Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals.

PubMed

Assefa, Yibeltal; Damme, Wim Van; Williams, Owain D; Hill, Peter S

2017-01-01

We analysed the performance of Ethiopia in achieving the health-related millennium development goals (MDGs) with the aim of acquiring lessons for the sustainable development goals (SDGs). Ethiopia achieved most of the health MDGs: a 67% reduction in under-five mortality, a 71% decline in maternal mortality ratio, a 90% decline in new HIV infections, a decrease in malaria-related deaths by 73% and a more than 50% decline in mortality due to tuberculosis. We argue that these achievements are due to implementation of a mix of comprehensive strategies within the health system and across other sectors of the government. Scaling up of interventions by disease control programmes (including the health extension programme) and strengthening of the health system have played important roles towards the achievements. These health gains could not have been realised without progress in the other MDGs: poverty reduction, education, access to safe drinking-water and peace and stability of the country. However, the gains were not equitable, with differences between urban and rural areas, among regions and socioeconomic strata. Ethiopia's remarkable success in meeting most of the targets of the health-related MDGs could be explained by its comprehensive and multisectoral approach for health development. The inequity gap remains a challenge that achieving the health-related SDGs requires the country to implement strategies, which specifically target more marginal populations and geographic areas. This also needs peace and stability, without which it is almost impossible to improve health.

Achieving Millennium Development Goals 4 and 5 in India.

PubMed

Chatterjee, A; Paily, V P

2011-09-01

This review relates to achieving the Millennium Development Goals (MDGs), especially MDGs 4 and 5, by India by the year 2015. India contributes the maximum number of maternal deaths (68,000) to the global estimate of 358,000 maternal deaths annually. Infant mortality rate (IMR) is also high at 50 per 1000 (2009). Low budgetary spending on health, poverty, lower literacy, poor nutritional status, rural-urban divide and lack of trained workers in the health sector are cited as reasons for a high maternal mortality ratio and IMR. Increased spending by the Government of India on the health sector has started to show encouraging results. Recent assessments by world bodies like the World Health Organisation have given hope that MDGs 4 and 5 are achievable. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

The Papua New Guinea medical supply system - documenting opportunities and challenges to meet the Millennium Development Goals

PubMed Central

2014-01-01

Objectives Limited human resources are widely recognised as an impediment to achieving the health-related Millennium Development Goals in Pacific Island Countries, with the availability of medical supplies and suitably trained health personnel crucial to ensuring a well-functioning medical supply chain. This paper presents our findings as we seek to answer the research question ‘What factors influence the availability of medical supplies within the health facilities of Papua New Guinea?’ Methods We used a qualitative, triangulated strategy using semi-structured interviews, workplace observation and semi-structured focus groups. The parallel use of the interview tool and workplace observation tool allowed identification of ‘know-do’ gaps between what the interviewee said they did in their work practices, and the actual evidence of these practices. Focus groups provided further opportunities for raising and elaborating issues. Results During 2 weeks of data collection we conducted 17 interviews and 15 observational workplace surveys in 15 facilities. Sixteen health personnel participated in 3 focus groups across 2 provinces and one district. An array of medical supply issues across all levels of the medical supply chain were revealed, including standard operating procedures, facilities, transport, emergency medical kits, the cold chain and record keeping. The influence of health worker training and competency was found to be common across all of these issues. Conclusion The factors influencing the availability of medical supplies in PNG consist of a range of interrelating issues, consisting of both simple and complex problems involving the different levels and cadres of workers within the medical supply chain. Health systems sustainability theory suggests that a coordinated approach which addresses the inter-related nature of these issues, led by the PNG government and supported by suitable development partners, will be required for sustainable health systems change to occur. These changes are necessary for PNG to meet the health-related Millennium Development Goals. PMID:25848545

The Papua New Guinea medical supply system - documenting opportunities and challenges to meet the Millennium Development Goals.

PubMed

Brown, Andrew N; Gilbert, Ben

2014-01-01

Limited human resources are widely recognised as an impediment to achieving the health-related Millennium Development Goals in Pacific Island Countries, with the availability of medical supplies and suitably trained health personnel crucial to ensuring a well-functioning medical supply chain. This paper presents our findings as we seek to answer the research question 'What factors influence the availability of medical supplies within the health facilities of Papua New Guinea?' We used a qualitative, triangulated strategy using semi-structured interviews, workplace observation and semi-structured focus groups. The parallel use of the interview tool and workplace observation tool allowed identification of 'know-do' gaps between what the interviewee said they did in their work practices, and the actual evidence of these practices. Focus groups provided further opportunities for raising and elaborating issues. During 2 weeks of data collection we conducted 17 interviews and 15 observational workplace surveys in 15 facilities. Sixteen health personnel participated in 3 focus groups across 2 provinces and one district. An array of medical supply issues across all levels of the medical supply chain were revealed, including standard operating procedures, facilities, transport, emergency medical kits, the cold chain and record keeping. The influence of health worker training and competency was found to be common across all of these issues. The factors influencing the availability of medical supplies in PNG consist of a range of interrelating issues, consisting of both simple and complex problems involving the different levels and cadres of workers within the medical supply chain. Health systems sustainability theory suggests that a coordinated approach which addresses the inter-related nature of these issues, led by the PNG government and supported by suitable development partners, will be required for sustainable health systems change to occur. These changes are necessary for PNG to meet the health-related Millennium Development Goals.

Setting the stage for equity-sensitive monitoring of the maternal and child health Millennium Development Goals.

PubMed Central

Wirth, Meg E.; Balk, Deborah; Delamonica, Enrique; Storeygard, Adam; Sacks, Emma; Minujin, Alberto

2006-01-01

OBJECTIVE: This analysis seeks to set the stage for equity-sensitive monitoring of the health-related Millennium Development Goals (MDGs). METHODS: We use data from international household-level surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) to demonstrate that establishing an equity baseline is necessary and feasible, even in low-income and data-poor countries. We assess data from six countries using 11 health indicators and six social stratifiers. Simple bivariate stratification is complemented by simultaneous stratification to expose the compound effect of multiple forms of vulnerability. FINDINGS: The data reveal that inequities are complex and interactive: inferences cannot be drawn about the nature or extent of inequities in health outcomes from a single stratifier or indicator. CONCLUSION: The MDGs and other development initiatives must become more comprehensive and explicit in their analysis and tracking of inequities. The design of policies to narrow health gaps must take into account country-specific inequities. PMID:16878225

Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008

PubMed Central

2011-01-01

Background Combat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments. Methods The Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data. Results Over 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan. Conclusion The Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment. PMID:21281496

Health in the developing world: achieving the Millennium Development Goals.

PubMed Central

Sachs, Jeffrey D.

2004-01-01

The Millennium Development Goals depend critically on scaling up public health investments in developing countries. As a matter of urgency, developing-country governments must present detailed investment plans that are sufficiently ambitious to meet the goals, and the plans must be inserted into existing donor processes. Donor countries must keep the promises they have often reiterated of increased assistance, which they can easily afford, to help improve health in the developing countries and ensure stability for the whole world. PMID:15654410

Antenatal HIV Testing in Sub-Saharan Africa During the Implementation of the Millennium Development Goals: A Systematic Review Using the PEN-3 Cultural Model.

PubMed

Blackstone, Sarah R; Nwaozuru, Ucheoma; Iwelunmor, Juliet

2018-01-01

This study systematically explored the barriers and facilitators to routine antenatal HIV testing from the perspective of pregnant women in sub-Saharan Africa during the implementation period of the Millennium Development Goals. Articles published between 2000 and 2015 were selected after reviewing the title, abstract, and references. Twenty-seven studies published in 11 African countries were eligible for the current study and reviewed. The most common barriers identified include communication with male partners, patient convenience and accessibility, health system and health-care provider issues, fear of disclosure, HIV-related stigma, the burden of other responsibilities at home, and the perception of antenatal care as a "woman's job." Routine testing among pregnant women is crucial for the eradication of infant and child HIV infections. Further understanding the interplay of social and cultural factors, particularly the role of women in intimate relationships and the influence of men on antenatal care seeking behaviors, is necessary to continue the work of the Millennium Development Goals.

Health Literacy and the Millennium Development Goals in Nigeria

ERIC Educational Resources Information Center

Evawoma-Enuku, Usiwoma; Oyitso, Mabel; Enuku, Christie Akpoigho

2010-01-01

In this paper, the authors examined health related challenges facing Nigeria. They argued that the relationship between literacy and health in today's knowledge-based economy further puts pressure on countries like Nigeria to raise its literacy rates if it is to compete in the global market. This line of thought is based on the fact that in…

Pakistan and the Millennium Development Goals for Maternal and Child Health: progress and the way forward.

PubMed

Rizvi, Arjumand; Bhatti, Zaid; Das, Jai K; Bhutta, Zulfiqar A

2015-01-01

The world has made substantial progress in reducing maternal and child mortality, but many countries are projected to fall short of achieving their Millennium Development Goals (MDGs) 4 and 5 targets. The major objective of this paper is to examine progress in Pakistan in reducing maternal and child mortality and malnutrition over the last two decades. Data from recent national and international surveys suggest that Pakistan lags behind on all of its MDGs related to maternal and child health and, for some indicators especially related to nutrition, the situation has worsened from the baseline of 1990. Progress in addressing key social determinants such as poverty, female education and empowerment has also been slow and unregulated population growth has further compromised progress. There is a need to integrate the various different sectors and programmes to achieve the desired results effectively and efficiently as many of the determinants and influencing factors are outside the health sector.

[International financing for cooperation to develop health in Latin America and the Caribbean].

PubMed

De Los Ríos, Rebecca; Arósquipa, Carlos; Vigil-Oliver, William

2011-08-01

The purpose of this study is (a) to examine the ways in which Latin America and the Caribbean (LAC) have benefited from increases in international development assistance for health (DAH) at the global level and whether the trend observed after the Millennium Summit has also applied to the Region; (b) to determine whether there are differences in the distribution of this assistance, based on the gross per capita income of each country; (c) to identify the possible effects of the 2008 international financial crisis on official bilateral assistance; and (d) to compare trends in public health expenditure in relation to DAH before and after the Millennium Summit. The study has found that DAH in LAC follows a very different pattern than in other regions of the world. The period from 1997 to 2008 was one of fluctuating stagnation, with average annual disbursements of US$ 1 200 million. Multilateral financial institutions accounted for 79% of the average disbursements in the upper-middle income countries between 2002 and 2008, while official bilateral assistance held the greatest share (61%) in the low- and lower-middle income countries. Bilateral assistance grew at an annual rate of 13% during this period, but in the year after the crisis, disbursements fell to US$ 20 million. Sixty-four percent of bilateral assistance came from the United States, Spain, and Canada, with 29% of it being directed to HIV/AIDS and sexually transmitted diseases. After the Millennium Summit DAH channeled to governments decreased 30% in the period 2001-2006, and its share of public health expenditure in the region was 0.3% for the same period, with an equally marginal proportion in relation to total health expenditure for 2008 (0.37%; US$ 2 per capita). The study concludes that after the Millennium Summit, DAH in LAC did not grow nor did it equal the trends prior to 2000, and public health expenditure followed its historical growth trend, without further increases in relation to the regional gross domestic product. Given these realities and the fact that LAC is the world's most unequal region, but not its poorest, it is imperative to reconsider the concepts, management, and delivery of cooperation in the development of health, using innovative approaches and alternative financing mechanisms that respond more effectively to the realities of the region.

The US Department of Defense Millennium Cohort Study: career span and beyond longitudinal follow-up.

PubMed

Smith, Tyler C

2009-10-01

To describe current and future career-span health research in the US Department of Defense Millennium Cohort Study. Collaborating with all military service branches and the Department of Veterans Affairs, the Millennium Cohort Study launched in 2001, before September 11 and the start of deployments in Afghanistan and Iraq, to conduct coordinated strategic research to determine any effects of military occupational and deployment-related exposures, on long-term health. More than 150,000 consenting members represent demographic, occupational, military, and health characteristics of the US military. More than 70% of the first two panels have submitted follow-up questionnaires and >50% have deployed since 2001. Prospective cohort data have identified subgroups of military populations at higher risk or more resilient to decrements in mental and physical health. Continued career span and beyond follow-up will answer long-term health questions related to military service.

Gender equity and health: evaluating the impact of Millennium Development Goal Three on women's health in South Asia.

PubMed

Shannon, Geordan D; Im, Dana D; Katzelnick, Leah; Franco, Oscar H

2013-01-01

Researchers evaluated the progress of Millennium Development Goal Three, which promotes gender equity and empowering women, by assessing the targets for education, employment, and government, and their relation to women's health in South Asia. Researchers obtained data from the United Nations, Inter-Parliamentary Union, International Labor Organization, World Bank, and World Health Organization. First, they performed a literature review including manuscripts that quantified a Millenium Development Goal Three outcome in South Asia and were published after 1991. They derived women's health outcomes from World Health Organization databases. Spearman's rank test was used to evaluate the relationship between change in gender parity and change in women's health outcomes. South Asia's average primary education Gender Parity Index (defined as the ratio of girls to boys enrolled in primary, secondary, and tertiary education and expressed as a value between 0 and 1.0) improved from 0.73 (SD 0.34) to 0.92 (SD 0.13) between 2000 and 2008. Secondary and tertiary education had a lower Gender Parity Index (average 2008 Gender Parity Index 0.87 (SD 0.21) and 0.59 (SD 0.23), respectively), but had also improved from 2000 (average Gender Parity Index = 0.77, SD 0.38) to 2008 (average Gender Parity Index = 0.52, SD 0.11). An average proportion of 22.1% (SD 12.58) of women participated in waged, non-agricultural employment and 16.6% (SD 10.3) in national parliaments. No clear association was found between change in gender equity and women's health in South Asia between 2000 and 2008. Some progress has been made toward gender equity in South Asia, although the results have been mixed and inequities persist, especially in employment and government. While gender equity does not appear to have been related to female health outcomes, both must be addressed simultaneously as priority development targets and remain prerequisites to achieving the overall Millennium Development Goals. [Supplementary material is available for this article. Go to the publisher's online edition of Women & Health for the following resource: addition tabulated data and statistical analysis].

[Economic factors related to the Millennium Development Goals: a literature review].

PubMed

Palma, Marco; Hernández, Ildefonso; Alvarez-Dardet, Carlos; Gil-González, Diana; Ruiz, María T; Medina, Manuel

2009-08-01

To systematize all the information published on the status of and progress made toward the Health-related Millennium Development Goals (HMDGs), as well as to understand associations with certain economic factors and the potential for success. A search was conducted for all scientific articles covering the Millennium Development Goals in general, published from 1 January 2000 to 31 August 2006, in the electronic databases of the EBSCO, CSA Illumina, Thomson Gale, SwetsWise, and BIREME. All original articles in English or Spanish that evaluated HMDG status, progress, and determinants were selected. The analysis evaluated the distribution of determinants of HMDG status or progress, the HMDGs referred to, the study type, the relationship between economic indicators and health, the study location, and the status and potential for attaining the HMDGs. The quality of the articles was also rated. Of the 304 original articles found, 114 (37.5%) covered one or more HMDGs. The most frequently addressed goals were those concerning infant and maternal mortality. Of the 39 articles that evaluated HMDGs and their association with economic variables, 13 dealt with economic factors related to equity, policy, or globalization. Economic and policy factors were most frequently associated with HMDG status or progress. There is a definitive trend toward measuring HMDG status and progress according to economic factors that reflect the population's condition. There is an information gap regarding government spending, international commerce, international aid, and global economic policy. The potential for achieving HMDGs in poor countries is low.

Efficiency in Reaching the Millennium Development Goals. World Bank Working Paper.

ERIC Educational Resources Information Center

Jayasuriya, Ruwan, Ed.; Wodon, Quentin, Ed.

The Millennium Development Goals (MDGs) provide clear targets and areas of focus for international organizations such as the World Bank. At a conceptual level, to reduce poverty and hunger, to improve education and health indicators, and to promote gender equality and sustainable development, countries can either increase the resources they…

Establishing a disability-inclusive agenda for sustainable development in 2015 and beyond.

PubMed

Geiger, Brian F

2015-03-01

Disability was omitted from the Millennium Declaration and eight Millennium Development Goals. As a result, individuals with disabilities and their advocates, health-related agencies and major United Nations (UN) groups collaborated to explicate the rights and needs of persons with disabilities. A community empowerment approach was guided by the Convention on the Rights of Persons with Disabilities, input from expert groups, public meetings held across the globe, questionnaires sent to civil society representatives, and rich online conversation. Persons with disabilities have the right to health, education, gainful employment, social protection, and participation in political and public life. Selected results from The World We Want consultation for the topic of 'Inequalities and a disability-inclusive agenda' illustrate the potential of reaching consensus among a broad array of constituents, informing decisions about policy and practice. © The Author(s) 2014.

An Update on the United Nations Millennium Development Goals.

PubMed

Campbell, Della Anne

The United Nations Millennium Development Goals initiative, designed to meet the needs of the world's poorest, ended in 2015. The purpose of this article is to describe the progress made through the Millennium Development Goals and the additional work needed to address vulnerable populations worldwide, especially women and children. A description of the subsequent Sustainable Development Goals, enacted to address the root causes of poverty and the universal need for development for all people, is provided. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Community participation in formulating the post-2015 health and development goal agenda: reflections of a multi-country research collaboration.

PubMed

Brolan, Claire E; Hussain, Sameera; Friedman, Eric A; Ruano, Ana Lorena; Mulumba, Moses; Rusike, Itai; Beiersmann, Claudia; Hill, Peter S

2014-10-10

Global discussion on the post-2015 development goals, to replace the Millennium Development Goals when they expire on 31 December 2015, is well underway. While the Millennium Development Goals focused on redressing extreme poverty and its antecedents for people living in developing countries, the post-2015 agenda seeks to redress inequity worldwide, regardless of a country's development status. Furthermore, to rectify the UN's top-down approach toward the Millennium Development Goals' formulation, widespread negotiations are underway that seek to include the voices of people and communities from around the globe to ground each post-2015 development goal. This reflexive commentary, therefore, reports on the early methodological challenges the Go4Health research project experienced in its engagement with communities in nine countries in 2013. Led by four research hubs in Uganda, Bangladesh, Australia and Guatemala, the purpose of this engagement has been to ascertain a 'snapshot' of the health needs and priorities of socially excluded populations particularly from the Global South. This is to inform Go4Health's advice to the European Commission on the post-2015 global goals for health and new governance frameworks. Five methodological challenges were subsequently identified from reflecting on the multidisciplinary, multiregional team's research practices so far: meanings and parameters around qualitative participatory research; representation of marginalization; generalizability of research findings; ethical research in project time frames; and issues related to informed consent. Strategies to overcome these methodological hurdles are also examined. The findings from the consultations represent the extraordinary diversity of marginal human experience requiring contextual analysis for universal framing of the post-2015 agenda. Unsurprisingly, methodological challenges will, and did, arise. We conclude by advocating for a discourse to emerge not only critically examining how and whose voices are being obtained at the community-level to inform the post-2015 health and development goal agenda, but also how these voices are being translated and integrated into post-2015 decision-making at national and global levels.

Pakistan and the Millennium Development Goals for Maternal and Child Health: progress and the way forward.

PubMed

Rizvi, Arjumand; Bhatti, Zaid; Das, Jai K; Bhutta, Zulfiqar A

2015-04-03

The world has made substantial progress in reducing maternal and child mortality, but many countries are projected to fall short of achieving their Millennium Development Goals (MDGs) 4 and 5 targets. The major objective of this paper is to examine progress in Pakistan in reducing maternal and child mortality and malnutrition over the last two decades. Data from recent national and international surveys suggest that Pakistan lags behind on all of its MDGs related to maternal and child health and, for some indicators especially related to nutrition, the situation has worsened from the baseline of 1990. Progress in addressing key social determinants such as poverty, female education and empowerment has also been slow and unregulated population growth has further compromised progress. There is a need to integrate the various different sectors and programmes to achieve the desired results effectively and efficiently as many of the determinants and influencing factors are outside the health sector. Pakistan has to accelerate improvement of access to maternal health services, particularly contraception, emergency obstetric care and skilled birth attendance; the need to improve maternal and child nutrition cannot be over-emphasised.

