The public health workforce is a key component of public health system.To articulate the scope of public health workforce,we reviewed the relevant World Health Organization(wHO)guidance and peer-reviewed journal artic...The public health workforce is a key component of public health system.To articulate the scope of public health workforce,we reviewed the relevant World Health Organization(wHO)guidance and peer-reviewed journal articles on this subject.Specifically,we assessed and compared the relevant publications produced by WHO Headquarters and Regional Offices along with other literature on this issue.Our focus was on the“occupation,workplace setting,and employer of public health workforce”.It is noteworthy that WHO has adopted a conceptual framework with an inclusive scope of the public health workforce,while setting out a 5-year vision to strengthen capacity across all WHO Member States for a multidisciplinary workforce to deliver the essential public health functions,including emergency preparedness and response.The importance of public health workforce in global and national responses to the coronavirus disease 2019(COVID-19)pandemic is recognized.We also observed that there were diverse understandings of the scope of public health workforce worldwide,including macro-,meso-and micro-level perspectives.In the post-COVID-19 era,we suggest that policy-makers and practitioners at the national,regional and global level adopt a coordinated approach to expand and strengthen the national workforce as guided by the WHO towards the health-related targets of United Nations Sustainable Development Goals such as health security and Universal Health Coverage.展开更多
Agricultural workers are among the most vulnerable groups facing occupational health risks,yet their protection remains insufficient globally.Despite employing nearly one-third of the global workforce,agriculture is o...Agricultural workers are among the most vulnerable groups facing occupational health risks,yet their protection remains insufficient globally.Despite employing nearly one-third of the global workforce,agriculture is one of the most hazardous sectors,with risks intensified by climate change and limited regulatory coverage.This commentary examines emerging challenges,research gaps,and policy directions,with a focus on international frameworks and China's recent experiences.While initiatives like Healthy China 2030 and pilot projects using international tools have advanced rural occupational health,major barriers persist,especially for precarious and informal agricultural workers.Strengthening national actions and international coordination is urgently needed.Reviving the Joint ILO/WHO Committee on Occupational Health would help bridge the gap between global commitments and local implementation.Protecting agricultural workers is essential for promoting human rights,advancing public health resilience,and achieving sustainable development goals related to health,labor,and food security.展开更多
Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) ...Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.展开更多
Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of sk...Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.展开更多
For this editorial,our colleague Dr.Naeema Hasan Al Qasseer,former World Health Organization(WHO)Senior Scientist of Nursing and Midwifery joins me to add her wisdom and experience on the topic of integrative maternal...For this editorial,our colleague Dr.Naeema Hasan Al Qasseer,former World Health Organization(WHO)Senior Scientist of Nursing and Midwifery joins me to add her wisdom and experience on the topic of integrative maternal-child health nursing.展开更多
Neglected and underutilized species of plants(NUS)have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty,hunger and malnutrition as they can help make agricultural pro...Neglected and underutilized species of plants(NUS)have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty,hunger and malnutrition as they can help make agricultural production systems more sustainable and resilient.Adaptation of NUS to changing environments over several millennia has rendered most of these plants resistant to pests and climate change.In this paper,we explore the potential values of some of the Mayan fruit trees justifying conservation efforts in their native habitats.Our research was primarily based on a scoping review using Google Scholar.We considered articles published in English,Spanish and Portuguese.Our review rendered two sets of articles including those focusing on the nutritional and medicinal properties of NUS and their products,and those focusing on their uses in traditional medicine.Both sets of papers strongly support arguments for conservation of NUS.Additionally,our scoping review expands and includes a case study on the conservation of NUS,highlighting the critical role of civil society on how it can spearhead rescue efforts of botanical resources through the creation of what is possibly the first arboretum of its kind in the Americas.Among the project's key selling points was not only the rescue of an important component of Yucatan's cultural heritage but its nutritional value as well as its potential medicinal properties.Our paper is not prescriptive on how to preserve or even commercially exploit NUS.It is intended as a thought-provoking piece on the potential of a One Health approach as a multi-sectoral platform to support conservation efforts,while stimulating greater interest in the subject and encouraging more action from the academic and pharmaceutical sectors as well as civil society.展开更多
BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and...BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and blindness is estimated to be four times higher in low and intermediate-resource settings than in high-income settings.[1]展开更多
Detection and treatment of drug resistance in extrapulmonary tuberculosis(EPTB)is a major challenge worldwide.Drug resistance in EPTB has not been studied extensively.However,patients with drug-resistant EPTB have bee...Detection and treatment of drug resistance in extrapulmonary tuberculosis(EPTB)is a major challenge worldwide.Drug resistance in EPTB has not been studied extensively.However,patients with drug-resistant EPTB have been reported to have poor outcomes[1].Rifampicin and isoniazid are the cornerstone drugs in the management of EPTB.Resistance in Mycobacterium(M.)tuberculosis to these drugs commonly arises due to mutations in the‘rpoB’gene and‘katG&inhA’genes,which confer resistance to rifampicin and isoniazid,respectively.Treatment outcomes are affected by the presence of these mutations.In addition,anatomical and physiological barriers impede the effective delivery of drugs to the affected extrapulmonary site[1].An analysis of the frequency of mutations in drug resistant M.tuberculosis strains causing EPTB in our region can help identify patterns of drug resistance.This,in turn,can provide inputs that may be used for modifying standard treatment regimens to make them more effective.The present study aims to identify the frequency and pattern of mutations in the‘rpoB’gene and‘katG&inhA’genes in M.tuberculosis strains isolated from EPTB samples.展开更多
With the reduction of sequencing costs,optimization of algorithms,and improvement of multi-omics integration capabilities,transcriptomics,as a core technology for analyzing gene expression dynamics and discovering key...With the reduction of sequencing costs,optimization of algorithms,and improvement of multi-omics integration capabilities,transcriptomics,as a core technology for analyzing gene expression dynamics and discovering key functional molecules,has shown great potential in the field of disease prevention and control[1,2].The multi-continental transcriptomics study of tick-borne poxvirus not only provides a new perspective for understanding the evolution and transmission of vector-mediated viruses,but also reflects the trend of transcriptomics research and highlights its key role in disease prevention and control[3].展开更多
In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Boju...In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.展开更多
Fibroblast growth factor(FGF)signaling encompasses a multitude of functions,including regulation of cell proliferation,differentiation,morphogenesis,and patterning.FGFs and their receptors(FGFR)are crucial for adult t...Fibroblast growth factor(FGF)signaling encompasses a multitude of functions,including regulation of cell proliferation,differentiation,morphogenesis,and patterning.FGFs and their receptors(FGFR)are crucial for adult tissue repair processes.Aberrant FGF signal transduction is associated with various pathological conditions such as cartilage damage,bone loss,muscle reduction,and other core pathological changes observed in orthopedic degenerative diseases like osteoarthritis(OA),intervertebral disc degeneration(IVDD),osteoporosis(OP),and sarcopenia.In OA and IVDD pathologies specifically,FGF1,FGF2,FGF8,FGF9,FGF18,FGF21,and FGF23 regulate the synthesis,catabolism,and ossification of cartilage tissue.Additionally,the dysregulation of FGFR expression(FGFR1 and FGFR3)promotes the pathological process of cartilage degradation.In OP and sarcopenia,endocrine-derived FGFs(FGF19,FGF21,and FGF23)modulate bone mineral synthesis and decomposition as well as muscle tissues.FGF2 and other FGFs also exert regulatory roles.A growing body of research has focused on understanding the implications of FGF signaling in orthopedic degeneration.Moreover,an increasing number of potential targets within the FGF signaling have been identified,such as FGF9,FGF18,and FGF23.However,it should be noted that most of these discoveries are still in the experimental stage,and further studies are needed before clinical application can be considered.Presently,this review aims to document the association between the FGF signaling pathway and the development and progression of orthopedic diseases.Besides,current therapeutic strategies targeting the FGF signaling pathway to prevent and treat orthopedic degeneration will be evaluated.展开更多
