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1.
Br J Nurs ; 29(5): 322-323, 2020 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-32167823

RESUMEN

In light of the emergence of the new coronavirus in China, Emeritus Professor Alan Glasper, from the University of Southampton, discusses the response strategies adopted by international and national public health agencies.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Salud Pública , Organización Mundial de la Salud/organización & administración , Animales , China/epidemiología , Humanos , Higiene , Pandemias , Zoonosis
5.
Global Health ; 15(1): 64, 2019 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-31847852

RESUMEN

The WHO Eastern Mediterranean Region is endowed with deep intellectual tradition, interesting cultural diversity, and a strong societal fabric; components of a vibrant platform for promoting health and wellbeing. Health has a central place in the Sustainable Development Goals (SDGs) for at least three reasons: Firstly, health is shaped by factors outside of the health sector. Secondly, health can be singled out among several SDGs as it provides a clear lens for examining the progress of the entire development process. Thirdly, in addition to being an outcome, health is also a contributor to achieving sustainable development. Realizing this central role of health in SDGs and the significance of collaboration among diverse sectors, the WHO is taking action. In its most recent General Program of Work 2019-2023 (GPW 13), the WHO has set a target of promoting the health of one billion more people by addressing social and other determinants of health through multi-sectoral collaboration. The WHO Regional Office for the Eastern Mediterranean Region, through Vision 2023, aims at addressing these determinants by adopting an equity-driven, leaving no one behind approach. Advocating for Health in All Policies, multi-sectoral action, community engagement, and strategic partnerships are the cornerstone for this approach. The focus areas include addressing the social and economic determinants of health across the life course, especially maternal and child health, communicable diseases, non-communicable diseases, and injuries. The aspirations are noteworthy - however, recent work in progress in countries has also highlighted some areas for improvement. Joint work among different ministries and departments at country level is essential to achieve the agenda of sustainable development. For collaboration, not only the ministries and departments need to be engaged, but the partnerships with other stakeholders such as civil society and private sector are a necessity and not a choice to effectively pursue achievement of SDGs.


Asunto(s)
Equidad en Salud/organización & administración , Desarrollo Sostenible , Organización Mundial de la Salud/organización & administración , Humanos , Región Mediterránea
6.
J Glob Health ; 9(2): 020802, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31673346

RESUMEN

The Program for the Control of Diarrheal Diseases (CDD) of the World Health Organization (WHO) was created in 1978, the year the Health for All Strategy was launched at the Alma Ata International Conference on Primary Health Care. CDD quickly became one of the pillars of this strategy, with its primary goal of reducing diarrhea-associated mortality among infants and young children in developing countries. WHO expanded the previous cholera-focused unit into one that addressed all diarrheal diseases, and uniquely combined support to research and to national CDD Programs. We describe the history of the Program, summarize the results of the research it supported, and illustrate the outcome of the Program's control efforts at country and global levels. We then relate the subsequent evolution of the Program to an approach that was more technically broad and programmatically narrow and describe how this affected diarrheal diseases-related activities globally and in countries.


Asunto(s)
Diarrea/prevención & control , Desarrollo de Programa , Organización Mundial de la Salud/organización & administración , Preescolar , Países en Desarrollo/estadística & datos numéricos , Diarrea/mortalidad , Metas , Humanos , Lactante , Recién Nacido
7.
Malar J ; 18(1): 353, 2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31630677

RESUMEN

A resolution for eradicating malaria, if passed by the World Health Assembly (WHA), will have a distracting effect on all countries with malaria. The continued prevalence of malaria is indicative of weak public health infrastructure. True, smallpox was eradicated by international efforts following WHA resolution: the success factor was primary prevention using a safe and effective vaccine. A resolution to eradicate polio was passed in 1988, with a target year of 2000, but even in 2019 success is not within reach. Public health experts are hesitant to move forward with measles eradication before polio is eradicated. Country by country elimination of malaria is a better way, ensuring the strengthening of public health infrastructure, with many other health benefits.