Carrot Soup, Magic Bullets, and Scientific Research for Education and Development

ERIC Educational Resources Information Center

Chabbott, Colette

2007-01-01

Following the UN Millennium Summit in 2000, the Millennium Development Goals (MDGs) set global sector specific development targets to be achieved by the year 2015. In this article, the author explores the role of health and education research in producing technological innovations and global policy options and goals, such as the MDGs. Here, she…

The Challenges of Attaining Millennium Development Goals in Education in Africa by 2015

ERIC Educational Resources Information Center

Ojogwu, C. N.

2009-01-01

Millennium Development Goals were established by the United Nations to help underdeveloped countries to overcome problems of illiteracy, poverty, low health status and quality of life. Much emphasis was placed on the attainment of MDG targets in education because of its pivotal role in national development. The targets include education for all…

Issues of maternal health in Pakistan: trends towards millennium development goal 5.

PubMed

Malik, Muhammd Faraz Arshad; Kayani, Mahmood Akhtar

2014-06-01

Pakistan has third highest burden of maternal and children mortality across the globe. This grim situation is further intensified by flaws of planning and implementation set forth in health sector. Natural calamities (earth quakes, floods), disease outbreaks and lack of awareness in different regions of country also further aggravate this situation. Despite of all these limitations, under the banner of Millennium Development Goals (MDGs) a special focus and progress in addressing maternal health issue (set as goal 5) has been made over the last decade. In this review, improvement and short falls pertaining to Goal 5 Improve maternal health have been analyzed in relation to earlier years. A decline in maternal mortality ratio (MMR) (490 maternal deaths in 1990 to 260 maternal deaths per 100,000 women in 2010) is observed. Reduction in MMR by three quarters was not achieved but a decline from very high mortality to high mortality index was observed. Increase usage of contraceptives (with contraceptive prevalence rate of 11.8 in 1990 to 37 in 2013) also shed light on women awareness about their health and social issues. Based on progress level assessment (WHO guidelines),access of Pakistani women to universal reproductive health unit falls in moderate category in 2010 as compared to earlier low access in 1990. From the data it looks that still a lot of effort is required for achieving the said targets. However, keeping in view all challenges, Pakistan suffered in the said duration, like volatile peace, regional political instability, policy implementation constrains, population growth, this slow but progressive trend highlight a national resilience to address the havoc challenge of maternal health. These understandings and sustained efforts will significantly contribute a best possible accomplishment in Millennium Development Goal 5 by 2015.

The millennium development goals and road traffic injuries: exploring the linkages in South Asia.

PubMed

Hyder, Adnan A; Ghaffar, Abdul

2004-12-01

In a major summit of the members of the United Nations (UN) in 2000, a Millennium Declaration was adopted which called for making the elimination of poverty and promotion of sustainable development a global priority. A road map was agreed upon to operationalize the declaration, and the Millennium Development Goals (MDG) were integrated within the document. The MDGs are now increasingly being used to assess the performance of countries, institutions and the global community. WHO declares that the MDGs provide "a set of outcomes that are relevant to the development of national health policy frameworks". It also states that although MDGs do not cover all the components of public health, when broadly interpreted "the goals provide an opportunity to address important cross-cutting issues and key constraints to health". Consistent with WHO's call for a broad interpretation of the MDGs, and building on the health linkages identified by WHO, this paper explores the linkages between the MDGs and the impact of road traffic injuries (RTI). This is done in the context of South Asia, one of the poorest and populated regions of the developing world.

Discourse, ideas and power in global health policy networks: political attention for maternal and child health in the millennium development goal era.

PubMed

McDougall, Lori

2016-05-18

Maternal and child health issues have gained global political attention and resources in the past 10 years, due in part to their prominence on the Millennium Development Goal agenda and the use of evidence-based advocacy by policy networks. This paper identifies key factors for this achievement, and raises questions about prospective challenges for sustaining attention in the transition to the post-2015 Sustainable Development Goals, far broader in scope than the Millennium Development Goals. This paper relies on participant observation methods and document analysis to develop a case study of the behaviours of global maternal and child health advocacy networks during 2005-2015. The development of coordinated networks of heterogeneous actors facilitated the rise in attention to maternal and child health during the past 10 years. The strategic use of epidemiological and economic evidence by these networks enabled policy attention and promoted network cohesion. The time-bound opportunity of reaching the 2015 Millennium Development Goals created a window of opportunity for joint action. As the new post-2015 goals emerge, networks seek to sustain attention by repositioning their framing of issues, network structures, and external alliances, including with networks that lay both inside and outside of the health domain. Issues rise on global policy agendas because of how ideas are constructed, portrayed and positioned by actors within given contexts. Policy networks play a critical role by uniting stakeholders to promote persuasive ideas about policy problems and solutions. The behaviours of networks in issue-framing, member-alignment, and strategic outreach can force open windows of opportunity for political attention -- or prevent them from closing.

Promoting equity to achieve maternal and child health.

PubMed

Thomsen, Sarah; Hoa, Dinh Thi Phuong; Målqvist, Mats; Sanneving, Linda; Saxena, Deepak; Tana, Susilowati; Yuan, Beibei; Byass, Peter

2011-11-01

Maternal and child mortality rates, the targets for two of the eight Millennium Development Goals, remain unacceptably high in many countries. Some countries have made significant advances in reducing deaths in pregnancy, childbirth, and childhood at the national level. However, on a sub-national basis most countries show wide disparities in health indices which are not necessarily reflected in national figures. This is a sign of inequitable access to and provision of health services. Yet there has been little attention to health equity in relation to the Millennium Development Goals. Instead, countries have focused on achieving national targets. This has led to an emphasis on utilitarian, as opposed to universalist, approaches to public health, which we discuss here. We recommend a policy of "proportionate universalism". In this approach, universal health care and a universal social policy are the ultimate goal, but in the interim actions are carried out with intensities proportionate to disadvantage. We also briefly describe an initiative that aims to promote evidence-based policy and interventions that will reduce inequity in access to maternal and child health care in China, India, Indonesia and Viet Nam. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Beyond the Millennium Development Goals: public health challenges in water and sanitation.

PubMed

Rheingans, R; Dreibelbis, R; Freeman, M C

2006-01-01

Over 1 billion people lack access to improved water sources and 2.6 billion lack access to appropriate sanitation, greatly contributing to the global burden of disease. The international community has committed to reducing by half the proportion of the world's population lacking access to water and sanitation as a part of the Millennium Development Goals (MDGs). However, the disease burden due to poor access, is borne primarily by the poorest countries and the poorest people within them. Simply reducing the proportion of people without adequate access will not automatically result in proportional reductions in the related disease burden. The public health challenge inherent in meeting the MDG targets is ensuring that improvements result in access to water and sanitation for the critical at-risk populations. Innovative approaches are required to ensure the availability of low-cost, simple, and locally acceptable water and sanitation interventions and integrating these approaches into existing social institutions, such as schools, markets, and health facilities.

Trend in infant mortality rate in Argentina within the framework of the Millennium Development Goals.

PubMed

Finkelstein, Juliana Z; Duhau, Mariana; Speranza, Ana

2016-06-01

Infant mortality rate (IMR) is an indicator of the health status of a population and of the quality of and access to health care services. In 2000, and within the framework of the Millennium Development Goals, Argentina committed to achieve by 2015 a reduction by two thirds of its 1990 infant mortality rate, and to identify and close inter-jurisdictional gaps. The objective of this article is to describe the trend in infant mortality rate in Argentina and interjurisdictional gaps, infant mortality magnitude and causes, in compliance with the Millennium Development Goals. A descriptive study on infant mortality was conducted in Argentina in 1990 and between 2000 and 2013, based on vital statistics data published by the Health Statistics and Information Department of the Ministry of Health of Argentina. The following reductions were confirmed: 57.8% in IMR, 52.6% in neonatal mortality rate and 63.8% in post-neonatal mortality rate. The inter-provincial Gini coefficient for IMR decreased by 27%. The population attributable risk decreased by 16.6% for IMR, 38.8% for neonatal mortality rate and 51.5% for post-neonatal mortality rate in 2013 versus 1990. A significant reduction in infant mortality and its components has been shown, but not enough to meet the Millennium Development Goals. The reduction in IMR gaps reached the set goal; however, inequalities still persist. Sociedad Argentina de Pediatría.

Free solar lanterns to below poverty line girls in India: a step toward achieving millennium development goals.

PubMed

Garg, Rajesh

2014-01-01

Development sectors like health cannot function in isolation. Intersectoral coordination between various departments helps in bringing a positive change in the health-seeking behavior of society in the long run. The decision by the Government of India to provide free solar lanterns (lamps) to the school-going girls of below poverty line families is a welcome step in this context. This initiative would help in reducing the number of school dropout girls and thus help in improving the health indicators that are directly related to women's education. Thus it is an initiative that will help in attainment of Millennium Development Goals through women's education and empowerment. Along with that, the environment-friendly approach will definitely have an impact on health of the girls by switching from kerosene/wood stoves to solar lantern light. Also this initiative would pave the path of real "intersectoral coordination" in the health sector in India that is marred with watertight functioning of various departments. There is an urgent need to popularize the scheme and involve different stakeholders like corporate houses, media, nongovernment organizations, multinational welfare agencies, and local governing bodies for ensuring the availability and utilization of solar lanterns in India.

How states exerted power to create the Millennium Development Goals and how this shaped the global health agenda: Lessons for the sustainable development goals and the future of global health.

PubMed

Marten, Robert

2018-04-26

Since 2000, the eight Millennium Development Goals (MDGs) provided the framework for global development efforts transforming the field now known as global health. The MDGs both reflected and contributed to shaping a normative global health agenda. In the field of global health, the role of the state is largely considered to have diminished; however, this paper reasserts states as actors in the conceptualisation and institutionalisation of the MDGs, and illustrates how states exerted power and engaged in the MDG process. States not only sanctioned the MDGs through their heads of states endorsing the Millennium Declaration, but also acted more subtly behind the scenes supporting, enabling, and/or leveraging other actors, institutions and processes to conceptualise and legitimize the MDGs. Appreciating the MDGs' role in the conceptualisation of global health is particularly relevant as the world transitions to the MDGs' successor, the Sustainable Development Goals (SDGs). The SDGs' influence, impact and importance remains to be seen; however, to understand the future of global health and how actors, particularly states, can engage to shape the field, a deeper sense of the MDGs' legacy and how actors engaged in the past is helpful.

Meeting the 2015 Millennium Development Goals with new interventions for abused women.

PubMed

Karmaliani, Rozina; Shehzad, Shireen; Hirani, Saima Shams; Asad, Nargis; Akbar Ali Hirani, Shela; McFarlane, Judith

2011-12-01

In a developing country such as Pakistan, where illiteracy, poverty, gender differences, and health issues are prevalent, violence against women is a commonly observed phenomenon. The rising incidences of abuse among women indicate a need to introduce evidence-based community-derived interventions for meeting Millennium Developmental Goals by 2015. This article discusses the application of counseling, economic skills building, and microcredit programs as practical and effective interventions to improve the health outcomes of abused women and, therefore, improving maternal and child health in the Pakistani society. Copyright © 2011 Elsevier Inc. All rights reserved.

Successful behavioral health business development for the millennium.

PubMed

Pyrce, J M

1998-08-01

The business development framework for provider positioning, market share, and competition has significantly shifted in the late 1990s as providers prepare for the millennium. The use of the Marketing Four Ps is a helpful tool for providers to thoroughly evaluate their product/service viability, pricing objectives, promotional mix, and place accessibility, and will allow organizations to reposition in their marketplace, maximize market share, and develop new partnerships with previous competitors.

The potential impact of plant biotechnology on the Millennium Development Goals.

PubMed

Yuan, Dawei; Bassie, Ludovic; Sabalza, Maite; Miralpeix, Bruna; Dashevskaya, Svetlana; Farre, Gemma; Rivera, Sol M; Banakar, Raviraj; Bai, Chao; Sanahuja, Georgina; Arjó, Gemma; Avilla, Eva; Zorrilla-López, Uxue; Ugidos-Damboriena, Nerea; López, Alberto; Almacellas, David; Zhu, Changfu; Capell, Teresa; Hahne, Gunther; Twyman, Richard M; Christou, Paul

2011-03-01

The eight Millennium Development Goals (MDGs) are international development targets for the year 2015 that aim to achieve relative improvements in the standards of health, socioeconomic status and education in the world's poorest countries. Many of the challenges addressed by the MDGs reflect the direct or indirect consequences of subsistence agriculture in the developing world, and hence, plant biotechnology has an important role to play in helping to achieve MDG targets. In this opinion article, we discuss each of the MDGs in turn, provide examples to show how plant biotechnology may be able to accelerate progress towards the stated MDG objectives, and offer our opinion on the likelihood of such technology being implemented. In combination with other strategies, plant biotechnology can make a contribution towards sustainable development in the future although the extent to which progress can be made in today's political climate depends on how we deal with current barriers to adoption.

Countdown to 2015: will the Millennium Development Goal for child survival be met?

PubMed Central

Lawn, Joy E; Costello, Anthony; Mwansambo, Charles; Osrin, David

2007-01-01

The Millennium Development Goals (MDGs), ratified by most nations in 2000, set specific targets for poverty reduction, eradication of hunger, education, gender equality, health and environmental sustainability. MDG 4 aims to reduce child mortality with a target of reducing under‐five mortality rates by two thirds over the period 1990–2015. Over the last year, Live Aid, Make Poverty History, the G8 summits and prominent entertainers have directed unprecedented attention towards development and health. Africa particularly has been in the spotlight. Reports are published and commitments are made, but is there real progress? Are poor people being reached with essential health care? Who will hold leaders to account: celebrities, activists or health professionals? PMID:17515627

Free treatment, rapid malaria diagnostic tests and malaria village workers can hasten progress toward achieving the malaria related millennium development goals: the Médecins Sans Frontières experience from Chad, Sierra-Leone and Mali

PubMed Central

Tayler-Smith, Katie; Kociejowski, Alice; de Lamotte, Nadine; Gerard, Seco; Ponsar, Frederique; Philips, Mit; Zachariah, Rony

2011-01-01

Halving the burden of malaria by 2015 and ensuring that 80% of people with malaria receive treatment is among the health related targets of the Millennium Development Goals (MDGs). Despite political momentum toward achieving this target, progress is slow and many with malaria (particularly in poor and rural communities in Africa) are still without access to effective treatment. Finding ways to improve access to anti-malarial treatment in Africa is essential to achieve the malaria related and other MDG targets. During its work in Chad, Sierra Leone and Mali in the period 2004 to 2008, Médecins Sans Frontières showed that it was possible to significantly improve access to effective malaria treatment through: i) the removal of health centre level user fees for essential healthcare for vulnerable population groups, ii) the introduction of free community based treatment for children using malaria village workers to diagnose and treat simple malaria in communities where geographical and financial barriers limited access to effective malaria care, iii) the improved diagnosis and treatment of malaria using rapid diagnosis tests and artemisinin based combination therapy, at both health facilities and in the community. This paper describes and discusses these strategies and their related impact. PMID:28299053

Limitations of the Millennium Development Goals: a literature review

PubMed Central

Fehling, Maya; Nelson, Brett D.; Venkatapuram, Sridhar

2013-01-01

With the Millennium Development Goals (MDGs) showing uneven progress, this review identifies possible limitations arising from the MDG framework itself rather than extrinsic issues. A multidisciplinary literature review was conducted with a focus on limitations in the formulation of the MDGs, their structure, content and implementation. Of 1837 MDG-related articles, 90 met criteria for analysis. Articles describe MDGs as being created by only a few stakeholders without adequate involvement by developing countries and overlooking development objectives previously agreed upon. Others claim MDGs are unachievable and simplistic, not adapted to national needs, do not specify accountable parties and reinforce vertical interventions. While MDGs have promoted increased health and well-being in many countries by recognising and deliberating on the possible constraints of the MDG framework, the post-2015 agenda may have even greater impact. Complex problems have simple, easy to understand, wrong answers (Henry Louis Mencken) PMID:24266508

Structural violence: a barrier to achieving the millennium development goals for women.

PubMed

Mukherjee, Joia S; Barry, Donna J; Satti, Hind; Raymonville, Maxi; Marsh, Sarah; Smith-Fawzi, Mary Kay

2011-04-01

In 2000, all 191 United Nations member states agreed to work toward the achievement of a set of health and development goals by 2015. The achievement of these eight goals, the Millennium Development goals (MDGs) is highly dependent on improving the status of women, who play a key role in health and education in families and communities around the world. Yet structural violence, defined as the systematic exclusion of a group from the resources needed to develop their full human potential, remains a significant barrier against women's development and threatens the achievement of the MDGs. Although sound evidence has long existed for improving women's survival, the will to address women's health concretely and holistically is only recently gaining the advocacy needed to change policy. Concrete examples of the integration of approaches to mitigate structural violence within the delivery of health services do exist and should be incorporated into global advocacy for women's health.

Acid sulfate soils and human health--a Millennium Ecosystem Assessment.

PubMed

Ljung, Karin; Maley, Fiona; Cook, Angus; Weinstein, Philip

2009-11-01

Acid sulfate soils have been described as the "nastiest soils on earth" because of their strong acidity, increased mobility of potentially toxic elements and limited bioavailability of nutrients. They only cover a small area of the world's total problem soils, but often have significant adverse effects on agriculture, aquaculture and the environment on a local scale. Their location often coincides with high population density areas along the coasts of many developing countries. As a result, their negative impacts on ecosystems can have serious implications to those least equipped for coping with the low crop yields and reduced water quality that can result from acid sulfate soil disturbance. The Millennium Ecosystem Assessment called on by the United Nations in 2000 emphasised the importance of ecosystems for human health and well-being. These include the service they provide as sources of food and water, through the control of pollution and disease, as well as for the cultural services ecosystems provide. While the problems related to agriculture, aquaculture and the environment have been the focus of many acid sulfate soil management efforts, the connection to human health has largely been ignored. This paper presents the potential health issues of acid sulfate soils, in relation to the ecosystem services identified in the Millennium Ecosystem Assessment. It is recognised that significant implications on food security and livelihood can result, as well as on community cohesiveness and the spread of vector-borne disease. However, the connection between these outcomes and acid sulfate soils is often not obvious and it is therefore argued that the impact of such soils on human well-being needs to be recognised in order to raise awareness among the public and decision makers, to in turn facilitate proper management and avoid potential human ill-health.

Towards good practice for health statistics: lessons from the Millennium Development Goal health indicators.

PubMed

Murray, Christopher J L

2007-03-10

Health statistics are at the centre of an increasing number of worldwide health controversies. Several factors are sharpening the tension between the supply and demand for high quality health information, and the health-related Millennium Development Goals (MDGs) provide a high-profile example. With thousands of indicators recommended but few measured well, the worldwide health community needs to focus its efforts on improving measurement of a small set of priority areas. Priority indicators should be selected on the basis of public-health significance and several dimensions of measurability. Health statistics can be divided into three types: crude, corrected, and predicted. Health statistics are necessary inputs to planning and strategic decision making, programme implementation, monitoring progress towards targets, and assessment of what works and what does not. Crude statistics that are biased have no role in any of these steps; corrected statistics are preferred. For strategic decision making, when corrected statistics are unavailable, predicted statistics can play an important part. For monitoring progress towards agreed targets and assessment of what works and what does not, however, predicted statistics should not be used. Perhaps the most effective method to decrease controversy over health statistics and to encourage better primary data collection and the development of better analytical methods is a strong commitment to provision of an explicit data audit trail. This initiative would make available the primary data, all post-data collection adjustments, models including covariates used for farcasting and forecasting, and necessary documentation to the public.

22 CFR 1300.3 - Functions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Functions. 1300.3 Section 1300.3 Foreign Relations MILLENNIUM CHALLENGE CORPORATION ORGANIZATION AND FUNCTIONS OF THE MILLENNIUM CHALLENGE CORPORATION § 1300.3 Functions. (a) MCC provides United States assistance for global development; and (b...

Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

PubMed

Usfar, Avita A; Achadi, Endang L; Martorell, Reynaldo; Hadi, Hamam; Thaha, Razak; Jus'at, Idrus; Atmarita; Martianto, Drajat; Ridwan, Hardinsyah; Soekirman

2009-01-01

Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.

