GO Health!!!

Key facts

• On average, women live six to eight years longer than men globally.
• In 2007, women's life expectancy at birth was more than 80 years in 35 countries, but only 54 years in the WHO African Region.
• Girls are far more likely than boys to suffer sexual abuse.
• Road traffic injuries are the leading cause of death among adolescent girls in high- and middle-income countries.
• Essentially all (99%) of the half a million maternal deaths every year occur in developing countries.
• Breast cancer is the leading cancer killer among women aged 20–59 years in high-income countries.
• Globally, cardiovascular disease, often thought to be a "male" problem, is the leading killer of women.

---

Infancy and childhood (0-9 years)

Both death rates and the causes of death are similar for boys and girls during infancy and childhood. Pre-term births, birth asphyxia and infections are the main causes of death during the first month of life, which is also the time of life when mortality is the highest.
Pneumonia, diarrhoea and malaria are the main causes of death during the first five years of life, with malnutrition being a major factor.
Globally, girls under five years are more likely to be overweight than boys, which – together with obesity – may lead to cardiovascular disease, diabetes, muculoskeletal disorders and some cancers later in life.
Girls are far more likely than boys to suffer sexual violence (any sexual abuse: 8.7% boys; 25.3% girls globally).

Adolescent girls (10-19 years)

Unintentional injuries
Injuries from road traffic accidents are the leading cause of death among adolescent girls (10–19 years) in high- and middle-income countries.
Mental health
Suicide and mental health disorders contribute significantly to the burden of ill-health and death in all regions.
HIV/AIDS
HIV infection is high in virtually all countries that have generalized HIV epidemics. Adolescent girls are at risk of unsafe and often unwanted and forced sexual activity that can lead to HIV/AIDS, other sexually transmitted infections, unwanted pregnancy and unsafe abortion.
Adolescent pregnancy
Pregnancy-related complications are a leading cause of death among girls aged 15–19 years in developing countries; unsafe abortion – provided by unskilled persons in unhygienic conditions – contributes substantially to these deaths.
Substance use
Adolescent girls are increasingly using tobacco and alcohol, which risks compromising their health, including in later life, as do poor diet and physical inactivity. For instance, there is evidence that tobacco advertising is increasingly targeting young girls and women.

Reproductive age (15-44 years) and adult women (20-59 years)

HIV/AIDS
For women in their reproductive years (15–44), HIV/AIDS is the leading cause of death and disease worldwide, while unsafe sex is the main risk factor in developing countries. Biological factors, lack of access to information and health services, economic vulnerability and unequal power in sexual relations expose young women particularly to HIV infection.
Maternal health
Every year, 99% of some half a million maternal deaths occur in developing countries. Despite the increase in contraceptive use over the past 30 years, significant unmet needs remain in all regions. For example, in sub-Saharan Africa, one in four women who wish to delay or stop childbearing does not use any family planning method.
Tuberculosis
Tuberculosis is often linked to HIV infection and the third leading cause of death among women of reproductive age (15–44 years) in low-income countries and worldwide. It ranks fifth worldwide among women aged 20–59 years.
Injuries
Injuries from road traffic accidents figure among the top 10 causes of death among adult women (20-59 years) globally. Furthermore, in the WHO South-East Asia Region, burns are a leading cause of death among women aged 15–44. Women suffer significantly more fire-related injuries and deaths than men. Many fire-related deaths are related to cooking accidents and many are a result of intimate partner and family violence.
Cervical cancer
Cervical cancer is the second most common type of cancer among women, with virtually all cases linked to genital infection with the human papillomavirus (HPV). Almost 80% of cases today and an even higher proportion of deaths from cervical cancer occur in low-income countries, where access to cervical cancer screening and treatment virtually does not exist.
Violence
Violence against women is widespread around the world. Women who have been physically or sexually abused have higher rates of mental ill-health, unintended pregnancies, abortions and miscarriages than non-abused women. Most violence against women is perpetrated by an intimate male partner. Increasingly in many conflicts sexual violence is also used as a tactic of war.
Depression and suicide
Women are more susceptible to depression and anxiety than men. An estimated 73 million adult women worldwide suffer a major depressive episode each year. Mental disorders following childbirth, including depression, are estimated to affect about 13% of women within a year of delivery. Suicide is the seventh top cause of death globally for women aged 20-59 years.
Chronic obstructive pulmonary disease (COPD)
Tobacco use and the burning of solid fuels for indoor heating and cooking are the primary risk factors for chronic obstructive pulmonary disease (COPD) – a lung ailment – in women. Women prepare most of the family food, hence, the burden of COPD caused by exposure to indoor smoke is over 50% higher among women than among men.

