Page 262 – Public Health Update

Microplanning for immunization service delivery using the Reaching Every District (RED) strategy

by Public Health Update April 3, 2017

The RED strategy

‘Reaching Every District’ (RED) is the name given to a strategy of district capacity building to address common obstacles to increasing immunization coverage, with a focus on planning and monitoring.

DOWNLOAD WHO :RED Strategy

The first steps in developing the RED strategy were taken in July 2002 at a meeting of immunization partners, who identified common obstacles and ways to improve access to immunization, in order to achieve the global immunization goal 80% coverage in all districts, and 90% nationally by 2010.

Description of the five RED operational components

1. Re-establishing outreach services
In many countries a large proportion of the population can only be reached regularly though outreach sessions. Outreach is any delivery strategy that requires health facility staff to leave their facility to deliver immunization. Ideally a minimum of four contacts per year are required to fully immunize an infant. For some communities, access can only be provided irregularly, and may require mobile teams to provide outreach, which will involve resources beyond the health facility and district level. Outreach sessions, especially mobile teams present opportunities to provide other interventions with immunization.

2. Supportive supervision

Supportive supervision implies providing on site training to health workers at the time of a supervisory visit, or at regular district meetings. To be supportive, supervisors should make regular schedules for visits, help to solve problems locally and follow up regularly with supply and resource issues. Supervisors will themselves need training to adapt their own approaches to supervision.

3. Linking services with communities

Involving the community with the planning and delivery of the service will encourage community ownership and improve attendance. Identifying community volunteers providing them with a role, such as follow up of defaulters, and holding regular meetings is an important step towards building a link with the community.

4. Monitoring and use of data for action

Monitoring and use of data for action implies not only the timely collection of data at district level, but the use of the data to solve problems. Some simple tools, including wall charts that display access and utilization need little training, but are very useful to take action according to monthly progress. Not only do districts collect coverage data, but also a large amount of other information, including logistics, supply, surveillance, all of which should be used to improve the immunization system. Some qualitative data may not be available in regular reports and may need to collected though supervisory visits.

5. Planning and
management of resources

The district micro plan is the key to the RED strategy. The micro plan should be based upon a local situation analysis which involves every health facility and through them the community that they serve. At the national level, there is a responsibility to ensure the needed financial and human resources are available to the district, while the district must ensure the resources are efficiently used, through regular monitoring and adjusting the micro plan. Continuing to fund the RED strategy for more than the first year of implementation is vital for sustainability of coverage increase.

There are 10 steps to making a health facility microplan:

STEP 1: Quantitative analysis of local immunization data

STEP 2: Preparing and reviewing an operational map
STEP 3: Identifying special activities for the hard-to-reach and problem areas
STEP 4: Preparing a health facility session plan
STEP 5: Problem solving using the RED strategy
STEP 6: Making a workplan for one quarter
STEP 7: Using a monitoring chart
STEP 8: Working with the community and tracking defaulters
STEP 9: Managing supplies
STEP 10: Making use of the monthly report

There are six steps to making a district microplan by putting together all the health facility microplans:

STEP 1: Analyses of district level data to identify priority areas

STEP 2: Making a map to show all health facilities and outreach sites

STEP 3: Making a district workplan

STEP 4: Making an estimate of resource requirements

STEP 5: Conducting regular monitoring and review of progress
STEP 6: Taking action based on a review of progress

Source of info DOWNLOAD WHO :RED Strategy

April 3, 2017 0 comments

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World Autism Awareness Day 2017: "Toward Autonomy and Self-Determination"

by Public Health Update April 2, 2017

written by Public Health Update

Autism is a lifelong neurological condition that manifests during early childhood, irrespective of gender, race or socio-economic status. The term Autism Spectrum refers to a range of characteristics. Appropriate support, accommodation and acceptance of this neurological variation allow those on the Spectrum to enjoy equal opportunity, and full and effective participation in society.

Autism is mainly characterized by its unique social interactions, non-standard ways of learning, keen interests in specific subjects, inclination to routines, challenges in typical communications and particular ways of processing sensory information.

The rate of autism in all regions of the world is high and the lack of understanding has a tremendous impact on the individuals, their families and communities.