Brain Health Fitness: Beyond Retirement

ERIC Educational Resources Information Center

Anand, Raksha; Chapman, Sandra B.; Rackley, Audette; Zientz, Jennifer

2011-01-01

The greatest accomplishment of the 20th century--the doubling of the human lifespan--has brought issues related to brain health to the forefront of public health policy. Given that our bodies are outlasting our minds, maximizing brain health is the scientific cause of this millennium. In this paper, we address three major issues related to…

Millennium Development Goal 5 and adolescents: looking back, moving forward

PubMed Central

Vogel, Joshua P; Pileggi-Castro, Cynthia; Chandra-Mouli, Venkatraman; Pileggi, Vicky Nogueira; Souza, João Paulo; Chou, Doris; Say, Lale

2015-01-01

Since the Millennium Declaration in 2000, unprecedented progress has been made in the reduction of global maternal mortality. Millennium Development Goal 5 (MDG 5; improving maternal health) includes two primary targets, 5A and 5B. Target 5A aimed for a 75% reduction in the global maternal mortality ratio (MMR), and 5B aimed to achieve universal access to reproductive health. Globally, maternal mortality since 1990 has nearly halved and access to reproductive health services in developing countries has substantially improved. In setting goals and targets for the post-MDG era, the global maternal health community has recognised that ultimate goal of ending preventable maternal mortality is now within reach. The new target of a global MMR of <70 deaths per 100 000 live births by 2030 is ambitious, yet achievable and to reach this target a significantly increased effort to promote and ensure universal, equitable access to reproductive, maternal and newborn services for all women and adolescents will be required. In this article, as we reflect on patterns, trends and determinants of maternal mortality, morbidity and other key MDG5 indicators among adolescents, we aim to highlight the importance of promoting and protecting the sexual and reproductive health and rights of adolescents as part of renewed global efforts to end preventable maternal mortality. PMID:25613967

Worth the Risk: Four Approaches to Safety in International Learning, Including Selected and Annotated Resource Guide. CBIE Research Millennium Series No. 1

ERIC Educational Resources Information Center

Myles, Wayne; Mitchell, Lynne

2000-01-01

More and more Canadians are departing the country for international study, training and work experiences. Increasingly Canadian organizations and institutions are developing programs that further this mobility. However there is a dearth of resources and a lack of guidelines related to ensuring health and safety while abroad. "Worth the…

Global women's health: a spotlight on caregiving.

PubMed

Berg, Judith A; Woods, Nancy Fugate

2009-09-01

Caregiving is a women's health issue globally, as many more women than men are informal caregivers. Caregiving related to gender role socialization, burden, and economic and health consequences has been discussed in the literature. Together this body of work demonstrates some positive but mainly negative consequences to the health and economic circumstances of women. Overall achievement of the United Nations' Millennium Development Goals has important implications for informal caregivers globally, because achievement of these goals is essential to reducing the undue burden, the lost opportunities, and the injustice of health care systems that take advantage of women's volunteer caregiving.

Millennium development goals and oral health in cities in Southern Brazil.

PubMed

Bueno, Roberto Eduardo; Moysés, Samuel Jorge; Moysés, Simone Tetu

2010-06-01

To investigate social determinants of oral health, analysing the occurrence of associations between millennium development goals (MDG) indicators and oral health (OH) indicators. An ecological study was performed in two distinct phases. In Phase 1, MDG indicators and related covariates were obtained from the demographic census of the Brazilian Institute of Geography and Statistics, the Ministry of Health database and the 2000 Human Development Atlas, making up the whole set of independent variables. Principal component analysis was carried out for the independent variables showing the correlations among the variables comprising the main components, and generating a synthetic index allowing the performance of the cities to be known with regard to the MDG (MDG index). In Phase 2, the DMFT index (mean number of decay, missing or filled permanent teeth) and the CF index (prevalence of caries-free individuals), in 12 years old were obtained from the epidemiological survey undertaken in 2002-2003, in 49 cities in southern Brazil, and were analysed in relation to the MDG index using Spearman's correlation.   A statistically significant correlation was found for the DMFT and CF indices, respectively, with: the MDG index (R(2)=0.49 and 0.48; P = 0.00); the socioeconomic status of the population (R(2)= 0.12 and 0.12; P = 0.02); the socioenvironmental characteristics (R(2)=0.41 and 0.46; P= 0.00).   The MDG synthetic index of the cities analysed and the respective components relating to their socioeconomic and socioenvironmental status demonstrated a positive correlation with OH indicators. As such, intersectoral public policies based on population strategies that act on social determinants of general and oral health need to be integrated so as to impact on the MDG and OH outcomes. © 2010 John Wiley & Sons A/S.

Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata.

PubMed

Morley, Christopher P; Wang, Dongliang; Mader, Emily M; Plante, Kyle P; Kingston, Lindsey N; Rabiei, Azadeh

2017-07-18

The Millennium Development Goals (MDGs) are 8 international development goals voluntarily adopted by 189 nations. The goals included health related aims to reduce the under-five child mortality rate by two-thirds (MDG4), and to reduce the maternal mortality ratio by three-quarters (MDG5). To assess the relationship between the healthcare workforce and MDGs 4-5, we examined the physician workforces of countries around the globe, in terms of the Physician Density Level (PDL, or number of physicians per 1000 population), and compared this rate across a number of years to several indicator variables specified as markers of progress towards MDG4 and MDG5. Data for each variable of interest were obtained from the World Bank's Millennium Development Goals and World Development Indicators databases for 208 countries and territories from 2004 to 2014, representing a ten-year period for which the most information is available. We analyzed the relationships between MDG outcomes and PDL, controlling for national income levels and other covariates, using linear mixed model regression. Dependent variables were logarithmically transformed to meet assumptions necessary for multivariate analysis. In unadjusted models, an increase of every one physician per 1000 population (one unit change in PDL) lowered the risk of not being vaccinated for measles-mumps-rubella (MMR) to 29.3% (p < 0.001, 95% CI: 22.2%-38.7%) and for not receiving diphtheria-tetanus-pertussis (DTaP) vaccination rate decreased to 38.5% (p < 0.001, 95% CI: 28.7% - 51.7%). Maternal mortality rate decreased to 76.6% (p < 0.001, 95% CI: 74.3% - 79.0%), neonatal mortality decreased to 58.8% (p < 0.001, 95% CI: 54.8% - 63.2%) and under-5 mortality rate decreased to 52.1% (p < 0.001, 95% CI: 48.0% - 56.4%), with every one-unit change in PDL. Adjusted models tended to reflect unadjusted risk assessments. The maintenance and improvement of the health workforce is a vital consideration when assessing how to achieve global development goals related to health outcomes.

Changing patterns of breast cancer incidence and mortality by education level over four decades in Norway, 1971-2009.

PubMed

Trewin, Cassia B; Strand, Bjørn Heine; Weedon-Fekjær, Harald; Ursin, Giske

2017-02-01

In the last century, breast cancer incidence and mortality was higher among higher versus lower educated women in developed countries. Post-millennium, incidence rates have flattened off and mortality declined. We examined breast cancer trends by education level, to see whether recent improvements in incidence and mortality rates have occurred in all education groups. We linked individual registry data on female Norwegian inhabitants aged 35 years and over during 1971–2009. Using Poisson models, we calculated absolute and relative educational differences in age-standardised breast cancer incidence and mortality over four decades. We estimated educational differences by Slope and Relative Index of Inequality, which correspond to rate difference and rate ratio, comparing the highest to lowest educated women. Pre-millennium, incidence and mortality of breast cancer were significantly higher in higher versus lower educated women. Post-millennium, educational differences in breast cancer incidence and mortality attenuated. During 2000–2009, breast cancer incidence was still 38% higher for higher versus lower educated women (Relative Index of Inequality: 1.38, 95% confidence interval: 1.31–1.44), but mortality no longer varied significantly by education level (Relative Index of Inequality: 1.09, 95% confidence interval: 0.99–1.19). Among women below 50 years, however, the education gradient for mortality reversed, and mortality was 28% lower for the highest versus lowest educated women during 2000–2009 (Relative Index of Inequality: 0.72, 95% confidence interval: 0.51–0.93). Post-millennium improvements in breast cancer incidence and mortality have primarily benefited higher educated women. Breast cancer mortality is now highest among the lowest educated women below 50 years. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Linking exposures and health outcomes to a large population-based longitudinal study: the Millennium Cohort Study.

PubMed

Smith, Tyler C

2011-07-01

To describe current efforts and future potential for understanding long-term health of military service members by linking the Millennium Cohort Study data to exposures and health outcomes. The Millennium Cohort Study launched in 2001, before September 11 and the start of combat operations in Afghanistan and Iraq. Other substantial Department of Defense (DoD) health, personnel, and exposure databases are maintained in electronic form and may be linked by personal identifiers. More than 150,000 consenting members comprise the Millennium Cohort from all services, and include active duty, Reserve, and National Guard current and past members, and represent demographic, occupational, military, and health characteristics of the U.S. military. These prospective data offer symptom assessment, behavioral health, and self-reported exposures that may complement and fill gaps in capability presented by other DoD electronic health and exposure data. In conjunction with Millennium Cohort survey data, prospective individual-level exposure and health outcome assessment is crucial to understand and quantify any long-term health outcomes potentially associated with unique military occupational exposures.

Meeting the millennium development goals in Sub-saharan Africa: what about mental health?

PubMed

Skeen, Sarah; Lund, Crick; Kleintjes, Sharon; Flisher, Alan

2010-01-01

Mental health is a crucial public health and development issue in sub-Saharan Africa (SSA), a region where little progress has been made towards achieving the Millennium Development Goals (MDGs). In this paper we argue that not only will limited progress in achieving these targets have a significant impact on mental health, but it will be impossible to achieve some of these aspirations in the absence of addressing mental health concerns. We consider the strong relationship of mental health with dimensions of human development represented in the MDGs, including reducing poverty, achieving universal primary education, decreasing child mortality rates, improving maternal health, HIV, environmental factors and improving the lives of those living in informal settlements. With these links in mind, we examine the mental health context in SSA settings and provide some specific examples of best practice for addressing mental health and the MDGs. It is recommended that the role of mental health interventions in accelerating the realization of the MDGs is investigated; further efforts are dedicated to probing the impact of different development projects upon mental health outcomes, and that mental health is declared a global development priority for the remainder of the MDG period and beyond.

Health inequities, environmental insecurity and the attainment of the millennium development goals in sub-Saharan Africa: the case study of Zambia.

PubMed

Anyangwe, Stella C E; Mtonga, Chipayeni; Chirwa, Ben

2006-09-01

The United Nations Millennium Development Goals (MDGs) are a series of 8 goals and 18 targets aimed at ending extreme poverty by 2015, and there are 48 quantifiable indicators for monitoring the process. Most of the MDGs are health or health-related goals. Though the MDGs might sound ambitious, it is imperative that the world, and sub-Saharan Africa in particular, wake up to the persistent and unacceptably high rates of extreme poverty that populations live in, and find lasting solutions to age-old problems. Extreme poverty is a cause and consequence of low income, food insecurity and hunger, education and gender inequities, high disease burden, environmental degradation, insecure shelter, and lack of access to safe drinking water and basic sanitation. It is also directly linked to unsound governance and inequitable distribution of public wealth. While many regions in the world will strive to attain the MDGs by 2015, most of the countries in sub-Saharan Africa, with major human development challenges associated with socio-economic disparities, will not. Zambia's MDG progress reports of 2003 and 2005 show that despite laudable political commitment and some advances made towards achieving universal primary education, gender equality, improvement of child health and management of the HIV/AIDS epidemic, it is not likely that Zambia will achieve even half of the goals. Zambia's systems have been weakened by high disease burden and excess mortality, natural and man-made environmental threats and some negative effects of globalization such as huge external debt, low world prices for commodities and the human resource "brain drain", among others. Urgent action must follow political will, and some tried and tested strategies or "quick wins" that have been proven to produce high positive impact in the short term, need to be rapidly embarked upon by Zambia and other countries in sub-Saharan Africa if they are to achieve the Millennium Development Goals.

Sustainable Health Development Goals (SHDG): breaking down the walls

PubMed Central

Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

2015-01-01

The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world. PMID:26966502

Sustainable Health Development Goals (SHDG): breaking down the walls.

PubMed

Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

2015-01-01

The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world.

Development and use of the generic WHO/CDC logic model for vitamin and mineral interventions in public health programmes

PubMed Central

De-Regil, Luz Maria; Peña-Rosas, Juan Pablo; Flores-Ayala, Rafael; del Socorro Jefferds, Maria Elena

2015-01-01

Objective Nutrition interventions are critical to achieve the Millennium Development Goals; among them, micronutrient interventions are considered cost-effective and programmatically feasible to scale up, but there are limited tools to communicate the programme components and their relationships. The WHO/CDC (Centers for Disease Control and Prevention) logic model for micronutrient interventions in public health programmes is a useful resource for planning, implementation, monitoring and evaluation of these interventions, which depicts the programme theory and expected relationships between inputs and expected Millennium Development Goals. Design The model was developed by applying principles of programme evaluation, public health nutrition theory and programmatic expertise. The multifaceted and iterative structure validation included feedback from potential users and adaptation by national stakeholders involved in public health programmes' design and implementation. Results In addition to the inputs, main activity domains identified as essential for programme development, implementation and performance include: (i) policy; (ii) products and supply; (iii) delivery systems; (iv) quality control; and (v) behaviour change communication. Outputs encompass the access to and coverage of interventions. Outcomes include knowledge and appropriate use of the intervention, as well as effects on micronutrient intake, nutritional status and health of target populations, for ultimate achievement of the Millennium Development Goals. Conclusions The WHO/CDC logic model simplifies the process of developing a logic model by providing a tool that has identified high-priority areas and concepts that apply to virtually all public health micronutrient interventions. Countries can adapt it to their context in order to support programme design, implementation, monitoring and evaluation for the successful scale-up of nutrition interventions in public health. PMID:23507463

[A mid-term review of the Millennium Development Goals: where are we with the goals on health?].

PubMed

Kaddar, Miloud

2009-01-01

The eight Millennium Development Goals (MDGs) are the expressed commitment by world leaders to combat the most obvious forms of social inequality in the world: poverty, illiteracy and disease. The MDGs set health priorities and serve as markers of the most fundamental problems to solve: the maternal and child health high mortality, and the fight against major endemic diseases. Thus, health appears in three of the eight goals, and plays a decisive role in achieving the other MDGs such as the eradication of poverty and hunger, promotion of education and gender equality. While progress has been made in various domains and in numerous countries, enormous gaps and lack of funding remain. This is the case for infant mortality and HIV/AIDS, and even more so in the area of maternal mortality reduction especially in sub-Saharan Africa and Southeast Asia. The recent proliferation of forums and international partnerships for health have put at the forefront the targeted health-related MDG, increased financial resources for the benefit of poor countries but have made the architecture of global health even more fragmented and complex. Attempts to align on country priorities, needs and national health plans, and also to harmonize donors and partners' actions and funding according to the 2005 Paris Declaration principles, were difficult to actually materialize. The revitalization of primary health care and the strengthening of health systems are now back on the international and national health agenda.

Positioning women's and children's health in African union policy-making: a policy analysis

PubMed Central

2012-01-01

Background With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. Methods The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. Results With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010). This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and impact. AU policies related to reproductive, maternal, newborn and child health also use fewer policy frames than do AU policies related to HIV/AIDS, tuberculosis and malaria. Conclusion We suggest that more effective prioritization of women's and children's health in African Union policies would be supported by widening the range of policy frames used (notably health and economic) and strengthening the evidence base of all policy frames used. In addition, we suggest it would be beneficial if the partner groups advocating for women's and children's health were multi-stakeholder, and included, for instance, health care professionals, regional institutions, parliamentarians, the media, academia, NGOs, development partners and the public and private sectors. PMID:22340362

Positioning women's and children's health in African union policy-making: a policy analysis.

PubMed

Toure, Kadidiatou; Sankore, Rotimi; Kuruvilla, Shyama; Scolaro, Elisa; Bustreo, Flavia; Osotimehin, Babatunde

2012-02-16

With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010).This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and impact. AU policies related to reproductive, maternal, newborn and child health also use fewer policy frames than do AU policies related to HIV/AIDS, tuberculosis and malaria. We suggest that more effective prioritization of women's and children's health in African Union policies would be supported by widening the range of policy frames used (notably health and economic) and strengthening the evidence base of all policy frames used. In addition, we suggest it would be beneficial if the partner groups advocating for women's and children's health were multi-stakeholder, and included, for instance, health care professionals, regional institutions, parliamentarians, the media, academia, NGOs, development partners and the public and private sectors.

Violence against women and the Millennium Development Goals: facilitating women's access to support.

PubMed

Ellsberg, M

2006-09-01

Violence against women is a serious health and development concern, as well as a violation of women's human rights. Violence against women has a devastating effect on women's sexual and reproductive health, as well as the health of their children, and is rooted in gender inequality. Reducing violence against women is therefore a key strategy for the achievement of the Millennium Development Goals. Key lessons have emerged from more than two decades of experiences dealing with violence against women within the health sector. Interventions must go beyond training and curricula reform and utilize a system-wide approach, including changes in policies, procedures and attention to privacy and confidentiality. Providers must work together with other sectors, particularly at a community level, to strengthen local networks for support of survivors of violence. Prevention activities are critical, particularly those that seek to change cultural norms and laws that encourage violence and discriminate against women and girls.

Impact of reproductive health on socio-economic development: a case study of Nigeria.

PubMed

Adinma, J I B; Adinma, E D

2011-03-01

The link between reproductive health, sexual and reproductive right, and development was highlighted at the International Conference on Population and Development held in Egypt. Developmental disparities are related to socio-economic differences which have led to the identification of distinct socio-economic classifications of nations. Human development represents the socioeconomic standing of any nation, in addition to literacy status and life expectancy. Africa accounts for 25% of the world's landmass but remains the world's poorest continent. Nigeria, the most populous country in Africa, has policies and programmes geared towards the improvement of its socio-economic standing and overal development, with little positive result. Reproductive health is a panacea towards reversing the stalled socio-economic growth of Nigeria as evident from the linkage between reproductive health and development, highlighted in Millennium Development Goals 3, 4, 5 and 6. Fast tracking Nigeria's development requires implementation of reproductive health policies and programmes targeted on women and children.

The Role of Health Education Specialists in Supporting Global Health and the Millennium Development Goals

ERIC Educational Resources Information Center

Geiger, Brian F.; Davis, Thomas M.; Beric, Bojana; Devlin, Michele K.

2011-01-01

Knowledge and skills for global health program design, implementation and monitoring is an expectation for practicing public health professionals. Major health education professional organizations including American Association for Health Education (AAHE), Society of Public Health Education (SOPHE) and International Union for Health Promotion and…

[Health, equity, and the Millennium Development Goals].

PubMed

Torres, Cristina; Mújica, Oscar J

2004-06-01

In September 2000 representatives of 189 countries met for the Millennium Summit, which the United Nations convened in New York City, and adopted the declaration that provided the basis for formulating the Millennium Development Goals (MDGs). The eight goals are part of a long series of initiatives that governments, the United Nations system, and international financial institutions have undertaken to reduce world poverty. Three of the eight goals deal with health, so the health sector will be responsible for implementing, monitoring, and evaluating measures proposed to meet targets that have been formulated: to reduce by two-thirds the mortality rate in children under 5 years of age between 1990 and 2015; to reduce by three-quarters the maternal mortality rate between 1990 and 2015; and to halt and begin to reverse the spread of HIV/AIDS by the year 2015, as well as to halt and begin to reverse the incidence of malaria, tuberculosis, and other major diseases. The health sector must also work with other parties to achieve targets connected with two other of the goals: to improve access to affordable essential drugs, and to reduce the proportion of persons who do not have safe drinking water. Adopting a strategy focused on the most vulnerable groups-ones concentrated in locations and populations with the greatest social exclusion-would make possible the largest total reduction in deaths among children, thus reaching the proposed target as well as producing greater equity. In the Region of the Americas the principal challenges in meeting the MDGs are: improving and harmonizing health information systems; designing health programs related to the MDGs that bring together the set of services and interventions that have the greatest impact, according to the special characteristics of the populations who are intended to be the beneficiaries; strengthening the political will to support the MDGs; and guaranteeing funding for the measures undertaken to attain the MDGs.

[Transition from Millennium Development Goals to Sustainable Development Goals from the perspective of the social determinants of health and health equity].

PubMed

Urbina-Fuentes, Manue; Jasso-Gutiérrez, Luis; Schiavon-Ermani, Raffaela; Lozano, Rafael; Finkelman, Jacobo

2017-01-01

The United Nations Declaration of 2000 agreed on eight millennium development goals (MDGs) to be met in 2015. The results show that poverty continues through population growth and advances in both rich and poor countries are threatened by economic crises and inequities in geographic areas and population groups within countries. In a globalized world with great social and economic inequalities, from the perspective of the social determinants of health (SDH), the relevance of the new 17 sustainable development goals (SDGs) is greater. Faced with the health challenges in our country to achieve SDGs, the symposium "The transition from MDGs to SDGs from the perspective of SDH and health equity" was presented at the XLIV Congress of the National Academy of Medicine. The presentations dealt with five important aspects of the transition in Mexico: background and context; the current state of the MDGs in childhood; the impact on gender equity and adolescent fertility; the health system and the theme of environmental health and were presented by Dr. Raffaela Schiavon, Jacobo Finkelman, Luis Jasso and Rafael Lozano.