Older women (60 years and over)

Because they tend to live longer than men, women represent a growing proportion of all older people. Worldwide, in 2007, 55% of adults aged 60 years and over were women, a proportion that rises to 58% at age 70 and above. Chronic conditions – mainly cardiovascular disease and COPD – account for 45% of deaths in women over 60 years of age worldwide. A further 15% of deaths are caused by cancers, mainly of the breast, lung and colon. Many of the health problems faced by women in older age are the result of risk factors that arise in their adolescence and adulthood, such as smoking, sedentary lifestyles and unhealthy diets. Other debilitating health problems faced by older women are poor vision (including cataracts), hearing loss, arthritis, depression and dementia.
Cardiovascular disease: heart attacks and strokes
Globally, cardiovascular disease (mainly heart attacks/ischaemic heart disease and stroke), often thought to be a "male" problem, is the main killer of older women. Women often show different symptoms from men, which contributes to under diagnosis of heart disease in women. Women also tend to develop heart disease later in life than men. Tobacco is implicated in nearly 10% of cardiovascular disease in women.
Breast, lung and colon cancer
Cancers of the breast, lung and colon are among the top ten causes of death of older women globally. The incidence (new cases) of breast cancer is much higher in high-income countries compared to low- and middle-income countries, but mortality is similar. This is due to the availability of better treatment in the high-income countries. For lung and colon cancer, both incidence and mortality are currently higher in high-income countries. Globally, 71% of lung cancer deaths are caused by tobacco use.

Table: 10 leading causes of death in females by country income group, 2004

*Chronic obstructive pulmonary disease.
**Includes severe neonatal infections and other non-infectious causes arising in the perinatal period.

Visit my another blog : www.e-nanra.blogspot.com , www.adsensebox.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com

Key facts

• Polio (poliomyelitis) mainly affects children under five years of age.
• One in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.
• Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 1 352 reported cases in 2010. The reduction is the result of the global effort to eradicate the disease.
• In 2012, only three countries (Afghanistan, Nigeria and Pakistan) remain polio-endemic, down from more than 125 in 1988.
• Persistent pockets of polio transmission in northern Nigeria and the border between Afghanistan and Pakistan are the current focus of the polio eradication initiative.
• As long as a single child remains infected, children in all countries are at risk of contracting polio. In 2009-2010, 23 previously polio-free countries were re-infected due to imports of the virus.
• In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems.
• Success hinges on financing the next steps of the global eradication initiative.

---

Polio and its symptoms

Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.

People most at risk

Polio mainly affects children under five years of age.

Prevention

There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.

Global caseload

Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries then, to 1352 reported cases in 2010. In 2012, only parts of three countries in the world remain endemic for the disease - the smallest geographic area in history - and case numbers of wild poliovirus type 3 are down to lowest-ever levels.

The Global Polio Eradication Initiative

Launch

In 1988, the forty-first World Health Assembly, consisting then of delegates from 166 Member States, adopted a resolution for the worldwide eradication of polio. It marked the launch of the Global Polio Eradication Initiative, spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF). This followed the certification of the eradication of smallpox in 1980, progress during the 1980s towards elimination of the poliovirus in the Americas, and Rotary International’s commitment to raise funds to protect all children from the disease.

Progress

Overall, since the Global Polio Eradication Initiative was launched, the number of cases has fallen by over 99%. In 2012, only three countries in the world remain polio-endemic. Persistent pockets of polio transmission in northern Nigeria and along the border between Afghanistan and Pakistan are key epidemiological challenges.
In 1994, the WHO Region of the Americas (36 countries) was certified polio-free, followed by the WHO Western Pacific Region (37 countries and areas including China) in 2000 and the WHO European Region (51 countries) in June 2002. In 2010, the European Region suffered its first importation of polio after certification. In 2011, the WHO Western Pacific Region also suffered an importation of poliovirus.
In 2009, more than 361 million children were immunized in 40 countries during 273 supplementary immunization activities (SIAs). Globally, polio surveillance is at historical highs, as represented by the timely detection of cases of acute flaccid paralysis.

Objectives

The objectives of the Global Polio Eradication Initiative are:

• to interrupt transmission of wild poliovirus as soon as possible;
• to achieve certification of global polio eradication;
• to contribute to health systems development and strengthen routine immunization and surveillance for communicable diseases in a systematic way.

Strategies

There are four core strategies to stop transmission of the wild poliovirus in areas that are affected by the disease or considered at high risk of re-infection:

• high infant immunization coverage with four doses of oral poliovirus vaccine (OPV) in the first year of life;
• supplementary doses of OPV to all children under five years of age during SIAs;
• surveillance for wild poliovirus through reporting and laboratory testing of all acute flaccid paralysis (AFP) cases among children under fifteen years of age;
• targeted “mop-up” campaigns once wild poliovirus transmission is limited to a specific focal area.

Before a WHO region can be certified polio-free, three conditions must be satisfied:

• there are at least three years of zero polio cases due to wild poliovirus;
• disease surveillance efforts in countries meet international standards; and
• each country must illustrate the capacity to detect, report and respond to “imported” polio cases.