The stigmatization and discrimination associated with neurological differences remain substantial obstacles to diagnosis and therapies, an issue that must be addressed by both public policy-makers in developing nations, as well as donor countries.

Throughout its history, the United Nations family has celebrated diversity and promoted the rights and well-being of persons with disabilities, including children with learning differences and developmental disabilities. In 2008, the Convention on the Rights of Persons with Disabilities entered into force, reaffirming the fundamental principle of universal human rights for all. Its purpose is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity. It is a solid tool to foster an inclusive and caring society for all and to ensure that all children and adults with autism can lead full and meaningful lives.

The United Nations General Assembly unanimously declared 2 April as World Autism Awareness Day to highlight the need to help improve the quality of life of those with autism so they can lead full and meaningful lives as an integral part of society.

Theme for World Autism Awareness Day 2017: “Toward Autonomy and Self-Determination”

Autism spectrum disorders
Fact sheet (January 2016)

Key facts

1 in 160 children has an autism spectrum disorder (ASD).

ASD begin in childhood but tend to persist into adolescence and adulthood.

While some people with ASD are able to live independent and productive lives, others have severe disabilities and require life-long care and support.

Evidence-based psychosocial interventions, such as behavioural treatment, can reduce difficulties in communication and social behaviour, with a positive impact on wellbeing and quality of life.

Interventions targeting people with ASD need to be accompanied by broader actions for making physical, social and attitudinal environments more accessible, inclusive and supportive.

Worldwide, people with ASD are often subject to stigma, discrimination and human rights violations. Globally, access to services and support for people with ASD is inadequate.

World Health Organization

April 2, 2017 0 comments

National Plan, Policy & Guidelines Public Health Notes Public Health Programs

National Tuberculosis Programme, NEPAL

by Public Health Update March 23, 2017

written by Public Health Update

Tuberculosis (TB) remains as a public health problem in Nepal, as it is responsible for ill health among thousands of people each year. TB also ranks as the sixth leading cause of death in the country. During this reporting year, NTP registered 34,121 TB cases.

Among them 15,655 (46%) were new smear positive TB cases, 2,202 (6%) were smear positive retreatment cases, 6,686 (20%) were sputum smear negative and 8,966 (26%) were extra‐pulmonary TB cases. Out of total registered cases in NTP, there were 12,300 (36%) female and 21,821 (64%) male. According to the latest WHO data published in May 2014, tuberculosis deaths in Nepal reached 5,506. This is 3.5% of total deaths. The age adjusted death rate is 27.80 per 100,000 of population. This ranks Nepal as 43 in the world.

WHO HQ Reports G2 PROD EXT TBCountryProfile1

The majority of TB cases and deaths occur among men, the burden of disease among women seems significantly lower (2:1). TB mortality is unacceptably high given that most deaths are preventable if people can access tuberculosis care for diagnosis and the correct treatment is provided. Short‐course regimens of first‐line drugs that can cure around 90% of all cases (Treatment success rate reported in 2014/15) have been recorded for a decade. National Tuberculosis Program has adopted the global STOP TB Strategy and Million Development Goals (MDGs) as TB control strategy of the country Tuberculosis (TB), a major public health problem of Nepal infected About 45 percent of the total population. Every year, about 45,000 people develop active TB, out of them 20,000 have infectious pulmonary disease and that are able to spread the disease to others. Treatment by Directly Observed Treatment Short course (DOTS) has reduced the number of deaths. DOTS have successfully been implemented throughout the country since April 2001.

A total of 4244 DOTS treatment centers are providing TB treatment service. Expansion of this cost effective and highly successful treatment strategy has proven its efficacy in reducing the mortality and morbidity in Nepal. The NTP has coordinated with the public sectors, private sectors, local government bodies, I/NGOs, social workers, educational sectors and other sectors of society in order to sustain the present significant results achieved by National Tuberculosis Program (NTP).

