National Plan, Policy & GuidelinesResearch & Publication

COVID19 Resources: Guidelines and Documents- Ministry of Health and Population 

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COVID19 Resources: Guidelines and Documents- Ministry of Health and Population

Order for Hazard Allowance Management

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Order for COVID-19 Unified Hospital Operation- 2077

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Order for Hospital Grant

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Coronavirus disease (COVID-19) Resources: Guidelines, Recording and Reporting Formats

Collateral Threats of COVID-19 and Climate Change

WHO Press Release: On Unauthorized Use of WHO Logo

The bumpy road to better health: How embedded research strengthened health services in Ghana

When Will COVID-19 End Data-Driven Estimation of End Dates (updated on April 28)

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Environmental Health & Climate ChangeGuest PostPublic HealthResearch & Publication

Collateral Threats of COVID-19 and Climate Change

by Public Health Update
written by Public Health Update

Collateral Threats of COVID-19 and Climate Change

Sundar  Lamichhane

The COVID-19 outbreak has become a global human tragedy, affecting millions of people all around the world. The pandemic has resulted in the largest number of shutdowns/lockdowns worldwide at the same time in history. As of May 2 2020, more than 3.4 million cases have been reported in 212 countries and territories, resulting in more than 239,622 deaths. The Covid-19 pandemic may turn out to be the tip of the iceberg of the climate crisis. The geo-physical and socio economic changes that the world is experiencing today will bring unprecedented challenges, including public health crises like this current pandemic.  Between 2030 and 2050, WHO estimates climate change will cause approximately 250, 000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress.

COVID-19 and climate change both pose existential threats to the people all over the globe; both were foretold by scientists and researchers. While it may not affect large number of people that we have seen with current pandemic, climate change will apply mounting pressures on healthcare systems. In order for healthcare systems to meet these challenges, concerned authorities and people should learn lessons from the current pandemic. Although the Covid-19 pandemic itself might not be directly linked to environmental and climate change but there are, some parallels that can be drawn:

  • As seen on the current pandemic we require well-resourced, equitable health systems with a strong and supported health workforce to protect us from health security threats, including climate change in upcoming future. Global cooperation and advance preparedness is required to mitigate the burden on healthcare systems, reducing morbidity and mortality.
  • Ongoing pandemic shows that inequality is a major barrier in ensuring the health and wellbeing of people. Being specific social and economic inequality contributes in unequal access to healthcare systems. The consequences of COVID-19 seems to be greater for cities and people exposed to higher levels of pollution, which are most often people living in poorer areas. In case for health impacts of climate change, we have to face similar unexpected ramifications with one of its major causes, the burning of fossil fuels, eventually adding pollution to the airand impacting the health of poorer people living in poverty.
  • To be safe and protect themselves from the current pandemic people all around the world dramatically change their behavior which guided us to realize the potential of lifestyle change can bring sustainable change in society. This temporary shift of behaviors could lead to a long-term shift in old behaviors and assumptions, which can be one of the sustainable way to prevent ourselves from catastrophic consequences of climate change and upcoming calamities.
  • Climate change may shift the dimension of disease occurrence (where when and how severe). Looking at the current pandemic difficulty is seen in differentiating the symptoms with other similar flu in early days. Disease monitoring and prevention guidelines should be updated so that clinicians can best recognize novel contexts and symptoms of conditions and recommend preventive measures to their patients, given the changing patterns and mechanisms of disease development brought by climate change.

Consequences of COVID-19 pandemic can last on a time scale for months creating problem for everyone living now but the outcome of climate change can have consequential impacts for future generations. This pandemic had taught us valuable lessons to build more robust healthcare response plans at the state and community levels to support vulnerable population and all other people

Through close international collaboration and effective action the spread of COVID-19 is slowing down within their own borders. In the same way for the stabilization of climate all nations should reduce their emissions (CO2 and other harmful gases) Going it alone doesn’t work. This needs strong and effective coordination from all the countries around the globe.