Asunto(s)
Erradicación de la Enfermedad/organización & administración , Salud Global , Cooperación Internacional , Malaria/prevención & control , Organización Mundial de la Salud/organización & administración , Humanos
8.
Malar J ; 18(1): 352, 2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31630679

RESUMEN

Several efforts are being made now for malaria elimination with a goal for eradication. New tools and strategies are being developed and there is currently renewed political engagement and interest. Several technical groups have produced a guide on elimination for policymakers and indicated different research questions to be addressed. The World Health Assembly resolution and the United Nations General Assembly convened a high-level roundtable "From High Burden to High Impact: Getting back on track to end Malaria". In Africa, the Head of states pronounced a vision for an Africa free of malaria and launched the slogan "Zero malaria starts with me". Massive efforts to sustain research capacity in the endemic countries will be critical. It will be important to both increase domestic financing, and advocate to sustain and increase funding from major donor countries. It is unethical to continue to observe deaths of so many children in malaria endemic countries, the most vulnerable populations. Considering malaria eradication as a vision and working with all the opportunities we now have could accelerate the process. Eliminating malaria with a country regional approach and progressing step by step will give us consistent information on our way towards eradication.


Asunto(s)
Erradicación de la Enfermedad/organización & administración , Salud Global , Cooperación Internacional , Malaria/prevención & control , Organización Mundial de la Salud/organización & administración , Humanos
10.
Int Health ; 11(5): 338-340, 2019 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-31529110

RESUMEN

Neglected tropical diseases (NTDs) are a group of diseases that disproportionately affect the poorest of the poor. While for years attention has focused on single diseases within this group, efforts during the past decade have resulted in their being grouped together to highlight that they are fundamentally diseases of neglected populations. The formation of a World Health Organization department to address these diseases consolidated the efforts of the many stakeholders involved. In the past decade, focus has shifted from the Millennium Development Goals (MDGs), where NTDs are not mentioned, to the Sustainable Development Goals (SDGs), where NTDs are not only mentioned, but clear indicators are provided to measure progress. It has also been a decade where many NTD programmes have scaled up rapidly thanks to work by affected countries through their master plans, the commitment of partners and the unprecedented donations of pharmaceutical manufacturers. This decade has also seen the scaling down of programmes and acknowledgement of the elimination of some diseases in several countries. Given the successes to date, the challenges identified over the past decade and the opportunities of the coming decade, the NTD Programme at the WHO is working with partners and stakeholders to prepare the new NTD roadmap for 2021 to 2030. The focus is on three major paradigm shifts: a change of orientation from process to impact, a change in technical focus from diseases to delivery platforms and a change from an external-based agenda and funding to a more country-led and funded implementation within health systems. This article reviews the past decade and offers a glimpse of what the future might hold for NTDs as a litmus test of SDG achievements.


Asunto(s)
Enfermedades Desatendidas/prevención & control , Medicina Tropical/organización & administración , Medicina Tropical/tendencias , Humanos , Desarrollo Sostenible , Organización Mundial de la Salud/organización & administración
12.
Health Res Policy Syst ; 17(1): 76, 2019 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-31391057

RESUMEN

BACKGROUND: WHO has recognised the need to ensure that guideline processes are transparent and evidence based, and that the resulting recommendations are relevant and applicable. Along with decision-making criteria that require findings from effectiveness reviews, WHO is increasingly using evidence derived from qualitative evidence syntheses (QES) to inform the values, acceptability, equity and feasibility implications of its recommendations. This is the first in a series of three papers examining the use of QES in developing clinical and health systems guidelines. METHODS: WHO convened a group of methodologists involved in developing recent (2010-2018) guidelines that were informed by QES. Using a pragmatic and iterative approach that included feedback from WHO staff and other stakeholders, the group reflected on, discussed and identified key methods and research implications from designing QES and using the resulting findings in guideline development. Our aim in this paper is to (1) describe and discuss how the findings of QES can inform the scope of a guideline and (2) develop findings for key guideline decision-making criteria. RESULTS: QES resulted in the addition of new outcomes that are directly relevant to service users, a stronger evidence base for decisions about how much effective interventions and related outcomes are valued by stakeholders in a range of contexts, and a more complete database of summary evidence for guideline panels to consider, linked to decisions about values, acceptability, feasibility and equity. CONCLUSIONS: Rigorously conducted QES can be a powerful means of improving the relevance of guidelines, and of ensuring that the concerns of stakeholders, at all levels of the healthcare system and from a wide range of settings, are taken into account at all stages of the process.


