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This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes im
...
plementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
more
WHO-OHCHR launch new guidance to improve laws addressing human rights abuses in mental health care
Ahead of World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) are jointly launching a new guidance, entitled "Mental health, h
...
uman rights and legislation: guidance and practice", to support countries to reform legislation in order to end human rights abuses and increase access to quality mental health care.
Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common. Involuntary hospitalization and treatment, unsanitary living conditions and physical, psychological, and emotional abuse characterize many mental health services across the world.
more
In In recent years, China has increased its international engagement in health. Nonetheless, the lack
of data on contributions has limited efforts to examine contributions from China. Existing estimates that track
development assistance for health (DAH) from China have relied primarily on one data
...
set. Furthermore, little is known
about the disbursing agencies especially the multilaterals through which contributions are disbursed and how these
are changing across time. In this study, we generated estimates of DAH from China from 2007 through 2017 and
disaggregated those estimates by disbursing agency and health focus area.
more
Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information
on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of
aid. The purpose of this study was to analyse official developm
...
ent assistance (ODA) for reproductive health activities in
conflict-affected countries from 2003 to 2006.
Methods and Findings: The Creditor Reporting Syst
more
The COVID-19 pandemic has been the biggest disaster in living memory, on almost any measure. More than 6.5 million people are confirmed to have died in less than three years, and the pandemic’s indirect impacts have touched the lives of virtually every community on the planet.
Our World Disasters
...
Report 2022 focuses on the coronavirus pandemic and preparedness: both the ways preparedness ahead of COVID-19 was inadequate, and how the world can prepare more effectively for future public health emergencies.
more
People affected by impairments and disabilities associated with TB are even more likely to belong to marginalized segments of society and are more likely to have their human rights unprotected. The challenges faced by people affected by TB include the consequences of impairment and disability associ
...
ated with the disease, its treatment as well as with the stigma and discrimination applied to people affected by TB. There is now compelling evidence that the disease and its treatment affect quality of life and life expectancy even after successful treatment.
The WHO Global Tuberculosis Programme has produced the first policy brief on TB-associated disability, building on the increasing evidence in recent years on the unaddressed needs of people with TB who experience impairment and disability while on TB treatment and after completing TB treatment.
more
This document presents the World Health Organization Operational framework for building climate resilient and low carbon health systems*. ***The framework's goal is to increase the climate resilience of health systems to protect and improve the health of communities in an unstable and changing clima
...
te, while optimizing the use of resources and implementing strategies to reduce GHG emissions. It aims to contribute to the design of transformative health systems that can provide safe and quality care in a changing climate.
Implementation of the framework's ten components would help health organizations, authorities, and programmes to be better able to anticipate, prevent, prepare for, and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes. Implementing low carbon health practices would contribute to climate change mitigation while also improving health outcomes. Achieving these aims is an important contribution to universal health coverage (UHC), global health security, and specific targets within the Sustainable Development Goals (SDGs). The document is a useful resource for decision-makers in health systems, including public health agencies, and other specialized institutions, and for decision-makers in health-determining sectors.
more
The Disaster Recovery Framework (DRF) Guide for the Health Sector provides guidance on how to implement a comprehensive, integrated, and structured approach to disaster recovery. Its overarching goal is to minimize the impact of the disaster on communities and help countries to recover quickly and e
...
ffectively from disasters, in coordination with key stakeholders.
The DRF Guide for the Health Sector is adapted from the generic DRF Guide, and draws on the Implementation Guide For Health Systems Recovery in Emergencies, the Health Emergency and Disaster Risk Management Framework as well as the Disaster Recovery Guidance Series. The guide also makes links with multi-sectoral, government-led recovery planning processes such as the Post-Disaster Needs Assessment (PDNA), and it supports the implementation of the HDPN.
more
Zimbabwe has, over the years, grappled with the repercussions of the climate crisis, which have led to erratic rainfall patterns characterized by either severe floods or prolonged periods of drought. The nation has experienced a concerning trend of numerous regions reporting rainfall levels below th
...
e usual during what should be "normal" years. The upcoming El Niño event forecasted for 2023-2024, which is associated with drier-than-average rainfall, is poised to exacerbate this predicament. It is expected to intensify aridity, significantly impacting food and animal production across many areas, including those typically classified as "dry regions."
more
Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20·0%; domestic financing is therefore critical to sustaining the response to HIV/AIDS. To understand whether domestic resources could fill the financing gaps created by declines in development assistance, we aimed to track spe
...
nding on HIV/AIDS and estimated the potential for governments to devote additional domestic funds to HIV/AIDS.
more
Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t
...
reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector
...
al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
Background
Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death.
Methods
This review is based on articles retrieved by a selective search in PubMed, as well as on r
...
elevant guidelines.
Results
Evidence-based treatment options are available only for congestive heart failure with a low ejection fraction. Pharmacotherapy is based on neurohumoral inhibition of the renin-angiotensin-aldosterone system and the adrenergic system. The prognosis of patients with this condition has been further improved recently through the introduction of combined angiotensin receptor antagonists and neprilysin inhibitors. Modern implantable devices are a further component of treatment. Implantable defibrillators and special pacemakers for cardiac resynchronization are well established; the utility of alternative devices (baroreflex modulation or cardiac contractility modulation) needs to be investigated in further studies. It was recently shown that the catheter-based treatment of secondary mitral regurgitation with a MitraClip improves the outcome of selected patients.
Conclusion
The treatment of chronic systolic heart failure as recommended in the relevant guidelines, with drugs and implanted devices if indicated, can significantly improve the clinical outcome.
more
A global Pandemic, Preparedness and Response (RRR) architecture
In April 2020, Gavi and COVAX joined the Access to COVID-19 Tools Accelerator (ACT-A) to provide equitable global access to COVID-19 vaccines to tackle the pandemic. In June 2020, the Gavi COVAX Advance Market Commitment (AMC) was launched to finance equitable access in 92 lower-income countries. Si
...
nce then, US$ 10 billion has been raised for the AMC to procure vaccines and support delivery. Despite a challenging supply situation, COVAX has now shipped one billion doses to 144 countries, including over 870 million to AMC economies.
more
This report provides an analysis of donor government funding to address the HIV response in low- and
middle-income countries in 2022, the latest year available, as well as trends over time. It includes both
bilateral funding from donors and their contributions to the Global Fund to Fight AIDS, Tub
...
erculosis and
Malaria (Global Fund), UNITAID, and UNAIDS. Overall, the analysis shows that while donor government
funding for HIV increased between 2021 and 2022, this was primarily due to the timing of payments from
the U.S. government and not actual increases in commitments.
more
Donor government disbursements to combat HIV in low- and middle-income countries totaled US$8 billion in 2018, little changed from the US$8.1 billion total in 2017 and from the levels of a decade ago, finds a new report from the Kaiser Family Foundation (KFF) and the Joint United Nations Programme o
...
n HIV/AIDS (UNAIDS)
more
The annual Development Co-operation Report brings new evidence, analysis and ideas on
sustainable development to members of the OECD Development Assistance Committee (DAC) and the international community more broadly. The objectives are to promote best practices and innovation in development co-ope
...
ration and to inform and shape policy reform and behaviour change to realise better lives and the Sustainable Development Goals for all
more
Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and
...
outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
more
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu
...
ral practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
more
