Noncommunicable diseases (NCDs) such as cancer, cardiovascular disease, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Kazakhstan. This report provides evidence through three analyses that NCDs reduce economic output and ...discusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs (direct and indirect costs) comprise 2.3 trillion tenge, equivalent to 4.5% of gross domestic product in 2017. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment. For example, the salt policy package achieved a benefit-to-cost ratio of 118.4 over 15 years, a return of more than 118 tenge for every 1 tenge invested.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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According to 2014 Census data, almost a third of the population in Myanmar do not have adequate identity and civil documentation. Of these, 54 percent are women.
Women who live in remote or conflict affected areas, who are displaced or belong to stateless ethnic and religious minorities face the... consequences of an insecure legal identity. They cannot enrol their children in school, open a bank account, travel freely or register land.
The report provides an analysis of the gender aspects of citizenship legislation in Myanmar and its application in light of the standards set by the UN Convention on the Elimination of Discrimination Against Women (CEDAW). It analyses in detail women’s ability to acquire citizenship on an equal basis as men, their ability to acquire, retain or confer citizenship following marriage and their ability to confer citizenship to their children. The report highlights the normative and practical challenges faced by women and proposes ways forward.
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Long-lasting insecticidal nets (LNs) constitute a core vector control intervention against malaria. A number of new LN products are under development and will require assessment of risks to humans. This document provides an updated generic model that can be used for the risk assessment of exposure t...o insecticides of individuals sleeping under LNs and during the washing of nets.
In an Annex, exposures and health risks are described for the conventional treatment or retreatment of nets (ITNs) with an insecticide considering that such practices may still be used in evaluation of ITNs and their use. The generic model does not include the risks associated with the manufacturing of LNs in a factory environment.
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A publication about girls escaping natural disasters and violent conflict in Eastern Africa
Children are on the move. In East Africa region, it is estimated that over 5 million children have migrated across borders or been forcibly displaced in their own country.
Forcable displacement is p...ushing more and more children out of their homes and communities, escaping the violence of war and conflict, only to fall vulnerable to other forms of violence. Girls are particularly vulnerable and need extra protection.
Every day, girls on the move in East Africa face a variety of rights violations, including:
• Exploitation and violence
• Being separated from their families
• Deprivation of essential services
• Use and recruitment by armed groups
• Sexual abuse
• Child marriage
This report highlights concerns that girls in eastern Africa face and calls on international and national decision makers to prevent and end violence that children face when they are forced to flee their homes.
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The National Institute for Transforming India (NITI) Aayog has developed the Composite Water Management Index (CWMI) to enable effective water management in Indian states in the face of extreme water stress. The Index and this associated report are expected to: (1) establish a clear baseline and ben...chmark for state-level performance on key water indicators; (2) uncover and explain how states have progressed on water issues over time, including identifying high-performers and under-performers, thereby inculcating a culture of constructive competition among states; and, (3) identify areas for deeper engagement and investment on the part of the states. Eventually, NITI Aayog plans to develop the index into a composite, national-level data management platform for all water resources in India.
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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise ...potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
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Cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancers, and other non-communicable diseases are among the leading causes of morbidity and mortality in low-income, middle-income, and high-income countries, and The Lancet Taskforce recently made the case for investing in non-...communicable disease prevention. Now, in The Lancet Planetary Health, Benjamin Bowe and colleagues report that exposure to PM2·5 air pollution is indeed a risk factor for diabetes.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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The objectives of pertussis surveillance are to:hmonitor disease burden and the impact of the pertussis vaccination programme, with a special focus on understanding the morbidity and mortality in children < 5 years of agehgenerate data to inform vaccine schedule and delivery strategy decisions to op...timize the impact of vaccinationhdetect and guide public health response to outbreaks of pertussis
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The guide is organized into the major types of toxicities, the associated symp-toms, possible offending medications, and the suggested nursing assessments and interventions. Some symptoms (e.g. nausea) may be associated with a num-ber of underlying causes and may be mild, or a symptom of... a more serious medical situation requiring urgent attention. The pathophysiology for medica-tion-related fatigue and hypersalivation are unclear and these symptoms are not grouped under a specific type of toxicity. Additional information (comments) are provided for each toxicity to highlight relevant clinical information that may assist in management of side effects. Medications more strongly associated with the side effect appear in bold text. The appendices include tools nurses can use to more thoroughly assess patient complaints of pain, depression and neuropathy.
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The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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Objective: The study aimed to describe the current epidemiological, clinical and immunological profile of newly
detected HIV - positive patients in Northern Benin by 2016. Methods: It was a prospective study conducted from May 2 to
October 31, 2016 on three main sites of care of people living with... HIV (PLHIV) in the department of Borgou in Benin. All
new cases of HIV infection have been systematically and comprehensively recruited. Initial epidemiological, clinical and
immunological data were collected using a questionnaire. These data were entered and analyzed using the Epi Info 7 software.
Results: In total, 185 adults (68 male and 117 female) newly screened HIV positive were included in this study. The middle age
was 36.2 ± 10.9 years and the sex ratio was 0.6 One hundred and thirty-five patients (73%) were between 25 and 50 years old.
In terms of the profession, 132 patients (71.3%) were engaged in liberal activities (craftmen, traders and retailers). The
majority was schooled (113 or 61.1%) and resided in urban areas (146 or 79%). One hundred and sixteen patients lived in
couple (62.7%) with an average monthly income estimated at 70 US Dollars. Clinically, 123 patients (66.5%) were in WHO
stage III. The body mass index was over 18.5 kg/m2 in 124 patients (67%). The median number of TCD4 lymphocytes was
254.5 cells/ml and 25 patients (13.5%) had a number of CD4 over 500 cells/ml. HIV1 was really predominant (97.8%). Most
patients (152 or 82.2%) had been screened for clinical suspicion. Conclusion: HIV infection in Benin remains the prerogative
of young, female, educated and poor people. Screening is delayed and hence the need to develop innovative strategies for early
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Annex 1: Measuring progress towards targets
Annex 2: Modelling the impact of the 90-(90)-90 strategy
Annex 3: Investment packages by country setting
Annex 4: Country strategies
Annex 5: Strategic frameworks for research and development for new tools
Annex 6 : Estimating the cost of the 90-(90)-...90 strategy
Accessed November 2017
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This guidance has been developed in line with the WHO corporate risk management framework, the WHO business continuity and contingency plans, as well as the Inter-Agency Emergency Response Preparedness Framework. It is based on a common organiza-tional approach and procedures for managing including ...emergency response across all hazards and at each level of the Organization. It relates WHO’s responsibilities (1) under the International Health Regulations (2005) and the Sendai Framework for Disaster Risk Reduction 2015-2030, and other international treaties; (2) as the United Nations’ lead agency for health and the health cluster; and (3) as a member of the United Nations or Humanitarian Country Teams
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В борьбе с туберкулезом достигнуты значительные прорывы, среди которых ускоренные и более точные методы диагностики и первые новые лекарственные средства за 50 л...т, однако сохраняется губительное отставание во внедрении этих нововведений в практику и обеспечения доступа к ним для уязвимых и социально ущемленных групп населения, в том числе заключенных, людей, живущих с ВИЧ, внутренних и внешних мигранты и наркопотребителей
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Zambia has about 1.2 physicians, nurses, and midwives per 1000 population while the minimum acceptable density threshold is 2.3 per 1000 population. The estimated shortage of doctors, nurses and midwives in Zambia is about 14,960. However, with the projected population growth the deficit more than d...oubles disproportionately to, 25,849 in 2020, and 46,549 in 2035, at the current rate of HRH production. Worryingly, the human resources for health crisis has persisted for over 20 years. The efforts before and leading up to the development and implementation of the 2013 – 2016 National Training Operational Plan (NTOP) and the National Human Resources for Health Strategic Plan (2011 – 2016) yielded certain achievements, however, the HRH numbers and skill-mix gap remained disturbingly enormous.
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To complement the Global Strategy progress reporting, this report provides a detailed look at country leadership and action toward the Every Newborn National Milestones by 2020. Countries have taken the initiative to show the way forward and have demonstrated significant progress. As part of monitor...ing this progress, countries have adopted the Every Newborn Tracking Tool. This report presents a compilation of the data collated by the Every Newborn Tracking Tool in 2016, when 51 countries adopted the tool; it also spotlights examples of specific country activity for each National Milestone. Finally, Global Milestones for 2020 were part of the Every Newborn Action Plan to guide global and regional work in support of country efforts and this report highlights relevant progress towards those Global Milestones.
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Glob Health Sci Pract; March 24, 2017, Vol. 5, No. 1, pp. 44-56