertaking infectious disease preparedness and response activities to ensure that access to safe abortion care (SAC) is maintained when an infectious disease outbreak occurs.
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It is an operational guide which can serve to support health actors to maintain SAC services during outbreaks and ensure that necessary SAC considerations are integrated within outbreak responses; it is not a clinical guide. The locational focus of this document is humanitarian and fragile settings; however, recommendations may apply to infectious disease outbreaks in all low-resource populations. This guide is intended to complement Sexual and Reproductive Health and Rights During Infectious Disease Outbreaks: Operational Guidance for Humanitarian and Fragile Settings.
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Neonatal tetanus (NT), a severe newborn illness from the toxigenic strains of Clostridium tetani, persists in middle- and low-income countries due to non-sterile childbirth practices. Unlike smallpox and polio, tetanus cannot be eradicated: Clostridium tetani spores exist in the environment, and ani
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mal reservoirs. However, elimination as a public health issue is achievable through widespread tetanus vaccination, clean deliveries, and proper umbilical cord care. The goal of eliminating maternal and neonatal tetanus (MNT) as a public health problem is considered met when all municipalities in a country have an annual incidence rate of NT of less than 1 case per 1000 live births. The Region of the Americas achieved the maternal and neonatal tetanus elimination (MNTE) target in 2017 when elimination was validated in the Republic of Haiti. Yet maintaining this progress requires continued efforts. High vaccination coverage, booster doses in countries lacking them, hygienic practices, and strong maternal and child health services are key. The Pan American Health Organization’s (PAHO) integrated maternal and neonatal immunization platform further strengthens this fight against early childhood diseases.
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Rwanda Malaria Strategic Plan 2020–2024
Ministry of Health, Rwanda; Rwanda Biomedical Centre (RBC)
Ministry of Health, Republic of Rwanda
(2020)
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The Rwanda Malaria Strategic Plan 2020–2024 outlines Rwanda’s national strategy to reduce malaria morbidity and mortality by at least 50% compared to 2019 levels. The vision is a malaria-free Rwanda contributing to socioeconomic development.
The plan includes strengthening prevention through lo
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ng-lasting insecticide-treated nets, indoor residual spraying, and larval source management; ensuring universal access to testing and treatment; improving surveillance and data use; and enhancing program management, coordination, and financing. It also emphasizes community engagement and behavior change to ensure at least 85% of the at-risk population adopts protective practices.
The strategy builds on past lessons, involves multi-sectoral collaboration, and aligns with global malaria goals. It highlights equity, quality services, and evidence-based interventions as guiding principles, aiming to mobilize national and international resources for sustained impact.
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The Best Buys for Disease Elimination is a practical, evidence-based guide to the most effective actions for countries to implement in order to eliminate communicable diseases. The guide highlights the efficient use of resources and prioritizing populations in vulnerable situations.
“The Region
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of the Americas is advancing steadily towards the elimination of communicable diseases,” said Dr. Jarbas Barbosa, PAHO Director. “To achieve this, it is necessary to increase and sustain high vaccination coverage, engage communities to expand access to diagnosis and treatment, strengthen surveillance, and bring integrated services to marginalized communities, incarcerated populations, and those living in informal settlements,” he added.
For each disease and condition included in the Elimination Initiative, the Best Buys are presented as one-page documents with clear, accessible information. Each Best Buy summarizes expected impact goals, disease elimination targets, key operational indicators, and priority interventions that have proven to be cost-effective in different contexts.
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Nurses are key players in health promotion and disease prevention and the backbone of health care systems worldwide. Nurses work on the front lines of disease prevention,
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health promotion, and health management and are often the unsung heroes in health care facilities and emergency response. Despite the critical role they play in health care, there is a nursing shortage across the world that will affect the delivery of competent nursing care. This fact sheet highlights key action points for targeted investment in the nursing workforce and calls on Member States to strengthen nursing within the context of their own country efforts. Suggestions for action and strategies for strengthening the nursing workforce in primary health care services are through investment in education, jobs, leadership, and service delivery are provided.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid
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ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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Workplace Pandemic Preparedness. Training Manual
recommended
Ministry of Health Ghana; NADMO Ghana
GiZ Deutsche Gesellschaft für Internationale Zusammenarbeit
(2013)
C1
A training manual for identifying, assessing, preventing and controlling the risks of pandemics in the workplace. This training manual has been developed for both medical and non-medical personnel who may be called upon to lead emergency response, (eg epidemic outbreak, etc), ensure effective conta
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inment whiles work continues and essential goods and services continue to be supplied.
The manual provides insight into some of the local epidemics experienced in Ghana such as Cholera, Cerebrospinal meningitis (CSM) and Influenza(s), the causes, signs and symptoms and preventive measures with a view to increasing knowledge among management, staff and their families as well as immediate communities within which they work.
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PAHO has systematically identified and collected basic information on all investigations related to Zika, both those already published and those on track to be published.
Each study has been categorized in the areas of virus, vectors and reservoirs; epidemiology; disease pathogenesis and consequen
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ces of Zika infection; clinical management; public health interventions; health systems and services response; research and product development; and causality. You can also search by publication type: published articles, protocol and publication of preliminary results.
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The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the s
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ituation of health and well-being of older persons in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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Combination file of all the documents related to the national guidelines for accreditation, supervision and regulation of ART clinics in India. Documents included:
National Guidelines for Accreditation, Supervision & Regulation of ART Clinics in India | Preliminary Pages | Corrigendum | Chapter 1
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- Introduction, Brief history of ART and Requirement of ART Clinics | Chapter 2 - Screening of Patients for ART - Selection Criteria and Possible Complications | Chapter 3 - Code of Practice, Ethical Considerations and Legal Issues | Chapter 4 - Sample Consent Forms | Chapter 5 - Training | Chapter 6 - Future Research Prospects | Chapter 7 - Providing ART Services to the Economically Weaker Sections of the Society | Chapter 8 - Establishing a National Database for Human Infertility | Chapter 9 - Composition of the National Accreditation Committee | Bibliography
| Members of the Expert Group for Formulating the National Guidelines for Accredation, Supervision and Regulation of ART Clinics
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