Laboratory stocks must be contained and safe management of the wild virus in inactivated polio vaccine (IPV) manufacturing sites must be assured before the world can be certified polio-free.
The Independent Monitoring Board (IMB) evaluates on a quarterly basis the progress towards each of the major milestones of the Global Polio Eradication Initiative Strategic Plan 2010-2012, determine the impact of any 'mid-course corrections' that are deemed necessary, and advise on additional measures when appropriate.

Coalition

The Global Polio Eradication Initiative (GPEI) is spearheaded by WHO, Rotary International, CDC and UNICEF. The eradication of polio is about equity in health and the moral imperative of reaching every child with an available health intervention.
The polio eradication coalition includes governments of countries affected by polio; private sector foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. the World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Luxembourg, Malaysia, Monaco, the Netherlands, New Zealand, Norway, Oman, Portugal, Qatar, the Republic of Korea, the Russian Federation, Saudi Arabia, Spain, Sweden, Switzerland, Turkey, United Arab Emirates, the United Kingdom and the United States of America); the European Commission; humanitarian and nongovernmental organizations (e.g. the International Red Cross and Red Crescent societies and the Global Poverty Project) and corporate partners (e.g. Sanofi Pasteur and Wyeth). Volunteers in developing countries also play a key role: 20 million people have participated in mass immunization campaigns.

Priorities for polio eradication

As long as a single child remains infected with polio, children in all countries are at risk of contracting the disease.
To stop transmission of the wild poliovirus and optimize the benefits of polio eradication, the global priorities are:

Stopping wild poliovirus transmission in endemic countries

Polio today is more geographically restricted than ever before. The highest priority is reaching all children during SIAs in the four countries which have never stopped transmission of polio. To succeed, high levels of political commitment must be maintained at national, state/provincial and district levels. In 2010, a new strategic plan was launched, based on lessons learned in the past years and an independent evaluation of the major barriers to stopping polio transmission. This strategic plan is based on district-specific planning to address the unique challenges of each of the infected areas, fully exploiting new tools such as bivalent oral polio vaccine and strengthening health systems.

Putting an end to re-established transmission

Three countries - Angola, Chad and the Democratic Republic of the Congo - are classified as having 're-established transmission' because they have had ongoing transmission for over 12 months. These countries are treated with the same level of priority as the endemic countries. In early 2011, all three countries initiated emergency action plans to address the situation and fill operational gaps.

Preventing new outbreaks

Poliovirus has a habit of finding pockets of inadequately vaccinated children. As China, Congo, the Russian Federation and Tajikistan have learned, the poliovirus does not respect national borders. To minimize the risk of outbreaks from importation, countries must maintain high population immunity levels.

Closing the funding gap

Substantial financial resources are required to support polio eradication. However, in addition to the obvious humanitarian benefits, economic modelling has demonstrated the financial benefits of polio eradication to be at least US$ 40-50 billion. Success in carrying out the necessary vaccination campaigns and surveillance hinges on sufficient funds from financial stakeholders.

Impact of the initiative

More than eight million people who would otherwise have been paralysed are walking today because they have been immunized against polio since the initiative began in 1988.
By preventing a debilitating disease, the Global Polio Eradication Initiative is helping reduce poverty, and is giving children and their families a greater chance of leading healthy and productive lives.
By establishing the capacity to access children everywhere, more than two billion children worldwide have been immunized during SIAs, demonstrating that well-planned health interventions can reach even the most remote, conflict-affected or poorest areas.
Planning for SIAs provides key demographic data – “finding” children in remote villages and households for the first time, and "mapping" their location for future health services.
In most countries, the Global Polio Eradication Initiative has expanded the capacity to tackle other infectious diseases, such as avian influenza or Ebola, by building effective disease-reporting and surveillance systems, training local epidemiologists and establishing a global laboratory network. This capacity has also been deployed in health emergencies such as the 2010 floods in Pakistan and the 2011 drought in the Horn of Africa.
Routine immunization services have been strengthened by bolstering the cold chain, transport and communications systems for immunization. Improving these services helped to lay the groundwork for highly successful measles vaccination campaigns that have saved millions of young lives.
Vitamin A is often administered during polio SIAs. Since 1988, more than 1.2 million childhood deaths have been prevented through provision of vitamin A during polio SIAs.
On average, one in every 250 people in a country has been involved in polio immunization campaigns. More than 20 million health workers and volunteers have been trained to deliver OPV and vitamin A, fostering a culture of disease prevention.
Through the synchronization of SIAs, many countries have established a new mechanism for coordinating major cross-border health initiatives aimed at reaching all people – a model for regional and international cooperation for health.