The Millennium Development Goals Agenda: Constraints of Culture, Economy, and Empowerment in Influencing the Social Mobility of Pakistani Girls on Mathematics and Science Related Higher Education Courses in Universities in Pakistan

ERIC Educational Resources Information Center

Mujtaba, Tamjid; Reiss, Michael J.

2015-01-01

The third of the eight Millennium Development Goals is to promote gender equality and empower women. This article discusses the factors that are associated with 31 female higher education students' choices and aspirations to pursue education and careers in mathematics and science-related fields. The analysis is based on semistructured interviews.…

Can the Millennium Development Goals database be used to measure the effects of globalisation on women's health in Sub-Saharan Africa? A critical analysis.

PubMed

Wamala, Sarah; Breman, Anna; Richardson, Matt X; Loewenson, Rene

2010-03-01

Africa has had poor returns from integration with world markets in globalisation, has experienced worsening poverty and malnutrition and has high burdens of HIV and communicable disease, with particular burdens on women. It is therefore essential to describe the impact of globalisation on women's health. Indicators such as the Millennium Development Goals (MDGs) are presented as having a major role in measuring this impact, but an assessment of the adequacy of aggregate national indicators used in monitoring the MDGs for this purpose is lacking. The Millennium Development Goals' panel database 2000 to 2006 was used to investigate the association between globalisation and women's health in Sub-Saharan Africa based on various determinants of heath. Out of the 148 countries classified as developing countries, 48 were in Sub-Saharan Africa. Results suggest that developing countries are becoming more integrated with world markets through some lowering of trade barriers. At the same time, women's occupational roles are changing, which could affect their health status. However, it is difficult to measure the impact of globalisation on women's health from the MDG database. First, data on trade liberalization is aggregated at the regional level and does not hold any information on individual countries. Second, too few indicators in the MDG database are disaggregated by sex, making it difficult to separate the effects on women from those on men. The MDG database is not adequate to assess the effects of globalisation on women's health in Sub-Saharan Africa. We recommend that researchers aim to address this research question to find other data sources or turn to case studies. We hope that results from this study will stimulate research on globalisation and health using reliable sources.

The Vanuatu medical supply system – documenting opportunities and challenges to meet the Millennium Development Goals

PubMed Central

Brown, Andrew; Gilbert, Ben

2012-01-01

Objectives: Limited human resources are widely recognised as a barrier to achieve health-related Millennium Development Goals. Availability of medical supplies and suitably trained health personnel are crucial to ensuring a well-functioning medical supply system. The objective of this paper is to identify the factors which influence the availability of medical supplies within the health facilities of Vanuatu. Methods: A qualitative triangulated strategy using semi-structured interviews, observational workplace surveys and semi-structured focus groups was developed. This research was approved by the Human Ethics Committee of the University of Canberra and was funded through a direct grant from the United Nations Population Fund Suva, Pacific sub regional office. Results: During two weeks of data collection, 21 interviews were conducted, observational workplace surveys were completed in 19 facilities and 22 personnel participated in three focus groups across three provinces. The interviewees had a wide range of primary professional groupings and were representative of the Vanuatu health workforce. A complex array of medical supply issues are described from within the three tiered structure of the medical supply system. Conclusion: The results of this research have further informed our understanding of the competencies required by healthcare personnel to conduct medical supply management activities effectively in Pacific Island countries. As a result of this research, a platform is provided for the government of Vanuatu to engage development partners to work toward a sustainable medical supply system. PMID:23093895

Associations between maternal experiences of racism and early child health and development: findings from the UK Millennium Cohort Study.

PubMed

Kelly, Yvonne; Becares, Laia; Nazroo, James

2013-01-01

Emerging evidence suggests that experienced racism might help explain observed ethnic inequalities in early child health and development. There are few studies outside the US context and none that consider mothers' experiences of racism in relation to a range of early childhood health and developmental markers. The authors used cross-sectional data from the UK Millennium Cohort Study on 2136 mothers and their 5-year-old children from ethnic minority groups. Measures of racism tapped two dimensions of mothers' experience: perceived frequency of racist attacks in residential area and interpersonal racism. Markers of child health and development were obesity; socioemotional difficulties; cognitive: verbal, non-verbal and spatial ability test scores. There was a suggestion that the mothers' experience of interpersonal racism was associated with an increased risk of obesity ('received insults' OR=1.47; 'treated unfairly' OR=1.57; 'disrespectful treatment by shop staff' OR=1.55), but all CIs crossed 1.0, and size estimates were attenuated on further statistical adjustment. Perception of racism in the residential area was associated with socioemotional difficulties (fully adjusted coefficient=1.40, SE=0.47) and spatial abilities (fully adjusted coefficient=-1.99, SE=0.93) but not with verbal or non-verbal ability scores. Maternal experiences of racist insults were associated with non-verbal ability scores (fully adjusted coefficient=-1.70, SE=0.88). The results suggest that mothers' experienced racism is linked to markers of early child health and development. Interventions that aim to improve early child development and address ethnic health inequalities need to incorporate approaches to tackling racism at all levels of society.

Cervical cancer prevention and the Millennium Development Goals.

PubMed

Wittet, Scott; Tsu, Vivien

2008-06-01

The advent of new technologies such as the human papillomavirus (HPV) vaccine and HPV DNA tests--along with new insights into the appropriate use of low-resource technologies such as visual inspection of the cervix and treatment of cervical lesions with cryotherapy--have increased optimism about the potential for effective disease control in low-resource settings. Nevertheless, it is also important to ask ourselves how new health initiatives contribute, or fail to contribute, to major global undertakings such as achievement of the Millennium Development Goals (MDGs). While reproductive health in general, and cervical cancer prevention in particular, are not explicitly mentioned among the MDGs, they are implied; and it is certain that women cannot contribute to sustainable development without good health. The question is, in what ways do scaled-up cervical cancer prevention activities, including introduction of the new HPV vaccines and increased access to precancer screening and treatment, contribute to attainment of the MDGs?

Poverty, development, and women: why should we care?

PubMed

Thompson, Joyce E Beebe

2007-01-01

Healthy, prosperous nations require healthy women and newborns. Young girls and women in resource-poor nations suffer the greatest ill-health consequences from low status, denial of basic human rights, and poverty. Poverty and poor health result in poor economic development. The Millennium Development Goals call for immediate efforts to reduce poverty, improve health, especially of girls and women, and foster development in the world's poorest nations.

Sustaining the vision for Millennium Development Goal 6, to halt and reverse the spread of HIV/AIDS and other infections.

PubMed

Campbell, Della Dee; Moran, Barbara

2010-01-01

The purpose of Millennium Development Goal 6 is to halt and reverse the spread of HIV/AIDS, malaria, and other diseases and provide universal access to treatment for HIV/AIDS. In this article we describe progress made in meeting the targets for HIV/AIDS set for 2015 and the President's Emergency Plan for AIDS Relief. This funding is geared toward developing sustainable solutions with which to combat diseases that threaten our global community. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Achieving the health Millennium Development Goals for South Africa: challenges and priorities.

PubMed

Chopra, Mickey; Lawn, Joy E; Sanders, David; Barron, Peter; Abdool Karim, Salim S; Bradshaw, Debbie; Jewkes, Rachel; Abdool Karim, Quarraisha; Flisher, Alan J; Mayosi, Bongani M; Tollman, Stephen M; Churchyard, Gavin J; Coovadia, Hoosen

2009-09-19

15 years after liberation from apartheid, South Africans are facing new challenges for which the highest calibre of leadership, vision, and commitment is needed. The effect of the unprecedented HIV/AIDS epidemic has been immense. Substantial increases in mortality and morbidity are threatening to overwhelm the health system and undermine the potential of South Africa to attain the Millennium Development Goals (MDGs). However The Lancet's Series on South Africa has identified several examples of leadership and innovation that point towards a different future scenario. We discuss the type of vision, leadership, and priority actions needed to achieve such a change. We still have time to change the health trajectory of the country, and even meet the MDGs. The South African Government, installed in April, 2009, has the mandate and potential to address the public health emergencies facing the country--will they do so or will another opportunity and many more lives be lost?

Millennium Development Goals 4 and 5: progress and challenges.

PubMed

Bryce, Jennifer; Black, Robert E; Victora, Cesar G

2013-10-16

The Millennium Development Goals have galvanized efforts to improve child survival (MDG-4) and maternal health (MDG-5). There has been important progress on both MDGs at global level, although it now appears that few countries will reach them by the target date of 2015. There are known and efficacious interventions to address most of the major causes of these deaths, but important gaps remain. The biggest challenge is to ensure that all women and children have access to life-saving interventions. Current levels of intervention coverage are too low, representing missed opportunities. Providing services at the community level is an important emerging priority, but preventing maternal and neonatal deaths also requires access to health facilities. Readers of the Medicine for Global Health collection in BMC Medicine are urged to make maternal and child health one of their key concerns, even if they work on other topics.

Child Health and Survival in a Changing World.

PubMed

Denno, Donna M; Paul, Shadae L

2017-08-01

Ninety-nine percent of the 5.9 million annual child deaths occur in low and middle-income countries. Undernutrition underlies 45% of deaths. Determinants include access to care, maternal education, and absolute and relative poverty. Socio-political-economic factors and policies tremendously influence health and their determinants. Most deaths can be prevented with interventions that are currently available and recommended for widespread implementation. Millennium Development Goal 4 was not achieved. Sustainable Development Goal 3.2 presents an even more ambitious target and opportunity to save millions of lives; and requires attention to scaling up interventions, especially among the poorest and most vulnerable children. Copyright © 2017 Elsevier Inc. All rights reserved.

Obesity and Associated Adverse Health Outcomes Among U.S. Military Members and Veterans: Findings from the Millennium Cohort Study

DTIC Science & Technology

2016-06-27

Obesity and Associated Adverse Health Outcomes Among US Military Members and Veterans: Findings from the Millennium Cohort Study Toni Rush1,2,3...Cynthia A. LeardMann3, and Nancy F. Crum-Cianflone1,3,4 Objective: To assess the prevalence of obesity and associated health outcomes among US service...members and veterans. Methods: Data from three survey cycles (2001–2008) of the Millennium Cohort Study were used to examine the prevalence of obesity

Behavioral economics: the key to closing the gap on maternal, newborn and child survival for Millennium Development Goals 4 and 5?

PubMed

Buttenheim, Alison M; Asch, David A

2013-05-01

Millennium Development Goals (MDGs) 4 and 5 set ambitious targets to reduce maternal, newborn and child mortality by 2015. With 2015 fast approaching, there has been a concerted effort in the global health community to "close the gap" on the MDG targets. Recent consensus initiatives and frameworks have refocused attention on evidence-based, low-cost interventions that can reduce mortality and morbidity, and have argued for additional funding to increase access to and coverage of these life-saving interventions. However, funding alone will not close the gap on MDGs 4 and 5. Even when high-quality, affordable products and services are readily available, uptake is often low. Progress will therefore require not just money, but also advances in health-related behavior change and decision-making. Behavioral economics offers one way to achieve real progress by improving our understanding of how individuals make choices under information and time constraints, and by offering new approaches to make it easier for individuals to do what is in their best interest and harder to do what is not. We introduce five behavioral economic principles and demonstrate how they could boost efforts to improve maternal, newborn, and child health in pursuit of MDGs 4 and 5.

[Primary health care and the millennium development goals].

PubMed

Faye, A; Bob, M; Fall, A; Fall, C

2012-01-01

Member countries of the World Health Organization (WHO) met in Alma Ata (8-12 September 1978) to define and advocate the implementation of primary health care (PHC) worldwide, above all, in developing countries, which had a real need to review their strategies for meeting the health needs of their populations. They did not suspect that 20 years later the vision they displayed would remain undeniably relevant. Here we examine the similarities and points of convergence of their declaration about PHC with the Millennium Development Goals that seek today to reduce poverty across the world. An exhaustive and analytic literature review was conducted to collect those similarities. Further analysis of the definitions, objectives, principles and recommendations of the Alma Ata Declaration and the Millennium Declaration reveals multiple dependencies and fundamental points of similarity between these two representations. Almost all states have pledged to achieve the eight MDG by 2015: to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability, and develop a global partnership for development. The Alma Ata conference defined primary health care as essential health care, based on practical methods and techniques that are both scientifically sound and socially acceptable, universally accessible to all individuals and all families of the community, through their full participation and at a cost that the community and countries can afford at all stages of their development in the spirit of self-reliance and self-determination. It is an integral part of economic and social development. The following principles are involved in the achievement of both primary health care and the MDG: social equity, community participation, and intersectorality. Public health is an essential condition of poverty eradication and MDG achievement. Public health issues are central to the problem of sustainable development and must therefore remain the focus of attention. It is increasingly urgent to break the vicious circle created by the close correlation between environmental degradation, poor health, and poverty.

Countdown to 2015: comparing progress towards the achievement of the health Millennium Development Goals in Ethiopia and other sub-Saharan African countries.

PubMed

Accorsi, Sandro; Bilal, Nejmudin Kedir; Farese, Pasquale; Racalbuto, Vincenzo

2010-05-01

Mid-way 2007 reports indicate that many low-income countries, at current rates of progress, are unlikely to reach the Millennium Development Goals (MDG) by 2015. In Ethiopia, a decline was observed in under-five mortality rates from 204 to 123 per 1000 live births between 1990 and 2005, showing good progress towards the achievement of MDG4. A downward trend was observed in the maternal mortality ratio; however, because of the high degree of sampling variability, it is not possible to reach any firm conclusion about the possibility of achieving MDG5. Regarding MDG6, good progress was observed in controlling HIV/AIDS and malaria, whereas MDG indicators related to tuberculosis are still below international standards. Therefore, performance was not uniform across programmes. In general, interventions that can be routinely scheduled, such as immunisation, had much higher coverage than those that rely on functional health systems and clinical services proximate to households with 24h availability, such as skilled care at birth. These mixed results highlight that, although MDGs focus on specific diseases and conditions, targets cannot be achieved without strengthening health systems. It is for this reason that the strategic health plan in Ethiopia is focusing on high-impact and cost-effective health interventions and on health systems strengthening. Copyright 2009 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

A Review of Groundwater Arsenic Contamination in Bangladesh: The Millennium Development Goal Era and Beyond

PubMed Central

Yunus, Fakir Md.; Khan, Safayet; Chowdhury, Priyanka; Milton, Abul Hasnat; Hussain, Sumaira; Rahman, Mahfuzar

2016-01-01

Arsenic contamination in drinking water has a detrimental impact on human health which profoundly impairs the quality of life. Despite recognition of the adverse health implications of arsenic toxicity, there have been few studies to date to suggest measures that could be taken to overcome arsenic contamination. After the statement in 2000 WHO Bulletin that Bangladesh has been experiencing the largest mass poisoning of population in history, we researched existing literature to assess the magnitude of groundwater arsenic contamination in Bangladesh. The literature reviewed related research that had been initiated and/or completed since the implementation of the Millennium Development Goals (MDGs) under four domains: (1) extent of arsenic contamination; (2) health consequences; (3) mitigation and technologies and (4) future directions. To this means, a review matrix was established for analysis of previous literature based on these four core domains. Our findings revealed that several high-quality research articles were produced at the beginning of the MDG period, but efforts have dwindled in recent years. Furthermore, there were only a few studies conducted that focused on developing suitable solutions for managing arsenic contamination. Although the government of Bangladesh has made its population’s access to safe drinking water a priority agenda item, there are still pockets of the population that continue to suffer from arsenic toxicity due to contaminated water supplies. PMID:26891310

A Review of Groundwater Arsenic Contamination in Bangladesh: The Millennium Development Goal Era and Beyond.

PubMed

Yunus, Fakir Md; Khan, Safayet; Chowdhury, Priyanka; Milton, Abul Hasnat; Hussain, Sumaira; Rahman, Mahfuzar

2016-02-15

Arsenic contamination in drinking water has a detrimental impact on human health which profoundly impairs the quality of life. Despite recognition of the adverse health implications of arsenic toxicity, there have been few studies to date to suggest measures that could be taken to overcome arsenic contamination. After the statement in 2000 WHO Bulletin that Bangladesh has been experiencing the largest mass poisoning of population in history, we researched existing literature to assess the magnitude of groundwater arsenic contamination in Bangladesh. The literature reviewed related research that had been initiated and/or completed since the implementation of the Millennium Development Goals (MDGs) under four domains: (1) extent of arsenic contamination; (2) health consequences; (3) mitigation and technologies and (4) future directions. To this means, a review matrix was established for analysis of previous literature based on these four core domains. Our findings revealed that several high-quality research articles were produced at the beginning of the MDG period, but efforts have dwindled in recent years. Furthermore, there were only a few studies conducted that focused on developing suitable solutions for managing arsenic contamination. Although the government of Bangladesh has made its population's access to safe drinking water a priority agenda item, there are still pockets of the population that continue to suffer from arsenic toxicity due to contaminated water supplies.

Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

PubMed Central

Mitra, Amal K.; Rodriguez-Fernandez, Gisela

2010-01-01

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC. PMID:20623022

Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

PubMed

Mitra, Amal K; Rodriguez-Fernandez, Gisela

2010-05-01

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

Assessing the Progress of Gender Parity in Education through Achieving Millennium Development Goals: A Case Study of Quetta District Balochistan

ERIC Educational Resources Information Center

Rashid, Abdul; Bibi, Zainab; Din, Siraj ud

2012-01-01

Using secondary data of Government Schools and literacy department for 10 years that is 2000-2010, this paper assesses the progress on the issue of gender equality within the framework of education related Millennium Development Goals (MDG) in district Quetta. The assessment is based on the selected indicators of goals by applying descriptive…

Emerging diseases and implications for Millennium Development Goals in Africa by 2015 - an overview.

PubMed

Aluwong, Tagang; Bello, Mohammed

2010-01-01

Emerging zoonotic diseases have assumed increasing fundamental importance in both public and animal health, as the last few years have seen a steady increase of new cases, each emerging from an unsuspected geographic area and causing serious problems, often leading to mortalities among animals and humans. The reasons for disease emergence or re-emergence are multiple and include certain major factors, such as expansion of the human population, climate change and globalisation of trade. Further contributing issues, such as the increased movement of animal species, microbial evolution, ecological disruption, changes in human behaviour, all imply that emerging diseases will not only continue to occur, but the rate of their emergence will also increase. These will constitute constraints for the attainment of the Millennium Development Goals by African Governments by 2015. There is no doubt that the current trend calls for more and stronger partnerships between national and international organisations, veterinary and medical communities, environmentalists, academics and policy-makers of various governments on the continent within the context of the global 'One Health' movement. This article attempts to analyse the impact of emerging diseases and the implications for the achievement of the Millennium Development Goals in Africa by the year 2015.

Social, economic, and political factors in progress towards improving child survival in developing nations.

PubMed

Lykens, Kristine; Singh, Karan P; Ndukwe, Elewichi; Bae, Sejong

2009-01-01

Child mortality is a persistent health problem faced by developing nations. In 2000 the United Nations (UN) established a set of high priority goals to address global problems of poverty and health, the Millennium Development Goals, which address extreme poverty, hunger, primary education, child mortality, maternal health, infectious diseases, environmental sustainability, and partnerships for development. Goal 4 aims to reduce by two thirds, between 2000 and 2015, the under-five mortality rate in developing countries. In sub-Saharan Africa from 2000 to 2006 these rates have only been reduced from 167 per 1,000 live births to 157, and 27 nations in this region have made no progress towards the goal. A country-specific database was developed from the UN Millennium Development Goal tracking project and other international sources which include age distribution, under-nutrition, per capita income, government expenditures on health, external resources for health, civil liberties, and political rights. A multiple regression analysis examined the extent to which these factors explain the variance in child mortality rates in developing countries. Nutrition, external resources, and per capita income were shown to be significant factors in child survivability. Policy options include developed countries' renewed commitment of resources, and developing nations' commitments towards governance, development, equity, and transparency.

