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1
The African Palliative Care Association is pleased to publish the first edition of Palliative Care Standards for Africa. The development of these standards was achieved through wide consultation with service beneficiaries and providers, and they have been developed to suit different levels of
...
service delivery, from primary to tertiary. These standards are underpinned by the World Health Organization’s definition of palliative care, and recognise that scaling up palliative care requires a public health approach with four pillars: policy, education, drug availability and implementation. In addition, the increasing need to establish specific indicators of quality and effectiveness for palliative care has been a big driving force behind these comprehensive standards. It is APCA’s wish that they will provide a framework for the development of evaluation
and performance indicators that can facilitate programme improvement and development. The standards are designed to allow the development or improvement of palliative care across the different services levels, within the organisational capacity of various service providers. They describe a relationship between primary, intermediary and tertiary level service providers, with expectations for all providers articulated through detailed criteria for each standard. It is therefore expected that these standards will influence the planning and delivery of palliative care services at all levels of health care service delivery.
more
This document provides the specifications for major pesticide application equipment used for control of vectors of diseases. The specification guidelines contained herein are intended to assist national authorities and other public health users in selecting equipment of assured quality for applicati
...
on of pesticides for vector control.
The test methods described herein are intended to assess whether the equipment will function for a minimum of three years with appropriate routine maintenance according to the manufacturer’s label instructions. Manufacturers shall be requested to provide warranty against manufacturing defects with guaranteed after-sales service on the equipment, any certification required by national authorities regarding materials used in the construction of the equipment, and results of tests that have been carried out for compliance with national or international specifications. more
The test methods described herein are intended to assess whether the equipment will function for a minimum of three years with appropriate routine maintenance according to the manufacturer’s label instructions. Manufacturers shall be requested to provide warranty against manufacturing defects with guaranteed after-sales service on the equipment, any certification required by national authorities regarding materials used in the construction of the equipment, and results of tests that have been carried out for compliance with national or international specifications. more
This guidance is targeted to primary health care policy-makers and only addresses issues relevant for primary health care providers. It has been prepared on the basis of a systematic review of the best available evidence and emergent country practic
...
es in response to the COVID-19 outbreak in the WHO European Region. It will be updated on a regular basis as new information becomes available.
more
Diarrhea is one of the world’s leading causes of child illness and death, and rotavirus is the most common cause of severe diarrhea. Yet it can be prevented and treated. There is a vaccine. And while hundreds of thousands of children in India
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will gain access to rotavirus vaccines -part of a national introduction marking Asia’s largest so far -millions of children globally still lack access. This new report from the Rota Council summarizes the latest evidence on rotavirus disease and vaccines and identifies 21 recommendations for stakeholders to scale up coverage and prevent hundreds of thousands of child deaths annually.
more
Developing health centres and hospital s indices for Syria, based on HeRAMS dataset 2014
World Health Organization
(2017)
C_WHO
This research paper uses the Health Resources and services Availability Mapping System (HeRAMS) database to develop two composite indices – one for health centres and one for hospitals – in order to analyse and assess the health facilities’ performance across time and to evaluate the di
...
sparities among regions in the Syrian Arab Republic. The indices will provide an evidence-based tool for the main actors in the health sector to identify gaps, to intervene accordingly and to assess the impact of their interventions on the health system. The process of constructing the indices includes description and selection of variables, application of normalization techniques and weighting methods, and sensitivity analysis.
A literature review, analysis of the scope of the HeRAMS database, analysis of the crisis situation, data limitation and expert consultations were the main aspects of the construction process of the indices.
more
Based on scientific evidence, expert consensus and country experiences, the WHO core components for infection prevention and control (IPC) are the foundation for establishing or strengthening effective programmes at the national and facility level.
These new guidelines on core components of infecti
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on prevention and control (IPC) at the national and acute health care facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC.
more
The Committee discussed the implications for preparedness for smallpox-like events reflected by the ongoing COVID-19 pandemic. The Committee noted how quickly diagnostics and vaccines could be developed and deployed when resources and political will
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were abundant. This rapidity was also due to the fact that the genetic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been shared worldwide. It was noted that in one country SARS-CoV-2 had been reconstructed in a laboratory from the viral genome sequence before the first case of COVID-19 had been reported, highlighting the benefits of synthetic biology technologies for accelerated development of diagnostics as well as the oft-described potential risks. Lessons learned about clinical care during the COVID-19 pandemic were also discussed.