Future benefits of polio eradication

Once polio is eradicated, the world can celebrate the delivery of a major global public good that will benefit all people equally, no matter where they live. Economic modelling has found that the eradication of polio in the next five years would save at least US$ 40-50 billion, mostly in low-income countries

For more information contact

WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int

Visit my another blog : www.e-nanra.blogspot.com , www.adsensebox.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com

Key facts

• Worldwide obesity has more than doubled since 1980.
• In 2008, more than 1.4 billion adults, 20 and older, were overweight. Of these over 200 million men and nearly 300 million women were obese.
• 65% of the world's population live in countries where overweight and obesity kills more people than underweight.
• More than 40 million children under the age of five were overweight in 2010.
• Obesity is preventable.

---

What are overweight and obesity?

• a BMI greater than or equal to 25 is overweight
• a BMI greater than or equal to 30 is obesity.

Facts about overweight and obesity

• More than 1.4 billion adults, 20 and older, were overweight.
• Of these overweight adults, over 200 million men and nearly 300 million women were obese.
• Overall, more than one in ten of the world’s adult population was obese.

What causes obesity and overweight?

• an increased intake of energy-dense foods that are high in fat, salt and sugars but low in vitamins, minerals and other micronutrients; and
• a decrease in physical activity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

What are common health consequences of overweight and obesity?

• cardiovascular diseases (mainly heart disease and stroke), which were the leading cause of death in 2008;
• diabetes;
• musculoskeletal disorders (especially osteoarthritis - a highly disabling degenerative disease of the joints);
• some cancers (endometrial, breast, and colon).

Facing a double burden of disease

• While they continue to deal with the problems of infectious disease and under-nutrition, they are experiencing a rapid upsurge in noncommunicable disease risk factors such as obesity and overweight, particularly in urban settings.
• It is not uncommon to find under-nutrition and obesity existing side-by-side within the same country, the same community and the same household.

How can overweight and obesity be reduced?

• limit energy intake from total fats;
• increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts;
• limit the intake of sugars;
• engage in regular physical activity;
• achieve energy balance and a healthy weight.

• support individuals in following the recommendations above, through sustained political commitment and the collaboration of many public and private stakeholders;
• make regular physical activity and healthier dietary patterns affordable and easily accessible too all - especially the poorest individuals.

• reducing the fat, sugar and salt content of processed foods;
• ensuring that healthy and nutritious choices are available and affordable to all consumers;
• practicing responsible marketing;
• ensuring the availability of healthy food choices and supporting regular physical activity practice in the workplace.

WHO response

Key facts

• Climate change affects the fundamental requirements for health – clean air, safe drinking water, sufficient food and secure shelter.
• The global warming that has occurred since the 1970s was causing over 140 000 excess deaths annually by the year 2004.
• Many of the major killers such as diarrhoeal diseases, malnutrition, malaria and dengue are highly climate-sensitive and are expected to worsen as the climate changes.
• Areas with weak health infrastructure – mostly in developing countries – will be the least able to cope without assistance to prepare and respond.
• Reducing emissions of greenhouse gases through better transport, food and energy-use choices can result in improved health.

---

Climate change

What is the impact of climate change on health?

Extreme heat

Natural disasters and variable rainfall patterns

Patterns of infection

Measuring the health effects

Who is at risk?

WHO response

• Advocacy: to raise awareness that climate change is a fundamental threat to human health.
• Partnerships: to coordinate with partner agencies within the UN system, and ensure that health is properly represented in the climate change agenda.
• Science and evidence: to coordinate reviews of the scientific evidence on the links between climate change and health, and develop a global research agenda.
• Health system strengthening: to assist countries to assess their health vulnerabilities and build capacity to reduce health vulnerability to climate change. 

Visit my another blog : www.e-nanra.blogspot.com , www.adsensebox.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com

Key facts

• 346 million people worldwide have diabetes.
• In 2004, an estimated 3.4 million people died from consequences of high blood sugar.
• More than 80% of diabetes deaths occur in low- and middle-income countries.
• WHO projects that diabetes deaths will double between 2005 and 2030.
• Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.

---

What is diabetes?

Type 1 diabetes

Type 2 diabetes

Gestational diabetes

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG)

What are common consequences of diabetes?

• Diabetes increases the risk of heart disease and stroke. 50% of people with diabetes die of cardiovascular disease (primarily heart disease and stroke).
• Combined with reduced blood flow, neuropathy in the feet increases the chance of foot ulcers and eventual limb amputation.
• Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. After 15 years of diabetes, approximately 2% of people become blind, and about 10% develop severe visual impairment.
• Diabetes is among the leading causes of kidney failure. 10-20% of people with diabetes die of kidney failure.
• Diabetic neuropathy is damage to the nerves as a result of diabetes, and affects up to 50% of people with diabetes. Although many different problems can occur as a result of diabetic neuropathy, common symptoms are tingling, pain, numbness, or weakness in the feet and hands.
• The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes.

What is the economic impact of diabetes?

How can the burden of diabetes be reduced?