Vision:

Tuberculosis free Nepal

Goal:

To reduce mortality, morbidity and transmission of tuberculosis until it is no longer a public health problem

Objectives:

To dramatically reduce the National burden of TB by 2015 in line with the Millennium Development Goals and the Stop TB Partnership targets

Achieve universal access to high‐quality diagnosis and patient‐centered treatment
Reduce the human suffering and socioeconomic burden associated with TB
Protect poor and vulnerable populations from TB, TB/HIV and multi‐drug‐resistant TB

Targets:

MDG 6, Target 8: …halted by 2015 and begun to reverse the incidence.

Targets linked to the MDGs and endorsed by the Stop TB Partnership:

By 2005: detect 100% of new sputum smear‐positive TB cases and cure at least 85%of these cases.

By 2015: reduce prevalence of and death due to TB by 50% relative to 1990.
By 2050: eliminate TB as a public health problem (<1 case per million population).

Components of the Stop TB strategy

1. Pursue high‐quality DOTS expansion &enhancement

Political commitment with increased and sustained financing

Case detection through quality‐assured bacteriology
Standardized treatment with supervision and patient support
An effective drug supply and management system
Monitoring and evaluation system, and impact measurement

2. Address TB/HIV, DR‐TB and other challenges

Implement collaborative TB/HIV activities

Prevent and control multi‐drug‐resistant TB
Address prisoners, refugees and other high‐risk groups and special situations

3. Contribute to health system strengthening

Actively participate in efforts to improve system‐wide policy, human resources, financing,management, service delivery, and information systems

Share innovations that strengthen systems, including the Practical Approach to Lung Health (PAL)
Adapt innovations from other fields

4. Engage all care providers

Public‐Public, and Public‐Private Mix (PPM) approaches

International Standards for Tuberculosis Care (ISTC)

5. Empower people with TB, and communities

Advocacy, communication and social mobilization

Community participation in TB care
Patients’ Charter for Tuberculosis Care

6. Enable and promote research

Programme‐based operational research

DoHS, Annual Report 2071/72 (2014/2015)

END TB STRATEGY (WHO)

World TB Day 2017 – Unite efforts to leave no one behind #UnitetoEndTB

March 23, 2017 0 comments

PH Important Day

World TB Day 2017 – Unite efforts to leave no one behind #UnitetoEndTB

by Public Health Update March 23, 2017

written by Public Health Update

World TB Day, falling on March 24th each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries. It commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus. At the time of Koch’s announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch’s discovery opened the way towards diagnosing and curing TB.

This year, we commemorate the 135th anniversary of Dr Robert Koch’s announcement in 1882 of his discovery of the TB bacillus, the cause of tuberculosis. His groundbreaking research opened the way toward diagnosing and curing this disease.

World TB Day is an opportunity for people everywhere to join this fight by helping to educate others about TB and by urging governments to take action.

http://www.stoptb.org

Key facts

Tuberculosis (TB) is one of the top 10 causes of death worldwide.
In 2015, 10.4 million people fell ill with TB and 1.8 million died from the disease (including 0.4 million among people with HIV). Over 95% of TB deaths occur in low- and middle-income countries.
Six countries account for 60% of the total, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa.
In 2015, an estimated 1 million children became ill with TB and 170 000 children died of TB (excluding children with HIV).
TB is a leading killer of HIV-positive people: in 2015, 35% of HIV deaths were due to TB.
Globally in 2015, an estimated 480 000 people developed multidrug-resistant TB (MDR-TB).
TB incidence has fallen by an average of 1.5% per year since 2000. This needs to accelerate to a 4–5% annual decline to reach the 2020 milestones of the “End TB Strategy”.
An estimated 49 million lives were saved through TB diagnosis and treatment between 2000 and 2015.
Ending the TB epidemic by 2030 is among the health targets of the newly adopted Sustainable Development Goals.

World Health Organization

DOWNLOAD

National Tuberculosis Programme, NEPAL

March 23, 2017 0 comments

PH Important Day

World Water Day 2017 : Why waste water?

by Public Health Update March 22, 2017

written by Public Health Update

World Water Day, on 22 March every year, is about taking action to tackle the water crisis. Today, there are over 663 million people living without a safe water supply close to home, spending countless hours queuing or trekking to distant sources, and coping with the health impacts of using contaminated water. This year’s theme: Why waste water? in support of SDG 6.3 on improving water quality and reducing, treating and reusing wastewater.