The Belt and Road Initiative provides a unique opportunity to improve health outcomes in vast regions of the world. Launched in 2013, the Initiative has been conceived as a platform for collaboration that is forward-l...The Belt and Road Initiative provides a unique opportunity to improve health outcomes in vast regions of the world. Launched in 2013, the Initiative has been conceived as a platform for collaboration that is forward-looking and mutually benefi cial. It is being built on shared values and a vision of a common destiny. As the Chinese President Xi Jinping said in September 2018, China hopes to create “a road of peace, prosperity, openness, green development and innovation and a road that brings together different civilizations.”[1]展开更多
Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 re...Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.展开更多
Objective:To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.Methods:This study was a retrospective evaluation of the quality of malaria case management at...Objective:To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.Methods:This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage.The review period was from January to December 2008.The sample included twelve lower level health facilities from four districts.The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities,more than 80%of the patients had a temperature taken to establish their fever status.About 67%(CI_(95)66.1-68.7)were tested for parasitemia by either rapid diagnostic test or microscopy,whereas the remaining22.5%(CI_(95)213.1-23.7)were not subjected to any malaria test.Of the 2247 malaria cases reported(complicated and uncomplicated),71%were parasitologicaily confirmed while 29%were clinically diagnosed(unconfirmed).About 56%.(CI_(95)53.9-58.1)of the malaria cases reported were treated with artemether-lumefantrine(AL),35%(CI_(95)33.1-37.0)with sulphadoxine-pyrimethamine,8%(CI_(95)6.9-9.2)with quinine and 1%did not receive any anti-malarial.Approximately 30%of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial,contrary to the guidelines.There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used,and in the choice of anti-malarials for the treatment of malaria confirmed cases.Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not.Gender,in service training on malaria,years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices.Conclusions:Malaria case management was characterised by poor adherence to treatment guidelines.The non-adherence was mainly in leans of:inconsistent use of confirmatory tests(rapid diagnostic test or microscopy)for malaria;prescribing anti-malarials which are not recommended(e.g.sulphadoxine-pyrimethamine)and prescribing anti-malarials to cases testing negative.Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.展开更多
Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With j...Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With just 11 years to achieve its goal of universal health coverage by the year 2030, significant efforts will be needed to quantify the scale of the burden facing decision-makers about health system strengthening and redevelopment. Convergence of the health systems will be an additional challenge in Myanmar. Methods: Results from a WHO study in 2009 and 2014, combined with data from the 2016 Global Burden of Disease Study, were compiled and analysed for Myanmar to assess the levels and trends of selected NCDs and NCD risk factors. Results: The prevalence of major NCDs in Myanmar are in general higher than global and regional averages, with a significant increase in diabetes mellitus and chronic obstructive pulmonary diseases in the last 25 years. Major NCD risk factors in Myanmar include smoking, use of smokeless tobacco, alcohol consumption among men, low level of fruit and vegetable consumption, hypertension, and emerging of overweight and obesity, especially among women. Tobacco use increased in both sexes between 2009 and 2014, but only significantly in men. Rates of hypertension increased for both men and women, including those currently on medications—suggesting a need for better treatment regimens. Overweight and obesity rates increased in both men and women, although the increase in obesity for men was not significant. Alcohol consumption results were mixed—with lower levels of high level drinking in men, but generally increased consumption by women. Intake of fruit and vegetables increased slightly between 2009 and 2014 and rates of high levels of physical activity also increased. Diabetes prevalence rates increased significantly in women (X2 = 11.3;p = 0.01) and men (X2 = 9.6;p = 0.02) between 2009 and 2014. Conclusions: Improved awareness of risk factors, coupled with early diagnosis and effective treatment of conditions and risks, is paramount to keeping the population healthy and economically active, and maintaining health care costs. Proven cost-effective interventions to prevent and control NCD-related risk factors, notably increasing tobacco taxes, should be endorsed and implemented in the population. Inaction could hamper the country’s effort to achieve universal health coverage by the year 2030.展开更多