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Abstract: Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public health. A plethora of info
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rmation concerning the chronic phase of human Chagas disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss the current status of acute Chagas disease cases globally, the immunological findings related to the acute phase and their possible influence in disease outcome, and reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV invection management.
more
UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills &
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vocational training opportunities. The WFHS also facilitates referral to other services including Psychosocial Counseling Centers (PSCCs).
The aim of this guidance note is to provide an overview of approaches on how to successfully integrate adolescent and youth (A&Y) programming into the WFHSs. UNFPA activities for women’s and girl’s protection in health facilities aim to protect women and girls including child marriage. Given that vulnerable women and girls in Afghanistan continue to access health facilities, particularly for reproductive health and maternal health services, it is crucial to provide support for survivors in the same location to improve access to essential psychosocial and protection support for women and girls. To support the integration of A&Y in the WFHS programming each WFHS will be supported by two full time Youth Educators. A female Youth Educator who will be working within the WFHS and a male Youth Educator who will be working in the community. The role of the Youth educators is to increase A&Y awareness and knowledge on living healthy lifestyles and ensuring a referral system to services in existing facilities.
more
The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will
...
continue rising over the following years. The Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex.
more
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased ris
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k for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
more
Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this
...
burden, we posit that studies evaluating cardiovascular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
more
The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will
...
continue rising over the following years. The Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
more
Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr
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ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
more
COVID-19 has heavily emphasized how contact tracing is crucial for managing outbreaks, and as part of the strategy for adjusting, and eventually lifting, lockdowns and other stringent public health and social measures. As the pandemic develops further, it
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will be a core measure to manage further waves of infection. In early June 2020, the World Health Organization (WHO) convened an online global consultation on contact tracing in the context of COVID-19, looking at the lessons of the pandemic to date; known and emerging best practices; and the measures necessary for urgent implementation, scale-up, maintenance and enhancement of contact tracing activities.
more
Standard operating procedures (SOP) for the management of tuberculosis in children
National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program), Kenya
Ministry of Health, Kenya
(2017)
C1
2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and th
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ey have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
more
This guide is designed to accompany the training module, Communicating with health workers about COVID-19 vaccination. It provides detailed explanations, resources and guidance to accompany the slides in the training module and support those implementing the training. It is intended for training fac
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ilitators or trainers of trainers (ToTs) who will be conducting the training at the country level either face-to-face or online with a group of participants. Facilitators can use this guidance document to help them adapt the training content to their local context and facilitate discussion with training participants. Facilitators are encouraged to have this guide available to them as a tool during the training session.
more
Patient safety assessment manual
recommended
3rd edition. Patient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that reflect current best practice and WHO gu
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idance. The manual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritized and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
more
The WHO End TB Strategy aims to end the global TB epidemic by 2030, in alignment with Goal 3 of the United Nations (UN) Sustainable Development Goals (SDGs). Member States of the World Health Organization (WHO) and the UN committed to ending the TB epidemic through adoption of WHO’s End TB Strateg
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y and the UN SDGs in 2014 and 2015, respectivel
Almost half of the deaths worldwide caused by TB in 2019 occurred in the WHO South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this Region is therefore essential if the global goal of ending the TB epidemic is to be realized. Despite substantial gains made in the Region, the threat to
health worldwide posed by the COVID-19 pandemic has the potential to reverse these gains and eclipse the focus on the global TB emergency.
While continuing to tackle COVID-19-related challenges, countries will need to rapidly and urgently deploy supplementary measures to address the large numbers of missed cases, poor treatment outcomes and, potentially, a higher TB burden.
The Regional Strategic Plan towards Ending TB in the Region 2021–2025 clearly articulates priority interventions, analyses the challenges, bottlenecks and opportunities, and focuses on implementation considerations in the Region.
more
As part of our commitment to the fight against NCDs, Nigeria was signatory to the political declaration at the UN General Assembly High Level Meeting on NCDs in September 2011. Thus, the purpose of this document is to develop and ensure the implementation of policies and p
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rogrammes that will engender and guarantee a healthy lifestyle and quality health for all Nigerians. The core sections include background, scope of the policy, policy goal, strategic thrusts for implementation, programme management and coordination, roles of stakeholders and partnership coordination. It is expected that with the adoption of this policy, the control and prevention of NCDs and their associated risk factors will be well integrated at all levels of government and health care delivery system in Nigeria. This policy document is therefore a stepping stone towards the development of guidelines for the prevention and management of NCDs.
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