The pandemic should serve as a wake-up call to realize and address the nature related risks caused by human activities. Strong policies should be formulated and implemented to address the various climate change issues.

References

Sundar  Lamichhane, BPH 7th semester student, SHAS Pokhara University, Pokhara Metropolitan City-30, Lekhnath, Kaski, Nepal, Email:lcsundar7@gmail.com, contact No: 9861182963

Want to submit an article?

Send us your articles to mail4sagun@gmail.com with your name and photo. Public Health Update encourages public health students and professionals to submit views and voices.

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National Health NewsPublic Health News

WHO Press Release: On Unauthorized Use of WHO Logo

by Public Health Update
written by Public Health Update

WHO Press Release: On Unauthorized Use of WHO Logo

1 May 2020 

News release
Nepal


Screen Shot 2020 05 01 at 13.21.41

The World Health Organization (WHO), Country Office for Nepal, has been receiving information about unauthorized use of the WHO logo in some instances in the country. We wish to draw attention to the fact that the emblem/logo/symbol of the WHO is part of the Organization’s intellectual property, and its use implies endorsement by the WHO; and the logo may only be used with the express written permission of the WHO. Guidance on the procedure to obtain permission to use the WHO logo is available on the WHO’s website.

The use of the WHO logo is restricted to government agencies and institutions that have an official collaborating status with the WHO and only in conjunction with the work that they are undertaking with the WHO.

We request all to follow the said guidelines and share this information with partners. Please inform WHO, Country Office Nepal, in case you notice a breach.

1 May 2020  News release Nepal

For media inquiries, email samatya@who.int

The use of the WHO emblem and logo is governed by a resolution of the First World Health Assembly (resolution WHA1.133), which states that “appropriate measures should be taken to prevent the use, without authorization by the Director-General, and in particular for commercial purposes by means of trade-marks or commercial labels, of the emblem, the official seal and the name of the World Health Organization, and of abbreviations of that name through the use of its initial letters”. WHO’s rules accepted by its 194 Member States do not allow the Organization’s name, emblem or logo to be used to promote specific companies, products or ideologies. – WHO

Read more:

Use of the WHO logo or emblem requires express written permission
The WHO Logo and Emblem

The bumpy road to better health: How embedded research strengthened health services in Ghana

Joint EMRO/TDR Small Grants Scheme Implementation Research on Infectious Diseases of Poverty

WHO convenes manufacturers, regulatory authorities meet on COVID-19 vaccines

Johns Hopkins University Jobs Opportunities [Health Care Services and Research]

WHO Myth busters: Taking a hot bath does not prevent the new coronavirus disease

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Health SystemsInternational Plan, Policy & GuidelinesPublic HealthPublic Health InnovationPublic Health UpdateReportsResearch & PublicationSuccess Stories

The bumpy road to better health: How embedded research strengthened health services in Ghana

by Public Health Update
written by Public Health Update

The bumpy road to better health: How embedded research strengthened health services in Ghana

Ghana’s success story

For over 20 years, Ghana’s CHPS programme has been the focus of the country’s primary health care strategy. It’s a community-centred approach that has transformed maternal and child health in the most inaccessible parts of the country. But how did it come into being, and what has Ghana done differently that has made it so successful? Community-based Health Planning and Services – more commonly referred to by its acronym CHPS (pronounced ‘chips’) – is well known by health systems experts across the world. In rural areas, CHPS is often the first point of contact with government health services. As in many other low- and middle-income countries, Ghana experiences a great number of impediments to improving health and well-being for its citizens. Many people live long distances from the nearest health centre. Access to electricity, mobile-cellular coverage and clean water are a challenge in rural areas. While international standards suggest that the ideal ratio is one doctor per 1 000 people, in Ghana in 2017 there was only one doctor per 8 098 people, and most of these doctors lived in cities and towns. In addition to logistical challenges, there are also local cultural beliefs preventing women from seeking care, even during childbirth.

