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Approaches for mobile and migrant populations in the context of malaria multi-drug resistance and malaria elimination in the Greater Mekong Subregion
Regional Office for South-East Asia, World Health Organization ( 2016-02 )
Abstract

The emergence of multifrug-resistant malaria in the Greater Mekong Subregion (GMS) has been identified as an emergency issue that may have catastrophic consequences on the future of malaria elimination in the GMS as well as globally. In recognition of the need for a cohesive regional response, GMS countries have committed to a shared goal of eliminating malaria from the GMS by 2030 working within the framework of the Strategy for Malaria Elimination in the Greater Mekong Subregion 2015-2030. Population mobility has been identified as a key concern in the context of multidrug-resistant malaria; and in a region of highly porous borders where the majority of intra-Mekong migration occurs through informal channels, addressing the health needs of migrant populations has never been more critical. Migration in the GMS is strongly associated with shifting land use, including large-scale rural infrastructure projects and agricultural industries that attract migrant labour and influence human-vector contact. Migrant workers are highly likely to be exposed to high-risk work in forests or on construction sites but are frequently unable to access quality health-care services and may resort to self-treatment with substandard antimalarial drugs with potentially serious consequences for their own health and for drug resistance. Governments and development partners are now called upon to recognize that containing multidrug resistance and eliminating malaria in the GMS will require a future-oriented and multisectoral approach including non-health ministers, private sector and development partners. In addition, it will require programmes that include targeted activities to reach out to mobile and migrant populations; interventions that are timed with seasonal mobility; development and scale-up of migrant-friendly health services; and strengthening of programme activities to engage mobile populations. Ultimately, addressing health in other public policies as part of a ‘health in all policies’ (HiAP) approach would be crucial to achieving successful health outcomes where multiple stakeholders from non-health fields must be engaged to systematically incorporate health issues into relevant national security, labour, migration and economic development policies.

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SEA/RC69/17: Migration and Health
Regional Office for South-East Asia, World Health Organization ( 2016-07 )
Abstract

One in every seven people living in the world today is either an international or an internal migrant during the time of both war and peace. Over the past years, Governing Bodies of WHO and several global consultations had addressed the issues related to migration and health at various forums. The recent refugee crises on an unprecedented scale globally have posed serious questions on the limitations of the global and national health frameworks to address the issue and re-energized discussions on this topic. The attached Working Paper highlights the background and chronologies of global and regional meetings, problem statement and key challenges, scope, guiding principles, the South-East Asia regional perspective and the way forward. This Working Paper was presented to the High-Level Preparatory Meeting for its review and recommendations. The recommendations made by the HLP meeting for consideration by the Sixty-ninth Session of the Regional Committee are: Actions by Member States (1) Organize country-level preparatory workshops to have consolidated and firm practical actions ready for focused discussions at the Second Global Consultation on Migration and Health in Colombo on 25–27 October 2016. (2) Consider the six action points proposed as the way forward. These are: (i) making health systems adoptive, (ii) addressing threats of newly emerging communicable diseases, (iii) maintaining targeted programmes for elimination of communicable disease with time-bound targets, (iv) ensuring systematic data collection for evidence-based scenarios for planning and advocacy, (v) maintaining robust partnerships between different UN agencies and other international organizations to ensure division of labour, and (vi) sharing of good experiences and best practices from countries. Actions by WHO (1) Provide technical assistance and play a coordinating role in developing a comprehensive regional strategic framework on migration and health. (2) Coordinate and ensure a working and robust partnership forum in the SEA Region and a roadmap for the division of labour among partners as well as WHO technical departments/units in SEARO and WHO headquarters. (3) Support Member States to better prepare for the forthcoming global events (UN General Assembly on 19 September 2016 and the Second Global Consultation in Colombo on 25–27 October 2016). This Working Paper and the HLP Meeting recommendations are submitted to the Sixty-ninth Session of the WHO Regional Committee for South-East Asia for its consideration and decision.

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SEA/RC69/13: The Decade for Health Workforce Strengthening in the SEA Region 2015–2024: First review of progress, challenges and opportunities
Regional Office for South-East Asia, World Health Organization ( 2016-07 )
Abstract

