Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, ...based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health.
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This document focus on the direct consequences of the virus (morbidity and mortality) in specific populations and on the results of measures aimed at mitigating the spread of the virus, with indirect impacts on socio-economic conditions. In this complex scenario, the gender approach has not received... due attention during the pandemic. Gender is one of the structural determinants of health, but it does not appear in analyses of the direct and indirect effects of the pandemic, despite being essential in the recognition and analysis of the differential impacts on men and women and their interaction with the different determinants of health.
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Each humanitarian setting provides distinct opportunities and challenges for actors to coordinate and collaborate at strategic and operational levels. The Health and Protection Joint Operational Framework has been developed to ensure that the health and protection response during humanitarian emerge...ncies can adapt to each environment and is adequately coordinated to ensure high-quality services to meet the needs of affected individuals and at-risk groups based on their situation or vulnerabilities.
The Health and Protection JOF was conceived in 2019 as a collaboration between the Global Health Cluster (GHC), the Global Protection Cluster (GPC) and its Areas of Responsibility (AoRs), the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG), and the Inter-Agency Working Group for Reproductive Health in Crisis (IAWG), in addition to key technical experts.
A Steering Group (SG) comprised of representatives from each of these entities guided the framework through a joint global analysis of good practices, gaps, and barriers to integrated and inter-sectoral response coordination. This included a mixed methods review of policy and practice, a survey of humanitarian experts, multiple case studies, structured stakeholder interviews, and field visits. This exercise produced a zero-draft which was then reviewed by field practitioners in three operational contexts to clarify and fully coordinate its operationally focused lens. Finally, the JOF was reviewed by the SG including via a series of consultations in early 2023 to consolidate the current framework.
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Research results of sexual and gender-based violence (SGBV) prevention and response before, during and after disasters in Indonesia, Lao PDR and the Philippines
This report contributes new evidence on why and how sexual and gender-based violence (SGBV) risks increase during humanitarian disasters.... It details how humanitarian actors can better prevent and respond to such escalation of SGBV, and better meet the needs of affected women, girls, men and boys. This research is based on community views of disaster-affected women, adolescent girls, men and adolescent boys in three South-East Asian countries: Indonesia, Lao PDR and the Philippines.
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The IDF Diabetes Atlas report highlights the disproportionate prevalence of type 2 diabetes (T2D) among Indigenous Peoples globally. It emphasizes the social and health disparities resulting from colonization, loss of traditional practices, and systemic inequities. The report includes prevalence dat...a across various Indigenous populations, identifying significant variability and often higher rates among Indigenous women compared to men. The report calls for culturally responsive and community-driven interventions to address diabetes prevention and management while advocating for better data collection and representation to support Indigenous communities worldwide.
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Travailler avec les dirigeants communautaires pour lutter contre la VBG est une très bonne et prometteuse approche, car les dirigeants communautaires sont les gardiens de toutes nos croyances et coutumes. Étant donné que la VBG est enracinée dans les croyances et les coutumes, essayer de s...attaquer à la VBG sans impliquer les dirigeants communautaires peut mener à un grand conflit, et vous n’aurez aucun résultat. Les dirigeants communautaires ont également des rôles à jouer dans la réponse aux survivantes de la VBG. Les survivantes s’adressent aux chefs de villages pour faire part de leurs préoccupations et de leurs expériences, et les dirigeants ont des pratiques pour traiter les préoccupations et une approche de la justice qui se base d’abord sur le maintien de la cohésion sociale, mais la VBG ne peut pas être résolue comme n’importe quel autre conflit. D’après mon expérience des programmes de VBG dans mon propre pays et ailleurs, j’ai appris qu’il est plus difficile d’impliquer les dirigeants communautaires dans certains endroits que dans d’autres. Parfois, les aspects religieux rendent les choses plus difficiles. Mais si vous demandez à n’importe quel dirigeant de décrire ce qu’est un dirigeant, ce qu’un dirigeant fait, il parlera de la protection de la communauté. Et c’est aussi ce que nous voulons — protéger les femmes et les filles dans la communauté.
