We investigate whether and to what extent Chinese development finance affects infant mortality, combining 92 demographic and health surveys (DHS) for a maximum of 53 countries and almost 55,000 sub-national locations over the 2002-2014 period. We address causality by instrumenting aid with a set of ...interacted variables. Variation over
time results from indicators that measure the availability of funding in a given year. Cross-sectional variation results from a sub-national region’s “probability to receive aid.” Controlled for this probability in tandem with fixed effects for country-years and provinces, the interactions of these variables form powerful and excludable instruments. Our results show that Chinese aid increases infant mortality at sub-national scales, but decreases mortality at the countrylevel. In several tests, we show that this stark contrast likely results from aid being fungible within recipient countries.
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Bioethics 519 (online) doi:10.1111/bioe.12145 Volume 29 Number 8 2015 pp. 488–596;
Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreak, and are primarily aimed at preventing and mitigating human-to-human transmission. These plans carry presumptive weight ...and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization (WHO). The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, thisfocus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.
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The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r...ules, and how money flows to health service providers. So far, early assessments have shown that PFM systems ranged from being a fundamental enabler to acting as a roadblock in the COVID-19 health response. While service delivery mechanisms have been extensively documented throughout the pandemic, the underlying PFM mechanisms of the response also merit attention. To highlight the importance of PFM in health emergency contexts, this rapid review analyses various country PFM experiences and identifies early lessons emerging from the financing of the health response to COVID-19. The assessment is done by stages of the budget cycle: budget allocation, budget execution, and budget oversight. Identifying lessons from the varying PFM modalities used to finance the response to COVID-19 is fundamental both for health policy-makers and for finance authorities to prepare for future health emergencies.
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Ocean plastic pollution has reached crisis level: every minute, more than an entire garbage truck of plastic makes its way into the world’s oceans—roughly 11 million metric tons annually. While plastic waste presents an immediate threat to marine wildlife and ecosystems, this global challenge al...so has implications for major industries such as fishing and tourism, impacting the livelihoods of millions of people. The drivers and impacts of ocean plastic pollution also contribute to global challenges in food security, human health, and climate change.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to:
Consider... the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve universal health coverage and the Sustainable Development Goals, t...he beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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In the last five years, i.e. how old turned the Campaign “Indifesa” (Defenceless) in 2016, that was launched by Terre des Hommes in 2012, the world has become smaller. One can actually say that the derangements following the Arab Spring in 2011 reshuffled what is stable and what produces instabi...lity; between those, who live in a peaceful world, and those, who try to survive in areas affected by violence. All that significantly reduced the distance between those, who live there, along the Mediterranean cost, and those, who live here. Such deep disorder made even more acute, visible and tangible also for the so called developed world all the serious violations of the human rights suffered by little girls and girls: on the one hand the widespread political instability and violence made even more precarious the little girls and young women’s conditions on the Mediterranean southern coast, where they were already fragile; and on the other hand the migration flows further worsened them, matching at the same time the conditions of those young and very young migrants to those of the European girls of the same age.
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The Guidelines on promotive and preventive mental health interventions for adolescents - Helping Adolescents thrive (HAT), provide evidence-informed recommendations on psychosocial interventions to promote mental health, prevent mental disorders, and reduce self-harm and other risk behaviours among ...adolescents.
The HAT Guidelines aims to inform policy development, service planning and the strengthening of health and education systems, and facilitate mainstreaming of adolescent mental health promotion and prevention strategies across sectors and delivery platforms.
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In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts to transform the health system. These changes should foster equitable and efficient expenditures and create or strengthen comprehensive integrated health systems with... a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
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Evidence shows that FGM can cause several physical, mental and sexual health complications in girls and women, and in newborns. Health-care providers play an important role in supporting girls and women living with FGM, and improving their health and well-being. They are in a unique position to infl...uence and change the attitudes of their patients about FGM.
WHO is committed to scaling up the health-sector response to address FGM prevention and care. One aspect is to strengthen the quality of FGM prevention and care services by building the capacity of health-care providers. Several guidance materials have been produced to target health-care providers. These include FGM content for training curricula, clinical guidelines and a clinical handbook.
This training manual complements previous publications by building person-centred communication skills specifically for FGM prevention.
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The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see... page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
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People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi...enced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.
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Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at
risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have
consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health.
In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to
213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals
per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more
Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
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The 2019-2023 Strategy for UNU-IIGH, developed in
2018, built on UNU-IIGH’s strategic advantage and
position vis-à-vis the UN and global health ecosystem.
The Strategy set a goal to advance evidencebased policy on key issues related to sustainable
development and health and shifted the Instit...ute’s
body of work from investigator-driven global health
projects to three priority-driven, policy-relevant pillars
of work, each reflecting UNU-IIGH’s unique value
position.
When the COVID-19 pandemic hit in 2020, the
Institute adapted and reprioritised its areas of work
while continuing to deliver on the main strategic
objectives of translating evidence to policy, generating
policy-relevant analyses on gender and health, and
strengthening capacity for local decision making
especially in the Global South.
The new strategic plan encompasses four work packages:
1. Gender Equality and Intersectionality: through this work, we will aim to improve the quality of health care through a human-centred approach, by ensuring the health system is responsive to the needs of structurally excluded individuals and communities; and by advancing a positive and enabling environment for the frontline health workforce—e.g. addressing the experience of gender-based violence.
2. Power and Accountability: through this work, we will catalyse equitable shifts in power and address key accountability deficits that prevent the equitable and effective functioning of the global health system and prevent adequate responsiveness to the needs of states and populations in the Global South.
3. Digital Health Governance: through this work, we will address the colonial legacies and power asymmetries that negatively impact robust digital health governance, identify ways to strengthen health data governance with a particular focus on SRHR and promote diversity in technology design and development.
4. Climate Justice and Determinants of Health: through this work we will leverage UNU-IIGH's position within the UN and network of UNU institutes, network experts, practitioners, policy-makers, and academics to advance evidence-based policy on the different dimensions of the climate emergency and its impact on health.
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Yaya et al. BMC Pregnancy and Childbirth (2018) 18:194
Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services
and fertility control methods, is one of the most critical challenges for public health sector. There are significant
disparities in materna...l health care indicators across many geographical locations, maternal, economic, sociodemographic
factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization
level of maternal health care, and examined disparities in the determinants of major maternal health outcomes
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PH...C approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around t...he hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644
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Constituting the second part of the World Drug Report 2022, the present booklet contains an overview of the global demand for and supply of drugs.
The first chapter of the booklet begins with the latest estimates of the number of people who use drugs, the distribution of those users by type of drug...s, age and sex, and recent trends in the use of drugs. The chapter also reviews the impact of the coronavirus disease (COVID-19) pandemic on drug use patterns and service provision. Other issues examined in the chapter are the health consequences of drug use, including the number of people in treatment for drug use disorders and the extent of drug injecting and of HIV and hepatitis C among people who inject drugs. The chapter concludes with a review of the extent to which strategies, policies and interventions are in place to respond to the drug use problem.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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