Technical brief by the H4+ (UNAIDS, UNFPA, UNICEF, UN Women, WHO and the World Bank)
Preliminary version for country introduction
Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris...k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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As detailed in MSF’s report Confronting the mental health emergency on Samos and Lesbos, the scale of the needs for mental healthcare and the severity of patients’ conditions have overwhelmed the capacity of mental health services on the islands.
4th edition 2022 of the Handbook includes new WHO recommendations that expand contraceptive choices. Also, guidance on starting ongoing contraception following emergency contraception is provided.
Drawing on lessons from recent outbreaks, this new edition details tangible me...asures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and the use of digital technologies by providers. It also expands guidance for women and young people at high risk of HIV.
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For each medicine the Formulary provides information on use, dosage, adverse effects, contraindications and warnings, supplemented by guidance on selecting the right medicine for a range of conditions
NEPAL CHILDREN’S EARTHQUAKE RECOVERY CONSULTATION - To better understand the consequences of the Nepal Earthquake for children, four child-centred agencies, in coordination with the Ministry of Federal Affairs and Local Development (MoFALD) and the Central Child Welfare Board (CCWB), conducted a C...hildren’s Earthquake Recovery Consultation using Focus Group Discussions (FGDs) with more than 1,800 girls and boys from the 14 most severely-affected districts. The objectives of the consultation were to hear directly from children the challenges they are facing in the aftermath of the earthquakes; to assess the impact of the crisis on their roles, responsibilities and future opportunities; and to seek their views on and recommendations for recovery.
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The Need for a Regional Response to an Unprecedented Migration Crisis.
This report provides an overview of where the more than 2 million Venezuelans who have left the country since 2014, at least half of them in the past year and a half alone, are now living, the conditions they face, their prospe...cts of obtaining legal status in the host countries, and applicable international standards that should guide host governments’ responses.
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Broken Links: Psychosocial support for people separated from family members (Training
module) and the corresponding Broken Links field guide are designed to support staff and
volunteers in a wide range of settings where they may be in contact with families who have
been separated from their loved... ones. The field guide and the training module outline the
causes and consequences of being separated from family members, as well as the types of
contact staff and volunteers might have with families affected by separation.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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All young people, including those with special needs and from the most vulnerable groups, have the right to quality health care services. Unfortunately, this right is not a reality, particularly in the case of sexual and reproductive health services. Many youth in need of sexual and reproductive hea...lth care may either decline or be denied access to health services for a variety of reasons: Providers are often biased and do not feel comfortable serving youth who are sexually active; youth do not feel comfortable accessing existing services because they are not "youth-friendly" and may not meet their needs; and, often, community members do not feel that youth should have access to sexual and reproductive health services.
To address provider and site bias toward serving youth, EngenderHealth created a training curriculum intended to sensitize all staff at a health care facility on the provision of youth-friendly services. The curriculum was created as a result of the participatory work that we have been doing with youth in Nepal to address the needs of all levels of providers at different service-delivery settings. The curriculum has been field-tested and used in Nepal, Russia, Mongolia, and the United States.
Youth-Friendly Services allows staff to reflect upon and assess their own beliefs about adolescent sexuality while ensuring that those values and attitudes do not compromise the basic sexual and reproductive health rights to which youth are entitled. The curriculum also helps providers understand cross-cultural principles of adolescent development and health needs specific to youth. Once participant knowledge, attitudes, and skills are improved, sites conduct a self-assessment on the youth-friendliness of their services and create an action plan for specific improvements.
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Miscellaneous
Chapter J.2
The aim of this handbook is to provide guidance for trained anaesthetists working for the ICRC and to offer advice in areas where practice will differ from that in their home country. It is designed to supplement the practical training given in ICRC war-surgery seminars and to support the work of th...e ICRC in war surgery
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Humanitarian emergencies and crises (Humanitarian emergencies and crises) are large-scale events that may result in the breakdown of health care systems and society, forced displacement, death, and physical, psychological, social and spiritual suffering on a massive scale. Current responses to Human...itarian emergencies and crises rightfully focus on saving lives, but for both ethical and medical reasons, the prevention and relief of pain, as well as other physical and psychological symptoms, social and spiritual distress, also are imperative. Therefore, palliative care, should be integrated into responses to Humanitarian emergencies and crises. The principles of humanitarianism and impartiality require that all patients receive care and should never be abandoned for any reason, even if they are dying. Thus, there is significant overlap in the principles and mission of palliative care and humanitarianism: relief of suffering; respect for the dignity of all people; support for basic needs; and accompaniment during the most difficult of times
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Report on ILGA-Europe/COC fact-finding mission
In many contexts, the safe delivery of health care services is challenged by the lack of respect for health care personnel who face insults, threats and violence. Consequences include the disruption of health services, high staff turnover in health facilities, high levels of stress impacting the qua...lity of the services and health care personnel being forced to flee. This manual intends to complement the existing training materials and is aimed at supporting staff in health care facilities to cope with stress and violent experiences, including how they can protect themselves by de-escalating potentially violent situations.
No publication year indicated
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