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DHS Further Analysis Reports No. 107 - This report, based largely on the 2014-15 national survey in Rwanda, focuses on changes and trends in reproductive behavior since 2010. In the 4-5 years after the 2010 survey, fertility continued its decline to 4.2 births per woman as contraceptive prevalence i...ncreased slightly. However, the earlier downward trend in number of children desired appears stalled. This is clearly evident from an increase in the proportions of married women and men who say they want more children. Child mortality has significantly declined and remains strongly related to fertility; while age at marriage has continued to increase. The demographic goals specified in the 1998-99 plan for development, Rwanda Vision 2020, appear on track, but the annual rate of population growth remains high, currently 2.5%, because fertility is high. Furthermore, large numbers of young people are now entering their child-bearing years. Although most trends seem encouraging, especially compared with other countries in sub-Saharan Africa, significant population growth is expected in Rwanda, from 12 to 16 million people by 2030, and to 22 million people by mid-century, even with assumed reductions of fertility.
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Diese Studie liefert einschlägige Informationen aus erster Hand über die Lebenswirklichkeit von syrischen Kindern, die arbeiten müssen: in ihrem Heimatland, in den Nachbarstaaten oder in Europa. Der syrische Bürgerkrieg ist die schlimmste humanitäre Katastrophe unserer Zeit. Hunderttausende Men...schen – Erwachsene und Kinder – wurden getötet. Zwei Drittel aller Syrer haben ihr Zuhause und ihre Existenzgrundlage verloren. Millionen Syrer wurden aus ihrem Lebensumfeld gerissen und gezwungen, innerhalb ihres Landes oder in die Nachbarländer zu fliehen. Die enormen Auswirkungen auf andere Länder ziehen internationale Aufmerksamkeit auf sich. Diese richtet sich nicht nur auf die humanitäre Krise in den betroffenen Gebieten und Ländern, sondern auch auf deren wirtschaftliche und soziale Last. Das durch die verschiedenen Konfliktparteien verursachte Blutvergießen hält an, das Leid wird größer. Rund die Hälfte aller syrischen Flüchtlinge und Vertriebenen sind Kinder und Jugendliche: Diese sind doppelt verletzlich – als Kinder und als Flüchtlinge oder Vertriebene.
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Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(TB) patients. Objective: To assess whether differences in gender and HIV
status affect diagn...ostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee...ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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This publication presents guidance on good practice from the Ayeyarwaddy Delta in Myanmar, outlining the key factors which contributed to the successful implementation and outcome of a range of community-based Disaster Risk Reduction initiatives implemented by the Myanmar Consortium for Community Re...silience (MCCR).
The content was developed over a period of two months between November-December 2015, involving a desk review of MCCR project documents including impact studies, monitoring reports and newsletters. Field visits were undertaken to the Ayeyarwaddy Delta to document the perspectives of key stakeholders at community level, including a total of 93 adults (men and women) and 57 children (girls and boys) from eight communities targeted under the DIPECHO IX project.
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Almost two years after the signing of the Political Accord for Peace and Reconciliation (APPR), the Central African population is still hostage to an unstable and unpredictable security environment. Continuing conflicts in several areas of the country, structural weaknesses combined with the socio-e...conomic effects of the COVID-19 pandemic, and the devastating effects of natural disasters have plunged 2.6 million people into dire needs. Of this total, 1.6 million have severe humanitarian needs, a figure unmatched for five years, reflecting a deterioration in the physical and mental well-being and living conditions of populations across the country.
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Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by th...e force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.
Hypertension is a serious medical condition and can increase the risk of heart, brain, kidney and other diseases. It is a major cause of premature death worldwide, with upwards of 1 in 4 men and 1 in 5 women – over a billion people – having the condition. The burden of hypertension is felt disproportionately in low- and middle-income countries, where two thirds of cases are found, largely due to increased risk factors in those populations in recent decades.
