In the mid-1990s the World Health Organisation seemed doomed to either "flounder in a morass of petty corruption and ineffective bureaucracy" or to die. Neither of these happened. Instead, Gro Harlem Brundtland, who took office as director general in July 1998, restored the organisation's reputation as a credible force in global health. Last week the World Health Assembly approved Jong-Wook Lee as Brundtland's successor. Unlike Brundtland, Lee is not being charged with saving the organisation but with harnessing its potential to transform the lives of the poorest.
Equity in Health
New protocol for malnutrition management to save lives in Mozambique
Improved measures to tackle acute malnutrition in Mozambique are expected to save the lives of thousands of children and adults. During a five-day workshop supported by the UN Children's Fund (UNICEF) last week, about 100 health workers in the capital, Maputo, adopted a protocol outlining step-by-step guidelines for the management of acute malnutrition in children.
New survey finds highest rates of drug-resistant TB to date
WHO, 26 February 2008
Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a new report published today. The report presents findings from the largest global survey to date on the scale of drug resistance in tuberculosis. The report also found a link between HIV infection and MDR-TB.
New UNAIDS report warns AIDS epidemic still in early phase
A new report released by the Joint United Nations Programme on HIV/AIDS (UNAIDS) warns that the AIDS epidemic is still in an early phase. HIV prevalence is climbing higher than previously believed possible in the worst-affected countries and is continuing to spread rapidly into new populations in Africa, Asia, the Caribbean and Eastern Europe.
New WHO roadmap for primary health care incomplete, says PHM
Twenty-five years ago WHO promised 'Health for All' through the Alma Ata declaration. However, the UN body abandoned the primary health care agenda in the later years. ‘Health systems, including primary health care’, a new WHO document, endorses the primary health care agenda. It is a welcome return to the basics. Grassroots movements like the People’s Health Movement (PHM) offer a cautious welcome, but say this is not enough. The UN health body’s new ‘road map’ that is being presented during the ongoing World Health Assembly endorses the importance of primary health care - something that grass roots movements like the PHM has been demanding for years.
Further details: /newsletter/id/30466
Newborn survival in Malawi: A decade of change and future implications
Zimba E, Kinney MV, Kachale F, Waltensperger KZ, Blencowe H, Colbourn T et al: Health Policy and Planning 27: iii88-iii103, March 2012
Malawi is one of two low-income sub-Saharan African countries on track to meet the Millennium Development Goal (MDG 4) for child survival despite high fertility and HIV rates and low health worker density. In this study, researchers examined changes in newborn survival in the decade 2000-2010, and assessed national and external funding, as well as policy and programme changes. Compared with the 1990s, they found that progress towards MDGs 4 and 5 accelerated considerably from 2000 to 2010. They argue that a significant increase in facility births and other health system changes, including increased human resources, likely contributed to the 3.5% annual decline in neonatal mortality rate. The initial entry point for newborn care in Malawi was mainly through facility initiatives, such as Kangaroo Mother Care. This transitioned to an integrated and comprehensive approach at community and facility level through the Community-Based Maternal and Newborn Care package, now being implemented in 17 of 28 districts. Addressing quality gaps, especially for care at birth in facilities, and including newborn interventions in child health programmes, will be critical to the future agenda of newborn survival in Malawi, the paper concludes.
Newborn survival in Uganda: A decade of change and future implications
Mbonye AK, Sentongo M, Mukasa GK, Byaruhanga R, Sentumbwe-Mugisa O, Waiswa P et al: Health Policy and Planning 27: iii104-iii117, March 2012
As part of a multi-country analysis, the authors of this paper examined changes for newborn survival in Uganda over the past decade through mortality and health system coverage indicators as well as national and external funding for health, and changes in policies and programmes. Between 2000 and 2010 Uganda’s neonatal mortality rate reduced by 2.2% per year, which is greater than the regional average rate of decline but lower than national reductions in maternal mortality and under-five mortality. Attention and policy change for newborn health is comparatively recent, the authors note. In 2006, a national Newborn Steering Committee was launched, which was given a mandate from the Ministry of Health to advise on newborn survival issues. This multi-disciplinary and inter-agency network of stakeholders has been able to preside over a number of important policy changes at various levels of facility care, education and training, in addition to community-based service delivery through village health teams and changes to essential drugs and commodities. The committee’s comprehensive reach has enabled rapid policy change and increased attention to newborn survival in a relatively short space of time. Translating this favourable policy environment into district-level implementation and high quality services is now the priority.
Next wave of interventions to reduce under-five mortality in Rwanda: a crosssectional analysis of demographic and health survey data
Amoroso C; Nisingizwe M; Rouleau D; et al: BMC Pediatrics 18(27) doi: 10.1186/s12887-018-0997-y, 2018
This paper reports on a cross-sectional study of 9002 births to 6328 women age 15–49 in the 2010 Rwanda Demographic and Health Survey to identify correlates of under-five mortality in all children under-five, 0–11 months, and 12–59 months. The results indicated that of 14 covariates associated with under-five mortality in bivariate analysis, the following remained associated with under-five mortality in multivariate analysis: household being among the poorest of the poor, child being a twin, mother having 3–4 births in the past 5 years compared to 1–2 births, mother being HIV positive, and mother not using contraceptives compared to using a modern method. Mother experiencing physical or sexual violence in the last 12 months was associated with under-five mortality in children ages 1–4 years. Under five survival was associated with a preceding birth interval 25–50 months compared to 9–24 months, and having a mosquito net. It was concluded that in the past decade, Rwanda rolled out integrated management of childhood illness, near universal coverage of childhood vaccinations, a national community health worker program, and a universal health insurance scheme. The results of the study suggest that Rwanda’s next wave of U5 mortality reduction should target programs in improving neonatal outcomes, poverty reduction, family planning, HIV services, malaria prevention, and prevention of intimate partner violence.
NGOs debate Global Health Fund
On the 4th October 2001, more than 30 participants gathered at the Healthlink Worldwide offices in London to discuss and debate plans to establish a ‘Global Health Fund’. The event was jointly organised by the Health and Development Forum and British Overseas NGOs in Development [BOND]. Participants came from a wide range of organisations including British and international NGOs, academic institutions, the World Health Organisation and concerned individuals. The intention of the meeting was to update participants on developments concerning the establishment of the Fund, share views on this and identify key views and issues which could be fed into the consultation process.
Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need
Amara AH, Aljunid SM: Globalization and Health 10(24): 3 April 2014
With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic non-communicable diseases (NCDs). This study reviewed the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries.