INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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El Niño conditions persisting during the 2015/16 planting season have caused the worst drought in 35 years in Southern Africa, resulting in a second consecutive failed harvest. This has created severe food shortages and compounded existing vulnerabilities. Since July 2016, Namibia and Botswana have... declared national drought emergencies, in addition to the declarations made earlier by Lesotho, Malawi, Swaziland and Zimbabwe. Madagascar issued a letter of solidarity with the SADC Appeal, and Mozambique has maintained a red alert in affected areas.
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This guideline provides global, evidence-informed recommendations on the use of indicators for assessing a population’s
iron status and application of the use of ferritin concentrations for monitoring and evaluating iron interventions.
World's largest Science, Technology & Medicine Open Access book publisher
Chapter 7 from the book People's Movements in the 21st Century - Risks, Challenges and Benefits
The new guide provides practical, first-line management recommendations for mental, neurological and substance use conditions. Contents include modules on assessing and managing conditions such as acute stress, grief, moderate-severe depressive disorder, post-traumatic stress disorder, epilepsy, and... harmful use of alcohol and drugs.
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A handbook for leaders and managers
Meeting report
Geneva, 16-18 November 2016
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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IHME’s Financing Global Health report provides an overview of health spending around the world, with a special focus on investments in health in low- and middle-income countries. The report examines how this funding for health is changing each year and forecasts how it may change in the future. Fi...nancing Global Health examines where money for health originates and what health issues it funds.
This year, Financing Global Health 2023 looks at how interest payments on loans that many countries took out during the COVID-19 pandemic to keep their economies afloat and their people protected are now straining health budgets. It also details how development partners’ investments in health in low- and middle-income countries – development assistance for health – have changed since reaching historic levels during the COVID-19 pandemic, dropping by $19.4 billion between 2021 and 2023, from $84.0 billion to $64.6 billion.
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Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents, and children: recommendations for a public health approach : December 2014 supplement to the 2013 Consolidated guidelines on the use of antiretroviral drugs... for treating and preventing HIV infection.
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This report, which involved input from across WaterAid, in particular from the Programme Support Unit (PSU) of WaterAid UK, includes case studies from a variety of countries, including Bangladesh, Burkina Faso, Eswatini, Ethiopia, Ghana, India and Nepal, each demonstrating what must be done now to i...mprove WASH services and address current challenges, in order to increase community resilience to climate change.
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Since the beginning of the Ukraine crisis on 24 February 2022, WHO has supported Government-led efforts and initiatives alongside key partners on the ground. Building on efforts to date, and working alongside Bulgaria’s health authorities to bring added value to existing mechanisms, the WHO Countr...y Office Bulgaria, the WHO Regional Office for Europe and the WHO Health and Migration Programme, in close collaboration with the Ministry of Health of Bulgaria and key partners, undertook a joint review mission to support Bulgaria, with a focus on addressing the health system needs of refugees, migrants, asylum seekers and vulnerable host populations in Bulgaria.
The assessment team developed this report on the key findings and a package of potential interventions based on the opportunities identified and the need for technical support and assistance. The report summarizes concrete areas of work for which collaborations can be further strengthened. The joint review team identified key recommendations for consideration across 8 priority areas. The report and the outcomes of the review mission serve as a basis for future technical collaboration in the area of refugee health, to address the health needs of refugees and third-country nationals fleeing from Ukraine.
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