Water for Two Worlds: Designing Terrestrial Applications for Exploration-class Sanitation Systems

NASA Technical Reports Server (NTRS)

Adams, Constance; Andersson, Ingvar; Feighery, John

2004-01-01

At the United Nations Millennium Summit in September of 2000, the world leaders agreed on an ambitious agenda for reducing poverty and improving lives: the Millennium Development Goals (MDGs) , a list of issues they consider highly pernicious, threatening to human welfare and, thereby, to global security and prosperity. Among the eight goals are included fundamental human needs such as the eradication of extreme poverty and hunger, the promotion of gender equality, the reduction of child mortality and improvement of maternal health, and ensuring the sustainability of our shared environment. In order to help focus the efforts to meet these goals, the United Nations (UN) has established a set of eighteen concrete targets, each with an associated schedule. Among these is Target 10: "By 2015, reduce by half the proportion of people without access to safe drinking water." A closely related target of equal dignity was agreed at the World Summit on Sustainable Development (Johannesburg, September 2002): "By 2015, reduce by half the proportion of people without access to basic sanitation".

Challenges experienced by South Africa in attaining Millennium Development Goals 4, 5 and 6.

PubMed

Mulaudzi, Fhumulani M; Phiri, Seepaneng S; Peu, Doriccah M; Mataboge, Mmamakwa L S; Ngunyulu, Nkhensani R; Mogale, Ramadimetja S

2016-05-06

Despite progress made by other countries worldwide in achieving Millennium Development Goals (MDGs) 4, 5 and 6, South Africa is experiencing a challenge in attaining positive outcomes for these goals. To describe the challenges experienced by South Africa regarding the successful implementation of MDGs 4, 5 and 6. An integrative literature review was used to identify and synthesise various streams of literature on the challenges experienced by South Africa in attaining MDGs 4, 5 and 6. The integrative review revealed the following themes: (1) interventions related to child mortality reduction, (2) implementation of maternal mortality reduction strategies, and (3) identified barriers to zero HIV and TB infections and management. It is recommended that poverty relief mechanisms be intensified to improve the socio-economic status of women. There is a need for sectoral planning towards maternal health, and training of healthcare workers should emphasise the reduction of maternal deaths. Programmes addressing the reduction of maternal and child mortality rates, HIV, STIs and TB need to be put in place.

[Impact of female genital mutilation on the millennium goals].

PubMed

Ruiz, Ismael Jiménez; Martínez, María Pilar Almansa; Bravo, María Del Mar Pastor

2015-01-01

To relate the Female Genital Mutilation as a negative factor for the achievement of the Millennium Development Goals 1, 3, 4, 5 and 6. Data collection was through review literature review between in the years 2014 and 2015 in the databases Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO and in the webs of WOK, UNICEF, UNAF and WHO using the descriptors: female circumcision, millennium development goals, rights of women. Articles published between years 2010 y 2015, were included and finally 24 articles were selected. The Female Genital Mutilation is based on gender discrimination, and reinforces and encourages the circle of poverty. This practice causes physical complications that may affect the infant mortality and morbidity, complications in pregnancy and childbirth and there is a relationship between the practice and the transmission of human immunodeficiency virus. The fight against Female Genital Mutilation contributes to the achievement of five of the eight Millennium Goals.

Critical thinking in health professions education: summary and consensus statements of the Millennium Conference 2011.

PubMed

Huang, Grace C; Newman, Lori R; Schwartzstein, Richard M

2014-01-01

Critical thinking is central to the function of health care professionals. However, this topic is not explicitly taught or assessed within current programs, yet the need is greater than ever, in an era of information explosion, spiraling health care costs, and increased understanding about metacognition. To address the importance of teaching critical thinking in health professions education, the Shapiro Institute for Education and Research and the Josiah Macy Jr. Foundation jointly sponsored the Millennium Conference 2011 on Critical Thinking. Teams of physician and nurse educators were selected through an application process. Attendees proposed strategies for integrating principles of critical thinking more explicitly into health professions curricula. Working in interprofessional, multi-institutional groups, participants tackled questions about teaching, assessment, and faculty development. Deliberations were summarized into consensus statements. Educational leaders participated in a structured dialogue about the enhancement of critical thinking in health professions education and recommend strategies to teach critical thinking.

Left endocarditis, changes in the new millennium.

PubMed

Noureddine-López, Mariam; de la Torre-Lima, Javier; Ruiz-Morales, Josefa; Gálvez-Acebal, Juan; Hidalgo-Tenorio, Carmen; de Alarcón González, César Arístides

2018-05-25

a description of infective left endocarditis at the turn of the millennium. A multicentre prospective study into the left endocarditis using data collected from the Andalusian cohort for the study of cardiovascular infections during 1984-2014. Of the 1,604 endocarditis cases collected, 382 belonged to G1 (group-1, period 1983-1999) and 1,222 to G2 (group-2, 2000-2014). Patients in the new millennium have a significantly higher mean age, have more comorbidity and concomitant diseases, and nosocomial and health-related endocarditis are more frequent, as well as complications. An increase in methicillin-resistant Staphylococcus aureus, Enterococcus sp., Gram-negative bacilli and Streptococcus bovis was noted. Regarding treatment, there is an increase in the use of cephalosporins and a decrease in penicillins; there is more surgery when admitted to hospital and less delay. Mortality stands at around 30% in both millennia. In the multivariate analysis, mortality was associated with: previous millennium (G1), age, Charlson index, renal failure and septic shock, and aetiologically with Staphylococcus aureus. Mortality remains stable, despite diagnostic and therapeutic improvements, because patients are older, have greater comorbidity, a closer relationship with the health care system (nosocomial) and microorganisms are more aggressive. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Creating a living document: developing the National Association of School Nurses Mission Statement for the new millennium.

PubMed

Brandt, C M

1999-12-01

The second in a series of three articles devoted to the development, maintenance, and implementation of the National Association of School Nurses 1998-2001 Strategic Plan and how it relates to the practice of school nurses. Information about the development of a mission/vision statement for the organization is given along with strategies for developing a local school district school health program strategic plan. A previous Nursing Practice Management section article discussed the development of the Association's strategic plan considering the changing health care climate, the shifting needs of school children, and the economic climate for school funding. A future Nursing Practice Management section article will discuss the implementation of the seven goal areas in the National Association of School Nurses 1998-2001 Strategic Plan.

Health care financing and utilization of maternal health services in developing countries.

PubMed

Kruk, Margaret E; Galea, Sandro; Prescott, Marta; Freedman, Lynn P

2007-09-01

The Millennium Development Goals call for a 75% reduction in maternal mortality between 1990 and 2015. Skilled birth attendance and emergency obstetric care, including Caesarean section, are two of the most important interventions to reduce maternal mortality. Although international pressure is rising to increase donor assistance for essential health services in developing countries, we know less about whether government or the private sector is more effective at financing these essential services in developing countries. We conducted a cross-national analysis to determine the association between government versus private financing of health services and utilization of antenatal care, skilled birth attendants and Caesarean section in 42 low-income and lower-middle-income countries. We controlled for possible confounding effects of total per capita health spending and female literacy. In multivariable analysis, adjusting for confounders, government health expenditure as a percentage of total health expenditure is significantly associated with utilization of skilled birth attendants (P = 0.05) and Caesarean section (P = 0.01) but not antenatal care. Total health expenditure is also significantly associated with utilization of skilled birth attendants (P < 0.01) and Caesarean section (P < 0.01). Greater government participation in health financing and higher levels of health spending are associated with increased utilization of two maternal health services: skilled birth attendants and Caesarean section. While government financing is associated with better access to some essential maternal health services, greater absolute levels of health spending will be required if developing countries are to achieve the Millennium Development Goal on maternal mortality.

Diarrhoeal diseases in developing countries: a situational analysis.

PubMed

Kumar, S G; Subitha, L

2012-01-01

Recent data showed that there is no much reduction in diarrhoea related morbidity in developing countries. This is important in view of the Millennium Developmental Goal (MDG) to be achieved by 2015. This study reviewed and analyzed after gathering the recent literature information from Pubmed, internet and other sources. The authors discussed public health issues related to diarrhoeal diseases that include problem burden, determinants, intervention strategies, management, prevention and recent developments for control of diarrhoea among under-five children in developing countries. The study emphasizes the need for strengthening of comprehensive diarrhoeal disease prevention strategy at primary level including improvement of water quality, hygiene and sanitation, along with provision of oral rehydration solution and zinc supplements, and research in the field of vaccine and cost effective interventions.

Health Research and Millennium Development Goals: Identifying the Gap From Public Health Perspective.

PubMed

El Lawindi, Mona I; Galal, Yasmine S; Khairy, Walaa A

2015-08-23

Assessing the research output within the universities could provide an effective means for tracking the Millennium Development Goals (MDGs) progress. This analytical database study was designed to assess the trend of research theses conducted by the Public Health Department (PHD), Faculty of Medicine, Cairo University during the period 1990 to 2014 as related to the: MDGS, Faculty and department research priority plans and to identify the discrepancies between researchers' priorities versus national and international research priorities. A manual search of the theses was done at the Postgraduate Library using a specially designed checklist to chart adherence of each thesis to: MDGs, Faculty and department research plans (RPs). The theses' profile showed that the highest research output was for addressing the MDGS followed by the PHD and Faculty RPs. Compliance to MDGs 5 and 6 was obvious, whereas; MDGs 2, 3, and 7 were not represented at all after year 2000. No significant difference was found between PH theses addressing the Faculty RPs and those which were not before and after 2010. A significantly lower percent of PH theses was fulfilling the PHD research priorities compared to those which were not after 2010. This study showed a definite decline in research output tackling the MDGS and PHD research priorities, with a non-significant increase in the production of theses addressing the Faculty RPs. The present study is a practical model for policy makers within the universities to develop and implement a reliable monitoring and evaluation system for assessment of research output.

World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality.

PubMed

Bustreo, F; Okwo-Bele, J-M; Kamara, L

2015-02-01

Child mortality has decreased substantially globally-from 12.6 million in 1990 to 6.3 million in 2013-due, in large part to of governments' and organisations' work, to prevent pneumonia, diarrhoea and malaria, the main causes of death in the postneonatal period. In 2012, the World Health Assembly adopted the Decade of Vaccines Global Vaccine Action Plan 2011-2020 as the current framework aimed at preventing millions of deaths through more equitable access to existing vaccines for people in all communities. The Global Alliance for Vaccines and Immunization (GAVI) plays a critical role in this effort by financing and facilitating delivery platforms for vaccines, with focused support for the achievements of improved vaccination coverage and acceleration of the uptake of WHO-recommended lifesaving new vaccines in 73 low-income countries. The GAVI Alliance has contributed substantially towards the progress of Millennium Development Goal 4 and to improving women's lives. By 2013, the GAVI Alliance had immunised 440 million additional children and averted six million future deaths from vaccine-preventable diseases in the world's poorest countries. The GAVI Alliance is on track to reducing child mortality to 68 per 1000 live births by 2015 in supported countries. This paper discusses the GAVI Alliance achievements related to Millennium Development Goal 4 and its broader contribution to improving women's lives and health systems, as well as challenges and obstacles it has faced. Additionally, it looks at challenges for the future and how it will continue its work related to reducing child mortality and improving women's health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

From Millennium Development Goals to post-2015 sustainable development: sexual and reproductive health and rights in an evolving aid environment.

PubMed

Hill, Peter S; Huntington, Dale; Dodd, Rebecca; Buttsworth, Michael

2013-11-01

Using research from country case studies, this paper offers insights into the range of institutional and structural changes in development assistance between 2005 and 2011, and their impact on the inclusion of a sexual and reproductive health and rights agenda in national planning environments. At a global level during this period, donors supported more integrative modalities of aid - sector wide approaches, poverty reduction strategy papers, direct budgetary support - with greater use of economic frameworks in decision-making. The Millennium Development Goals brought heightened attention to maternal mortality, but at the expense of a broader sexual and reproductive health and rights agenda. Advocacy at the national planning level was not well linked to programme implementation; health officials were disadvantaged in economic arguments, and lacked financial and budgetary controls to ensure a connection between advocacy and action. With increasing competency in higher level planning processes, health officials are now refocusing the post-2015 development goals. If sexual and reproductive health and rights is to claim engagement across all its multiple elements, advocates need to link them to the key themes of sustainable development: inequalities in gender, education, growth and population, but also to urbanisation, migration, women in employment and climate change. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Volunteer Service and Service Learning: Opportunities, Partnerships, and United Nations Millennium Development Goals.

PubMed

Dalmida, Safiya George; Amerson, Roxanne; Foster, Jennifer; McWhinney-Dehaney, Leila; Magowe, Mabel; Nicholas, Patrice K; Pehrson, Karen; Leffers, Jeanne

2016-09-01

This article explores approaches to service involvement and provides direction to nurse leaders and others who wish to begin or further develop global (local and international) service or service learning projects. We review types of service involvement, analyze service-related data from a recent survey of nearly 500 chapters of the Honor Society of Nursing, Sigma Theta Tau International (STTI), make recommendations to guide collaborative partnerships and to model engagement in global and local service and service learning. This article offers a literature review and describes results of a survey conducted by the STTI International Service Learning Task Force. Results describe the types of service currently conducted by STTI nursing members and chapters, including disaster response, service learning, and service-related responses relative to the Millennium Development Goals (MDGs). The needs of chapter members for information about international service are explored and recommendations for promoting global service and sustainability goals for STTI chapters are examined. Before engaging in service, volunteers should consider the types of service engagement, as well as the design of projects to include collaboration, bidirectionality, sustainability, equitable partnerships, and inclusion of the United Nations Sustainable Development Goals. STTI supports the learning, knowledge, and professional development of nurses worldwide. International service and collaboration are key to the advancement of the nursing profession. Culturally relevant approaches to international service and service learning are essential to our global organization, as it aims to impact the health status of people globally. © 2016 Sigma Theta Tau International.

Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce

PubMed Central

Dussault, Gilles; Franceschini, Maria Cristina

2006-01-01

Access to good-quality health services is crucial for the improvement of many health outcomes, such as those targeted by the Millennium Development Goals (MDGs) adopted by the international community in 2000. The health-related MDGs cannot be achieved if vulnerable populations do not have access to skilled personnel and to other necessary inputs. This paper focuses on the geographical dimension of access and on one of its critical determinants: the availability of qualified personnel. The objective of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health personnel, and to identify and assess the strategies developed to correct them. It reviews the recent literature on determinants, barriers and the effects of strategies that attempted to correct geographical imbalances, with a focus on empirical studies from developing and developed countries. An analysis of determinants of success and failures of strategies implemented, and a summary of lessons learnt, is included. PMID:16729892

Education, Development and Poverty Reduction: A Literature Critique

ERIC Educational Resources Information Center

Cremin, Peadar; Nakabugo, Mary Goretti

2012-01-01

The concept of development has evolved from an exclusive focus on economic growth towards an interrelated, even integrated approach involving progress across a range of disciplines such as health, education, economics and agriculture. The Millennium Development Goals (MDGs) are rooted in this evolved conception of development. A concerted global…

An appraisal of China's progress toward the Millennium Development Goals as they relate to children.

PubMed

Strand, Mark A; Fischer, Philip R

2014-08-01

Since their inception in 2000, the Millennium Development Goals (MDGs) have improved understanding of the global development process. Although the goals will not be significantly achieved on a global scale, each country has had accomplishments deserving of attention and analysis. With regard to the MDGs as they relate to children, China has made significant achievements, the deeper understanding of which might help in the process of refreshing the MDGs beyond 2015. China's accomplishments in economic development and human welfare, and the benefits this has brought to its children potentially teach lessons that can be modelled by other countries moving from low- to middle-income status.

Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health

PubMed Central

Bircher, Johannes; Kuruvilla, Shyama

2014-01-01

The Millennium Development Goals (MDGs) mobilized global commitments to promote health, socioeconomic, and sustainable development. Trends indicate that the health MDGs may not be achieved by 2015, in part because of insufficient coordination across related health, socioeconomic, and environmental initiatives. Explicitly acknowledging the need for such collaboration, the Meikirch Model of Health posits that: Health is a state of wellbeing emergent from conducive interactions between individuals' potentials, life's demands, and social and environmental determinants. Health results throughout the life course when individuals' potentials – and social and environmental determinants – suffice to respond satisfactorily to the demands of life. Life's demands can be physiological, psychosocial, or environmental, and vary across contexts, but in every case unsatisfactory responses lead to disease. This conceptualization of the integrative nature of health could contribute to ongoing efforts to strengthen cooperation across actors and sectors to improve individual and population health – leading up to 2015 and beyond. PMID:24943659

Health Status of Gulf War and Era Veterans Serving in the US Military in 2000.

PubMed

Porter, Ben; Long, Kyna; Rull, Rudolph P; Dursa, Erin K

2018-05-01

This research describes Gulf War and era veterans enrolled in the Millennium Cohort Study, who were sampled from US military personnel serving in 2000, and compares health characteristics of this sample to a Department of Veterans Affairs study sampled from the complete population. Demographics characteristics of this sample were described. Self-reported health characteristics were compared between the two studies. Gulf War and era veterans in the Millennium Cohort were generally healthier than in the VA study; they had fewer medical conditions and mental health disorders and better self-reported health. In both studies, Gulf War veterans had poorer health outcomes than era veterans. The Millennium Cohort Study is a unique resource for examining the long-term health effects of Gulf War deployment, particularly comparing deployed and nondeployed personnel and examining illnesses with long latencies.

From the Millennium Development Goals to Sustainable Development Goals.: The response to the HIV epidemic in Indonesia: challenges and opportunities.

PubMed

Wijayanti, Fetty; Tarmizi, Siti Nadia; Tobing, Viny; Nisa, Tiara; Akhtar, Muhammad; Trihandini, Indang; Djuwita, Ratna

2016-11-28

Since the first case was reported in 1981, the Indonesian government and civil society have implemented many initiatives to respond to the HIV/AIDS epidemic. From an historical perspective, the country now has the means to rapidly diagnose cases of HIV infection and provide antiretroviral therapy. The concern expressed by international health agencies about a potential major HIV epidemic in the country has not been confirmed, as evidenced by a slowing down of the number cases. The threat from non-sterile needle sharing has been relatively well controlled through harm-reduction programmes; however, drug trafficking remains a challenge. It has reached worrying levels and involves law enforcement units at the forefront of the battle. In parallel, the level of condom use in high-risk behaviour groups seems unsuccessful in reducing infection rates, especially among heterosexuals. The lack of information and the high mobility of the groups at risk of acquiring HIV infection have created tremendous challenges for outreach programmes. Heterosexual transmission represents the most important route of transmission in the country. When reflecting on the country's 2014 Millennium Development Goals, condom use during high-risk sex only reaches 43.5%, and only 21.3% of young people have a comprehensive knowledge about HIV/AIDS. The 2030 Millennium Development Goal Agenda offers an opportunity to catch up on goals that still need to be achieved. Therefore, efforts are underway to try to halt the epidemic by 2030 and also to ensure that all high-risk populations are included in this effort.

Resource allocation in Pakistan's health sector: a critical appraisal and a path toward the Millennium Development Goals.

PubMed

Shaikh, Babar Tasneem; Ejaz, Irum; Mazhar, Arslan; Hafeez, Assad

2013-01-01

Pakistan is trying hard to sustain its progress toward the Millennium Development Goals. However, because of a lack of political commitment to innovative solutions to improve its financing mechanism, the health system is unable to provide even essential and basic services to the people. The country, with more than 70% of the population living on less than two US dollars a day, largely depends on direct taxes for its revenue. Because of inadequate financing, the quality of government services is inexcusably poor; therefore, a majority of people seek healthcare in the private sector. This has led to a horde of issues pertaining to equity, accessibility and fairness. High out-of-pocket expenses on health jeopardize a family's livelihood, pushing it into a vicious circle of poverty. In the wake of recent devolution, this paper presents options for future health financing that enables the provinces to exert their autonomy to safeguard the health of the most vulnerable in the country. Our recommendations follow the vision of the World Health Organization and the Commission on Macroeconomics and Health, to achieve universal health coverage and social protection for the poor. Copyright © 2013 Longwoods Publishing.