The bumpy road to better health: How embedded research strengthened health services in Ghana is the story of how an experiment in the north of Ghana changed the health of a nation. How health staff in remote and rural areas are working tirelessly to prevent the deaths of mothers and children. How a radical approach to health research, known as embedded research, has revolutionized how the government delivers health services under difficult circumstances.

Five steps Ghana took to infuse evidence into its primary health care system

Step 1: Believe in research

Trust in the power of research evidence.
Ghana has worked over the last thirty years to build a ‘learning health system’: research and routine data collected through health services play a large role in decision-making and identifying challenges. The creation of three health research centres spread across the country has become a critical part of its health service. A lot of effort has also gone into establishing strong links with researchers working in local universities. This has all contributed to a culture shift that has allowed for greater use of evidence in decision-making about the way services are delivered. 

Step 2: Get everyone around the table
Build a shared agenda for change.
Successful embedded research projects bring everyone together – researchers, implementers and policy-makers – from the very beginning. In Ghana, the roll out of the CHPS programme also involved directly engaging communities. Input from development partners was also helpful. Agreeing on the questions to be asked, the methods to be used and who is to be involved was critical for moving forward together.

 

Step 3: Communicate regularly
Share data and intelligence as it becomes available.
It has been important in Ghana to share information about what is being revealed while the research is underway. This active sharing has allowed for adjustments to programmes based on new knowledge and for researchers to respond to emerging policy or implementation priorities. For example, in one of the CHPS study areas, some asides made during focus group discussions highlighted that lower-level staff in the health facilities felt that their supervision was too stern and not supportive. The district director was able to swiftly address the issue, holding human resource management training on addressing conflict and conducting monitoring visits. Observing and reacting to new information can have real impacts for those working on the frontline of health.

 

Step 4: Think local
Research should respond to real-world challenges. Embedded research needs to respond to the problems and challenges that are being faced by policy-makers and health staff on the frontlines. In Ghana, one way they ensured this was through establishing partnerships with local research institutions and not just relying on national or international experts.


Step 5: Keep going
Always build on success. In Ghana, they built on findings from an experiment to create a primary health care system that is addressing the needs of its rural communities. But the scale-up process was not easy and required continued research to support innovations and get the programme back on the right road. Even where the programme is working well, embedded research is helping it to evolve and to respond to changing needs within communities.

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Global Health NewsOutbreak NewsPublic HealthPublic Health News

WHO convenes manufacturers, regulatory authorities meet on COVID-19 vaccines

by Public Health Update
written by Public Health Update

WHO convenes manufacturers, regulatory authorities meet on COVID-19 vaccines

29 April 2020 

News release
SEAR/PR/1731

New Delhi – Gearing up for the much needed COVID-19 vaccines, the World Health Organization today organized a meeting of vaccine manufacturers and national regulatory authorities from its South-East Asia Region.

“The manufacturing capacity that exists in our Region is of the quality and scale required to produce and roll-out a COVID-19 vaccine globally. This Region is a vaccine manufacturing powerhouse, and it must now also play a lead role in overcoming the ongoing pandemic,” said Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia.

At the virtual meeting, leading manufacturers from India, Indonesia and Thailand discussed timelines and production capacity, while regulatory bodies deliberated on adjustments that would be needed in processes to make COVID-19 vaccines available at the earliest.

Several steps must be completed before COVID-19 vaccine can be used on a large scale. These include pre-clinical and clinical trials, production, licensure, deployment of vaccines and plans for post-marketing surveillance.

Mapping the full landscape of vaccine development activities in the Region will help coordination with global stakeholders, and support countries preparing COVID19 vaccine deployment plans, she said.

Globally, WHO has mobilized a broad coalition of scientists, researchers and industry partners to develop and evaluate candidate vaccines for COVID-19. More than 120 potential vaccine candidates have been proposed globally, and WHO continues to track their type and progress.  Seven candidate vaccines are already in clinical evaluation and 82 vaccines are in pre-clinical evaluation.

Last week, WHO launched the Access to COVID-19 Tools Accelerator, which brings together key global health actors, private sector partners and other stakeholders to accelerate the development and production of COVID-19 essential health technologies, including vaccines, and to help guarantee equitable access. 

The launch of the initiative comes in the wake of a UN General Assembly resolution through which Member States called for all countries to have “equitable, efficient and timely” access to any future vaccines developed to fight COVID-19.

Dr Khetrapal Singh said, “All countries are now preparing to safely transition towards a ‘new normal’ in which social and economic life can function amid low or no COVID-19 transmission. As countries continue to assess and minimize risks, they are very much aware that we are in this together and must get through it together – that no country is safe until we all are safe, for which an effective vaccine that is accessible to all is needed.”

“We are also working to ensure that, once developed, safe and effective COVID-19 vaccines are available to all of humanity. To do that, we are coordinating expert consultations, developing target product profiles and supporting clinical trials. For the Region and for the world, WHO is committed to facilitating and coordinating your efforts,” the Regional Director said.

India, Indonesia and Thailand are among the world’s largest vaccine manufacturers.  Every day, millions of people of all ages are provided life-saving protection by vaccines produced in these three countries.

“As we mark World Immunization Week, we must build on our success and redouble our efforts to ensure all people in the Region can access the life-saving benefits vaccines bring.  Yes, the COVID-19 pandemic is a unique challenge. But I am certain that through collaboration and innovation we can produce a vaccine faster than ever before, while maintaining all standards,” Dr Khetrapal Singh said.

Harvard University Jobs and Opportunities [Faculty and Other Academic Positions]

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Postdoctoral position in the computational modeling of COVID-19. INSERM, France

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Adolescent Sexual and Reproductive Health (ASRH)Fact SheetGlobal Health NewsHealth in DataMaternal, Newborn and Child HealthOutbreak NewsPublic HealthPublic Health NewsPublic Health Update

New UNFPA projections predict calamitous impact on women’s health as COVID-19 pandemic continues

by Public Health Update
written by Public Health Update

New UNFPA projections predict calamitous impact on women’s health as COVID-19 pandemic continues

28 April 2020

NEW YORK / BANGKOK – As the COVID-19 pandemic rages on, the number of women unable to access family planning, facing unintended pregnancies, gender-based violence and other harmful practices could skyrocket by millions of cases in the months ahead, according to data released by UNFPA, the United Nations sexual and reproductive health agency.

The research reveals the enormous scale of the impact COVID-19 is having on women as health systems become overloaded, facilities close or only provide a limited set of services to women and girls, and many choose to skip important medical checkups through fear of contracting the virus. Global supply chain disruptions may also lead to significant shortages of contraceptives and gender-based violence is expected to soar as women are trapped at home for prolonged periods.

“This new data shows the catastrophic impact that COVID-19 could soon have on women and girls globally. The pandemic is deepening inequalities, and millions more women and girls now risk losing the ability to plan their families and protect their bodies and their health,” said Dr. Natalia Kanem, UNFPA Executive Director. “Women’s reproductive health and rights must be safeguarded at all costs. The services must continue; the supplies must be delivered; and the vulnerable must be protected and supported.”

KEY PROJECTIONS:

  • 47 million women in 114 low- and middle-income countries may not be able to access modern contraceptives and 7 million unintended pregnancies are expected to occur if the lockdown carries on for 6 months and there are major disruptions to health services. For every 3 months the lockdown continues, up to an additional 2 million women may be unable to use modern contraceptives.
  • 31 million additional cases of gender-based violence can be expected to occur if the lockdown continues for at least 6 months. For every 3 months the lockdown continues, an additional 15 million extra cases of gender-based violence are expected.
  • Due to the disruption of programmes to prevent female genital mutilation in response to COVID-19, 2 million female genital mutilation cases may occur over the next decade that could have been averted.
  • COVID-19 will disrupt efforts to end child marriage, potentially resulting in an additional 13 million child marriages taking place between 2020 and 2030 that  could otherwise have been averted.