Globally, the vast majority of all the wastewater from our homes, cities, industry and agriculture flows back to nature without being treated or reused – polluting drinking and bathing and irrigation and losing valuable nutrients and other recoverable materials.

Reducing and safely treating and reusing wastewater, for example in agriculture and aquaculture, protects worker, farmers and consumers promotes food security, health and well-being.

WHO

READ MORE (Why waste water? )

http://www.unwater.org

http://www.worldwaterday.org

Water and health

Contaminated water and poor sanitation are linked to transmission of diseases such as cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio. Absent, inadequate, or inappropriately managed water and sanitation services expose individuals to preventable health risks. This is particularly the case in health care facilities where both patients and staff are placed at additional risk of infection and disease when water, sanitation and hygiene services are lacking. Globally, 15% of patients develop an infection during a hospital stay, with the proportion much greater in low-income countries.

Inadequate management of urban, industrial and agricultural wastewater means the drinking-water of hundreds of millions of people is dangerously contaminated or chemically polluted.

Some 842000 people are estimated to die each year from diarrhoea as a result of unsafe drinking-water, sanitation and hand hygiene. But diarrhoea is largely preventable, and the deaths of 361 000 children aged under 5 each year could be avoided each year if these risk factors were addressed. Where water is not readily available, people may decide handwashing is not a priority, thereby adding to the likelihood of diarrhoea and other diseases.

Diarrhoea is the most widely known disease linked to contaminated food and water but there are other hazards. Almost 240 million people are affected by schistosomiasis – an acute and chronic disease caused by parasitic worms contracted through exposure to infested water.

In many parts of the world, insects that live or breed in water carry and transmit diseases such as dengue fever. Some of these insects, known as vectors, breed in clean, rather than dirty water, and household drinking-water containers can serve as breeding grounds. The simple intervention of covering water storage containers can reduce vector breeding and may also have a co-benefit of reducing faecal contamination of water at the household level.

WHO

March 22, 2017 0 comments

PH Important Day

World Oral Health Day – ''Live MOUTH SMART'' #WOHD17

by Public Health Update March 20, 2017

written by Public Health Update

World Oral Health Day (WOHD) is commemorated annually on 20 March in order to support the improvement of oral health world wide. WOHD focused to highlight the importance of oral health for a healthy body. The aim is to provide an occasion for global, regional and national activities related to oral health.

”Live MOUTH SMART” #WOHD17

World Oral Health Day was launched in 2013 to raise awareness of the importance of good oral health and its significance in safeguarding general health and well-being. This is done through an international awareness campaign created and launched by FDI World Dental Federation, adapted and promoted locally by national dental associations in over 140 countries worldwide.

WOHD was officially launched in 2007 and was originally celebrated on 12 September, the birth date of FDI founder Dr Charles Godon. However, the campaign was not fully activated until 2013, when further to a decision by FDI’s General Assembly (governing body) in September 2012 the date was changed to 20 March. The main reason for this being to avoid conflict with FDI’s World Dental Congress which took place during the same period.

The new date was chosen to reflect that:

Seniors must have a total of 20 natural teeth at the end of their life to be considered healthy

Children should possess 20 baby teeth
Healthy adults must have a total of 32 teeth and 0 dental cavities
Expressed on a numerical basis this can be translated as 3/20 hence March 20

http://worldoralhealthday.com/

How can you Live Mouth Smart?

Protect your oral health through life

Practice smart oral hygiene Your mouth is important at all ages. A healthy mouth free of oral disease can be maintained by making smart choices when it comes to your oral hygiene, diet and lifestyle habits:

Brush your teeth for two minutes, twice a day using either a manual or electric toothbrush and a fluoride toothpaste

Don’t rinse with water straight after brushing, spit out any excess toothpaste instead
Eat a healthy diet, with limited snacking of foods and drinks high in sugar
Quit tobacco use
Limit your alcohol consumption
Wear a mouthguard when engaging in contact sports How can you Live Mouth Smart?
Rinse with a fluoride mouthwash or chew sugar-free gum after meals and snacks when brushing isn’t possible
Visit your dentist or primary healthcare provider regularly for check-ups and cleanings Cleaning between teeth using floss or other interdental cleaners can also be beneficial to oral health.