<strong>Background:</strong> Main purpose of this article is to offer information, criteria and conceptual proposals that could clarify the extent or scope of environmental health, and systematize the appr...<strong>Background:</strong> Main purpose of this article is to offer information, criteria and conceptual proposals that could clarify the extent or scope of environmental health, and systematize the approaches for its institutional stewardship by environmental health services. Hopefully, it will be useful to managers, professionals, technicians and academics involved in the management, implementation, teaching or research of this multidisciplinary field. <strong>Methods:</strong> The notion of “environment” is examined, a definition is proposed, and a look is taken at the “green” and “blue” sides of environmental problems. A number of understandings in various countries for “environmental health” are put forth and lists of basic areas for environmental health are analyzed. <strong>Results:</strong> One finding is that all lists are, in reality, unsystematic groupings of three different constituents: determinants, processes and functions. Consideration of these groupings leads to a homogeneous list of 18 areas and 77 sub-areas. Sets or series are provided for each type of constituent (64 determinants, 18 processes and 25 functions), and their aggregation forms the enormous universe of environmental health activities. On the other hand, certain rules of operation are proposed which make it possible, through a form of algebra, to construct expressions based on the provided sets of constituents. And it becomes possible to employ a common symbolic language for describing or assigning activities in the environmental health services. <strong>Conclusions:</strong> The article analyses the contemporaneous extent of environmental health.展开更多
There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in fo...There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in formulating appropriate policies aimed at improving people’s lives due to lack of evidence-based research findings. We describe the potential of a Health and Demographic Surveillance System (HDSS) in informing appropriate health interventions towards reducing the high maternal and child deaths in rural communities of north western Nigeria through the Verbal Autopsy (VA) data collection. VA data collection involves the use of VA questionnaires—set of open ended and closed ended questions adapted from the World Health Organization (WHO) module— administered to the caregivers, parents or family members of a deceased person to elicit information on signs and symptoms and their durations, and other pertinent information about the deceased in the period before death. VA interviews were conducted by trained VA enumerators on all 2100 deaths reported during the update round 4 of routine data collection (July-December, 2012) and returned forms were checked for consistencies and completeness by a trained research officer. The forms were later coded by trained medical doctors for possible cause of death using the WHO International Classification of Diseases (ICD 10) codes. Fifty cases of neonatal deaths, 1650 cases of infant and child deaths, and 400 cases of adult deaths were reported during the update round 4 data collection. Neonatal sepsis was reported as the leading cause of neonatal deaths (58%) while malaria and intestinal infectious diseases were reported as the leading cause of infant and child deaths and adult deaths respectively (45% and 17%, respectively). The study provides documented evidence of high neonatal deaths due to neonatal sepsis in an area with low hygiene and high home delivery rates. The findings from the VA data collection at Nahuche HDSS inform the intervention study on home distribution of chlorhexidine to pregnant women. The findings from this study call on government and other stakeholders to strengthen research capacity to generate timely data and findings returned to policy makers within the shortest period of time for decision making.展开更多
The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Man...The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Many local hospitals have reported a surge of cases, with most cases presenting with severe respiratory complications. We aim to present a comprehensive surge filter protocol for outpatient programs to mitigate the surge of cases admitted in the emergency rooms and intensive care units (ICUs) of local hospitals in our community. Our surge filter protocol was developed based on a detailed review of how South Korea and Spain mounted their outpatient surge responses. Our preliminary findings revealed that our Four-Ts approach (<em>i.e.</em>, Test, Treat, Track, and Teach) has resulted in none of our patients reaching a clinical requirement for inpatient care.展开更多
This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthc...This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthcare delivery model including philosophies/values,structure,process and outcome were used to conduct a quality assessment of the integrated health system in Ghana.Each element clearly showed that Ghana is currently not running a coordinated health practice model,thus making it a tolerant,rather than an inclusive,health system.Therefore,the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana.The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics.As such,governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings.Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings.This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.展开更多