UNFPA is working with governments and partners to prioritize the needs of women and girls of reproductive age and to respond urgently during the challenging public health emergency. Our priorities are focusing on strengthening health systems, procuring and delivering essential supplies to protect health workers, ensuring access to sexual and reproductive health and gender-based violence services, and promoting risk communication and community engagement.

The research was conducted by UNFPA, with contributions from Avenir Health, Johns Hopkins University (USA) and Victoria University (Australia). Its projections were based upon recent UNFPA research into what will be required to achieve the organization’s goals by 2030. For each estimate, researchers projected the direct impact of COVID-19 on the issue in question and combined it with the disruption to global prevention programmes caused by the pandemic.

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When Will COVID-19 End Data-Driven Estimation of End Dates (updated on April 28)

by Public Health Update
written by Public Health Update

When Will COVID-19 End Data-Driven Estimation of End Dates (updated on April 28)

The Data-Driven Estimation of End Dates provides continuous predictive monitoring of COVID-19 developments as a complement to monitoring confirmed cases. SIR (susceptible-infected-recovered) model is regressed with data from different countries to estimate the pandemic life cycle curves and predict when the pandemic might end in respective countries and the world, with codes from Milan Batista and data from Our World in Data. Given the rapidly changing situations, the predictive monitors are updated daily with the latest data. Motivation, theory, method, and caution are in this paper.

When Will COVID-19 End Data-Driven Estimation of End Dates (updated on April 28)

When Will COVID-19 End Data-Driven Estimation of End Dates (updated on April 28)

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COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE)

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A live repository and dash-board for COVID-19 in Nepal

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National Plan, Policy & GuidelinesOutbreak NewsPublic HealthResearch & Publication

Updated Testing Guidelines for COVID-19, Nepal

by Public Health Update
written by Public Health Update

Updated Testing Guidelines for COVID-19, Nepal

(Approved from MoHP on 26 April 2020) Source: Epidemiology and Disease Control Division Facebook page

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Guest PostOutbreak NewsPublic HealthResearch & Publication

The science of hand sanitizers

by Public Health Update
written by Public Health Update

The science of hand sanitizers

Nirdesh Baral and Sandip Pahari 

The recent COVID-19 outbreak has threatened the human existence. With the corona outbreak terms such as “Quarantine”, “Contact Tracing” and “Hand Sanitizers” have also gained popularity among the general public. It is considered as the savior from the COVID-19.

Digital advocacy in context of COVID-19 | Rashmi Acharya

Health sanitizers is a liquid/gel/foam used to disinfect hands instantly. It is considered as convenient method of disinfecting hand where water and soap are not readily available. Hand sanitizer have variety of chemical as their active ingredient but broadly classified as Alcohol based and Non-Alcohol based.

More from authors: A state of Dual Pandemic: COVID-19 & Falsified Products

 

Direction of use of hand sanitizer includes:

  1. Apply product to the palm of one hand.
  2. Rub hands together.
  3. Rub the product over all surfaces of hands and fingers until hands are dry.

A brisk hand rub with few drops of hand sanitizer can kill highly pathogenic organism making you diseases free. In this Article, we will explore the science behind the sanitizer.

 

Chemical Composition

Hand Sanitizer were introduced in 1996 in medical settings and was popular since 1990’s due to its convenience. Alcohol based hand sanitizers have variety of ingredients in different composition however hand sanitizer with at least 60% alcohol content is preferred due to its effectiveness. Non-alcohol-based hand sanitizers contains benzalkonium chloride or triclosan as an active ingredient. Department of Drug Administration (DDA) has also released guidelines to standardize quality of hand sanitizer in Nepal.

