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Background: One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public
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is deficient. This study was therefore designed to assess the current level of awareness and knowledge of the Nigerian public of AMR.
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2023 is seeing intense heatwaves. According to a July 2023 briefing by the World Meteorological Association temperatures will frequently reach above 35–40°C in many places across the Mediterranean region, with temperatures in the Middle East and southeastern Türkiye reaching up to 45°C and, in
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North Africa, 44–49°C. April–May 2023 also saw temperature records broken across many parts of Asia, including Thailand, Laos and Myanmar.
The IPCC predicts that 420 million people will be exposed to extreme heat and heatwaves in the near future. Hundreds of thousands of people die from preventable heat-related causes each year, while temperature extremes and wildfires cause devastation to lives and livelihoods. According to the WMO, ‘heatwaves are amongst the deadliest natural hazards [and] heat is a rapidly growing health risk’.
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The 2020 Financing for Sustainable Development Report, the fifth report of the Inter-agency Task Force on Financing for Development, provides a comprehensive assessment of the state of sustainable finance. Prepared by more than 60 agencies of the United Nations system and partner international organ
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izations, the report brings together a wide range of expertise and perspectives. It puts forward a set of policy recommendations to mobilize financing flows, and align them with economic, social and environmental priorities. These recommendations should assist Member States and all other stakeholders as they work toward fully implementing the Addis Agenda and achieve the SDGs.
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Global growth is projected to slow significantly amid high inflation, tight monetary policy, and more restrictive credit conditions. The possibility of more widespread bank turmoil and tighter monetary policy could result in even weaker global growth and lead to financial dislocations in the most vu
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lnerable emerging market and developing economies (EMDEs). Comprehensive policy action is needed to foster macroeconomic and financial stability. Among many EMDEs, and especially in low-income countries, bolstering fiscal sustainability will require generating higher revenues, making spending more efficient, and improving debt management practices. Continued international cooperation is also necessary to tackle climate change, support populations affected by crises and hunger, and provide debt relief where needed.
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This Urban Flood Risk Handbook: Assessing Risk and Identifying Interventions is a roadmap for conducting an urban flood risk assessment in any city in the world. It includes practical guidance for a flood risk assessment project, covering the key hazard and risk modeling stages as well as the evalua
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tion of different flood-mitigating infrastructure intervention options and management of the project. The Handbook has been developed based on lessons learned from implementing urban flood risk assessments around the world in a diversity of contexts. It is intended for a wide variety of practitioners: project managers, city officials, and anyone else interested in conducting a strategic study of a city's flood risk and developing potential solutions for it. We expect this Handbook tocontribute to the understanding of urban flood risk, make this specialized knowledge more accessible to a wider public, and support the process of building cities that are not only capable of withstanding floods but also provide safe, inclusive, and sustainable environments for all their residents.
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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford th
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eir bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
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The definition of Official Development Assistance (ODA) has for 40 years been the global standard for measuring donor efforts in supporting development co-operation objectives. It has provided the yardstick for documenting the volume and the terms of the concessional resources provided, assessing do
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nor performance against their aid pledges and enabling partner countries, civil society and others to hold donors to account. Yet for all its value, the ODA definition has always reflected a compromise between political expediency and statistical reality. It is based on interpretation and consensus and therefore allows for flexibility. It has evolved over the decades, while preserving the original concepts of a definition based on principal developmental motivation, official character and a degree of concessionality. While agreement on the ODA concept was a major achievement, discussion of the appropriateness of this measure has never ended. The paper documents the evolution of the ODA concept and proposes a possible new approach to measuring aid effort.
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Los avances en el tratamiento del cáncer pediátrico han permitido ampliar las iniciativas más allá de la curación y abarcar aspectos como la detección precoz, la continuidad del tratamiento y la reducción de su toxicidad. Todo ello ha abierto paso a una visión más integral del cuidado de lo
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s pacientes, lo que supone mejores oportunidades de curación y una vida más plena, objetivos de la Iniciativa Mundial contra el Cáncer Infantil. Dentro de ese cuidado integral, la atención psicosocial incluye las dimensiones social, psicológica, espiritual y funcional del proceso de enfermedad de los pacientes. Esta serie recoge una serie de orientaciones y normas basadas en la evidencia que garantizan la calidad de dicha atención. Las normas son el resultado de la discusión y la revisión de distintos profesionales de América Latina y el Caribe. El módulo 1 se centra en la evaluación psicosocial como estrategia de apoyo a los objetivos de la Iniciativa Mundial contra el Cáncer Infantil y como herramienta para que los profesionales de la salud recaben la información necesaria para ofrecer a estos pacientes un abordaje integral enfocado en el bienestar, la adaptación al proceso de enfermedad y la adherencia al tratamiento.
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: Development assistance for health (DAH) is one of the most important means for Japan to promote
diplomacy with developing countries and contribute to the international community. This study, for the first time,
estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its
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flows, including source, aid
type, channel, target region, and target health focus area
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy
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2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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As a central component of the UNHCR Strategic Directions 2022-2026, UNHCR has identified eight focus areas for renewed attention and accelerated action, including Climate Action. This Focus Area Strategic Plan for Climate Action sets out a global roadmap for prioritized action, providing further cla
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rity on UNHCR’s role and direct contribution, its asks of others, and the immediate actions the organization will take to be optimally calibrated to advance this agenda.
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Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-
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incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
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t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Evidence-based psychological interventions are an important part of health, social, protection and education services and can help increase access to effective mental health treatments and progression towards universal health coverage.
This manual provides managers and others responsible for plan
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ning and delivering services with practical guidance on how to implement manualized psychological interventions for adults, adolescents and children. It covers the five key implementation steps: make an implementation plan; adapt for context; prepare the workforce; identify, assess and support potential beneficiaries; and monitor and evaluate the service.
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Ahead of World Malaria Day, the WHO Global Malaria Programme published a new operational strategy outlining its priorities and key activities up to 2030 to help change the trajectory of malaria trends, with a view to achieving the global malaria targets. The strategy outlines 4 strategic objectives
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where WHO will focus its efforts, including developing norms and standards, introducing new tools and innovation, promoting strategic information for impact, and providing technical leadership of the global malaria response.
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The document outlines strategies for reducing salt intake to combat high blood pressure, strokes, and heart disease in the Eastern Mediterranean Region. It highlights the need for progressive reductions in salt consumption, particularly in staple foods like bread, while promoting public awareness, e
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ngaging stakeholders, and setting regulatory standards to achieve sustainable health benefits.
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The risk communication and community engagement (RCCE) competency framework is a resource that details the essential behaviours and activities necessary for effective communication and engagement with communities before, during and after public health emergencies. The purpose of this framework is to
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establish and promote a common understanding of behavioural competencies and how they should be applied for high-performing and community-centred health emergency programmes. It is intended to support the development of standardized training programmes, professional development and talent acquisition and to enhance the capabilities of public health professionals involved in RCCE. Its goal is to inform the establishment of a skilled, well-trained RCCE workforce that consistently understands and executes the necessary behaviours and activities required to conduct RCCE activities with competence and professionalism.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta
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in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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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
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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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Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
CC
Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Met
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hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
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