READ MORE : CLICK HERE

March 20, 2017 0 comments

National Plan, Policy & Guidelines Public Health Notes Public Health Programs

Diseases Control Program in Nepal : Lymphatic Filariasis

by Public Health Update March 18, 2017

written by Public Health Update

Lymphatic Filariasis (LF) is a public health problem in Nepal. Nepal conducted LF mapping in 2001 and 2005 and remapping in 2012 by using ICT (Immunochromatography Test card) which revealed 13% average prevalence of LF infection in the country, ranging from <1% to 39%. Based on the ICT survey, morbidity reporting and geo‐ecological comparability sixty one districts of the country were mapped as endemic for LF.

The disease has been detected in different topographical areas ranging in altitude from 300 feet above sea level in the plain terai ecological zone to 5,800 feet above sea level in high hill areas. Comparatively, more LF cases are seen in the terai than in the hills, but valleys and river basin areas of hilly districts have also high disease burden. The disease is more prevalent in the rural areas of the country, predominantly affecting the poorer sector of the community. Wuchereria bancrofti is the only recorded parasite in Nepal and the mosquito, Culex.quinquefasciatus, an efficient vector of the disease has been recorded in all the endemic areas of the country.

Progress towards elimination

Epidemiology and Disease Control Division under the Department of Health Services has formulated a National Plan of Action (2003‐2020 AD) for the Elimination of Lymphatic Filariasis in Nepal by establishing a National Task Force under the Chairmanship of Director‐General, Department of Health Services.

The division initiated the implementation of Mass Drug Administration (MDA) in Parsa district in 2003 which was gradually scaled up to all endemic districts achieving 100% geographical coverage by FY 2069/70 (2013). The target of scaling up MDA to all endemic districts was achieved in 2013.

By this fiscal year 2071/72 (2014/2015), MDA has been stopped (phased out) in 20 districts, post MDA surveillance has been initiated in at least five districts and morbidity management has been initiated in selected districts and high endemic areas. All endemic districts will complete the recommended six rounds of MDA by 2018. The LF elimination programme has also indirectly contributed to strengthening of health system through training and capacity building activities. Between these periods of twelve years, various surveys have been carried out including mapping, base line surveys, follow up surveys, post MDA coverage survey and transmission assessment surveys (TAS). TAS done in 21 districts has revealed that the prevalence of LF infection has significantly reduced and contributed in preventing disabilities and sufferings due to LF. Over the period of last 12 years, more than 90 million doses has been administrated to at risk population.

GOAL:

People of Nepal no longer suffer from LF

Objectives

To eliminate LF as a public health problem by 2020;

To interrupt the transmission of lymphatic filariasis;
To reduce and prevent morbidity;
To provide de‐worming benefit through use of Albendazole to endemic community especially to the children; and
To reduce mosquito vectors through application of suitable and available vector control measures (Integrated Vector Management).

Strategies

Interruption of transmission by yearly Mass Drug Administration using two drug regimens (DiethylcarbamazineCitrate and Albendazole) for six years.

Morbidity management by self‐care and with supports using intensive but simple, effective and local hygienic techniques.

Target

To scale up MDA to all LF endemic districts by 2014

Achieve <1% prevalence (microfilaraemia rate) in all endemic districts after 6 years of MDA by 2018

Major activities

Mass drug administration (MDA) campaign

Advocacy, IEC/BCC activities.

Coordination
Monitoring and supervision
Training of health workers
Volunteers orientation
Media mobilization and advertisement
Coordination and collaboration with all stakeholders
School health programme‐interactions in schools
Morbidity management‐ hydrocele surgery camps
care training and material distribution to lymphedema (elephantiasis) cases.