文摘The public health workforce is a key component of public health system.To articulate the scope of public health workforce,we reviewed the relevant World Health Organization(wHO)guidance and peer-reviewed journal articles on this subject.Specifically,we assessed and compared the relevant publications produced by WHO Headquarters and Regional Offices along with other literature on this issue.Our focus was on the“occupation,workplace setting,and employer of public health workforce”.It is noteworthy that WHO has adopted a conceptual framework with an inclusive scope of the public health workforce,while setting out a 5-year vision to strengthen capacity across all WHO Member States for a multidisciplinary workforce to deliver the essential public health functions,including emergency preparedness and response.The importance of public health workforce in global and national responses to the coronavirus disease 2019(COVID-19)pandemic is recognized.We also observed that there were diverse understandings of the scope of public health workforce worldwide,including macro-,meso-and micro-level perspectives.In the post-COVID-19 era,we suggest that policy-makers and practitioners at the national,regional and global level adopt a coordinated approach to expand and strengthen the national workforce as guided by the WHO towards the health-related targets of United Nations Sustainable Development Goals such as health security and Universal Health Coverage.
基金the Project to Carry Out International Expert Consultation and Promote the Alignment of China's Occupational Health with International High-Standard Technical Rules(2024-2025)which is funded by the Ministry of Human Resources and Social Security of the People's Republic of China(Grant No.H20240785).
文摘Agricultural workers are among the most vulnerable groups facing occupational health risks,yet their protection remains insufficient globally.Despite employing nearly one-third of the global workforce,agriculture is one of the most hazardous sectors,with risks intensified by climate change and limited regulatory coverage.This commentary examines emerging challenges,research gaps,and policy directions,with a focus on international frameworks and China's recent experiences.While initiatives like Healthy China 2030 and pilot projects using international tools have advanced rural occupational health,major barriers persist,especially for precarious and informal agricultural workers.Strengthening national actions and international coordination is urgently needed.Reviving the Joint ILO/WHO Committee on Occupational Health would help bridge the gap between global commitments and local implementation.Protecting agricultural workers is essential for promoting human rights,advancing public health resilience,and achieving sustainable development goals related to health,labor,and food security.
文摘Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
文摘Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.
文摘For this editorial,our colleague Dr.Naeema Hasan Al Qasseer,former World Health Organization(WHO)Senior Scientist of Nursing and Midwifery joins me to add her wisdom and experience on the topic of integrative maternal-child health nursing.
文摘Neglected and underutilized species of plants(NUS)have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty,hunger and malnutrition as they can help make agricultural production systems more sustainable and resilient.Adaptation of NUS to changing environments over several millennia has rendered most of these plants resistant to pests and climate change.In this paper,we explore the potential values of some of the Mayan fruit trees justifying conservation efforts in their native habitats.Our research was primarily based on a scoping review using Google Scholar.We considered articles published in English,Spanish and Portuguese.Our review rendered two sets of articles including those focusing on the nutritional and medicinal properties of NUS and their products,and those focusing on their uses in traditional medicine.Both sets of papers strongly support arguments for conservation of NUS.Additionally,our scoping review expands and includes a case study on the conservation of NUS,highlighting the critical role of civil society on how it can spearhead rescue efforts of botanical resources through the creation of what is possibly the first arboretum of its kind in the Americas.Among the project's key selling points was not only the rescue of an important component of Yucatan's cultural heritage but its nutritional value as well as its potential medicinal properties.Our paper is not prescriptive on how to preserve or even commercially exploit NUS.It is intended as a thought-provoking piece on the potential of a One Health approach as a multi-sectoral platform to support conservation efforts,while stimulating greater interest in the subject and encouraging more action from the academic and pharmaceutical sectors as well as civil society.
