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The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio
...
ns such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
more
Air pollution is one of the leading causes of health complications and mortality worldwide, especially affecting lower-income groups, who tend to be more exposed and vulnerable. This study documents the relationship between ambient air pollution exposure and poverty in 211 countries and territories.
...
Using the World Health Organization’s (WHO) 2021 revised fine particulate matter (PM2.5) thresholds, we show that globally, 7.3 billion people are directly exposed to unsafe average annual PM2.5 concentrations, 80 percent of whom live in low- and middle-income countries. Moreover, 716 million of the world’s lowest income people (living on less than $1.90 per day) live in areas with unsafe levels of air pollution, especially in Sub-Saharan Africa. Air pollution levels are particularly high in lower-middle-income countries, where economies tend to rely more heavily on polluting industries and technologies. These findings are based on high-resolution air pollution and population maps with global coverage, as well as subnational poverty estimates based on harmonized household surveys.
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This short brief describes the main findings and the key lessons learned from the research project "Evaluation of the impact of alcohol control policies on morbidity and mortality in Lithuania and other Baltic states", funded by the United States National Institute on Alcohol Abuse and Alcoholism fo
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r the period 2000–2025. The WHO-backed project aims to assess the effects of alcohol control policies implemented in Estonia, Latvia and Lithuania and to investigate the impact they have had on both people's health and the countries' economies, based on concrete actions taken. The key findings of the project demonstrate that alcohol control policies such as taxation and availability measures decrease all-cause mortality and reduce inequalities, and that dismantling alcohol control policies has the opposite effect on population health. They also highlight that consumption of unrecorded alcohol will not necessarily go up if taxation is increased and that specific countermeasures can be taken to prevent an increase in unrecorded consumption.
more
The report provides an overview of alcohol consumption, related health harm, and policy responses in 30 European countries (EU Member States, Norway, and Switzerland). It highlights the high levels of alcohol consumption in the WHO European Region, which contribute to a significant disease burden co
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mpared to other regions. The report covers trends in alcohol consumption and harm between 2010 and 2016, noting some progress in reducing alcohol-attributable mortality but stagnation in consumption reduction and heavy episodic drinking.
The assessment of alcohol policies shows variability in implementation across countries, particularly in areas like pricing and reducing the negative consequences of drinking. It emphasizes the need for stronger evidence-based policies, such as better regulation, taxation, and accessibility restrictions, to further reduce alcohol-related harm and achieve health-related Sustainable Development Goals.
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The World Health Organization (WHO) launched the SAFER initiative in 2018 to address the global health and societal challenges posed by alcohol-related harm. The initiative outlines five key strategies aimed at reducing alcohol consumption and its associated consequences. These include strengthening
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restrictions on alcohol availability by implementing and enforcing policies to limit its accessibility and advancing drink-driving countermeasures, such as low blood alcohol concentration limits and random breath testing, to reduce alcohol-impaired driving incidents.
Additionally, SAFER emphasizes facilitating access to screening, brief interventions, and treatment for individuals with alcohol use disorders, ensuring that healthcare systems are equipped to provide effective support. Another core strategy is enforcing comprehensive bans or restrictions on alcohol advertising, sponsorship, and promotion to minimize its influence, particularly on vulnerable populations such as youth. Finally, the initiative advocates raising alcohol prices through excise taxes and pricing policies to make it less affordable and thereby reduce consumption.
By implementing these evidence-based, cost-effective measures, the SAFER initiative aims to reduce the global burden of alcohol-related deaths and disabilities, fostering healthier societies worldwide.
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The webpage by the National Institute on Drug Abuse (NIDA) discusses strategies for preventing drug misuse and addiction. It highlights the importance of early intervention, education, and support systems to reduce risk factors and strengthen protective factors. The content emphasizes the role of fa
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milies, schools, and communities in promoting healthy behaviors and minimizing the likelihood of substance abuse, offering evidence-based prevention programs and practical tips.
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Assessing the Impact of Workforce Nutrition Programmes on Nutrition, Health and Business Outcomes: A Review of the Global Evidence and Future Research Agenda
Dhillon, C.N.; Ortenzi, F.
International Journal of Environmental Research and Public Health
(2023)
CC
One in three people globally suffers from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all its forms. This narrative literature review aims to
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understand the impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We used PubMed as our primary research database, complemented by Google Scholar, to identify systematic reviews, meta-analyses, and randomised controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualised counselling and worksite environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on the impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps.