Prevention

• achieve and maintain healthy body weight;
• be physically active – at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;
• eat a healthy diet of between three and five servings of fruit and vegetables a day and reduce sugar and saturated fats intake;
• avoid tobacco use – smoking increases the risk of cardiovascular diseases.

Diagnosis and treatment

• moderate blood glucose control. People with type 1 diabetes require insulin; people with type 2 diabetes can be treated with oral medication, but may also require insulin;
• blood pressure control;
• foot care.

• screening and treatment for retinopathy (which causes blindness);
• blood lipid control (to regulate cholesterol levels);
• screening for early signs of diabetes-related kidney disease.

WHO activities to prevent and control diabetes

• provides scientific guidelines for diabetes prevention;
• develops norms and standards for diabetes care;
• builds awareness on the global epidemic of diabetes; including partnership with the International Diabetes Federation in the celebration of World Diabetes Day (14 November);
• conducts surveillance of diabetes and its risk factors.

For more information, please contact:

Key facts

• Influenza is an acute viral infection that spreads easily from person to person.
• Influenza circulates worldwide and can affect anybody in any age group.
• Influenza causes annual epidemics that peak during winter in temperate regions.
• Influenza is a serious public health problem that causes severe illnesses and deaths for higher risk populations.
• An epidemic can take an economic toll through lost workforce productivity, and strain health services.
• Vaccination is the most effective way to prevent infection.

---

Overview

Signs and symptoms

Who is at risk?

Transmission

Treatment

Seasonal epidemics

Disease effects

Prevention

• nursing-home residents (the elderly or disabled)
• elderly individuals
• people with chronic medical conditions
• other groups such as pregnant women, health care workers, those with essential functions in society, as well as children from ages six months to two years.

WHO response

Key facts:

• Violence against women - both intimate partner violence and sexual violence against women - are major public health problems and violations of women's human rights.
• A WHO multi-country study found that between 15–71% of women reported experiencing physical and/or sexual violence by an intimate partner at some point in their lives.
• These forms of violence result in physical, mental, sexual, and reproductive health and other health problems, and may increase vulnerability to HIV.
• Risk factors for being a perpetrator include low education, past exposure to child maltreatment or witnessing violence between parents, harmful use of alcohol, attitudes accepting of violence and gender inequality. Most of these are also risk factors for being a victim of intimate partner and sexual violence.
• School-based programmes to prevent relationship violence among young people (or dating violence) are supported by the best evidence of effectiveness. Other primary prevention strategies, such as microfinance combined with gender equality training and community-based initiatives that address gender inequality and communication and relationship skills, hold promise.
• Situations of conflict, post conflict and displacement may exacerbate existing violence and present new forms of violence against women.

---

Introduction

Scope of the problem

• between 15% of women in Japan and 70% of women in Ethiopia and Peru reported physical and/or sexual violence by an intimate partner;
• between 0.3–11.5% of women reported experiencing sexual violence by a non-partner;
• the first sexual experience for many women was reported as forced – 24% in rural Peru, 28% in Tanzania, 30% in rural Bangladesh, and 40% in South Africa.

Health consequences

• Health effects can include headaches, back pain, abdominal pain, fibromyalgia, gastrointestinal disorders, limited mobility and poor overall health. In some cases, both fatal and non-fatal injuries can result.
• Intimate partner violence and sexual violence can lead to unintended pregnancies, gynaecological problems, induced abortions and sexually transmitted infections, including HIV. Intimate partner violence in pregnancy also increases the likelihood of miscarriage, stillbirth, pre-term delivery and low birth weight.
• These forms of violence can lead to depression, post-traumatic stress disorder, sleep difficulties, eating disorders, emotional distress and suicide attempts.
• Sexual violence, particularly during childhood, can lead to increased smoking, drug and alcohol misuse, and risky sexual behaviours in later life. It is also associated with perpetration of violence (for males) and being a victim of violence (for females).

Impact on children

• Children who grow up in families where there is intimate partner violence may suffer a range of behavioural and emotional disturbances that can be associated with the perpetration or experiencing of violence later in life.
• Intimate partner violence has also been associated with higher rates of infant and child mortality and morbidity (e.g. diarrhoeal disease, malnutrition).

Social and economic costs

Risk factors

• lower levels of education (perpetrators and victims);
• exposure to child maltreatment (perpetrators and victims);
• witnessing parental violence (perpetrators and victims);
• antisocial personality disorder (perpetrators);
• harmful use of alcohol (perpetrators and victims);
• males who have multiple partners or are suspected by their partners of infidelity (perpetrators); and
• attitudes that are accepting of violence (perpetrators and victims).

• past history of violence as a perpetrator or victim;
• marital discord and dissatisfaction (perpetrators and victims).

• beliefs in family honour and sexual purity;
• ideologies of male sexual entitlement; and
• weak legal sanctions for sexual violence.

