People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi...enced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A...Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how the...y view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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According to the latest available estimates, more than 1 in 7 adolescents aged 10–19 is estimated to live with a diagnosed mental disorder globally. Almost 46,000 adolescents die from suicide each year, among the top five causes of death for their age group. Meanwhile, wide gaps persist between me...ntal health needs and mental health funding. The report finds that about 2 per cent of government health budgets are allocated to mental health spending globally.
The full report , excecutive summary, brief reports are available in English, French, Spanish and Arabic athttps://www.unicef.org/reports/state-worlds-children-2021?utm_source=referral&utm_medium=media&utm_campaign=sowc-web
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7 Febr. 2021
As COVID-19 continues to wreak havoc in countries – decimating people’s livelihoods, and leaving health systems struggling to provide healthcare and vaccines for the entire population - governments and donors should look to the Church as a partner. The essential Church networks, tr...usted and rooted in local communities, can reach the most vulnerable people and remote places where governments often struggle to reach. DR Congo is among several countries where the Catholic Church is the main provider of community health services, particularly in more remote areas.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system, and findings were further validated during a oneda...y
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
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Men are underrepresented in HIV testing services throughout sub-Saharan Africa. HIV testing is critical to achieve the UNAIDS 95-95-95 goals, as it is the first entry point to HIV care. In Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiag...nosed. Improved HIV testing among men is key to reaching UNAIDS goals, and to curbing HIV epidemics in the region.
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Reducing the global suicide mortality rate by a third by 2030 is a target of both the UN Sustainable Development Goals and the WHO Global Mental Health Action Plan. However, an impediment to meeting this goal is the fact that suicide and suicide attempts remain illegal in at least 23 countries world...wide. Decriminalization of suicide and suicide attempts represents one critical step governments can take in their efforts to prevent suicide. The WHO Policy Brief on the health aspects of decriminalization of suicide and suicide attempts cites data and research to make a case for decriminalizing suicide globally. It also includes case examples from countries that have recently decriminalized suicide and suicide attempts — Guyana and Pakistan, Singapore,— providing important insights to policy-makers, legislators, parliamentarians and other decision-makers.
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mnesty International’s annual report on the state of the world’s human rights in 2021, published in March 2022, shows that promises to “build back better” after the Covid-19 pandemic were little more than lip service. Hopes of global cooperation withered in the face of vaccine hoarding and c...orporate greed.
Governments suppressed independent and critical voices, with some even using the pandemic as a pretext to shrink further the civic space. New and unresolved conflicts erupted or persisted. Those forced to flee were subjected to a litany of abuses, including pushbacks by countries in the Global North. But hopes for a better post-pandemic world were kept alive by courageous individuals, social movements and civil society organizations.
The report is available in different languages
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Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia
The 80-page report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimination, lack of access to inclusive HIV prevention ed...ucation, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services.
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Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi...scal cutbacks in many developed countries, total assistance remained steady, reaching an all-time high of $31.3 billion in 2013. While annual increases have leveled off since 2010, continued international funding is a sign of the international development community’s enduring support for global health.
The report also shows shifts in sources of financing. As funding from many bilateral donors and development banks has declined, growth in funding from the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, non-governmental organizations, and the UK government is counteracting these cuts. Development assistance for different health issues is tracked up to 2011, revealing that the greatest increase in funding was for maternal, newborn, and child health.
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In October 2022, President Biden signed the Global Malnutrition Prevention and Treatment Act (GMPTA) into law, which directs USAID to prevent and treat malnutrition globally. The GMPTA further codifies USAID’s leadership on nutrition, with a focus on evidence-based interventions across health syst...ems and food systems, in both development and humanitarian settings.
Realizing the potential of good nutrition to save lives and ensure a brighter future for generations to come is central to U.S. Government priorities. For over 60 years, USAID has been a leader in the fight to end global malnutrition. Nutrition affects every aspect of human development: from the ability to fight disease, to children’s performance in school, to a nation’s health and economic advancement. There is overwhelming evidence of the power of good nutrition but, due to challenges in accessing safe, nutritious foods and health and sanitation services, many people in low- and middle-income countries remain undernourished.
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This Guidance Document provides practical assistance to Country Offices scaling up programmes to manage SAM in young children. It outlines a step-by-step process through which countries can analyse their current situation, identify barriers and bottlenecks through the MoRES approach, and plan action... to scale-up treatment. In particular it addresses the challenge of supporting governments to accelerate and sustain scale-up, build national capacities and source reliable and sustained supplies and financing for managing SAM. This document also provides complementary background information, references to international technical recommendations, resources and tools.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions... (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Many groups in sub-Saharan Africa have historically linked persons with disabilities with witchcraft as a component of a wider link between accusations of witchcraft and socially marginalized populations. It is commonly assumed that traditional prejudices towards persons with disabilities are recedi...ng in light of urbanization, education, mass media and efforts to confront such prejudice and stigma by governments,
disability advocates and civil society. Ratification of the UN Convention on the Rights of Persons with Disabilities (CRPD) by many African countries is considered an additional impetus for change.
Working Paper Series: No. 30
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An evidence-informed approach for non-formal, out-of-school CSE programmes that aims to reach young people from left-behind populations
This guidance is intended to assist anyone designing and/or implementing CSE in out-of-school settings, especially in low- and middle-income countries. This includ...es international and national civil-society organizations, community-based organizations, government departments, UN agencies, health authorities, non-formal education authorities and youth development authorities. It is also intended for anyone else involved in the design, delivery and evaluation of sexuality education programmes out of school, especially those working with the specific groups of young people addressed in the guidance.
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There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness and inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for ...COPD care contributes to preventive and management challenges. Thus, the majority of patients with COPD are misdiagnosed, misclassified and mismanaged or undertreated. With the struggling improvement in the quality of healthcare in Africa, studies conducted over the last 10 years indicates the rising trends in both the risk factors and the burden of COPD. The role of new risk factors such as indoor pollution, infections with human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB), in the pathogenesis of COPD in Africa is increasingly being recognized. This literature review attempts to collect and synthesize information that could be useful in improving COPD care and informing the governments to take appropriate actions for prevention, diagnosis and management of COPD in Africa.
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Résumé.
Malgré les efforts de promotion des mutuelles de santé depuis une décennie et l’existence d’une vingtaine de compagnies privées proposant des polices d’assurance maladie, moins de 1% de la population camerounaise bénéficie d’une couverture maladie. Les facteurs sous jacents ...sont entre autres : (i) la méfiance des ménages vis-à-vis des mutuelles de santé et des assureurs privés; (ii) l’absence d’obligation d’une assurance maladie qui en fait un produit de luxe ; (iii) l’ignorance des avantages des mécanismes assurantiels; (iv) la pauvreté et le montant élevé des primes d’adhésion et des cotisations annuelles ; et (v) la forte prévalence de l’emploi dans le secteur informel (80,6%). Pour y faire face nous proposons de : 1) Créer et pérenniser un environnement favorable à la promotion et au développement des MS ; 2) Subventionner les primes par le Gouvernement, les Partenaires et les Municipalités pour en réduire le prix d’achat ; 3) Instituer une collecte flexible des primes et établir un dispositif attractif de mutualisation du risque et des procédures d’achat qui inspirent confiance aux usagers et aux prestataires des soins.
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Health is essential in order to be able to lead a fulfilled and happy life. Health is not only a fundamental human right and one of the most valuable possessions any individual can have, it is also an essential prerequisite for social, economic and political development and stability. Health can onl...y be ensured and improved throughout the world through joint global action.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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