Health Systems in Transition. Vol. 5 No.3 2015
The use of the World Health Organization Health System Performance Assessment Framework
Antimicrobials are medicines, including antibiotics, antivirals, antifungals, and antiparasitics, that are used to prevent and treat infections in humans, animals, and plants. Antimicrobial Resistance (AMR) arises when bacteria, viruses, fungi, and parasites no longer respond to these medicines, ren...dering them ineffective and making infections more difficult to treat. This resistance increases the risk of disease spread, severe illness, disability, and death. Although AMR is a natural phenomenon driven by genetic
changes in pathogens, it is significantly accelerated by human activities such as the misuse and overuse of antimicrobials in healthcare, agriculture, and animal husbandry.
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Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph ...of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicat...ed, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting.
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The Demographic Dividend study on Rwanda assessed the socio-economic and human development potential of our country in the short, medium and long-term period using a comprehensive approach. It generated relevant policy and programme information to guide a well-informed polciy required to propel Rwan...da towards achieving its aspirations of being high middle income country by 2035 and high income country by 2050.
The primary objectives of this study were to assess Rwanda’s prospects for harnessing the demographic dividend and demonstrate priority policy and programme options that the country should adopt in order to optimise its chances of earning a maximum demographic dividend in the context of its youthful population and medium, long-term socio-economic development aspirations.
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The Event-based Surveillance Framework is intended to be used by authorities and agencies responsible for
surveillance and response. This framework serves as an outline to guide stakeholders interested in implementing
event-based surveillance (EBS) using a multisectoral, One Health approach. To ...that end, the document is arranged
in interlinked chapters and annexes that can be modified and adapted, as needed, by users.
This is a revised version of the original “Framework for Event-based Surveillance” that was published in 2018. This
framework does not replace any other available EBS materials, but rather builds on existing relevant or related
documents and serves as a practical guide for the implementation of EBS in Africa. This framework is aligned with
the third edition of the WHO Joint External Evaluation for the following indicators: strengthened early warning
surveillance systems that are able to detect events of significance for public health and health security (Indicator
D2.1); improved communication and collaboration across sectors and between National, intermediate and local
public health response levels of authority regarding surveillance of events of public health significance (Indicator
D2.2); and improved national and intermediate-level capacity to analyse data (Indicator D2.3). As countries begin
to implement and demonstrate EBS functionality they will ensure an increase in JEE scores and progress towards
meeting the requirements outlined in the IHR3F
Additionally, in African Union Member States that have adopted the Integrated Disease Surveillance and
Response (IDSR) strategy, this document is a complement to and can enhance the implementation of IDSR,
especially for the 3rd edition (2019) that includes components related to EBS.
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Needs assessment is essential for programme planning, monitoring and evaluation, and accountability, however needs assessment is still a critical weakness of humanitarian response. Organisations need to improve how they do assessments. The Assessment Capacities Project (ACAPS) and the Emergency Capa...city Building Project (ECB) have produced this guide to fill the gap that existed for a practical resource that pulls together the main lessons learned from various initiatives and experiences.
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Global HIV Strategic Information Working Group
A national overview with a case study from Cam Le district
The overall aims of this study are (1) to assess the extent to which social protection systems in Vietnam address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, ...in the design and delivery of social protection for people with disabilities. As most social protection programmes in Vietnam are targeted to various vulnerable groups (e.g. orphans, widows, single parents), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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A national overview with a case study from Tanahun district. The overall aims of this study are (1) to assess the extent to which social protection systems in Nepal address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, in th...e design and delivery of social protection for people with disabilities. As most social protection programmes in Nepal are targeted to various groups considered to be a high risk of poverty or marginalisation (e.g. orphans, widows), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at
risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have
consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health.
In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to
213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals
per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more
Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
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Guide de mise en œuvre à l’intention des Sociétés nationales de la Croix-Rouge et du Croissant-Rouge
The checklist tool described in this handbook is intended for EU/EEA public health authorities who need to assess the capacity for communicable disease prevention and control at migrant reception/detention centres hosting migrants for weeks/months (medium-term) in order to identify gaps and set prio...rities for development.
Using this tool, the aim is to monitor and support capacity development to prevent the onset and improve the management of communicable disease outbreaks at medium-term migration reception/detention centres, both on a day-to-day basis and in the event of a sudden influx of migrants.
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