文摘BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and blindness is estimated to be four times higher in low and intermediate-resource settings than in high-income settings.[1]
文摘Detection and treatment of drug resistance in extrapulmonary tuberculosis(EPTB)is a major challenge worldwide.Drug resistance in EPTB has not been studied extensively.However,patients with drug-resistant EPTB have been reported to have poor outcomes[1].Rifampicin and isoniazid are the cornerstone drugs in the management of EPTB.Resistance in Mycobacterium(M.)tuberculosis to these drugs commonly arises due to mutations in the‘rpoB’gene and‘katG&inhA’genes,which confer resistance to rifampicin and isoniazid,respectively.Treatment outcomes are affected by the presence of these mutations.In addition,anatomical and physiological barriers impede the effective delivery of drugs to the affected extrapulmonary site[1].An analysis of the frequency of mutations in drug resistant M.tuberculosis strains causing EPTB in our region can help identify patterns of drug resistance.This,in turn,can provide inputs that may be used for modifying standard treatment regimens to make them more effective.The present study aims to identify the frequency and pattern of mutations in the‘rpoB’gene and‘katG&inhA’genes in M.tuberculosis strains isolated from EPTB samples.
文摘With the reduction of sequencing costs,optimization of algorithms,and improvement of multi-omics integration capabilities,transcriptomics,as a core technology for analyzing gene expression dynamics and discovering key functional molecules,has shown great potential in the field of disease prevention and control[1,2].The multi-continental transcriptomics study of tick-borne poxvirus not only provides a new perspective for understanding the evolution and transmission of vector-mediated viruses,but also reflects the trend of transcriptomics research and highlights its key role in disease prevention and control[3].
文摘In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.
基金supported by the National Key R&D Program of China(2023YFC3603400)the National Natural Science Foundation of China(82072506,92268115)+2 种基金the Hunan Provincial Science Fund for Distinguished Young Scholars(2024JJ2089)the Science and Technology Innovation Program of Hunan Province(2021RC3025)the National Clinical Research Center for Geriatric Disorders(Xiangya Hospital,2021KF02).
文摘Fibroblast growth factor(FGF)signaling encompasses a multitude of functions,including regulation of cell proliferation,differentiation,morphogenesis,and patterning.FGFs and their receptors(FGFR)are crucial for adult tissue repair processes.Aberrant FGF signal transduction is associated with various pathological conditions such as cartilage damage,bone loss,muscle reduction,and other core pathological changes observed in orthopedic degenerative diseases like osteoarthritis(OA),intervertebral disc degeneration(IVDD),osteoporosis(OP),and sarcopenia.In OA and IVDD pathologies specifically,FGF1,FGF2,FGF8,FGF9,FGF18,FGF21,and FGF23 regulate the synthesis,catabolism,and ossification of cartilage tissue.Additionally,the dysregulation of FGFR expression(FGFR1 and FGFR3)promotes the pathological process of cartilage degradation.In OP and sarcopenia,endocrine-derived FGFs(FGF19,FGF21,and FGF23)modulate bone mineral synthesis and decomposition as well as muscle tissues.FGF2 and other FGFs also exert regulatory roles.A growing body of research has focused on understanding the implications of FGF signaling in orthopedic degeneration.Moreover,an increasing number of potential targets within the FGF signaling have been identified,such as FGF9,FGF18,and FGF23.However,it should be noted that most of these discoveries are still in the experimental stage,and further studies are needed before clinical application can be considered.Presently,this review aims to document the association between the FGF signaling pathway and the development and progression of orthopedic diseases.Besides,current therapeutic strategies targeting the FGF signaling pathway to prevent and treat orthopedic degeneration will be evaluated.