Asunto(s)
Medicina Basada en la Evidencia/organización & administración , Investigación sobre Servicios de Salud/organización & administración , Guías de Práctica Clínica como Asunto/normas , Investigación Cualitativa , Organización Mundial de la Salud/organización & administración , Aborto Inducido/normas , Comunicación , Toma de Decisiones , Medicina Basada en la Evidencia/normas , Conocimientos, Actitudes y Práctica en Salud , Investigación sobre Servicios de Salud/normas , Humanos , Servicios de Salud Materno-Infantil/normas , Atención Prenatal/normas , Rol Profesional , Revisiones Sistemáticas como Asunto , Vacunación/métodos
13.
Health Res Policy Syst ; 17(1): 74, 2019 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-31391071

RESUMEN

BACKGROUND: This is the third in a series of three papers describing the use of qualitative evidence syntheses (QES) to inform the development of clinical and health systems guidelines. WHO has recognised the need to improve its guideline methodology to ensure that decision-making processes are transparent and evidence based, and that the resulting recommendations are relevant and applicable to end users. In addition to the standard data on effectiveness, WHO guidelines increasingly use evidence derived from QES to provide information on acceptability and feasibility and to develop important implementation considerations. METHODS: WHO convened a group drawn from the technical teams involved in formulating recent (2010-2018) guidelines employing QES. Using a pragmatic and iterative approach that included feedback from WHO staff and other stakeholders, the group reflected on, discussed and identified key methods and research implications from designing QES and using the resulting findings in guideline development. As members of WHO guideline technical teams, our aim in this paper is to explore how we have used findings from QES to develop implementation considerations for these guidelines. RESULTS: For each guideline, in addition to using systematic reviews of effectiveness, the technical teams used QES to gather evidence of the acceptability and feasibility of interventions and, in some cases, equity issues and the value people place on different outcomes. This evidence was synthesised using standardised processes. The teams then used the QES to identify implementation considerations combined with other sources of information and input from experts. CONCLUSIONS: QES were useful sources of information for implementation considerations. However, several issues for further development remain, including whether researchers should use existing health systems frameworks when developing implementation considerations; whether researchers should take confidence in the evidence into account when developing implementation considerations; whether qualitative evidence that reveals implementation challenges should lead guideline panels to make conditional recommendations or only point to implementation considerations; and whether guideline users find it helpful to have challenges pointed out to them or whether they also need solutions. Finally, we need to explore how QES findings can be incorporated into derivative products to aid implementation.


Asunto(s)
Medicina Basada en la Evidencia/organización & administración , Investigación sobre Servicios de Salud/organización & administración , Guías de Práctica Clínica como Asunto/normas , Investigación Cualitativa , Organización Mundial de la Salud/organización & administración , Aborto Inducido/normas , Comunicación , Toma de Decisiones , Medicina Basada en la Evidencia/normas , Conocimientos, Actitudes y Práctica en Salud , Investigación sobre Servicios de Salud/normas , Humanos , Servicios de Salud Materno-Infantil/normas , Atención Prenatal/normas , Rol Profesional , Revisiones Sistemáticas como Asunto , Vacunación/métodos
14.
Health Res Policy Syst ; 17(1): 75, 2019 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-31391119

RESUMEN

BACKGROUND: WHO has recognised the need to improve its guideline methodology to ensure that guideline decision-making processes are transparent and evidence based, and that the resulting recommendations are relevant and applicable. To help achieve this, WHO guidelines now typically enhance intervention effectiveness data with evidence on a wider range of decision-making criteria, including how stakeholders value different outcomes, equity, gender and human rights impacts, and the acceptability and feasibility of interventions. Qualitative evidence syntheses (QES) are increasingly used to provide evidence on this wider range of issues. In this paper, we describe and discuss how to use the findings from QES to populate decision-making criteria in evidence-to-decision (EtD) frameworks. This is the second in a series of three papers that examines the use of QES in developing clinical and health system guidelines. METHODS: WHO convened a writing group drawn from the technical teams involved in its recent (2010-2018) guidelines employing QES. Using a pragmatic and iterative approach that included feedback from WHO staff and other stakeholders, the group reflected on, discussed and identified key methods and research implications from designing QES and using the resulting findings in guideline development. RESULTS: We describe a step-wise approach to populating EtD frameworks with QES findings. This involves allocating findings to the different EtD criteria (how stakeholders value different outcomes, equity, acceptability and feasibility, etc.), weaving the findings into a short narrative relevant to each criterion, and inserting this summary narrative into the corresponding 'research evidence' sections of the EtD. We also identify areas for further methodological research, including how best to summarise and present qualitative data to groups developing guidelines, how these groups draw on different types of evidence in their decisions, and the extent to which our experiences are relevant to decision-making processes in fields other than health. CONCLUSIONS: This paper shows the value of incorporating QES within a guideline development process, and the roles that qualitative evidence can play in integrating the views and experiences of relevant stakeholders, including groups who may not be otherwise represented in the decision-making process.