Source of Info: DoHS, Annual Report 2071/72 (2014/2015)

March 18, 2017 0 comments

Public Health Notes Public Health Programs

Early Warning Reporting System (EWARS), Nepal

by Public Health Update March 18, 2017

written by Public Health Update

Early Warning Reporting System (EWARS) is a hospital-based sentinel surveillance system currently operational in 40 hospitals throughout Nepal. EWARS is designed to complement the country’s Health Management Information System (HMIS) by providing timely reporting for the early 4 detection of selected vector-borne, water and food borne diseases with outbreak potential.

The hospital based reporting provides timely signal or alert and early detection of possible outbreak due to increased number of cases in the community leading to continuous transmission of the disease for timely response. This dynamics is lacking with HMIS being a monthly reporting system. The main objective of EWARS is to strengthen the flow of information on vector borne and other outbreak prone infectious diseases from the districts; and to facilitate prompt outbreak response to be carried out by Rapid Response Teams (RRTs) at Central, Regional and District level, which can be mobilized at short notice to support the local levels (DHO/HP/SHP) in case investigation and outbreak control activities. In the broader perspective, it also aids on program planning, evaluation, and the formulation of research hypotheses and to disseminate data/information on infectious diseases through appropriate feedback system It was established in 1997 first in 8 sentinel sites and expanded to 24 sites in 1998, 26 sites in 2002, 28 sites in 2003 and 40 sites in 2008.

The EWARS mainly focuses on the weekly reporting of number of cases and deaths (including “zero” reports) of six priority diseases: three vector-borne diseases Malaria, Kala-azar and Dengue and three outbreak potential diseases Acute Gastroenteritis (AGE), Cholera and Severe Acute Respiratory Infection (SARI). It equally focuses on immediate reporting (to be reported within 24 hours of diagnosis) of one confirmed case of Cholera, and severe and complicated Malaria and one suspect/clinical case of Dengue as well as 5 or more than 5 cases of AGE and SARI from the same geographical locality in a one week period. Based on the experiences of reported outbreaks of acute diarrhoeal diseases and influenza by several districts, these two diseases are included for reporting in EWARS from the year 2005. Likewise, Dengue and DHF case reporting will be required to be reported in EWARS due to its high potential of impending epidemics. Other communicable diseases besides these six prioritized diseases also need to be reported in EWARS, whenever the numbers of cases exceed the expected level.

Information Flow Mechanism in EWARS:

Elements

The four basic elements of surveillance that were the cornerstones for EWARS development were

a mechanism for hospital inpatient-ward-based case detection,

laboratories for identifying and characterizing microbes,
information systems, and
response (information feedback and mobilization of investigative and control efforts).

Objectives were:

to develop a comprehensive, computerized database of infectious diseases of public health importance

to monitor and describe trends of infectious diseases through a sentinel surveillance network of hospitals followed by public health action and research
to receive early warning signals of diseases under surveillance and to detect outbreaks
to instigate a concerted approach to outbreak preparedness, investigation and response
to disseminate data/information on infectious diseases through an appropriate feedback system.

The main focus of EWARS was reporting on a weekly basis the number of cases and deaths of the six priority diseases. These diseases were selected based on a number of criteria: widespread distribution; major causes of morbidity, mortality and disability; potential for causing outbreaks; already monitored under national programs; amenable to control through cost-effective means; and being a global priority for elimination, eradication and/or control. The selected EWARS diseases were divided into two groups:

(1) vaccine-preventable diseases (VPDs), which include acute flaccid paralysis (AFP), measles, and NNT; and

(2) vector-borne diseases (VBDs), which include KA, JE, and malaria. In addition, in the case of an outbreak, EWARS includes the immediate reporting of a single suspected/probable/confirmed case of AFP, NNT, severe and complicated malaria, and JE, as well as ten cases of measles from the same locality within 24 hours of diagnosis. Other communicable diseases are also reported periodically in EWARS.

EWARS began in September 1996 with the development of guidelines and the selection of eight sentinel sites (SSs). Training of the medical records assistants (MRAs) took place several months later, in November. Between December 1996 and March 1997 the SSs were visited to ensure that everything was in place so that EWARS could start functioning in April 1997.