Mental disorders, health inequalities and ethics: A global perspective

PubMed Central

NGUI, EMMANUEL M.; KHASAKHALA, LINCOLN; NDETEI, DAVID; ROBERTS, LAURA WEISS

2010-01-01

The global burden of neuropsychiatry diseases and related mental health conditions is enormous, underappreciated and under resourced, particularly in the developing nations. The absence of adequate and quality mental health infrastructure and workforce is increasingly recognized. The ethical implications of inequalities in mental health for people and nations are profound and must be addressed in efforts to fulfil key bioethics principles of medicine and public health: respect for individuals, justice, beneficence, and non-malfeasance. Stigma and discrimination against people living with mental disorders affects their education, employment, access to care and hampers their capacity to contribute to society. Mental health well-being is closely associated to several Millennium Development Goals and economic development sectors including education, labour force participation, and productivity. Limited access to mental health care increases patient and family suffering. Unmet mental health needs have a negative effect on poverty reduction initiatives and economic development. Untreated mental conditions contribute to economic loss because they increase school and work absenteeism and dropout rates, healthcare expenditure, and unemployment. Addressing unmet mental health needs will require development of better mental health infrastructure and workforce and overall integration of mental and physical health services with primary care, especially in the developing nations. PMID:20528652

Mental disorders, health inequalities and ethics: A global perspective.

PubMed

Ngui, Emmanuel M; Khasakhala, Lincoln; Ndetei, David; Roberts, Laura Weiss

2010-01-01

The global burden of neuropsychiatry diseases and related mental health conditions is enormous, underappreciated and under resourced, particularly in the developing nations. The absence of adequate and quality mental health infrastructure and workforce is increasingly recognized. The ethical implications of inequalities in mental health for people and nations are profound and must be addressed in efforts to fulfil key bioethics principles of medicine and public health: respect for individuals, justice, beneficence, and non-malfeasance. Stigma and discrimination against people living with mental disorders affects their education, employment, access to care and hampers their capacity to contribute to society. Mental health well-being is closely associated to several Millennium Development Goals and economic development sectors including education, labour force participation, and productivity. Limited access to mental health care increases patient and family suffering. Unmet mental health needs have a negative effect on poverty reduction initiatives and economic development. Untreated mental conditions contribute to economic loss because they increase school and work absenteeism and dropout rates, healthcare expenditure, and unemployment. Addressing unmet mental health needs will require development of better mental health infrastructure and workforce and overall integration of mental and physical health services with primary care, especially in the developing nations.

Reproductive health knowledge and practices among junior secondary school grade one students in Enugu State: threat to achieving millennium development goals in Nigeria.

PubMed

Nwaorgu, Obioma C; Onyeneho, Nkechi G; Okolo, May; Obadike, Ebele; Enibe, Gloria

2008-08-01

This was designed to provide background information for the implementation of family life and HIV/AIDS education in post primary schools in the Enugu State. A cross sectional survey of the reproductive health knowledge and practices of 412 junior secondary school pupils from 12 schools in Enugu State, Nigeria was undertaken using a uniform set of structured self-administered questionnaire. The results revealed that while the pupils demonstrated fair knowledge of human biology, they lacked knowledge of self-protective mechanisms as it related to sexual health. About (50%) of the participants reported that they have had sex, at the age of less than 11 years when they must have been in the primary school and most (89.3%) at age 11-14 years. Half (50.9%) of the respondents hold the belief that a girl would not get pregnant in her first sexual encounter. Statistically more of those who have ever had sex were betrayed this ignorance (p = 0.004). The boys were less certain about what constitutes the wrong ideas about reproductive health systems than the girls (p = 0.042). In the same vein, there was a difference (p < 0.0001) in the proportion of the rural residents, vis-a-vis their urban counterparts that could correctly identify the wrong ideas about human reproduction. This situation urgently calls for concerted efforts at addressing the poor reproductive health knowledge of these sexually active young people, for the millennium development goals (MDGs) target to be realized in Nigeria.

Intimate partner violence affects skilled attendance at most recent delivery among women in Kenya.

PubMed

Goo, Leslie; Harlow, Siobán D

2012-07-01

Delivery assistance by skilled health personnel is a key progress indicator for Millennium Development Goal 5, which aims to reduce the worldwide maternal mortality ratio by 75% between 1990 and 2015. The role of socio-demographic factors in determining skilled attendance at delivery has been widely explored, but relatively little attention has been paid to the effect of gender power relations on delivery care. This analysis investigated whether women's status in the household, as measured by their experience of intimate partner violence (IPV), affected skilled attendance at most recent delivery among women in Kenya. Cross-sectional data were obtained from the 2003 Kenya Demographic and Health Surveys (KDHS). 975 ever-married women who had given birth in the past year and completed the KDHS domestic violence module were included in the analysis. Logistic regression was used to assess the association between skilled attendance and IPV. In this sample, 46% reported having experienced any type of IPV, with 39% reporting physical violence, 21% emotional violence, and 13% sexual violence. After adjusting for demographic characteristics and number of antenatal visits, lifetime experience of emotional violence was found to decrease the odds of skilled attendance at most recent delivery by 40%, while lifetime experience of physical violence reduced the odds by 29%. Women's experience of IPV may influence receipt of skilled attendance during parturition, and should be addressed as national programs and their international partners align efforts to contribute to the achievement of Millennium Development Goal 5.

The post-millennium development goals agenda: include 'end to all wars' as a public health goal!

PubMed

Jayasinghe, Saroj

2014-09-01

The process of identifying global post-millennium development goals (post-MDGs) has begun in earnest. Consensus is emerging in certain areas (e.g. eliminating poverty) and conflicts and violence are recognized as key factors that retard human development. However, current discussions focus on tackling intra-state conflicts and individual-based violence and hardly mention eliminating wars as a goal. Wars create public health catastrophes. They kill, maim, displace and affect millions. Inter-state wars fuel intra-state conflicts and violence. The peace agenda should not be the monopoly of the UN Security Council, and the current consensus-building process setting the post-MDG agenda is a rallying point for the global community. The human rights approach will not suffice to eliminate wars, because few are fought to protect human rights. The development agenda should therefore commit to eliminating all wars by 2030. Targets to reduce tensions and discourage wars should be included. We should act now. © The Author(s) 2014.

The Millennium Development Goals: experiences, achievements and what's next

PubMed Central

Lomazzi, Marta; Borisch, Bettina; Laaser, Ulrich

2014-01-01

The Millennium Development Goals (MDGs) are eight international development goals to be achieved by 2015 addressing poverty, hunger, maternal and child mortality, communicable disease, education, gender inequality, environmental damage and the global partnership. Most activities worldwide have focused on maternal and child health and communicable diseases, while less attention has been paid to environmental sustainability and the development of a global partnership. Up to now, several targets have been at least partially achieved: hunger reduction is on track, poverty has been reduced by half, living conditions of 200 million deprived people enhanced, maternal and child mortality as well as communicable diseases diminished and education improved. Nevertheless, some goals will not be met, particularly in the poorest regions, due to different challenges (e.g. the lack of synergies among the goals, the economic crisis, etc.). The post-2015 agenda is now under discussion. The new targets, whatever they will be called, should reflect today's political situation, health and environmental challenges, and an all-inclusive, intersectoral and accountable approach should be adopted. PMID:24560268

The Millennium Development Goals: experiences, achievements and what's next.

PubMed

Lomazzi, Marta; Borisch, Bettina; Laaser, Ulrich

2014-01-01

The Millennium Development Goals (MDGs) are eight international development goals to be achieved by 2015 addressing poverty, hunger, maternal and child mortality, communicable disease, education, gender inequality, environmental damage and the global partnership. Most activities worldwide have focused on maternal and child health and communicable diseases, while less attention has been paid to environmental sustainability and the development of a global partnership. Up to now, several targets have been at least partially achieved: hunger reduction is on track, poverty has been reduced by half, living conditions of 200 million deprived people enhanced, maternal and child mortality as well as communicable diseases diminished and education improved. Nevertheless, some goals will not be met, particularly in the poorest regions, due to different challenges (e.g. the lack of synergies among the goals, the economic crisis, etc.). The post-2015 agenda is now under discussion. The new targets, whatever they will be called, should reflect today's political situation, health and environmental challenges, and an all-inclusive, intersectoral and accountable approach should be adopted.

Acquisition of Maternal Education and Its Relation to Single-Word Reading in Middle Childhood: An Analysis of the Millennium Cohort Study

ERIC Educational Resources Information Center

King, Thomas; McKean, Cristina; Rush, Robert; Westrupp, Elizabeth M.; Mensah, Fiona K.; Reilly, Sheena; Law, James

2017-01-01

Maternal education captured at a single time point is commonly employed as a predictor of a child's cognitive development. In this article, we ask what bearing the acquisition of additional qualifications has upon reading performance in middle childhood. This was a secondary analysis of the United Kingdom's Millennium Cohort Study, a cohort of…

Addressing disparities in maternal health care in Pakistan: gender, class and exclusion

PubMed Central

2012-01-01

Background After more than two decades of the Safe Motherhood Initiative and Millennium Development Goals aimed at reducing maternal mortality, women continue to die in childbirth at unacceptably high rates in Pakistan. While an extensive literature describes various programmatic strategies, it neglects the rigorous analysis of the reasons these strategies have been unsuccessful, especially for women living at the economic and social margins of society. A critical gap in current knowledge is a detailed understanding of the root causes of disparities in maternal health care, and in particular, how gender and class influence policy formulation and the design and delivery of maternal health care services. Taking Pakistan as a case study, this research builds upon two distinct yet interlinked conceptual approaches to understanding the phenomenon of inequity in access to maternal health care: social exclusion and health systems as social institutions. Methods/Design This four year project consists of two interrelated modules that focus on two distinct groups of participants: (1) poor, disadvantaged women and men and (2) policy makers, program managers and health service providers. Module one will employ critical ethnography to understand the key axes of social exclusion as related to gender, class and zaat and how they affect women’s experiences of using maternal health care. Through health care setting observations, interviews and document review, Module two will assess policy design and delivery of maternal health services. Discussion This research will provide theoretical advances to enhance understanding of the power dynamics of gender and class that may underlie poor women’s marginalization from health care systems in Pakistan. It will also provide empirical evidence to support formulation of maternal health care policies and health care system practices aimed at reducing disparities in maternal health care in Pakistan. Lastly, it will enhance inter-disciplinary research capacity in the emerging field of social exclusion and maternal health and help reduce social inequities and achieve the Millennium Development Goal No. 5. PMID:22871056

Millennium development goals and eye health.

PubMed

Faal, Hannah B

2012-01-01

In September 2000, world leaders made a commitment to build a more equitable, prosperous and safer world by 2015 and launched the Millennium Development Goals (MDGs). In the previous year, the World Health Organization and the International Agency for the Prevention of Blindness in partnership launched the global initiative to eliminate avoidable blindness by the year 2020-VISION 2020 the Right to Sight. It has focused on the prevention of a disability-blindness and recognized a health issue-sight as a human right. Both global initiatives have made considerable progress with synergy especially on MDG 1-the reduction of poverty and the reduction in numbers of the blind. A review of the MDGs has identified the need to address disparities within and between countries, quality, and disability. Noncommunicable diseases are emerging as a challenge to the MDGs and Vision 2020:0 the Right to Sight. For the future, up to and beyond 2015, there will be need for both initiatives to continue to work in synergy to address present and emerging challenges.

Millennium development goals and eye health

PubMed Central

Faal, Hannah B

2012-01-01

In September 2000, world leaders made a commitment to build a more equitable, prosperous and safer world by 2015 and launched the Millennium Development Goals (MDGs). In the previous year, the World Health Organization and the International Agency for the Prevention of Blindness in partnership launched the global initiative to eliminate avoidable blindness by the year 2020–VISION 2020 the Right to Sight. It has focused on the prevention of a disability-blindness and recognized a health issue–sight as a human right. Both global initiatives have made considerable progress with synergy especially on MDG 1–the reduction of poverty and the reduction in numbers of the blind. A review of the MDGs has identified the need to address disparities within and between countries, quality, and disability. Noncommunicable diseases are emerging as a challenge to the MDGs and Vision 2020:0 the Right to Sight. For the future, up to and beyond 2015, there will be need for both initiatives to continue to work in synergy to address present and emerging challenges. PMID:22944751

Anthrax vaccination in the Millennium Cohort: validation and measures of health.

PubMed

Smith, Besa; Leard, Cynthia A; Smith, Tyler C; Reed, Robert J; Ryan, Margaret A K

2007-04-01

In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research.

22 CFR 1300.6 - Office location.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Office location. 1300.6 Section 1300.6 Foreign Relations MILLENNIUM CHALLENGE CORPORATION ORGANIZATION AND FUNCTIONS OF THE MILLENNIUM CHALLENGE CORPORATION § 1300.6 Office location. The principal offices of the Millennium Challenge Corporation are...

How can health remain central post-2015 in a sustainable development paradigm?

PubMed

Hill, Peter S; Buse, Kent; Brolan, Claire E; Ooms, Gorik

2014-04-03

In two years, the uncompleted tasks of the Millennium Development Goals will be merged with the agenda articulated in the 2012 United Nations Conference on Sustainable Development. This process will seek to integrate economic development (including the elimination of extreme poverty), social inclusion, environmental sustainability, and good governance into a combined sustainable development agenda. The first phase of consultation for the post-2015 Sustainable Development Goals reached completion in the May 2013 report to the Secretary-General of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda. Health did well out of the Millennium Development Goal (MDG) process, but the global context and framing of the new agenda is substantially different, and health advocates cannot automatically assume the same prominence. This paper argues that to remain central to continuing negotiations and the future implementation, four strategic shifts are urgently required. Advocates need to reframe health from the poverty reduction focus of the MDGs to embrace the social sustainability paradigm that underpins the new goals. Second, health advocates need to speak--and listen--to the whole sustainable development agenda, and assert health in every theme and every relevant policy, something that is not yet happening in current thematic debates. Third, we need to construct goals that will be truly "universal", that will engage every nation--a significant re-orientation from the focus on low-income countries of the MDGs. And finally, health advocates need to overtly explore what global governance structures will be needed to finance and implement these universal Sustainable Development Goals.

How can health remain central post-2015 in a sustainable development paradigm?

PubMed Central

2014-01-01

In two years, the uncompleted tasks of the Millennium Development Goals will be merged with the agenda articulated in the 2012 United Nations Conference on Sustainable Development. This process will seek to integrate economic development (including the elimination of extreme poverty), social inclusion, environmental sustainability, and good governance into a combined sustainable development agenda. The first phase of consultation for the post-2015 Sustainable Development Goals reached completion in the May 2013 report to the Secretary-General of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda. Health did well out of the Millennium Development Goal (MDG) process, but the global context and framing of the new agenda is substantially different, and health advocates cannot automatically assume the same prominence. This paper argues that to remain central to continuing negotiations and the future implementation, four strategic shifts are urgently required. Advocates need to reframe health from the poverty reduction focus of the MDGs to embrace the social sustainability paradigm that underpins the new goals. Second, health advocates need to speak—and listen—to the whole sustainable development agenda, and assert health in every theme and every relevant policy, something that is not yet happening in current thematic debates. Third, we need to construct goals that will be truly “universal”, that will engage every nation—a significant re-orientation from the focus on low-income countries of the MDGs. And finally, health advocates need to overtly explore what global governance structures will be needed to finance and implement these universal Sustainable Development Goals. PMID:24708779

Water Quality and Sustainable Environmental Health

NASA Astrophysics Data System (ADS)

Setegn, S. G.

2014-12-01

Lack of adequate safe water, the pollution of the aquatic environment and the mismanagement of resources are major causes of ill-health and mortality, particularly in the developing countries. In order to accommodate more growth, sustainable fresh water resource management will need to be included in future development plans. One of the major environmental issues of concern to policy-makers is the increased vulnerability of ground water quality. The main challenge for the sustainability of water resources is the control of water pollution. To understand the sustainability of the water resources, one needs to understand the impact of future land use and climate changes on the natural resources. Providing safe water and basic sanitation to meet the Millennium Development Goals will require substantial economic resources, sustainable technological solutions and courageous political will. A balanced approach to water resources exploitation for development, on the one hand, and controls for the protection of health, on the other, is required if the benefits of both are to be realized without avoidable detrimental effects manifesting themselves. Meeting the millennium development goals for water and sanitation in the next decade will require substantial economic resources, sustainable technological solutions and courageous political will. In addition to providing "improved" water and "basic" sanitation services, we must ensure that these services provide: safe drinking water, adequate quantities of water for health, hygiene, agriculture and development and sustainable sanitation approaches to protect health and the environment.

Achieving Millennium Development Goals 4 and 5: a snapshot of life in rural India.

PubMed

Mullick, S S; Serle, E

2011-09-01

The case studies presented here illustrate the poignant reality of life for mothers and children in rural India. We highlight the challenges of achieving millennium development goals (MDGs) 4 and 5, by exploring the reasons behind maternal and childhood mortality using the three-delays model as a framework. Gender disparities, lack of empowerment of women, poor understanding of life-threatening illness, the inability to know when and where to seek help, security issues, deficiencies in understanding cultural perceptions, poorly equipped health facilities and a lack of skilled personnel are all highlighted. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Impact of the social agendas--Agenda 21 and Healthy Cities--upon Social Determinants of Health in Brazilian municipalities: measuring the effects of diffuse social policies through the dimensions of the Millennium Development Goals.

PubMed

do Nascimento, Paulo Roberto; Westphal, Marcia Faria; Moreira, Rafael da Silveira; Baltar, Valéria Troncoso; Moysés, Simone Tetu; Zioni, Fabiola; Minowa, Evelin

2014-01-01

In order to improve the quality of life and health of the population in recent years there have been several local social agendas, like Agenda 21 and Healthy Cities. To identify how social agendas are impacting on the living conditions and health in municipalities of the five regions of Brazil. Through an ecological longitudinal study, the social agendas' effects on the Social Determinants of Health were measured in 105 municipalities, using indicators related to the eight dimensions of the Millennium Development Goals (MDGs). Indicators were also calculated for other 175 non-exposed municipalities. Descriptive statistics were calculated for each group of municipalities at three different moments: in the year of the agenda implementation, then 3 and 6 years later. The models were adjusted by the method of GEE to assess the effects of the agendas, time and their interaction. Nonparametric analysis of variance was used for the ordinal data with repeated measures. Impacts of the agendas were detected for reduction of hunger and increase of universal access to education: 'percentage of children under one year with protein/caloric undernourishment' (interaction effect: p = 0.02) and 'Age-grade distortion in the 8th grade of fundamental education' (interaction effect: p < 0.001). The comparative discussion between model results and descriptive statistics recommends, at further research, extending the period of investigation, using compound indexes, improving the methodology for the apprehension of the impacts of the diffuse social policies for development, as well as using 'mixed methodologies', integrating quantitative and qualitative tools.

Cost effectiveness analysis of strategies for maternal and neonatal health in developing countries.

PubMed

Adam, Taghreed; Lim, Stephen S; Mehta, Sumi; Bhutta, Zulfiqar A; Fogstad, Helga; Mathai, Matthews; Zupan, Jelka; Darmstadt, Gary L

2005-11-12

To determine the costs and benefits of interventions for maternal and newborn health to assess the appropriateness of current strategies and guide future plans to attain the millennium development goals. Cost effectiveness analysis. Two regions classified by the World Health Organization according to their epidemiological grouping: Afr-E, those countries in sub-Saharan Africa with very high adult and high child mortality, and Sear-D, comprising countries in South East Asia with high adult and high child mortality. Effectiveness data from several sources, including trials, observational studies, and expert opinion. For resource inputs, quantities came from WHO guidelines, literature, and expert opinion, and prices from the WHO choosing interventions that are cost effective database. Cost per disability adjusted life year (DALY) averted in year 2000 international dollars. The most cost effective mix of interventions was similar in Afr-E and Sear-D. These were the community based newborn care package, followed by antenatal care (tetanus toxoid, screening for pre-eclampsia, screening and treatment of asymptomatic bacteriuria and syphilis); skilled attendance at birth, offering first level maternal and neonatal care around childbirth; and emergency obstetric and neonatal care around and after birth. Screening and treatment of maternal syphilis, community based management of neonatal pneumonia, and steroids given during the antenatal period were relatively less cost effective in Sear-D. Scaling up all of the included interventions to 95% coverage would halve neonatal and maternal deaths. Preventive interventions at the community level for newborn babies and at the primary care level for mothers and newborn babies are extremely cost effective, but the millennium development goals for maternal and child health will not be achieved without universal access to clinical services as well.

E-health in the new millennium: a research and practice agenda.