Prevention

WHO response

• building the evidence base on the scope and types of intimate partner and sexual violence in different settings and supporting countries' efforts to document and measure this violence. This is central to understanding the magnitude and nature of the problem at a global level;
• developing technical guidance for evidence-based intimate partner and sexual violence prevention and for strengthening the health sector responses to such violence;
• disseminating information and supporting national efforts to advance women's rights and the prevention of and response to intimate partner and sexual violence against women; and
• collaborating with international agencies and organizations to reduce/eliminate intimate partner and sexual violence globally. 

Visit my another blog : www.e-nanra.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com

High Cholesterol Overview

Cholesterol is a waxy, fatlike substance that the body needs to function normally. Cholesterol is naturally present in cell walls or membranes everywhere in the body, including the brain, nerves, muscles, skin, liver, intestines, and heart.
The body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If a person has too much cholesterol in the bloodstream, the excess may be deposited in arteries, including the coronary arteries of the heart, the carotid arteries to the brain, and the arteries that supply blood to the legs. Cholesterol deposits are a component of the plaques that cause narrowing and blockage of the arteries, producing signs and symptoms originating from the particular part of the body that has decreased blood supply.
Blockage to the leg arteries causes claudication (pain with walking) due to peripheral artery disease. Carotid artery blockage may cause stroke, and blockage of the coronary arteries leads to angina (chest pain) and heart attack.
Coronary heart disease (CHD) is caused by cholesterol and fat being deposited in the walls of the arteries that supply nutrients and oxygen to the heart. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. Narrowing of the arteries decreases that supply and can cause angina (chest pain) when the heart muscle does not receive enough oxygen. Cholesterol plaques can rupture, resulting in a blood clot formation that completely blocks the artery, stopping all blood flow and causing a heart attack, in which heart muscle cells die from lack of oxygen and nutrients.

Who has high cholesterol?

• Throughout the world, blood cholesterol levels vary widely. Generally, people who live in countries where blood cholesterol levels are lower, such as Japan, have lower rates of heart disease. Countries with very high cholesterol levels, such as Finland, also have very high rates of coronary heart disease. However, some populations with similar total cholesterol levels have very different heart disease rates, suggesting that other factors also influence risk for coronary heart disease.
  
  
• High cholesterol is more common in men younger than 55 years and in women older than 55 years.
  
  
• The risk for high cholesterol increases with age.

High Cholesterol Causes

High cholesterol levels are due to a variety of factors including heredity, diet, and lifestyle. Less commonly, underlying illnesses affecting the liver, thyroid, or kidney may affect blood cholesterol levels.

• Heredity: Genes may influence how the body metabolizes LDL (bad) cholesterol. Familial hypercholesterolemia is an inherited form of high cholesterol that may lead to early heart disease.

• Weight: Excess weight may modestly increase your LDL (bad) cholesterol level. Losing weight may lower LDL and raise HDL (good) cholesterol levels.

• Physical activity/exercise: Regular physical activity may lower triglycerides and raise HDL cholesterol levels.

• Age and sex: Before menopause, women usually have lower total cholesterol levels than men of the same age. As women and men age, their blood cholesterol levels rise until about 60-65 years of age. After about age 50 years, women often have higher total cholesterol levels than men of the same age.

• Alcohol use: Moderate (1-2 drinks daily) alcohol intake increases HDL (good) cholesterol but does not lower LDL (bad) cholesterol. Doctors don't know for certain whether alcohol also reduces the risk of heart disease. Drinking too much alcohol can damage the liver and heart muscle, lead to high blood pressure, and raise triglyceride levels. Because of the risks, alcoholic beverages should not be used as a way to prevent heart disease.

• Mental stress: Several studies have shown that stress raises blood cholesterol levels over the long term. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol.

For most people, the first high cholesterol treatment to try is three lifestyle changes:

• Eating better
• Maintaining (or losing) weight
• Exercising more

Visit my another blog : www.e-nanra.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com

Key facts

Tobacco kills up to half of its users.
Tobacco kills nearly six million people each year, of whom more than 5 million are users and ex users and more than 600 000 are nonsmokers exposed to second-hand smoke. Unless urgent action is taken, the annual death toll could rise to more than eight million by 2030.
Nearly 80% of the world's one billion smokers live in low- and middle-income countries.
Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.

Leading cause of death, illness and impoverishment

The tobacco epidemic is one of the biggest public health threats the world has ever faced. It kills nearly six million people a year of whom more than 5 million are users and ex users and more than 600 000 are nonsmokers exposed to second-hand smoke. Approximately one person dies every six seconds due to tobacco and this accounts for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease.

Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.

Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development.

In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves.
Gradual killer

Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of tobacco-related disease and death has just begun.

Tobacco caused 100 million deaths in the 20th century. If current trends continue, it will cause up to one billion deaths in the 21st century.
Unchecked, tobacco-related deaths will increase to more than eight million per year by 2030. More than 80% of those deaths will be in low- and middle-income countries.