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March 18, 2017 0 comments

PH Important Day Public Health

Kidney Disease & Obesity – Healthy Lifestyle for Healthy Kidneys! #worldkidneyday #move4kidneys!

by Public Health Update March 9, 2017

written by Public Health Update

World Kidney Day – 9 March 2017

“Kidney Disease & Obesity. Healthy Lifestyle for Healthy Kidneys”.

An opportunity to make a significant impact on kidney health awareness and disease prevention

Celebrated every year on the Second Thursday of March, World Kidney Day (WKD) is the global awareness campaign that aims at increasing awareness of the importance of our kidneys to our health and reduce the impact of kidney disease and its associated problems worldwide.

World Kidney Day was first celebrated in 2006. World Kidney Day is a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF).

Why is World Kidney Day Important?

Chronic Kidney Disease (CKD) is a non-communicable disease that affects 1 in 10 people worldwide.

While severity can vary, CKD is incurable and causes the patient to need lifelong care. As the incidence of kidney disease escalates, World Kidney Day plays a crucial role in educating the public, the medical community and governments and encouraging prevention and early detection of kidney disease.

Kidney Disease & Obesity

Obesity is defined as abnormal or excessive fat accumulation that may impair health. In 2014, worldwide over 600 million adults were obese. Obesity is a potent risk factor for the development of kidney disease. Obesity increases the risk of developing major risk factors of Chronic Kidney Disease (CKD), like diabetes and hypertension, and it has a direct impact on the development of CKD and end stage renal disease (ESRD).

The good news is that obesity, as well as CKD, is largely preventable. This year World Kidney Day promotes education about the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviours an affordable option.

Key Messages

10% of the global population is affected by Chronic Kidney Disease (CKD).

Globally, 2.6 million patients with end stage renal disease (ESRD) received dialysis in 2010. This number is projected to almost double to 5.4 million by 2030.
600 million people in the world are affected by obesity, 220 million of which are schoolaged children.
Individuals affected by obesity have an 83% increased risk of CKD, compared to individuals with a healthy weight.
Obesity is a well-established risk factor for developing major precursors to CKD and ESRD, such as diabetes, hypertension and kidney stones
Strategies to reduce excess weight and prevent the development of diabetes mellitus, hypertension and cardiovascular disease, will reduce the risk of kidney disease.

According to worldkidneyday.org, there are 8 golden rules for kidney health.

Keep regular control of your blood sugar. About 50% of people with Diabetes will develop kidney damage. Make sure you are doing all you can to stay in control!

Keep fit and active. Staying active helps in many areas to keep your kidneys healthy as well as promotes positive mood and weight loss.
Eat healthy and keep your weight in check. Making good food choices will go hand in hand with staying active to reduce weight and encourage good health.

Water, water, water! Keeping hydrated is good for your skin as well as your kidneys. Staying hydrated flushes the toxins out of the kidneys and reduces the chance of kidney stones.
No Smoking! Smoking is bad in many ways, but for the kidneys, the chance of developing cancer in them increases by 50% for smoke
rs.
Stay away from over-the-counter medicine for chronic issues. Many over-the-counter medicines such as ibuprofen can harm your kidneys if taken regularly. It is ok to take for emergencies, but see a physician if you are having chronic pain for options that will not cause harm.

March 9, 2017 0 comments

International Plan, Policy & Guidelines Public Health Research & Publication

Environmental pollution kills 1.7 million children each year – WHO

by Public Health Update March 8, 2017

written by Public Health Update

6 MARCH 2017 | GENEVA

More than 1 in 4 deaths of children under 5 years of age are attributable to unhealthy environments. Every year, environmental risks – such as indoor and outdoor air pollution, second-hand smoke, unsafe water, lack of sanitation, and inadequate hygiene – take the lives of 1.7 million children under 5 years, say two new WHO reports.

The first report, Inheriting a Sustainable World: Atlas on Children’s Health and the Environment reveals that a large portion of the most common causes of death among children aged 1 month to 5 years – diarrhoea, malaria and pneumonia – are preventable by interventions known to reduce environmental risks, such as access to safe water and clean cooking fuels.

“A polluted environment is a deadly one – particularly for young children,” says Dr Margaret Chan, WHO Director-General. “Their developing organs and immune systems, and smaller bodies and airways, make them especially vulnerable to dirty air and water.”