In 2014, Member States of the WHO South-East Asia Region agreed to the “Decade for Strengthening Human Resources for Health in SEA Region 2015–2024”. The same year, the WHO Regional Committee for South-East Asia endorsed resolution SEA-RC67-R6 on “Strengthening Health Workforce Education and Training in the Region”. The resolution requested the Regional Director to support Member States in the implementation of the Regional Strategy on Health Workforce Education and Training in the SEA Region 2014–2019; and to report on progress with health workforce development to the Regional Committee for South-East Asia every two years, starting 2016, for a decade. This is the first review. To review progress in implementation of the Decade for Strengthening Human Resources for Health in SEA Region, a self-report survey was conducted by SEAR Member States during March and April 2016. The High-Level Preparatory Meeting held in the WHO Regional Office in New Delhi from 11–14 July 2106 reviewed the attached Working Paper and made the following recommendations. Actions by Member States (1) Consider the implications of the new Global HRH Strategy: Workforce 2030 when developing national HRH strategies and plans, and link these to service delivery needs. (2) By end 2016, agree on feasible priority actions for HRH strengthening for 2017–2018, with a focus on HRH governance, rural retention and transformative education, in consultation with relevant stakeholders as needed. (3) Use regional events to help advance the national HRH agenda and share best practice and experience: for example, meetings of the Asia-Pacific Action Alliance on Human Resources for Health (AAAH) network; South-East Asia Regional Medical Education (SEARAME) network and the Measurement and Accountability for Results workshop, in late 2016.Actions by WHO (1) Provide technical assistance to Member States, including for strengthening governance and supporting HRH units to fulfil their functions. (2) Develop indicators for monitoring progress on HRH, especially on retention and transformative education, in alignment with the Global HRH Strategy: Workforce 2030, and to harmonize reporting on HRH. (3) Support production, synthesis and dissemination of regional evidence on rural retention and transformative education through case studies and briefing notes on crucial topics. (4) Provide a second progress report to RC71 in 2018. This Working Paper and the HLP Meeting recommendations are submitted to the Sixty-ninth Session of the WHO Regional Committee for South-East Asia for its consideration and decision.

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Strategy for oral health in South-East Asia, 2013-2020
Regional Office for South-East Asia, World Health Organization ( 2013 )
Abstract

Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic burden on individuals, families, societies, and health care systems. The recent emphasis on the role of determinants of health, common risk factors and their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control e orts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts, fully in line and integrated with planning for prevention and control of NCDs. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.

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Ending preventable maternal, newborn and child mortality: regional technical advisory group meeting. Recommendations and report, December 2015
Regional Office for South-East Asia, World Health Organization ( 2016 )
Abstract

Under the Regional Flagship project on ending preventable maternal and child mortality with a focus on reducing newborn mortality, the WHO Regional Director for South-East Asia has appointed the Technical Advisory Group (SEAR-TAG) to provide guidance to national governments, implementing partners and other stakeholders on how best to accelerate implementation of strategies, and monitor these. The inaugural meeting of SEAR-TAG was organized on 15-18 December 2015 to evolve a shared understanding of priorities, challenges and high impact approaches for reducing newborn mortality. The focus on addressing the issue high newborn mortality through the global approach of every newborn action plan will have additional benefits of reduction in maternal mortality and stillbirths. All twelve SEAR-TAG members, RMNCAH nodal persons from the ministries of health from Member States, representatives of UN agencies and other partners, INGOS and NGOs, representatives of Professional associations (Pediatrics, Neonatology and Obstetrics) and WHO Collaborating Centres participated in the meeting. There were deliberations to examine and identify ways to address three areas: coverage and equity gap in terms of low and uneven coverage of evidence-based interventions; quality gap in terms of inadequate quality of care; and an accountability gap in terms incomplete registration of births and deaths of mothers and newborns as well as stillbirths. The report provides the summary of proceedings of the SEAR-TAG meeting and the recommendations.

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Hospital-based birth defects surveillance: a guide to establish and operate
Regional Office for South-East Asia, World Health Organization ( 2016 )
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Hospital-based birth defects surveillance: facilitator guide
Regional Office for South-East Asia, World Health Organization ( 2016 )
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Status of SEA Regional Office building - SEA-RC68-23
Regional Office for South-East Asia, World Health Organization ( 2015-08-31 )
Abstract

The World Health House, as the buildings housing the WHO Regional Office for South- East Asia in New Delhi, India, are collectively known, is over 50 years old, necessitating greater investments to maintain the property fit for purpose. The results of two seismic vulnerability studies of the campus buildings in 2001 and 2010 independently agreed that in their current condition, the buildings present certain concerns in the event of seismic activity - particularly during the monsoon season when the groundwater table is high. The situation is exacerbated by the ground conditions of the site and the seismic vulnerability of the Delhi area in general. The following actions were recommended:  Demolish and rebuild the annexes, as the cost to reinforce and/or retrofit such buildings is economically unviable. The long, thin, footprint of these buildings, combined with an unorthodox foundation and structural design, bring into question the ultimate success of any strengthening works programme.  Reinforce/retrofit the main building and conference block with pertinent mitigation measures including slab repairs and reinforcing of horizontal and vertical structural supports. The High-Level Preparatory (HLP) Meeting for the Sixty-eighth Session of the WHO Regional Committee for South-East Asia held at the WHO Regional Office in New Delhi on 29 June–2 July 2015, reviewed the attached working paper and noted it. In view of the findings, and in collaboration with the Ministry of Health, the Secretariat has invited the Central Public Works Department (CPWD) to perform a more comprehensive study of the facility. With this information, a more informed decision may be taken as to whether it is appropriate and more financially viable to also demolish the main block and rebuild. A report on the condition of the campus will be presented to Member States incorporating the findings of the CPWD assessment in due course.

