To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management ...and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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The EiE Competency Framework builds on the INEE Minimum Standards to articulate a set of required, valued and recognized competencies for the humanitarian and education in the emergencies sectors. It broadly describes expected standards of performance across a number of competencies that can be appl...ied to different roles within an organization or sector. The framework provides a common lexicon for core humanitarian and technical competencies and defines expected knowledge, skills and attributes for each.
The framework is intended to inform staff recruitment, learning and professional development, performance management, planning, and organizational design. It is a sector-wide guidance to advance the accountability, effectiveness, and predictability of educational preparedness, response and recovery for affected populations.
The framework is primarily intended for use by EiE practitioners in humanitarian contexts. However, it is also relevant at the global level or in development settings in support of planning and emergency preparedness. It is best used in conjunction with the Core Humanitarian Competency Framework (CHCF) and where applicable, the Child Protection in Humanitarian Action (CPHA) Competency Framework. It is transferable across people, countries, and cultures and can be a valuable tool for entry-, mid-, and senior level professional development.
Available in English, Arabic, French, Portuguese and Spanish
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The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie...ty and other partners. The pivotal meeting sought to leverage political commitment, scientific innovation and community engagement to reshape the trajectory of malaria control in high burden African countries, and beyond.
At the end of the meeting and in the weeks that followed, Ministers of Health from the 11 “High Burden High Impact” African countries (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, Uganda and United Republic of Tanzania) signed the Yaoundé Declaration, pledging their “unwavering commitment” to the principle that “no one should die from malaria given the tools and systems available.” Success in reducing malaria morbidity and mortality will hinge on efforts by countries to translate this political commitment into actions and resources that will save lives.
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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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ajtmh.20-1538 Volume 104, 6. Mapping is a prerequisite for effective implementation of interventions against neglected tropical diseases (NTDs). Before the accelerated World Health Organization (WHO)/Regional Office for Africa (AFRO) NTD Mapping Project was initiated in 2014, mapping efforts in man...y countries were frequently carried out in an ad hoc and nonstandardized fashion. In 2013, there were at least 2,200 different districts (of the 4,851 districts in the WHO African region) that still required mapping, and in many of these districts, more than one disease needed to be mapped. During its 3-year duration from January 2014 through the end of 2016, the project carried out mapping surveysfor one ormore NTDs in at least 2,500 districts in 37 African countries. At the end of 2016, most (90%) of the 4,851 districts had completed the WHO-required mapping surveys for the five targeted Preventive Chemotherapy (PC)-NTDs, and the impact of this accelerated WHO/AFRO NTD Mapping Project proved to be much greater than just the detailed mapping results themselves. Indeed, the AFRO Mapping
Project dramatically energized and empowered national NTD programs, attracted donor support for expanding these programs, and developed both a robust NTD mapping database and data portal. By clarifying the prevalence and burden
of NTDs, the project provided not only the metrics and technical framework for guiding and tracking program implementation and success but also the research opportunities for developing improved diagnostic and epidemiologic sampling tools for all 5 PC-NTDs—lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma.
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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical man...ifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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The document "Combating False Information on Vaccines: A Guide for EPI Managers" is designed to help Expanded Program on Immunization (EPI) managers address vaccine misinformation. It begins by defining misinformation and explaining why it spreads rapidly, often due to its emotional appeal and simpl...istic explanations. The guide identifies common sources of vaccine misinformation, including influential individuals who profit from spreading false information. The document outlines strategies for combating misinformation, emphasizing the importance of EPI managers as trusted sources. It provides tips for identifying misinformation online, such as checking URLs, dates, and author credentials, and recognizing tactics like evoking strong emotions or pushing conspiracy theories. Two main approaches to fighting misinformation are discussed: prebunking and debunking. Prebunking involves warning individuals about potential misinformation before they encounter it, while debunking aims to correct false information after it has been consumed. The guide offers practical examples for both methods. Additionally, the document highlights the role of EPI managers in supporting health workers to trust immunization. It suggests being kind, nonjudgmental, and transparent when addressing concerns, and using motivational interviewing techniques to understand and respond to health workers' doubts. The guide also emphasizes the importance of creating a supportive environment for health workers, promoting pro-vaccine norms, and providing continuing education on vaccines. Overall, the guide aims to help EPI managers maintain trust in vaccines and provides comprehensive strategies to identify, address, and prevent the spread of vaccine misinformation in clinical and community settings. This document is necessary to equip EPI managers with the knowledge and tools to combat vaccine misinformation, support their teams, and promote trust in vaccines, ultimately protecting public health.
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The Feedback Starter-Kit responds to key questions ( ) and provides the most important tips ( ) for setting up and running a simple feedback mechanism. At the end of this document there is an overview of the templates needed to plan the mechanism and collect, answer, analyse and share community feed...back data. These templates contain the necessary basic elements to implement and run a feedback mechanism.
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