Asunto(s)
Medicina Basada en la Evidencia/organización & administración , Investigación sobre Servicios de Salud/organización & administración , Guías de Práctica Clínica como Asunto/normas , Investigación Cualitativa , Organización Mundial de la Salud/organización & administración , Aborto Inducido/normas , Comunicación , Toma de Decisiones , Medicina Basada en la Evidencia/normas , Conocimientos, Actitudes y Práctica en Salud , Investigación sobre Servicios de Salud/normas , Humanos , Servicios de Salud Materno-Infantil/normas , Atención Prenatal/normas , Rol Profesional , Revisiones Sistemáticas como Asunto , Vacunación/métodos
18.
J Rehabil Med ; 51(9): 675-682, 2019 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-31402390

RESUMEN

OBJECTIVE: To compare short generic International Classification of Functioning, Disability and Health (ICF)-based measures of functioning with traditional measures of stroke severity and dependence in subacute stroke. METHODS: In this cross-sectional study patients with stroke (n = 195) and their significant others completed the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) at discharge from rehabilitation. A neurologist assessed functioning with the 7-item World Health Organization (WHO) Minimal Generic Set of domains of functioning and health. These scores were compared with assessments of severity of stroke (National Institutes of Health Stroke Scale; NIHSS) and dependence (modified Rankin Scale; mRS; and Functional Independence Measure; FIM). RESULTS: From mild to severe stroke, increasing disability was found in single items and sum scores of WHODAS and the WHO Minimal Generic Set. Al-though proxies rated 6 out of the 12 separate WHODAS functions more impaired than did the patients, correlations between the different measures (proxy- and patient-WHODAS, the WHO Minimal Generic Set, mRS, NIHSS and FIM total and sub-scores) were strong to very strong, except for moderate correlations between patient-WHODAS, and NIHSS or FIM cognitive sub-score. CONCLUSION: Despite their brevity, both generic ICF-based tools were useful in finding disabilities for patient- and family-centred goal-setting and service-planning after subacute rehabilitation.


Asunto(s)
Evaluación de la Discapacidad , Accidente Cerebrovascular/diagnóstico , Organización Mundial de la Salud/organización & administración , Adulto , Anciano , Estudios Transversales , Personas con Discapacidad , Femenino , Humanos , Masculino , Persona de Mediana Edad
19.
BMC Public Health ; 19(1): 858, 2019 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-31266477

RESUMEN

BACKGROUND: When microorganisms (such as bacteria or viruses) are highly exposed to antimicrobial drugs, they can develop the capacity to defeat the drugs designed to eradicate them. Long-term accumulation of adaptations to survive drug exposure can lead to the development of antimicrobial resistance (AMR). The success of antibiotics has led to their widespread overuse and misuse in humans, animals and plants. MAIN TEXT: AMR is a global concern and solutions are not vertical actions in a single buy business model. Even if a transectoral approach is key, there is a lack of multi-disciplinary partnerships that allow for strategic cooperation between different sectors such as the pharmaceutical industry, agro-alimentary complex, patient care and education, NGOs and research and development. Global public health voices should lead this integration to align the progress of existing AMR successes. Maintaining the public's trust in preventive medicine, health systems and food production safety, together with public health driven, non-profit drug development, is a key factor. In its "Call for integrated action on AMR", signed by about 70 national and international organizations the World Federation of Public Health Associations (WFPHA) called "on all governments, the private sector, non-governmental organizations, health professionals, public and private research organizations, and all stakeholders to ensure that public health remains at the centre of all policy and scientific endeavours in the field of antimicrobial resistance". CONCLUSIONS: The "Global Charter for the Public's Health", developed by the WFPHA in association with WHO, is proposed in this article as a tool for implementation of complex public health actions such as AMR.


Asunto(s)
Farmacorresistencia Microbiana , Salud Global , Salud Pública , Sociedades/organización & administración , Organización Mundial de la Salud/organización & administración , Humanos
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