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SEA/RC69/19: Key issues arising out of the Sixty-ninth World Health Assembly and the 138th and 139th Sessions of the WHO Executive Board
Regional Office for South-East Asia, World Health Organization ( 2016-07 )
Abstract

The attached working paper highlights, from the perspective of the WHO South-East Asia Region, the most important and relevant resolutions endorsed by the Sixty-ninth World Health Assembly (held on 23–28 May 2016) and the 138th and 139th sessions of the Executive Board (held on 25–30 January 2016 and 30–31 May 2016, respectively). These resolutions are deemed to have important implications for the South-East Asia Region and merit follow-up action by both Member States as well as WHO at the regional and country levels. The background of the selected resolutions, their implications on collaborative activities with Member States, as applicable, along with actions proposed for Member States and WHO have been summarized. All the resolutions of the Sixty-ninth World Health Assembly and the Regional One Voice (ROV) on Agenda items presented at the Health Assembly and 138th and 139th sessions of the WHO Executive Board are provided in the annex to this Working Paper. The High-Level Preparatory Meeting held in New Delhi from 11–14 July 2016 reviewed the attached working paper and made the following recommendations: Action by Member States (1) Take necessary and appropriate follow-up action as requested by the Sixty-ninth World Health Assembly through its resolutions in the national context. Action by WHO (1) Take appropriate follow-up action at the regional and country levels and support Member States on the implementation of the specific issues as may be required. This Working Paper and the HLP Meeting recommendations are submitted to the Sixty-ninth Session of the WHO Regional Committee for South-East Asia for its consideration and decision.

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SEA/RC69/11: Ending preventable maternal and child mortality
Regional Office for South-East Asia, World Health Organization ( 2016-07 )
Abstract

There has been a significant decline in child mortality in the South-East Asia Region over the past few decades, from 118/1000 live births in 1990 to 43/1000 live births in 2015, or a decline of about 64% while the regional maternal mortality ratio (MMR) declined from 525 to 164 per 100 000 live births, a reduction of about 69%. Over the same period, neonatal mortality has declined less rapidly from 53/1000 live births to 24/1000 live births. These declines in mortality, however, narrowly miss the MDG targets of 75% (three fourths) reduction in maternal mortality (MDG5) and 67% (two third) reduction in child mortality (MDG4). In addition there are significant disparities in the achievements made in the Region in terms of social parameters such as poverty, education status and the status of women. The main barriers to progress have been constraints related to health financing, health workforce (midwives and skilled birth attendants, in particular) and to essential supplies and equipment. With the launch of the Sustainable Development Goals (SDGs) and the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030), new targets have been set for all countries. This provides renewed impetus to the efforts to end preventable mortality among women, newborns and children through a broad-based multisectoral approach as well as to address areas such as adolescent health and early child development that received less attention during the MDG phase. In April 2014, the WHO Regional Director for South-East Asia launched a Flagship Initiative on ending preventable maternal, newborn and child mortality with the focus on neonatal mortality. In support of this, the Regional Director convened a Regional Summit of H6 Leadership (WHO, UNICEF, UNFPA, UNAIDS, UN WOMEN and World Bank) in December 2015 that issued a joint statement for ending preventable mortality among newborns, children and mothers. This regional interagency platform will be effective for providing advocacy and technical assistance, promoting multisectoral action, and coordinating partner-donor support to Member States for the implementation of the Global Strategy.The attached Working Paper was presented to the High-Level Preparatory Meeting for its review and recommendations. The recommendations made by the HLP Meeting for consideration of the Sixty-ninth Session of the Regional Committee are: Actions by Member States (1) Update, based on the achievements and identified gaps in the progress, strategies and plans for RMNCAH, the framework for operationalizing the Global Strategy for Women’s, Children’s and Adolescents’ Health, and pay special attention to the principles of equity and the overriding SDG aim of “leaving no one behind”. (2) Continue to assume national leadership for effective planning, implementation and monitoring and reporting the progress in line with the monitoring framework of the Global Strategy and SDGs. (3) Focus on strategies to address major causes of mortality among mothers and newborns by strengthening midwifery skills, providing adequate financing, and expanding coverage with life-saving interventions with good quality of care. Actions by WHO (1) Continue to provide technical guidance and support to Member States for operationalizing the Global Strategy based on regional- and country-level contexts and specificities. (2) Provide support to strengthen planning and implementation capacity in Member States for improving the health of women, children and adolescents and support innovative approaches for reaching the unreached and unserved or underserved populations. (3) Assist in preparing a draft Resolution focusing on ending maternal, newborn and child mortality for consideration of the Sixty-ninth Session of the Regional Committee. This Working Paper and the HLP Meeting recommendations are submitted to the Sixty-ninth Session of the WHO Regional Committee for South-East Asia for its consideration and decision.