Raw materials

  1. Ethyl Alcohol -96% (minimum)
  2. Isopropyl Alcohol -99.8% (minimum)
  3. Hydrogen Peroxide – 3%
  4. Glycerol – 98%
  5. Sterile/Distilled/Boiled Cold water

DDA recommended standard: Instant Hand Sanitizer (Alcohol Based) Standard 2076

S.noChemicalsRequirement
1Ethyl Alcohol or Isopropyl Alcohol Content70% to 80% v/v
2pH6-8
3Microbicidal activity≥5 log reduction within 1 min
4Hydrogen Peroxide0.125% v/v or
Chlorhexidine Gluconate content 0.5%v/v may be used.

DDA recommended standard: Instant Hand Sanitizer (Alcohol Based) Standard 2076

Working Mechanism and effectiveness

The active ingredient of instant hand sanitizers is Ethyl Alcohol. Alcohol gains ability of the microbicidal activity with the concentration of 30% and optimum activity as concentration exceeds 60%. Alcohol kills pathogenic microbes in variety of way such as it disintegrates cell membrane, splitting cell and messing with metabolism of cell. Similarly, non-alcohol-based hand sanitizers with benzalkonium chloride as active ingredient have shown same level of microbicidal activity at just 0.13% concentration but exhibit harmful effects on health.

Handwashing vs Hand Sanitizer: Which is best?

A debatable question obviously arises as both methods are widely used to clean hand. A study has shown that Hand sanitizer is able to disinfect Escherichia coli, Serratia marcescens and Staphylococcus saprophyticus that a regular hand wash could not. However, hand washing has more merits than that of sanitizer.

CDC recommends handwashing than use of hand sanitization as hand sanitizer have various demerits such as;

  • Cannot kill wide range of virus including norovirus; Clostridium difficile, which can cause life-threatening diarrhea; or Cryptosporidium, a parasite that causes a diarrheal disease called cryptosporidiosis.
  • Is ineffective to work in greasy and dirty hands.
  • Fails to remove pesticides and heavy metals residue.
  • Health implication such as allergies, dryness of skin and mild irritation etc.

The above points suggest that hand sanitizer must be used as an alternative to hand washing but not as replacement. It is better to hand wash regularly following all six steps. However, best results can be yield if used in combination.

Authors

Nirdesh Baral, 7th Sem BPH Student, School of Health and Allied Sciences, Pokhara University
Email: nirdesh8@gmail.com, Cell No. +977-9816138346

Sandip Pahari, Assistant Professor, School of Health and Allied Sciences, Pokhara University
Email: sp.mph15@gmail.com, Cell No. +977-9846261237

Want to submit an article?

Send us your articles to mail4sagun@gmail.com with your name and photo. Public Health Update encourages public health students and professionals to submit views and voices.

A state of Dual Pandemic: COVID-19 & Falsified Products

Digital advocacy in context of COVID-19 | Rashmi Acharya

Interim Guideline for the establishment and Operationalization of molecular Laboratory for COVID-19 testing in Nepal

Interim Pocket Book of Clinical Management of COVID-19 in Healthcare Setting

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Coronavirus disease (COVID-19) Resources: Guidelines, Recording and Reporting Formats

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National Plan, Policy & GuidelinesResearch & Publication

Instant Hand Sanitizer (Alcohol Based) Standard 2076

by Public Health Update
written by Public Health Update

Instant Hand Sanitizer (Alcohol Based) Standard 2076

Government of Nepal

Department of Drug Administration

Instant Hand Sanitizer Standard 1 scaled Instant Hand Sanitizer Standard 2 scaled Instant Hand Sanitizer Standard 3 scaled Instant Hand Sanitizer Standard 4 scaled

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