Surveillance is key

Good monitoring tracks the extent and character of the tobacco epidemic and indicates how best to tailor policies. Only fifty-nine countries, representing under half of the world's population, monitor tobacco use by repeating nationally representative youth and adult surveys at least once every five years.
Second-hand smoke kills

Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water pipes. There is no safe level of exposure to second-hand tobacco smoke.

Every person should be able to breathe smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit.1

Under 11% of the world's population are protected by comprehensive national smoke-free laws.
The number of people protected from second-hand smoke more than doubled to 739 million in 2010 from 354 million in 2008.
Almost half of children regularly breathe air polluted by tobacco smoke.
Over 40% of children have at least one smoking parent.
Second-hand smoke causes more than 600 000 premature deaths per year.
In 2004, children accounted for 31% of the deaths attributable to second-hand smoke.
There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.

Tobacco users need help to quit

Studies show that few people understand the specific health risks of tobacco use. For example, a 2009 survey in China revealed that only 37% of smokers knew that smoking causes coronary heart disease and only 17% knew that it causes stroke.2

Among smokers who are aware of the dangers of tobacco, most want to quit. Counselling and medication can more than double the chance that a smoker who tries to quit will succeed.

National comprehensive health-care services supporting cessation are available in only 19 countries, representing 14% of the world's population.
There is no cessation assistance in 28% of low-income countries and 7% of middle-income countries.

Picture warnings work

Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit.

Studies carried out after the implementation of pictorial package warnings in Brazil, Canada, Singapore and Thailand consistently show that pictorial warnings significantly increase people's awareness of the harms of tobacco use.

Mass media campaigns can also reduce tobacco consumption, by influencing people to protect non-smokers and convincing youths to stop using tobacco.

Just 19 countries, representing 15% of the world's population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs. No low-income country meets this best-practice level.
Forty-two countries, representing 42% of the world’s population, mandate pictorial warnings.
Graphic warnings can persuade smokers to protect the health of non-smokers by smoking less inside the home and avoiding smoking near children.
More than 1.9 billion people, representing 28% of the world's population, live in the 23 countries that have implemented at least one strong anti-tobacco mass media campaign within the last two years.

Ad bans lower consumption

Bans on tobacco advertising, promotion and sponsorship can reduce tobacco consumption.

A comprehensive ban on all tobacco advertising, promotion and sponsorship could decrease tobacco consumption by an average of about 7%, with some countries experiencing a decline in consumption of up to 16%.
Only 19 countries, representing 6% of the world’s population, have comprehensive national bans on tobacco advertising, promotion and sponsorship.
Forty-six per cent of the world's population lives in countries that do not ban free distribution of tobacco products.

Taxes discourage tobacco use

Tobacco taxes are the most effective way to reduce tobacco use, especially among young people and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in low- and middle-income countries.

Only 27 countries, representing less than 8% of the world's population, have tobacco tax rates greater than 75% of the retail price.
Tobacco tax revenues are on average 154 times higher than spending on tobacco control, based on available data.

WHO response

WHO is committed to fight the global tobacco epidemic. The WHO Framework Convention on Tobacco Control entered into force in February 2005. Since then, it has become one of the most widely embraced treaties in the history of the United Nations with more than 170 Parties covering 87% of the world's population. The WHO Framework Convention is WHO's most important tobacco control tool and a milestone in the promotion of public health. It is an evidence-based treaty that reaffirms the right of people to the highest standard of health, provides legal dimensions for international health cooperation and sets high standards for compliance.

In 2008, WHO introduced a package of tobacco control measures to further counter the tobacco epidemic and to help countries to implement the WHO Framework Convention. Known by their acronym MPOWER, the measures are identified as "best buys" and "good buys" in tobacco control. Each measure corresponds to at least one provision of the WHO Framework Convention on Tobacco Control.

The six MPOWER measures are:

Monitor tobacco use and prevention policies
Protect people from tobacco use
Offer help to quit tobacco use
Warn about the dangers of tobacco
Enforce bans on tobacco advertising, promotion and sponsorship
Raise taxes on tobacco.

For more information contact:

WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int



Visit my another blog : www.e-nanra.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com

Key facts

• Essential medicines are medicines that satisfy the priority health care needs of a population. They are selected with regard to disease prevalence, safety, efficacy, and comparative cost-effectiveness.
• The WHO Model List of Essential Medicines includes over 350 medicines to treat priority conditions.
• The WHO Model List is updated every two years, using a transparent evidence-based process.
• The WHO Model List can be used by countries as a guide for the development of their own national essential medicines list.
• National lists of essential medicines can be used as the basis for procurement and supply of medicines in the public and private sector, schemes that reimburse medicine costs, medicine donations and to guide local medicine production.