文摘The Belt and Road Initiative provides a unique opportunity to improve health outcomes in vast regions of the world. Launched in 2013, the Initiative has been conceived as a platform for collaboration that is forward-looking and mutually benefi cial. It is being built on shared values and a vision of a common destiny. As the Chinese President Xi Jinping said in September 2018, China hopes to create “a road of peace, prosperity, openness, green development and innovation and a road that brings together different civilizations.”[1]
基金supported by the Project of International Expert Consultation for the National Occupational Health System Innovation funded by the Ministry of Science and Technology of China in 2020-2022(Grant No.G20200001489).
文摘Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.
基金Supported by The Bill and Melinda Gates Foundation support to PATH for the Malaria Control Evaluation Partnership for Africa(MACEPA)project,Grant Number:OPP1013468
文摘Objective:To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.Methods:This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage.The review period was from January to December 2008.The sample included twelve lower level health facilities from four districts.The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities,more than 80%of the patients had a temperature taken to establish their fever status.About 67%(CI_(95)66.1-68.7)were tested for parasitemia by either rapid diagnostic test or microscopy,whereas the remaining22.5%(CI_(95)213.1-23.7)were not subjected to any malaria test.Of the 2247 malaria cases reported(complicated and uncomplicated),71%were parasitologicaily confirmed while 29%were clinically diagnosed(unconfirmed).About 56%.(CI_(95)53.9-58.1)of the malaria cases reported were treated with artemether-lumefantrine(AL),35%(CI_(95)33.1-37.0)with sulphadoxine-pyrimethamine,8%(CI_(95)6.9-9.2)with quinine and 1%did not receive any anti-malarial.Approximately 30%of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial,contrary to the guidelines.There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used,and in the choice of anti-malarials for the treatment of malaria confirmed cases.Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not.Gender,in service training on malaria,years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices.Conclusions:Malaria case management was characterised by poor adherence to treatment guidelines.The non-adherence was mainly in leans of:inconsistent use of confirmatory tests(rapid diagnostic test or microscopy)for malaria;prescribing anti-malarials which are not recommended(e.g.sulphadoxine-pyrimethamine)and prescribing anti-malarials to cases testing negative.Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.
文摘Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With just 11 years to achieve its goal of universal health coverage by the year 2030, significant efforts will be needed to quantify the scale of the burden facing decision-makers about health system strengthening and redevelopment. Convergence of the health systems will be an additional challenge in Myanmar. Methods: Results from a WHO study in 2009 and 2014, combined with data from the 2016 Global Burden of Disease Study, were compiled and analysed for Myanmar to assess the levels and trends of selected NCDs and NCD risk factors. Results: The prevalence of major NCDs in Myanmar are in general higher than global and regional averages, with a significant increase in diabetes mellitus and chronic obstructive pulmonary diseases in the last 25 years. Major NCD risk factors in Myanmar include smoking, use of smokeless tobacco, alcohol consumption among men, low level of fruit and vegetable consumption, hypertension, and emerging of overweight and obesity, especially among women. Tobacco use increased in both sexes between 2009 and 2014, but only significantly in men. Rates of hypertension increased for both men and women, including those currently on medications—suggesting a need for better treatment regimens. Overweight and obesity rates increased in both men and women, although the increase in obesity for men was not significant. Alcohol consumption results were mixed—with lower levels of high level drinking in men, but generally increased consumption by women. Intake of fruit and vegetables increased slightly between 2009 and 2014 and rates of high levels of physical activity also increased. Diabetes prevalence rates increased significantly in women (X2 = 11.3;p = 0.01) and men (X2 = 9.6;p = 0.02) between 2009 and 2014. Conclusions: Improved awareness of risk factors, coupled with early diagnosis and effective treatment of conditions and risks, is paramount to keeping the population healthy and economically active, and maintaining health care costs. Proven cost-effective interventions to prevent and control NCD-related risk factors, notably increasing tobacco taxes, should be endorsed and implemented in the population. Inaction could hamper the country’s effort to achieve universal health coverage by the year 2030.
