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The Republic of the Union of Myanmar is at a historic moment, with a new civilian government assuming power in 2016. The country graduated to lower-middle-income status in 2015, and has made significant progress in reducing poverty, improving food s
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ecurity and addressing malnutrition.
The remaining challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities. more
The remaining challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities. more
Adaptation and roll-out of Epidemic Control for Volunteers’ (ECV) Toolkit and Training Manual in Myanmar
The ECV Toolkit ensures that volunteers have the proper training and essential communication tools (among other materials) before they are engaged in outbreak and epidemic response in thei ... r communities. It is known that in the middle of an outbreak or epidemic, volunteers have limited time to remember everything they have learned during trainings, or to develop effective response – the ECV Toolkit is therefore designed as a set of practical, easy-to-follow tools to be easily picked up and followed. more
The ECV Toolkit ensures that volunteers have the proper training and essential communication tools (among other materials) before they are engaged in outbreak and epidemic response in thei ... r communities. It is known that in the middle of an outbreak or epidemic, volunteers have limited time to remember everything they have learned during trainings, or to develop effective response – the ECV Toolkit is therefore designed as a set of practical, easy-to-follow tools to be easily picked up and followed. more
A study set out to investigate the factors affecting the prevalence of the practice among cross-border communities in East Africa and the Horn of Africa and the extent to which people cross borders to practise or undergo FGM and the effects of the p
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ractice on the women and girls in those communities. Changes were found in social norms in the cross-border communities investigated, indicating that the practice of female genital mutilation (FGM) can be eradicated. Effective interventions to end FGM need to be tailored to communities’ belief systems if they are to be “owned” by and mobilize the communities to change their culture. This report summarises the findings.
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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically p
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recluded an assessment of the pathogens leading to sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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his sequel to the Groundswell report includes projections and analysis of internal climate migration for three new regions: East Asia and the Pacific, North Africa, and Eastern Europe and Central Asia. Qualitative analyses of climate-related mobilit
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y in countries of the Mashreq and in Small Island Developing States (SIDS) are also provided. This new report builds on the scenario-based modeling approach of the previous Groundswell report from 2018, which covered Sub-Saharan Africa, South Asia, and Latin America. The two reports’ combined findings provide, for the first time, a global picture of the potential scale of internal climate migration across the six regions, allowing for a better understanding of how slow-onset climate change impacts, population dynamics, and development contexts shape mobility trends.
Available in English, French, Arabic, Spanish
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Development assistance for health (DAH)
plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically
focused on infectious diseases and maternal and child
health, there is a lack of comprehensiv
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e analysis of DAH
trends, strategic shifts and their impact on health systems
and outcomes. This study aims to provide a comprehensive
review of DAH from 1990 to 2022, examining its evolution
and funding allocation shifts.
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A new formulation of a drug to prevent excessive bleeding following childbirth could save thousands of women’s lives in low- and lower-middle-income countries, according to a study led by the World Health Organization (WHO) in collaboration with M
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SD for Mothers and Ferring Pharmaceuticals.
Currently WHO recommends oxytocin as the first-choice drug for preventing excessive bleeding after childbirth. Oxytocin, however, must be stored and transported at 2–8 degrees Celsius, which is hard to do, in many countries, depriving many women of access to this lifesaving drug. When they can obtain it, the drug may be less effective because of heat exposure.
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Q4: Can convulsive epilepsy be diagnosed at first level care by a non-specialist health care provider in low and middle income country settings?
How should humanitarian organisations prepare and respond to COVID-19 in humanitarian settings in low- and middle-income countries?
This Rapid Learning Review outlines 14 actions, insights and ideas for humanitarian actors to consider in their CO
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VID-19 responses. It summarises and synthesises the best available knowledge and guidance for developing a health response to COVID-19 in low- and middle-income settings as at April 2020
The paper, supported by the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock, will be updated throughout 2020 to reflect emerging knowledge and evidence on the most effective approaches to respond to the COVID-19 Pandemic.