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The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o...f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
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The article "The silent epidemic of COPD in Africa" discusses the under-recognized yet significant prevalence of chronic obstructive pulmonary disease (COPD) in Africa. Despite being the third leading cause of death worldwide, COPD remains poorly studied and largely unknown in sub-Saharan Africa. Th...e article highlights risk factors such as tobacco smoking and biomass smoke exposure, which significantly affect both men and women. Biomass smoke, in particular, is linked to COPD in younger individuals and impacts women due to prolonged exposure during cooking. The piece calls for better awareness, training for healthcare providers, and proactive measures to address and manage COPD in the region.
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Loss and damage is an urgent concern, driven by the increasingly harmful effects of climate change. Communities are experiencing new types and forms of climate impact, of higher frequency and intensity, which they are not equipped to handle. These impacts compel vulnerable communities to migrate to ...find alternative livelihoods and ways to survive. But migration generates grave socioeconomic consequences. Through case study analysis from 12 regions in Asia, Africa and the Pacific, this paper explores how climate change-induced migration is creating physical health, mental health and wellbeing issues — both for migrants and the families they leave behind. It then provides recommendations to policymakers on how to strengthen policy, planning and response frameworks to support communities manage health and wellbeing risks created by climate impacts.
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nContraception and Reproductive Medicine (2017) 2:26 DOI 10.1186/s40834-017-0053-6
Young women in Burkina Faso and Mali are increasingly using modern contraceptives for family planning; however, the LAPM contraceptive prevalence rate remains low. Our analysis indicates that social norms around idea...l family size for both men and women continue to drive young women’s choices around family planning and impede use of LAPMs. To increase modern contraceptive use and curb fertility rates, local governments and development organizations should focus on women’s empowerment and include male partners.
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The 2019 SLDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing ...of households carried out in each of the 578 selected EAs. The target groups were women age 15-49 and men age 15-59 in
randomly selected households across the country. A representative sample of approximately 13,872 households was selected for the survey. Half of the households (6,936) were selected for biomarker and men’s interview. The men’s survey was conducted in half (50%) of the sample households, and all men age 15-59 in these households were included. In this subsample, one eligible woman in each household was randomly selected to be asked additional questions about domestic violence.
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This report is part of the gender and noncommunicable diseases (NCDs) initiative launched by the WHO Regional Office for Europe, which aims to strengthen the response to NCDs through a gender approach. It is part of a series of country profiles and a synthesis report. The country profile of Ukraine ...presents a gender analysis of the WHO STEPwise survey (STEPS) data to support international commitments to reducing the burden of NCDs with evidence and knowledge exchange. A gender analysis of STEPS NCD risk-factor survey data describes how risk factors for chronic diseases differ between and among men and women by exploring and tracking the direction and magnitude of trends in risk factors and accessing services by sociodemographic variables. Important differences hide even in sex-disaggregated data that need to be unpacked through sociodemographic characteristics, because men and women are not homogenous groups. The report also recognizes gaps in evidence and calls for further analysis of the impact of gender-based inequalities.
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The Bolivarian Republic of Venezuela has been facing a prolonged socio-political and economic situation that has profoundly and negatively impacted social and health indicators. The COVID-19 pandemic further aggravated the humanitarian context in the
country, which stretched the limits of an alread...y weakened national health system. Violence and social conflicts, hyperinflation, constant political tensions, the persistence of migratory movements, and intensification of climate threats and natural hazards
have worsened the living conditions and health status of populations in vulnerable situations, including women, children, and indigenous people. A large influx of returnees back to Venezuela (Bolivarian Republic of) marked the first
two years of the pandemic. However, the country’s continued deteriorating political, socio-economic, and human rights situation resulted in renewed increased migration of Venezuelans in 2022. The profile of Venezuelan migrants has progressively changed
over the years, from single men in search of better economic opportunities to families with women and children in situations of extreme vulnerability. The increasingly irregular and unsafe journeys of those migrants are constantly putting their lives at high risk
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