文摘<strong>Background:</strong> Main purpose of this article is to offer information, criteria and conceptual proposals that could clarify the extent or scope of environmental health, and systematize the approaches for its institutional stewardship by environmental health services. Hopefully, it will be useful to managers, professionals, technicians and academics involved in the management, implementation, teaching or research of this multidisciplinary field. <strong>Methods:</strong> The notion of “environment” is examined, a definition is proposed, and a look is taken at the “green” and “blue” sides of environmental problems. A number of understandings in various countries for “environmental health” are put forth and lists of basic areas for environmental health are analyzed. <strong>Results:</strong> One finding is that all lists are, in reality, unsystematic groupings of three different constituents: determinants, processes and functions. Consideration of these groupings leads to a homogeneous list of 18 areas and 77 sub-areas. Sets or series are provided for each type of constituent (64 determinants, 18 processes and 25 functions), and their aggregation forms the enormous universe of environmental health activities. On the other hand, certain rules of operation are proposed which make it possible, through a form of algebra, to construct expressions based on the provided sets of constituents. And it becomes possible to employ a common symbolic language for describing or assigning activities in the environmental health services. <strong>Conclusions:</strong> The article analyses the contemporaneous extent of environmental health.
文摘There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in formulating appropriate policies aimed at improving people’s lives due to lack of evidence-based research findings. We describe the potential of a Health and Demographic Surveillance System (HDSS) in informing appropriate health interventions towards reducing the high maternal and child deaths in rural communities of north western Nigeria through the Verbal Autopsy (VA) data collection. VA data collection involves the use of VA questionnaires—set of open ended and closed ended questions adapted from the World Health Organization (WHO) module— administered to the caregivers, parents or family members of a deceased person to elicit information on signs and symptoms and their durations, and other pertinent information about the deceased in the period before death. VA interviews were conducted by trained VA enumerators on all 2100 deaths reported during the update round 4 of routine data collection (July-December, 2012) and returned forms were checked for consistencies and completeness by a trained research officer. The forms were later coded by trained medical doctors for possible cause of death using the WHO International Classification of Diseases (ICD 10) codes. Fifty cases of neonatal deaths, 1650 cases of infant and child deaths, and 400 cases of adult deaths were reported during the update round 4 data collection. Neonatal sepsis was reported as the leading cause of neonatal deaths (58%) while malaria and intestinal infectious diseases were reported as the leading cause of infant and child deaths and adult deaths respectively (45% and 17%, respectively). The study provides documented evidence of high neonatal deaths due to neonatal sepsis in an area with low hygiene and high home delivery rates. The findings from the VA data collection at Nahuche HDSS inform the intervention study on home distribution of chlorhexidine to pregnant women. The findings from this study call on government and other stakeholders to strengthen research capacity to generate timely data and findings returned to policy makers within the shortest period of time for decision making.
文摘The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Many local hospitals have reported a surge of cases, with most cases presenting with severe respiratory complications. We aim to present a comprehensive surge filter protocol for outpatient programs to mitigate the surge of cases admitted in the emergency rooms and intensive care units (ICUs) of local hospitals in our community. Our surge filter protocol was developed based on a detailed review of how South Korea and Spain mounted their outpatient surge responses. Our preliminary findings revealed that our Four-Ts approach (<em>i.e.</em>, Test, Treat, Track, and Teach) has resulted in none of our patients reaching a clinical requirement for inpatient care.
文摘This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthcare delivery model including philosophies/values,structure,process and outcome were used to conduct a quality assessment of the integrated health system in Ghana.Each element clearly showed that Ghana is currently not running a coordinated health practice model,thus making it a tolerant,rather than an inclusive,health system.Therefore,the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana.The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics.As such,governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings.Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings.This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.