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Now entering its ninth year, the crisis in north-east Nigeria has created vulnerabilities and humanitarian concerns. An estimated 7.7 million men, women, boys and girls are in acute need of protection and assistance. While the humanitarian community
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has provided life-saving assistance to over 5.6 million affected people in 2017 and helped stabilise living conditions for millions of people, reducing mortality and morbidity, significant humanitarian needs still remain.
The Humanitarian Response Plan at a glance:
STRATEGIC OBJECTIVE 1
Provide life-saving emergency assistance to the most vulnerable people in conflict-affected areas ensuring that assistance is timely and appropriate and meets relevant technical standards.
STRATEGIC OBJECTIVE 2
Ensure that all assistance promotes the protection, safety and dignity of affected people, and is provided equitably to women, girls, men and boys.
STRATEGIC OBJECTIVE 3
Foster resilience and early recovery, and strengthen the humanitarian development nexus by working towards collective outcomes.
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Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak healt
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h systems and poor infrastructure. Low-carbon approach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
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The global burden of disease due to mental disorders continues to rise, especially in low- and middle-income countries (LMIC). In addition to causing a large proportion of morbidity, mental disorders – especially severe mental disorders (SMD) –
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are linked with poorer health outcomes and increased mortality. SMD are defined as a group of conditions that include moderate to severe depression, bipolar disorder, and schizophrenia and other psychotic disorders. People with SMD have a two to three times higher average mortality compared to the general population, which translates to a 10-20 year reduction in life expectancy. While people with SMD do have higher rates of death due to unnatural causes (accidents, homicide, or suicide) than the general population, the
majority of deaths amongst people with SMD are attributable to physical health conditions, both
non-communicable and communicable.
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The Strong Families Programme was developed and piloted in Afghanistan thanks to the generous support of the US-INL. To date, this programme has further been piloted in Central America, Central and West Asia, East and West Africa thank
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s to the support of Sweden, France and the US
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This year’s MPI results show that more than two-thirds of the multidimensionally poor—886 millionpeople—live in middle-income countries. A further 440 million live in low-income countries. In both groups, data show, simple national averagescan
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hide enormous inequality inpatterns of povertywithin countries. For instance, in Uganda 55 percentof the population experience multidimensional poverty—similartotheaverage in Sub-Saharan Africa. But Kampala, the capital city, has an MPI rate of sixpercent, whileinthe Karamojaregion, the MPI soars to 96 percent—meaningthat partsof Ugandaspan the extremes of Sub-Saharan Africa.There is even inequality under the same roof. In South Asia, for example, almost a quarter ofchildren under five live in households where at least one child in the household is malnourished but at least one child is not.
There is also inequality among the poor. Findings of the2019 global MPI paint a detailed picture of the many differences in how-and how deeply -people experience poverty. Deprivationsamong the poor varyenormously: in general, higher MPI valuesgo hand in hand with greater variationin the intensity of poverty. Results also show that children suffer poverty more intensely than adults and are more likely to be deprived in all 10 of the MPI indicators, lackingessentialssuch as clean water, sanitation, adequate nutrition or primary education
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This policy brief identifies and explains the main reasons behind the rise of antimicrobial resistance (AMR) associated with improper use of antibiotics in the livestock sector. Focusing on the low- and middle- income country setting, this brief pro
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vides recommendations for a deliberated policy strategy aimed to prevent healthcare crisis that could happen as a result of AMR.
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Produced by Training and Research Support Centre for the Regional Network for Equity in Health in east and southern Africa (EQUINET), March 20, 2020.
This brief summarises and provides links to official, scientific and other resources to support a
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n understanding of and individual to regional level responses to the epidemic of ‘novel coronavirus’, also known as COVID-19.
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As of 12June 2020, there are 667confirmed COVID-19 casesin the OPT (565 of which are recovered cases), and 48% of which (320 cases) are in East Jerusalem and its suburbs. Additionally, there have been 5 reported COVID-19 deaths (1 in the West Bank,
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1 in Gaza and 3 in East Jerusalem)
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gap
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s are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly gre
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ater in individuals of a low socioeconomic status (SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pa
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cific Region. It analyses the overarching similarities, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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