The policy brief focuses on four key areas for intervention - air pollution, energy, transport and food systems. Air pollution causes 7 million deaths annually, and is a leading cause of both NCDs and climate change, thus all interventions to reduce air pollution have a positive impact on both human... and planetary health. In the energy sector, transition from fossil fuels to renewable energy is if vital importance to improving health, with mortality rates due to coal-generated electricity 1,000 times higher than for wind-generated electricity.
Promoting active transport such as walking and cycling in place of motorised transport has the dual benefit of reducing both air pollution and physical activity. Livestock production alone accounts for 18% of greenhouse gas emissions, with added emissions from food which are highly process and transported over long distances, and thus locally sourced plant based diets both prevent NCDs and promote human and planetary health.
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population wa...s very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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The following Emergency Response Plan for the COVID-19 pandemic seeks to set out activities that will be undertaken by humanitarian actors in Ukraine over the course of 2020 to respond to the public health impact of the epidemic – as well as the indirect, socio-economic impact on people’s well-b...eing, which will span across many areas. Given the extensive public exposure of the COVID-19 threat, the response will cover the whole of Ukraine, while providing a distinct focus on Donetska and Luhanska oblasts that have been ravaged by an armed conflict for the last six consecutive years. The planned COVID-19 response in the two conflict-affected oblasts will be treated as an annex to the current Humanitarian Response Plan for Ukraine
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt...ing a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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The development of the Country Cooperation Strategy (CCS) was based on a consultative and participatory process with strong commitment and support from the Ministry of Health of Ghana. The CCS draws on lessons from the implementation of the first, and second generation CCSs, the country focus strate...gy, and the United Nations Sustainable Development Cooperation Framework (2023–2025).
The strategic agenda of the CCS outlines three strategic priorities, which are:
1. improving universal access to essential health services through the primary health care approach.
2. health emergency preparedness and response: addressing gaps in IHR core capacities and strengthening national capacities to prevent, detect and respond appropriately to public health emergencies through a resilient health system.
3. addressing social, economic, and environmental determinants of health; promoting high-impact interventions to address public health risks using multisectoral approaches.
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The sixteenth meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases (STAG-NTD) was held as a hybrid meeting, 27–28 September 2022.
Dr Ren Minghui, Assistant Director-General, Universal Health Coverage/Communicable and Noncommunicable Diseases, welcomed participan...ts to the meeting. He said the World Health Organization’s Department of Control of Neglected Tropical Diseases (WHO/NTD) was in a state of transition. Following the death of the late esteemed Director Dr Mwelecele Ntuli Malecela earlier in the year, Dr Gautam Biswas had taken over as Acting Director but would soon retire; the appointment of a new Director was under way. Owing to rotation of STAG-NTD members, this would be the last meeting for some and the first meeting for several new participants. The work however would continue with the same commitment. Discussions over the next two days would focus on critical issues regarding recovery of NTD services following the disruptions caused by coronavirus disease (COVID-19), which had impacted many health services worldwide. He looked forward to receiving the advice and guidance of STAG-N
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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 Country Cooperation Strategy is the World Health Organization’s corporate framework developed in response to a country’s needs and priorities. The 2022–2025 CCS is the fourth for WHO in Sierra Leone. It is a medium-term strategic document that defines a broad framework for WHO’s work, at... all levels, with the Government of Sierra Leone and all health partners for the next four years. This document is guided by the country’s major policy and strategy documents including the 2020 National Health and Sanitation Policy (NHSP); the 2021–2025 National Health Sector Strategic Plan (NHSSP); and the 2019–2023 National Medium-term Development Plan (NMTDP). The current CCS also reflects the broad priorities of WHO as outlined in its Thirteenth General Programme of Work (2019–2023, extended to 2025) with a focus on improving access to universal health coverage, protecting people from health emergencies, and improving people’s health and well-being. The CCS priorities are also in alignment with the United Nations Sustainable Development Cooperation Framework (UNSDCF) in Sierra Leone and will contribute to attaining the country's SDG targets
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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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This document contains a series of desk reviews for the eight ENGAGE-TB priority countries supported by the Global Fund (DRC, Kenya, Indonesia, Mozambique, Myanmar, Nigeria, Pakistan and Tanzania). The document provides a situation assessment and gap analysis about the state of community based TB ac...tivities in these countries. The focus on these eight countries was justified by the high prevalence of TB and the very high number of missed/unreported cases.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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this toolkit presents a structured, rating-based methodology designed to provide a rapid, comprehensive assessment of the capacity of the human resource support system for a country’s supply chain. Data are gathered from a document review, focus group discussions, and in-country stakeholder interv...iews to identify the strengths, areas for improvement, opportunities, and challenges for a wide range of human resource inputs and components. The findings are transformed into specific recommendations and strategies for action based on an understanding of country priorities and programming gaps. It includes Word templates; PowerPoint templates and Exce-based Diagnostic Dashboard
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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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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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The National Strategic Plan on Malaria Prevention and Elimination Period 2021 – 2025 seeks to build on the previous national successes of the National Institute of Malariology, Parasitology, and Entomology (NIMPE) while addressing current challenges to reduce the overall burden of malaria in the S...outhern and Central provinces and to initiate elimination activities in remaining focal areas of transmission throughout the country. The overall targets proposed to be reached by 2025 are:
Reduce malaria morbidity rate to below 0.015/1,000 population
Reduce malaria mortality rate to below 0.002/100,000 population
Eliminate malaria in 55 provinces
Ensure no malaria outbreaks
To address the urgent threat of drug resistance, Viet Nam has committed to accelerate efforts to eliminate locally-acquired P. falciparum by 2023.
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Adolescents and young adults aged 10-24 remain underserved in the global response against HIV. Combination prevention, treatment and care programmes use a mix of evidence-based interventions to meet the current HIV prevention needs of adolescents and young adults. However, there needs to be a focus ...on priority interventions that are evidence-based, practical, contextual and sustainable. This document highlights interventions and recommendations that have passed through the evidence-based lens of the WHO.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based ...approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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: Development assistance for health (DAH) is one of the most important means for Japan to promote
diplomacy with developing countries and contribute to the international community. This study, for the first time,
estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its... flows, including source, aid
type, channel, target region, and target health focus area
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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This assessment is the first of its kind to be conducted in the south-eastern region of Myanmar. It is an important contribution to ensuring the full inclusion of women and children in Myanmar’s political, social, and cultural systems, with a specific focus on the issue of gender-based violence (G...BV) and its impact on these groups in south-eastern Myanmar. The United Nations Population Fund (UNFPA) is grateful for the participation of women, men, boys and girls from Mon, Kayin and Kayah States for sharing their views and experiences during the study.
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