Harmful exposures can start in the mother’s womb and increase the risk of premature birth. Additionally, when infants and pre-schoolers are exposed to indoor and outdoor air pollution and second-hand smoke they have an increased risk of pneumonia in childhood, and a lifelong increased risk of chronic respiratory diseases, such as asthma. Exposure to air pollution may also increase their lifelong risk of heart disease, stroke and cancer.

Top 5 causes of death in children under 5 years linked to the environmentA companion report, Don’t pollute my future! The impact of the environment on children’s health, provides a comprehensive overview of the environment’s impact on children’s
health, illustrating the scale of the challenge. Every year:
570 000 children under 5 years die from respiratory infections, such as pneumonia, attributable to indoor and outdoor air pollution, and second-hand smoke.
361 000 children under 5 years die due to diarrhoea, as a result of poor access to clean water, sanitation, and hygiene.
270 000 children die during their first month of life from conditions, including prematurity, which could be prevented through access to clean water, sanitation, and hygiene in health facilities as well as reducing air pollution.
200 000 deaths of children under 5 years from malaria could be prevented through environmental actions, such as reducing breeding sites of mosquitoes or covering drinking-water storage.
200 000 children under 5 years die from unintentional injuries attributable to the environment, such as poisoning, falls, and drowning.

Ongoing and emerging environmental threats to children’s health

“A polluted environment results in a heavy toll on the health of our children,” says Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health. “Investing in the removal of environmental risks to health, such as improving water quality or using cleaner fuels, will result in massive health benefits.”

For example, emerging environmental hazards, such as electronic and electrical waste (such as old mobile phones) that is improperly recycled, expose children to toxins which can lead to reduced intelligence, attention deficits, lung damage, and cancer. The generation of electronic and electrical waste is forecasted to increase by 19% between 2014 and 2018, to 50 million metric tonnes by 2018.

With climate change, temperatures and levels of carbon dioxide are rising, favouring pollen growth which is associated with increased rates of asthma in children. Worldwide, 11–14% of children aged 5 years and older currently report asthma symptoms and an estimated 44% of these are related to environmental exposures. Air pollution, second-hand tobacco smoke, and indoor mould and dampness make asthma more severe in children.

In households without access to basic services, such as safe water and sanitation, or that are smoky due to the use of unclean fuels, such as coal or dung for cooking and heating, children are at an increased risk of diarrhoea and pneumonia.

Children are also exposed to harmful chemicals through food, water, air and products around them. Chemicals, such as fluoride, lead and mercury pesticides, persistent organic pollutants, and others in manufactured goods, eventually find their way into the food chain. And, while leaded petrol has been phased out almost entirely in all countries, lead is still widespread in paints, affecting brain development.

Making all places safe for children

Reducing air pollution inside and outside households, improving safe water and sanitation and improving h
ygiene (including in health facilities where women give birth), protecting pregnant women from second-hand tobacco smoke, and building safer environments, can prevent children’s deaths and diseases.

For example, multiple government sectors can work together to improve the following:

Housing: Ensure clean fuel for heating and cooking, no mould or pests, and remove unsafe building materials and lead paint.

Schools: Provide safe sanitation and hygiene, free of noise, pollution, and promote good nutrition.

Health facilities: Ensure safe water, sanitation and hygiene, and reliable electricity.

Urban planning: Create more green spaces, safe walking and cycling paths.

Transport: Reduce emissions and increase public transport.

Agriculture: Reduce the use of hazardous pesticides and no child labour.

Industry: Manage hazardous waste and reduce the use of harmful chemicals.

Health sector: Monitor health outcomes and educate about environmental health effects and prevention.

Under the Sustainable Development Goals (SDGs) countries are working on a set of targets to guide interventions for children’s environmental health, as well as to end preventable deaths of newborns and children under five by 2030. In addition to SDG 3, which aims to ensure healthy lives and promote well-being for all, other SDGs work to improve water, sanitation and hygiene, transition to clean energy to reduce air pollution, and reverse climate change – all of which will have an impact on children’s health.

SOURCE OF INFO: WORLD HEALTH ORGANIZATION