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The World Health Organization (WHO) has developed this report to monitor progress and identify areas for action in the implementation of sodium reduction policies and other measures within Member States and across WHO regions and World Bank income groups. For the first time, a Sodium Country Score f
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rom 1 (the lowest level) to 4 (the highest level) is allocated to each Member State based on the level of implementation of sodium reduction policies and other measures. The Sodium Country Score is used to estimate the impact of policy progress on population dietary sodium intake and cardiovascular disease.
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The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, stakeholders, and young adults. Key findings include a
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preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
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The aim of the present paper is to review capacity building in public health nutrition (PHN), the need for which has been stressed for many years by a range of academics, national and international organisations. Although great strides have been made worldwide in the science of nutrition, there rema
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in many problems of undernutrition and increasingly of obesity and related chronic diseases. The main emphasis in capacity building has been on the nutrition and health workforce, but the causes of these health problems are multifactorial and require collaboration across sectors in their solution. This means that PHN capacity building has to go beyond basic nutrition and beyond the immediate health workforce to policy makers in other sectors. The present paper provides examples of capacity building activities by various organisations, including universities, industry and international agencies. Examples of web-based courses are given including an introduction to the e-Nutrition Academy. The scope is international but with a special focus on Africa. In conclusion, there remains a great need for capacity building in PHN but the advent of the internet has revolutionised the possibilities.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
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diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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Hypertension in adults: diagnosis and management
the National Institute for Health and Care Excellence (NICE)
the National Institute for Health and Care Excellence (NICE)
(2023)
CC
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di
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agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
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Position statement on endoscopic lung volume reduction in South Africa: 2022 update
Koegelenberg, C.F.; Van Zyl-Smit, R.N.; Dheda, K. et al.
African Journal of Thoracic and Critical Care Medicine
(2022)
CC
The article from the African Journal of Thoracic and Critical Care Medicine provides updated guidelines on endoscopic lung volume reduction (ELVR) for treating advanced emphysema, a severe form of chronic obstructive pulmonary disease (COPD), which is prevalent in South Africa and other low- and mid
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dle-income countries. The guidelines focus on identifying suitable patients based on specific criteria, such as age, lung function, and the presence of hyperinflation, while ruling out contraindications like pulmonary hypertension and recent smoking.
ELVR aims to reduce lung volume in the most damaged areas, improving breathing mechanics and quality of life. Various devices, including endobronchial valves, intrabronchial valves, and coils, are reviewed with evidence from clinical trials supporting their use. The guidelines emphasize careful patient selection and recommend only performing ELVR in specialized centers due to its high cost and risk of complications, such as pneumothorax.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue
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s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with
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disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and often reactive nature of non-governmental organisation (NGO) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.
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WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situation in a country, including the state of the health s
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ector, socioeconomic status and the major health determinants.
This CCS sets out WHO’s strategic framework for collaboration with the Syrian Arab Republic, from June 2022 until June 2025, in light of the 12 years of crisis that have had a devastating impact on the health sector and infrastructure of basic services. It carefully considers the current and projected issues during its transition from continued humanitarian assistance to recovery, resilience and development. The consolidation of health policies and strategies and health system strengthening, based on the strengthening of primary health care (PHC), aims to contribute to the achievement of national and global development and health goals and the targets of the SDGs.
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An essential component of the return process is counselling, which aims to support counselling beneficiaries to make an informed decision on their future migration pathways. Counselling provides the space for migrants to exert their agency, supports them to prepare for return and positively contr
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ibutes to their reintegration in countries of origin. The question of how to prepare and provide return counselling is of significant concern for all actors involved in the return process itself, but until
now very little has been done to offer a standardized approach to return counselling. The Return Counselling Toolkit intends to address this question and proposes a rights-based and migrant-centred approach to return counselling, which builds upon
IOM standards and the Organization’s long-standing experience in providing return and reintegration counselling to thousands of migrants every year, in a multiplicity of countries and contexts.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium
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term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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This brief presents the guidelines and agreements in the information document Status of access to sexual and reproductive health services, prepared by the Pan American Health Organization (PAHO) at the request of its Member States at the 30th Pan American Sanitary Conference. It was presented and un
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animously approved by the countries of the Region of the Americas at the 60th Meeting of the Directing Council, 75th session of the WHO Regional Committee for the Americas, held in Washington, D.C., USA, September 25-29, 2023. Its objective is to describe the status of access to sexual and reproductive health services in the Americas region, identify health responses and barriers to access, and suggest recommendations for countries. It was developed based on a review and systematization of data, plans and initiatives, scientific papers, United Nations reports, and legal and regulatory frameworks on sexual and reproductive health.
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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
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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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