PubMed

Metaxiotis, Kostas; Ptochos, Dimitrios; Psarras, John

2004-01-01

Advances in telecommunications, automated processes, web technologies and wireless computing are already forcing dramatic changes in a variety of sectors, ranging from business and industry to education and health. Yet, the electronic business space, in a broader sense, is still in a relatively early state of evolution, and it is only recently that policy makers have started looking at the potential of applying the tools and techniques of e-commerce to the tasks of other sectors. The use of the internet as a source of health information and connectivity between healthcare providers and consumers has increased interest in e-health. E-health offers the rich potential of supplementing traditional delivery of services and channels of communication in ways that extend the healthcare organisation's ability to meet the needs of its patients. To date, some e-health applications have improved the quality of healthcare, and later they will lead to substantial cost savings. However, e-health is not simply a technology but a complex technological and relational process. In this sense, practitioners and researchers who want to successfully exploit e-health need to pay attention to various pending issues that have to be addressed. The aim of this paper is to propose a novel taxonomy for e-health research in the new millennium by instantaneously presenting the current status with some major themes of e-health research.

Health Research and Millennium Development Goals: Identifying the Gap From Public Health Perspective

PubMed Central

El Lawindi, Mona I.; Galal, Yasmine S.; Khairy, Walaa A.

2016-01-01

Assessing the research output within the universities could provide an effective means for tracking the Millennium Development Goals (MDGs) progress. This analytical database study was designed to assess the trend of research theses conducted by the Public Health Department (PHD), Faculty of Medicine, Cairo University during the period 1990 to 2014 as related to the: MDGS, Faculty and department research priority plans and to identify the discrepancies between researchers’ priorities versus national and international research priorities. A manual search of the theses was done at the Postgraduate Library using a specially designed checklist to chart adherence of each thesis to: MDGs, Faculty and department research plans (RPs). The theses’ profile showed that the highest research output was for addressing the MDGS followed by the PHD and Faculty RPs. Compliance to MDGs 5 and 6 was obvious, whereas; MDGs 2, 3, and 7 were not represented at all after year 2000. No significant difference was found between PH theses addressing the Faculty RPs and those which were not before and after 2010. A significantly lower percent of PH theses was fulfilling the PHD research priorities compared to those which were not after 2010. This study showed a definite decline in research output tackling the MDGS and PHD research priorities, with a non-significant increase in the production of theses addressing the Faculty RPs. The present study is a practical model for policy makers within the universities to develop and implement a reliable monitoring and evaluation system for assessment of research output. PMID:26652084

Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

PubMed Central

2011-01-01

Background The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. Methods This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Results Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. Conclusion The relationship between women's post-earthquake mental health and reproductive health, socio-economic status, and health care access is complex and explained largely by the socio-cultural role of women. It is suggested that interventions that consider gender differences and that are culturally appropriate are likely to reduce the incidence. PMID:21718519

Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience.

PubMed

Anwar, Jasim; Mpofu, Elias; Matthews, Lynda R; Shadoul, Ahmed Farah; Brock, Kaye E

2011-06-30

The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. The relationship between women's post-earthquake mental health and reproductive health, socio-economic status, and health care access is complex and explained largely by the socio-cultural role of women. It is suggested that interventions that consider gender differences and that are culturally appropriate are likely to reduce the incidence.

Why the MDGs need good governance in pharmaceutical systems to promote global health.

PubMed

Kohler, Jillian Clare; Mackey, Tim Ken; Ovtcharenko, Natalia

2014-01-21

Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key lessons learned from existing initiatives in good governance. As the development community begins to identify post-2015 Millennium Development Goals targets, it is essential to evaluate programs in good governance in order to build on these results and establish sustainable strategies. This discussion on the pharmaceutical system illuminates why. Considering pharmaceutical governance initiatives such as those launched by the World Bank, World Health Organization, and the Global Fund, we argue that country ownership of good governance initiatives is essential but also any initiative must include the participation of impartial stakeholders. Understanding the political context of any initiative is also vital so that potential obstacles are identified and the design of any initiative is flexible enough to make adjustments in programming as needed. Finally, the inherent challenge which all initiatives face is adequately measuring outcomes from any effort. However in fairness, determining the precise relationship between good governance and health outcomes is rarely straightforward. Challenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals. Specifically, these challenges need to be acknowledged and responded to with global cooperation and innovation to establish localized and evidence-based metrics for good governance to promote global pharmaceutical safety.

Why the MDGs need good governance in pharmaceutical systems to promote global health

PubMed Central

2014-01-01

Background Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key lessons learned from existing initiatives in good governance. As the development community begins to identify post-2015 Millennium Development Goals targets, it is essential to evaluate programs in good governance in order to build on these results and establish sustainable strategies. This discussion on the pharmaceutical system illuminates why. Discussion Considering pharmaceutical governance initiatives such as those launched by the World Bank, World Health Organization, and the Global Fund, we argue that country ownership of good governance initiatives is essential but also any initiative must include the participation of impartial stakeholders. Understanding the political context of any initiative is also vital so that potential obstacles are identified and the design of any initiative is flexible enough to make adjustments in programming as needed. Finally, the inherent challenge which all initiatives face is adequately measuring outcomes from any effort. However in fairness, determining the precise relationship between good governance and health outcomes is rarely straightforward. Summary Challenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals. Specifically, these challenges need to be acknowledged and responded to with global cooperation and innovation to establish localized and evidence-based metrics for good governance to promote global pharmaceutical safety. PMID:24447600

Millennium development goal four and child health inequities in indonesia: a systematic review of the literature.

PubMed

Schröders, Julia; Wall, Stig; Kusnanto, Hari; Ng, Nawi

2015-01-01

Millennium Development Goal (MDG) 4 calls for reducing mortality of children under-five years by two-thirds by 2015. Indonesia is on track to officially meet the MDG 4 targets by 2015 but progress has been far from universal. It has been argued that national level statistics, on which MDG 4 relies, obscure persistent health inequities within the country. Particularly inequities in child health are a major global public health challenge both for achieving MDG 4 in 2015 and beyond. This review aims to map out the situation of MDG 4 with respect to disadvantaged populations in Indonesia applying the Social Determinants of Health (SDH) framework. The specific objectives are to answer: Who are the disadvantaged populations? Where do they live? And why and how is the inequitable distribution of health explained in terms of the SDH framework? We retrieved studies through a systematic review of peer-reviewed and gray literature published in 1995-2014. The PRISMA-Equity 2012 statement was adapted to guide the methods of this review. The dependent variables were MDG 4-related indicators; the independent variable "disadvantaged populations" was defined by different categories of social differentiation using PROGRESS. Included texts were analyzed following the guidelines for deductive content analysis operationalized on the basis of the SDH framework. We identified 83 studies establishing evidence on more than 40 different determinants hindering an equitable distribution of child health in Indonesia. The most prominent determinants arise from the shortcomings within the rural health care system, the repercussions of food poverty coupled with low health literacy among parents, the impact of low household decision-making power of mothers, and the consequences of high persistent use of traditional birth attendants among ethnic minorities. This review calls for enhanced understanding of the determinants and pathways that create, detain, and overcome inequities in child health in resource constraint settings like Indonesia and the promotion of actionable health policy recommendations and tailored investments.

Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

PubMed

Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2018-05-01

There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for EIHSP.

Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study

PubMed Central

Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2018-01-01

Abstract There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for EIHSP. PMID:29506146

Millennium Development Goal Four and Child Health Inequities in Indonesia: A Systematic Review of the Literature

PubMed Central

Schröders, Julia; Wall, Stig; Kusnanto, Hari; Ng, Nawi

2015-01-01

Introduction Millennium Development Goal (MDG) 4 calls for reducing mortality of children under-five years by two-thirds by 2015. Indonesia is on track to officially meet the MDG 4 targets by 2015 but progress has been far from universal. It has been argued that national level statistics, on which MDG 4 relies, obscure persistent health inequities within the country. Particularly inequities in child health are a major global public health challenge both for achieving MDG 4 in 2015 and beyond. This review aims to map out the situation of MDG 4 with respect to disadvantaged populations in Indonesia applying the Social Determinants of Health (SDH) framework. The specific objectives are to answer: Who are the disadvantaged populations? Where do they live? And why and how is the inequitable distribution of health explained in terms of the SDH framework? Methods and Findings We retrieved studies through a systematic review of peer-reviewed and gray literature published in 1995-2014. The PRISMA-Equity 2012 statement was adapted to guide the methods of this review. The dependent variables were MDG 4-related indicators; the independent variable “disadvantaged populations” was defined by different categories of social differentiation using PROGRESS. Included texts were analyzed following the guidelines for deductive content analysis operationalized on the basis of the SDH framework. We identified 83 studies establishing evidence on more than 40 different determinants hindering an equitable distribution of child health in Indonesia. The most prominent determinants arise from the shortcomings within the rural health care system, the repercussions of food poverty coupled with low health literacy among parents, the impact of low household decision-making power of mothers, and the consequences of high persistent use of traditional birth attendants among ethnic minorities. Conclusion This review calls for enhanced understanding of the determinants and pathways that create, detain, and overcome inequities in child health in resource constraint settings like Indonesia and the promotion of actionable health policy recommendations and tailored investments. PMID:25942491

Millennium Development Goals: how public health professionals perceive the achievement of MDGs.

PubMed

Lomazzi, Marta; Laaser, Ulrich; Theisling, Mareike; Tapia, Leticia; Borisch, Bettina

2014-01-01

There have been various consultations on the Millennium Development Goals (MDGs) by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts' points of view and these are mainly government driven. The World Federation of Public Health Associations (WFPHA) has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs. The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention. Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework.

Using Social Networking to Understand Social Networks: Analysis of a Mobile Phone Closed User Group Used by a Ghanaian Health Team

PubMed Central

Akosah, Eric; Ohemeng-Dapaah, Seth; Sakyi Baah, Joseph; Kanter, Andrew S

2013-01-01

Background The network structure of an organization influences how well or poorly an organization communicates and manages its resources. In the Millennium Villages Project site in Bonsaaso, Ghana, a mobile phone closed user group has been introduced for use by the Bonsaaso Millennium Villages Project Health Team and other key individuals. No assessment on the benefits or barriers of the use of the closed user group had been carried out. Objective The purpose of this research was to make the case for the use of social network analysis methods to be applied in health systems research—specifically related to mobile health. Methods This study used mobile phone voice records of, conducted interviews with, and reviewed call journals kept by a mobile phone closed user group consisting of the Bonsaaso Millennium Villages Project Health Team. Social network analysis methodology complemented by a qualitative component was used. Monthly voice data of the closed user group from Airtel Bharti Ghana were analyzed using UCINET and visual depictions of the network were created using NetDraw. Interviews and call journals kept by informants were analyzed using NVivo. Results The methodology was successful in helping identify effective organizational structure. Members of the Health Management Team were the more central players in the network, rather than the Community Health Nurses (who might have been expected to be central). Conclusions Social network analysis methodology can be used to determine the most productive structure for an organization or team, identify gaps in communication, identify key actors with greatest influence, and more. In conclusion, this methodology can be a useful analytical tool, especially in the context of mobile health, health services, and operational and managerial research. PMID:23552721

Using social networking to understand social networks: analysis of a mobile phone closed user group used by a Ghanaian health team.

PubMed

Kaonga, Nadi Nina; Labrique, Alain; Mechael, Patricia; Akosah, Eric; Ohemeng-Dapaah, Seth; Sakyi Baah, Joseph; Kodie, Richmond; Kanter, Andrew S; Levine, Orin

2013-04-03

The network structure of an organization influences how well or poorly an organization communicates and manages its resources. In the Millennium Villages Project site in Bonsaaso, Ghana, a mobile phone closed user group has been introduced for use by the Bonsaaso Millennium Villages Project Health Team and other key individuals. No assessment on the benefits or barriers of the use of the closed user group had been carried out. The purpose of this research was to make the case for the use of social network analysis methods to be applied in health systems research--specifically related to mobile health. This study used mobile phone voice records of, conducted interviews with, and reviewed call journals kept by a mobile phone closed user group consisting of the Bonsaaso Millennium Villages Project Health Team. Social network analysis methodology complemented by a qualitative component was used. Monthly voice data of the closed user group from Airtel Bharti Ghana were analyzed using UCINET and visual depictions of the network were created using NetDraw. Interviews and call journals kept by informants were analyzed using NVivo. The methodology was successful in helping identify effective organizational structure. Members of the Health Management Team were the more central players in the network, rather than the Community Health Nurses (who might have been expected to be central). Social network analysis methodology can be used to determine the most productive structure for an organization or team, identify gaps in communication, identify key actors with greatest influence, and more. In conclusion, this methodology can be a useful analytical tool, especially in the context of mobile health, health services, and operational and managerial research.

Poverty reduction and Millennium Development Goals: recognizing population, health, and environment linkages in rural Madagascar.

PubMed

Gaffikin, Lynne; Ashley, Jeffrey; Blumenthal, Paul D

2007-10-23

The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty. Madagascar is one such example, although some gains are being made. Attempts of this island nation to achieve its MDGs, expressed most recently in the form of a Madagascar Action Plan, are notable in their emphasis on (1) conserving the country's natural resource base, (2) the effect of demographic trends on development, and (3) the importance of health as a prerequisite for development. Leadership in the country's struggle for economic growth comes from the president of the Republic, in part, through his "Madagascar Naturally" vision as well as his commitment to universal access to family planning, among other health and development interventions. However, for resource-limited countries, such as Madagascar, to get or stay "on track" to achieving the MDGs will require support from many sides. "Madagascar cannot do it alone and should not do it alone." This position is inherent in the eighth MDG: "Develop a global partnership for development." Apparently, it takes a village after all - a global one.

Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

PubMed

Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

2015-04-29

The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

The Millennium Cohort: A 21-Year Contribution to the Understanding of Military and Veterans’ Health

DTIC Science & Technology

2009-12-10

syndrome (15 items) • Other anxiety syndrome (6 items) • Eating disorders (4 items; binge and bulimia nervosa) Has your doctor or other health...The Millennium Cohort: a 21-Year Contribution to the Understanding of Military and Veterans’ Health Second Annual Trauma Stress Disorders ...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at The Second Annual Trauma Spectrum Disorders

Staff-related access deficit and antenatal care coverage across the NUTS level 1 regions of Turkey.

PubMed

Yardim, Mahmut S

2010-01-01

At the heart of each health system, the workforce is central to advancing health. The World Health Organization has identified a threshold in workforce density below which high coverage of essential interventions, including those necessary to meet the health-related Millennium Development Goals (MDGs), is very unlikely. The International Labor Organization (ILO) has launched a similar indicator -staff related access deficit- using Thailand's health care professional density as a benchmark. The aim of this study is to assess the staff-related access deficit of the population across the 12 NUTS 1 level regions of Turkey. The main hypothesis is that staff-related access deficit has a correlation with and predicts the gap in antenatal care coverage (percentage of women unable to access to antenatal care) across different regions. Staff-related access deficit, as a threshold indicator, seems to have a linear relationship with the antenatal care coverage gap. The known inequalities in the distribution of the health care workforce among different regions of Turkey were put forward once more in this study using the SRA indicator. The staff-related access deficit indicator can be easily used to monitor the status of distributional inequalities of the health care workforce at different sub-national levels in the future.

Innovative Approaches to Funding the Millennium Development Goals. OECD Development Centre Policy Brief, No. 24

ERIC Educational Resources Information Center

Reisen, Helmut

2004-01-01

At the United Nations Millennium Summit in September 2000, world leaders adopted the Millennium Development Goals (MDGs), which set targets for reducing poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women by 20151. The need for additional development funding, if the MDGs are to be achieved by 2015, is…

Call for neonatal nursing specialization in developing countries.

PubMed

Premji, Shahirose S; Spence, Kaye; Kenner, Carole

2013-01-01

In an attempt to reach Millennium Development Goals, health facility births, which are births occurring in health centers, facilities, or institutions under the care of a skilled birth attendant, are increasing in developing countries. We examined the state of neonatal nursing care in the context of issues related to the capacity of these health facilities to provide quality care and the high facility mortality rates in those neonates admitted to hospital. Neonatal nursing as a specialty within a community-hospital-community network system is proposed as an effective scaling-up strategy to improve neonatal survival. Establishment of international competency standards for neonatal nursing together with regulatory processes with mechanisms to facilitate specialty education forms the basis for the specialty of neonatal nursing. We have identified a strategy to mobilize financial resources for the development of the specialty of neonatal nursing. Evaluation of trends in mortality and identification of process indicators will facilitate examination of the effectiveness of the introduction of the specialty of neonatal nursing as a scaling-up strategy.

Millennium Development Goals 4 and 5: Past and future progress.

PubMed

Gaffey, Michelle F; Das, Jai K; Bhutta, Zulfiqar A

2015-10-01

We review global and regional progress towards Millennium Development Goals (MDGs) 4 and 5 with respect to their indicators, drawing on the latest data available from the relevant United Nations inter-agency groups responsible for maternal and child mortality estimation, as well as recent reports from individual UN agencies and external monitoring groups reporting on MDG progress. We also draw on recent, comprehensive evidence syntheses to present an overview of a selection of existing effective interventions that, if collectively implemented at scale, would reduce maternal and child deaths well beyond the MDG target levels. We conclude with a summary of why and how a focus on maternal and child health in the post-2015 era should be maintained, as the global development agenda transitions from the MDGs to the Sustainable Development Goals. Copyright © 2015. Published by Elsevier Ltd.

Addressing maternal and child health in post-conflict Afghanistan: the way forward.

PubMed

Singh, P K; Rai, R K; Alagarajan, M

2013-09-01

Afghanistan's maternal and child mortality rates are among the highest in the world. The country faces challenges to meet the Millennium Development Goals set for 2015 which can be attributed to multiple causes related to accessibility, affordability and availability of health-care services. This report addresses the challenges in strengthening maternal and child health care in Afghanistan, as well discussing the areas to be prioritized. In order to ensure sound maternal and child health care in Afghanistan, policy-makers must prioritize monitoring and surveillance systems, integrating maternal and child health care with rights-based family planning methods, building human resources, offering incentives (such as the provision of a conditional cash transfer to women) and promoting action-oriented, community-based interventions. On a wider scale, the focus must be to improve the health infrastructure, organizing international collaboration and expanding sources of funding.

Buying results? Contracting for health service delivery in developing countries.

PubMed

Loevinsohn, Benjamin; Harding, April

To achieve the health-related Millennium Development Goals, the delivery of health services will need to improve. Contracting with non-state entities, including non-governmental organisations (NGOs), has been proposed as a means for improving health care delivery, and the global experience with such contracts is reviewed here. The ten investigated examples indicate that contracting for the delivery of primary care can be very effective and that improvements can be rapid. These results were achieved in various settings and services. Many of the anticipated difficulties with contracting were either not observed in practice or did not compromise contracting's effectiveness. Seven of the nine cases with sufficient experience (greater than 3 years' elapsed experience) have been sustained and expanded. Provision of a package of basic services by contractors costs between roughly US3 dollars and US6 dollars per head per year in low-income countries. Contracting for health service delivery should be expanded and future efforts must include rigorous evaluations.

Ranking 93 health interventions for low- and middle-income countries by cost-effectiveness

PubMed Central

Gelband, Hellen; Jamison, Dean; Levin, Carol; Nugent, Rachel; Watkins, David

2017-01-01

Background Cost-effectiveness rankings of health interventions are useful inputs for national healthcare planning and budgeting. Previous comprehensive rankings for low- and middle- income countries were undertaken in 2005 and 2006, accompanying the development of strategies for the Millennium Development Goals. We update the rankings using studies published since 2000, as strategies are being considered for the Sustainable Development Goals. Methods Expert systematic searches of the literature were undertaken for a broad range of health interventions. Cost-effectiveness results using Disability Adjusted Life-Years (DALYs) as the health outcome were standardized to 2012 US dollars. Results 149 individual studies of 93 interventions qualified for inclusion. Interventions for Reproductive, Maternal, Newborn and Child Health accounted for 37% of interventions, and major infectious diseases (AIDS, TB, malaria and neglected tropical diseases) for 24%, consistent with the priorities of the Millennium Development Goals. More than half of the interventions considered cost less than $200 per DALY and hence can be considered for inclusion in Universal Health Care packages even in low-income countries. Discussion Important changes have occurred in rankings since 2006. Priorities have changed as a result of new technologies, new methods for changing behavior, and significant price changes for some vaccines and drugs. Achieving the Sustainable Development Goals will require LMICs to study a broader range of health interventions, particularly in adult health. Some interventions are no longer studied, in some cases because they have become usual care, in other cases because they are no longer relevant. Updating cost-effectiveness rankings on a regular basis is potentially a valuable exercise. PMID:28797115

Have health inequalities changed during childhood in the New Labour generation? Findings from the UK Millennium Cohort Study.