---

Essential medicines are medicines that satisfy the priority health care needs of a population. They are selected with regard to disease prevalence, evidence of efficacy, safety, and comparative cost-effectiveness.
Essential medicines are intended to be available in functioning health systems at all times in adequate amounts, in appropriate dosage forms, with assured quality, and at prices individuals and the community can afford. The availability of medicines in developing countries is compromised by several factors, such as poor medicine supply and distribution systems, insufficient health facilities and staff, low investment in health and the high cost of medicines. Identifying a list of essential medicines for the health care needs of the population can help countries prioritize the purchasing and distribution of medicines, thereby reducing costs to the health system.

What is the WHO Model List of Essential Medicines?

The WHO Model List of Essential Medicines is a list of over 350 medicines. The WHO Model List includes treatment options for priority conditions such as malaria, HIV/AIDS, tuberculosis, reproductive health and also chronic diseases, such as cancer and diabetes, based on evaluation of the best available evidence.
Essential medicines are listed by their International Non-proprietary Name (INN) or generic name, without specifying a manufacturer. The list is updated every two years by the Expert Committee for the Selection and Use of Essential Medicines, using a transparent, evidence-based process. In 2007, the first ever WHO Model List of Essential Medicines for Children was developed and published.

Selection of essential medicines

The medicines included in the WHO Model List of Essential Medicines are selected with regard to disease prevalence, evidence of safety and efficacy, and comparative cost-effectiveness. As costs of medicines change over time, the price of a medicine is not a reason to exclude it from the WHO Model List if it meets the other stated selection criteria. Cost-effectiveness comparisons are made between alternative medicines within the same therapeutic group.
Applications for inclusion, changes or deletions to the Model List are submitted to the secretary of the Expert Committee for the Selection and Use of Essential Medicines. The Expert Committee is responsible for reviewing the evidence provided in an application and deciding whether to include or delete a medicine. The Expert Committee also identifies knowledge gaps and makes recommendations for future research that may be needed about medicines for the treatment of priority health problems. A medicine will be considered for deletion from the WHO Model List if its public health relevance has been questioned and/or there are concerns about its safety and efficacy and comparative cost-effectiveness compared to other medicines for the same condition.

How is the WHO Model List used?

The WHO Model List of Essential Medicines is an evidence-based resource that can be used by countries as a guide to develop their own national essential medicines list. Since the first WHO Model List of Essential Medicines was developed in 1977, many countries have developed their own national list. National lists of essential medicines can be used as the basis for procurement and supply of medicines in the public and private sector, schemes that reimburse medicine costs, medicine donations and to guide local medicine production.
The WHO Model List has been used to develop international lists for special conditions, such as The Interagency Emergency Health Kit (2006) and Essential Medicines for Reproductive Health (2006). Many international organizations, such as the United Nations Children Fund (UNICEF), United Nations High Commission for Refugees (UNHCR) and United Nations Fund for Population Activities (UNFPA), as well as nongovernmental organizations and international non-profit supply agencies, have adopted the essential medicines concept and base their medicine supply system on the WHO Model List.
The WHO Model Formulary is a guide on how to make effective use of the medicines on the WHO Model List of Essential Medicines. It follows the structure and sections used in the WHO Model List and provides a source of independent information on essential medicines for pharmaceutical policy-makers and prescribers worldwide. Also available is a WHO Model Formulary specifically for children.
The WHO Essential Medicines Library is a web-based service that provides access to information concerning individual medicines recorded in the WHO Model List, including disease information and text from the WHO Model Formulary. For each medicine, there are links to clinical evidence about efficacy and safety, WHO or other clinical guidelines, and price information.

Benefits

Identifying a limited number of essential medicines may lead to a better supply, more rational use, and lower costs. The selection of medicines has a considerable impact on the quality of care and the cost of treatment, it is therefore one of the areas where intervention is most cost-effective. Careful selection of medicines, linked with clinical treatment guidelines and monitoring and evaluation of prescribing can contribute to better health care.

WHO response

For the past 30 years the WHO Model List has led to a global acceptance of the concept of essential medicines as a powerful means to promote health equity. WHO continues its work in this area by:

• reviewing evidence for the safety, efficacy and comparative cost-effectiveness of medicines;
• developing the WHO Essential Medicines List for Children in 2007;
• revising the Model Essential Medicines Lists and related essential medicine resources regularly;
• providing independent prescriber information in the form of the WHO Model Formulary and the WHO Model Formulary for Children;
• providing technical support to countries for the adoption and implementation of the Essential Medicine List and Formulary; and
• promoting essential medicines strategies in collaboration with other international organizations, including the Interagency Pharmaceutical Coordination group, United Nations Development Programme, International Federation Red Cross and Red Crescent Societies, Médecins sans Frontières, UNICEF, UNHCR, and UNFPA.

For more information contact:

WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int

Visit my another blog : www.e-nanra.blogspot.com , www.visitandvacationindonesia.blogspot.com , www.easy-blogspot.blogspot.com