PubMed

Rougeaux, Emeline; Hope, Steven; Law, Catherine; Pearce, Anna

2017-01-11

To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government). The UK. Singleton children in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) years. Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from 'no academic qualifications' to 'degree' (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED). Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers). Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs influence health may further our understanding of how inequalities could be prevented in future generations of children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Have health inequalities changed during childhood in the New Labour generation? Findings from the UK Millennium Cohort Study

PubMed Central

Rougeaux, Emeline; Hope, Steven; Law, Catherine; Pearce, Anna

2017-01-01

Objectives To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government). Setting The UK. Participants Singleton children in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) years. Primary outcomes Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from ‘no academic qualifications’ to ‘degree’ (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED). Results Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers). Conclusions Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs influence health may further our understanding of how inequalities could be prevented in future generations of children. PMID:28077409

An index for quantifying female education and child health in emerging economies.

PubMed

Rodríguez Martín, José Antonio; Holgado Molina, María del Mar; Salinas Fernández, José Antonio

2015-02-01

To construct an index to measure female education and child health in the least developed countries (LDCs) of Asia. The design of our index includes the variables of female education and child health defined in the goals of the Millennium Declaration. For this purpose, we used Pena's P2 distance method for 2011, the last year for which data were available for the set of variables. We have proposed a territorial measure and classification of female education and child health in the LDCs of Asia. We believe that the most striking differences between countries relate to basic female education variables such as girls' primary completion rate, and female literacy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study

DTIC Science & Technology

2016-11-15

participants who were followed for the development of back pain for an average of 3.9 years. Methods. Descriptive statistics and longitudinal...health, military personnel, occupational health, outcome assessment, statistics, survey methodology . Level of Evidence: 3 Spine 2016;41:1754–1763ack...based on the National Health and Nutrition Examination Survey.21 Statistical Analysis Descriptive and univariate analyses compared character- istics

Examination of Post-Service Health-Related Quality of Life Among Rural and Urban Military Members of The Millennium Cohort Study

DTIC Science & Technology

2011-01-01

into the 2-tier rural and urban categories, which may have allowed for some misclassification of individual participant rural/urban status ( Berke et al...1994. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). Washington, DC: American Psychiatric Association. Berke , Ethan M...E. Kazis, Yujing Shen, Zhongxiao Cong, Xinhua S. Ren, Donald R. Miller, Austin Lee, and Jonathan B. Perlin. 2004. “Differences in Health-related

Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study.

PubMed

Mutale, Wilbroad; Bond, Virginia; Mwanamwenge, Margaret Tembo; Mlewa, Susan; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-08-01

The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambia's MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity to hold health workers accountable for the drugs and services. The study has shown that building block specific weaknesses had cross cutting effect in other health system building blocks. These linkages emphasised the need to use system wide approaches in assessing the performance of health system strengthening interventions.

Millennium Development Goals: how public health professionals perceive the achievement of MDGs

PubMed Central

Lomazzi, Marta; Laaser, Ulrich; Theisling, Mareike; Tapia, Leticia; Borisch, Bettina

2014-01-01

Background There have been various consultations on the Millennium Development Goals (MDGs) by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts’ points of view and these are mainly government driven. Designs The World Federation of Public Health Associations (WFPHA) has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs. The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Results Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention. Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. Conclusion The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework. PMID:25249060

Audacious goals for health and biomedical informatics in the new millennium.

PubMed

Greenes, R A; Lorenzi, N M

1998-01-01

The 1998 Scientific Symposium of the American College of Medical Informatics (ACMI) was devoted to developing visions for the future of health care and biomedicine and a strategic agenda for health and biomedical informatics in support of those visions. This symposium focus was prompted by the many major changes currently underway in health care delivery, education, and research, as well as in our health and biomedical enterprises, and by the constantly increasing role of information technology in both shaping and enabling these changes. The three audacious goals developed for 2008 are a virtual health care databank, a national health care knowledge base, and a personal clinical health record.

Preeclampsia in low and middle income countries-health services lessons learned from the PRE-EMPT (PRE-Eclampsia-Eclampsia Monitoring, Prevention and Treatment) project.

PubMed

von Dadelszen, Peter; Firoz, Tabassum; Donnay, France; Gordon, Rebecca; Justus Hofmeyr, G; Lalani, Shifana; Payne, Beth A; Roberts, James M; Teela, Katherine C; Vidler, Marianne; Sawchuck, Diane; Magee, Laura A

2012-10-01

The hypertensive disorders of pregnancy, in particular preeclampsia, matter because adverse events occur in women with preeclampsia and, to a lesser extent, in women with the other hypertensive disorders. These adverse events are maternal, perinatal, and neonatal and can alter the life trajectory of each individual, should that life not be ended by complications. In this review we discuss a number of priorities and dilemmas that we perceive to be facing health services in low and middle income countries as they try to prioritize interventions to reduce the health burden related to preeclampsia. These priorities and dilemmas relate to calcium for preeclampsia prevention, risk stratification, antihypertensive and magnesium sulphate therapy, and mobile health. Significant progress has been and is being made to reduce the impact of preeclampsia in low and middle income countries, but it remains a priority focus as we attempt to achieve Millennium Development Goal 5.

India at the crossroads of millennium development goals 4 and 5.

PubMed

Hazarika, Indrajit

2012-05-01

The current year marks the completion of two thirds of the period between the adoption of the millennium development goals (MDGs) and the target date of 2015. Although there has been some progress, it is incontestable that much more needs to be done. India contributes to 20% of births worldwide and has the highest proportion of children younger than 5 years. Global progress toward MDG 4 and 5 depends significantly on improvements in maternal and child health indicators in India. Although it has been reported that the country has made substantial progress, the pace has been slow and marred by vast regional variability. Certain states continue to have unacceptably high mortality and morbidity rates. This article provides a context to the current status of maternal and child health in India, highlights the achievements, and uses the available data effectively to emphasize the progress. The authors acknowledge the new initiatives and make recommendations for reinforcing the continuum of care.

The Contributions of Onchocerciasis Control and Elimination Programs toward the Achievement of the Millennium Development Goals

PubMed Central

Dunn, Caitlin; Callahan, Kelly; Katabarwa, Moses; Richards, Frank; Hopkins, Donald; Withers, P. Craig; Buyon, Lucas E.; McFarland, Deborah

2015-01-01

In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the “big three” diseases—namely HIV, tuberculosis (TB), and malaria—has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda. PMID:25996946

The Contributions of Onchocerciasis Control and Elimination Programs toward the Achievement of the Millennium Development Goals.

PubMed

Dunn, Caitlin; Callahan, Kelly; Katabarwa, Moses; Richards, Frank; Hopkins, Donald; Withers, P Craig; Buyon, Lucas E; McFarland, Deborah

2015-05-01

In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the "big three" diseases--namely HIV, tuberculosis (TB), and malaria--has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda.

Did the Millennium Development Goals Change Trends in Child Mortality?

PubMed

French, Declan

2016-10-01

There has been little assessment of the role the Millennium Development Goals (MDGs) have had in progressing international development. There has been a 41% reduction in the under-five mortality rate worldwide from 1990 to 2011 and an acceleration in the rate of reduction since 2000. This paper explores why this has occurred, and results for all developing countries indicate that it is not due to more healthcare or public health interventions but is driven by a coincidental burst of economic growth. Although the MDGs are considered to have played an important part in securing progress against poverty, hunger and disease, there is very little evidence to back this viewpoint up. A thorough analysis of the successes and failures of the MDGs is therefore necessary before embarking on a new round of global goals. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Household water treatment and the millennium development goals: keeping the focus on health.

PubMed

Clasen, Thomas F

2010-10-01

Waterborne diseases such as diarrhea are a major killer in low-income settings, particularly of young children. For those without access to safe drinking water, household water treatment, such as boiling, chlorinating, and filtering water in the home, when combined with safe storage (HWTS) can significantly improve water quality and prevent disease, thereby contributing to the child survival and other health priorities encompassed within the Millennium Development Goals (MDGs). There is uncertainly, however, about whether HWTS should count toward the MDG water target, which promotes "sustainable access to safe drinking water". This paper reviews the relevant research and concludes that it should not. Although HWTS can significantly improve water quality, it does not improve water quantity and access-key aspects of the MDG water target that are essential for optimal improvements in health and development. A policy that excludes HWTS from the MDG water target will discourage governments from diverting scarce public resources from comprehensive and long-term improvements in water supplies. At the same time, the health-oriented MDGs provide a sufficient case for scaling up effective and appropriate HWTS among target populations. Moreover, a health-based strategy for HWTS will help ensure that promotion of the intervention is driven by measurable improvements in outcomes rather than inputs, thus encouraging advances in both hardware and programmatic delivery that will make HWTS more effective, appropriate, and accessible to vulnerable populations.

The U.S. Department of Defense Millennium Cohort Study: Career Span and Beyond Longitudinal Follow-Up

DTIC Science & Technology

2009-10-01

PHQ*) Caffeine and fast food intake (2 questions) Strength and duration of physical activity (1 question with 3 items; NHIS *) Daily physical activity...Complementary and Alternative Medicine; NHIS , National Health Interview Survey; NHANES, National Health and Nutrition Examination Survey; SF36-V, Short...USAMRMC) Military Operational Medicine Research Pro- gram (MOMRP). The Millennium Cohort Study requires considerable financial and logistical support that

Critical Issues around the Millennium Development Goals and Education

ERIC Educational Resources Information Center

Archer, David

2005-01-01

At the UN Millennium Assembly in 2000 global leaders committed themselves to eight Millennium Development Goals (MDGs). Seven of these goals were set for achievement in 2015, including the achievement of universal primary education. Only one goal was set for 2005: the achievement of gender parity in primary and secondary education. There was good…

Millennium Development Goals progress: a perspective from sub-Saharan Africa

PubMed Central

English, Mike; English, Rex; English, Atti

2015-01-01

Sub-Saharan Africa is a highly diverse geo-political region. Any brief discussion of the progress made over the last 15 years towards the Millennium Development Goals (MDGs) will therefore not do justice to the true complexity of context and events. Our focus will be MDG4—to reduce child mortality by 66% from 1990 levels. We will touch briefly on MDG1, to eradicate extreme poverty and hunger, MDG2, to achieve universal primary education, and MDG5, to improve maternal health, which are inextricably linked with child well-being. We will also draw on an eclectic mix of additional global indicators. Acknowledging the limitations of this approach, we first offer a summary of expected progress and then point to debates on future goals. PMID:25613971

Addressing the migration of health professionals: the role of working conditions and educational placements.

PubMed

Witt, Julia

2009-11-18

This article provides a brief overview of the global health-worker shortage, which could undermine the Millennium Development Goal to halt and begin to reverse the spread of HIV/AIDS. The current situation suggests that long-term solutions to shortages can only be found by addressing the problem from a global perspective; that is, to eliminate shortages through substantial investments in training and retaining health workers in developed and developing countries, and not through policies that do not work towards solving this underlying problem, such as ones that restrict migration.

Evaluation of Millennium Development Goals in Reduction of Maternal and Child Mortality in Narok County, Kenya

ERIC Educational Resources Information Center

Koini, Stellah Malaso

2017-01-01

Background: Millennium Development Goals are the 21st Century worlds' concern to improve human way of life by 2015. In Kenya the Millennium Development Goals for reduction of maternal and child mortality has been recently powered by the beyond zero initiative which started in the year 2014 with the aim of reducing mortality as well as contributing…

Health Impact of US Military Service in a Large Population-Based Military Cohort: Findings of the Millennium Cohort Study, 2001-2008

DTIC Science & Technology

2011-01-01

427. 26. Smith TC, Wingard DL, Ryan MA, Kritz- Silverstein D, Slymen DJ, Sallis JF, for the Millennium Cohort Study Team: Prior assault and... Silverstein D, for the Millennium Cohort Study Team: New onset and persistent symptoms of post- traumatic stress disorder self reported after deployment...deployed to the 2003 Iraq war: a cohort study. Lancet 2006, 367(9524):1731-1741. 41. Smith TC, Wingard DL, Ryan MAK, Kritz- Silverstein D, Slymen DJ, Sallis

Why food in health security (FIHS)?

PubMed

Wahlqvist, Mark L

2009-01-01

Health is intrinsic to human security (HumS) although it is somewhat anthropocentric and about our own psychosocial and biomedical status more than various external threats. The 1994 United Nations Development Program definition of HumS includes economic, food, environmental, personal, community and political security with freedom from fear and want. Environmental factors are critical for health security (HealS), especially with widespread socio-economic difficulty, and health systems less affordable or accessible. The nexus between nutritionally-related disorders and infectious disease is the most pervasive world health problem. Most if not all of the Millennium Development Goals are food-linked. Maternal nutrition has life-long health effects on the yet-to-be born child. The mix of essential nutrient deprivation and energy imbalance is rife across many societies. Food systems require deeper understanding and governance to overcome these food-related health risks which are matters of food security (FoodS). Nutritionally-related Disability Adjusted Life Years (DALYS) are improving markedly in many parts of the world, along with poverty and hunger reduction and health system advances. But recent economic, energy, food, water, climate change and health crises along with conflict are limiting. It is time for international and regional understanding of how households and communities can collectively manage these threats in affordable and sustainable ways. There is untapped problem-solving capacity at the international local level if supported by combined food--health systems expertise, innovation, infrastructure and governance. Principles of equity and ethics must apply. The Food in Health Security (FIHS) roundtable aims to develop a Network to facilitate this process.

Empowering the Girl Child, Improving Global Health.

PubMed

Cesario, Sandra K; Moran, Barbara

The health and productivity of a global society is dependent upon the elimination of gender inequities that prevent girls from achieving their full potential. Although some progress has been made in reducing social, economic, and health disparities between men and women, gender equality continues to be an elusive goal. The Millennium Development Goals (2000-2015) and the Sustainable Development Goals (2015-2030) include intergovernmental aspirations to empower women and stress that change must begin with the girl child. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Health worker shortages in Zambia: an assessment of government responses.

PubMed

Gow, Jeff; George, Gavin; Mutinta, Given; Mwamba, Sylvia; Ingombe, Lutungu

2011-11-01

A dire health worker shortage in Zambia's national health programs is adversely impacting the quantity and quality of health care and posing a serious barrier to achieving Millennium Development Goals to improve population health. In 2005, Zambia's Ministry of Health developed a 10-year strategic plan for human resources for health to address the crisis through improved training, hiring, and retention. The plan has neither arrested nor reduced the shortage. We review the causes of the shortage, present results from a health worker survey showing that safe work conditions, manageable workloads, and career advancement opportunities matter more to respondents than financial compensation. We comment on the adequacy of government efforts to address the health worker shortage.

The Impact of School Quality, Socioeconomic Factors, and Child Health on Students' Academic Performance: Evidence from Sri Lankan Primary Schools

ERIC Educational Resources Information Center

Aturupane, Harsha; Glewwe, Paul; Wisniewski, Suzanne

2013-01-01

One of the eight Millennium Development Goals is that all children in developing countries should complete primary education. Much progress has been made toward this goal, but completing primary school does not ensure that students attain basic literacy and numeracy skills. Indeed, there is ample evidence that many children in developing countries…

International health policy and stagnating maternal mortality: is there a causal link?

PubMed

Unger, Jean-Pierre; Van Dessel, Patrick; Sen, Kasturi; De Paepe, Pierre

2009-05-01

This paper examines why progress towards Millennium Development Goal 5 on maternal health appears to have stagnated in much of the global south. We contend that besides the widely recognised existence of weak health systems, including weak services, low staffing levels, managerial weaknesses, and lack of infrastructure and information, this stagnation relates to the inability of most countries to meet two essential conditions: to develop access to publicly funded, comprehensive health care, and to provide the not-for-profit sector with needed political, technical and financial support. This paper offers a critical perspective on the past 15 years of international health policies as a possible cofactor of high maternal mortality, because of their emphasis on disease control in public health services at the expense of access to comprehensive health care, and failures of contracting out and public-private partnerships in health care. Health care delivery cannot be an issue both of trade and of right. Without policies to make health systems in the global south more publicly-oriented and accountable, the current standards of maternal and child health care are likely to remain poor, and maternal deaths will continue to affect women and their families at an intolerably high level.

Emerging Infectious Diseases, Antimicrobial Resistance and Millennium Development Goals: Resolving the Challenges through One Health.

PubMed

Asokan, G V; Kasimanickam, R K

2013-01-01

Most emerging infectious diseases are zoonoses, which could severely hamper reaching the targets of millennium development goals (MDG). Five out of the total eight MDG's are strongly associated with the Emerging Infectious Diseases (EIDs). Recent emergence and dissemination of drug-resistant pathogens has accelerated and prevent reaching the targets of MDG, with shrinking of therapeutic arsenal, mostly due to antimicrobial resistance (AMR). World Health Organization (WHO has identified AMR as 1 of the 3 greatest threats to global health. Until now, methicillin-resistant staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) have been observed in hospital-acquired infections. In India, within a span of three years, New Delhi metallo-β-lactamase prevalence has risen from three percent in hospitals to twenty- fifty percent and is found to be colistin resistant as well. Routine use of antimicrobials in animal husbandry accounts for more than 50% in tonnage of all antimicrobial production to promote growth and prophylaxis. This has consequences to human health and environmental contamination with a profound impact on the environmental microbiome, resulting in resistance. Antibiotic development is now considered a global health crisis. The average time required to receive regulatory approval is 7.2 years. Moreover, the clinical approval success is only 16%. To overcome resistance in antimicrobials, intersectoral partnerships among medical, veterinary, and environmental disciplines, with specific epidemiological, diagnostic, and therapeutic approaches are needed. Joint efforts under "One Health", beyond individual professional boundaries are required to stop antimicrobial resistance against zoonoses (EID) and reach the MDG.

Sexual and reproductive health and rights in the evolving post-2015 agenda: perspectives from key players from multilateral and related agencies in 2013.

PubMed

Brolan, Claire E; Hill, Peter S

2014-05-01

This paper reports the views of participants from key multilaterals and related agencies in the evolving global negotiations on the post-2015 development agenda on the strategic location of sexual and reproductive health and rights. The research was carried out in June and July 2013, following the release of the report of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, and comprised 40 semi-structured interviews with 57 participants and two e-mail respondents. All respondents were responsible for the post-2015 health and development agenda, or the post-2015 agenda more broadly, within their organisations. The interviews provide an insight into the intention to ensure that sexual and reproductive health and rights are integrated into the post-2015 trajectory by key players who sit at the interface of UN and Member State interaction. They reveal both an awareness of the shortcomings of the Millennium Development Goal process and its impact on advocacy for sexual and reproductive health and rights in early post-2015 engagement, as well as the vulnerability of sexual and reproductive health and rights in the remaining phases of post-2015 negotiations. Recent events bear these concerns out. Ensuring sexual and reproductive health and rights are included in the final post-2015 outcome document in the time remaining for negotiations, will be anything but a "doddle". Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Integrating medical, assistive, and universally designed products and technologies: assistive technology device classification (ATDC).

PubMed

Bauer, Stephen; Elsaesser, Linda-Jeanne

2012-09-01

ISO26000:2010 International Guidance Standard on Organizational Social Responsibility requires that effective organizational performance recognize social responsibility, including the rights of persons with disabilities (PWD), engage stakeholders and contribute to sustainable development. Millennium Development Goals 2010 notes that the most vulnerable people require special attention, while the World Report on Disability 2011 identifies improved data collection and removal of barriers to rehabilitation as the means to empower PWD. The Assistive Technology Device Classification (ATDC), Assistive Technology Service Method (ATSM) and Matching Person and Technology models provide an evidence-based, standardized, internationally comparable framework to improve data collection and rehabilitation interventions. The ATDC and ATSM encompass and support universal design (UD) principles, and use the language and concepts of the International Classification of Functioning, Disability and Health (ICF). Use ATDC and ICF concepts to differentiate medical, assistive and UD products and technology; relate technology "types" to markets and costs; and support provision of UD products and technologies as sustainable and socially responsible behavior. Supply-side and demand-side incentives are suggested to foster private sector development and commercialization of UD products and technologies. Health and health-related professionals should be knowledgeable of UD principles and interventions.

Reducing maternal mortality in Yemen: challenges and lessons learned from baseline assessment.

PubMed

Al Serouri, Abdul Wahed; Al Rabee, Arwa; Bin Afif, Mohammed; Al Rukeimi, Abdullah

2009-04-01

The Yemen is a signatory of the Millennium Development Goals (MDGs) and one of 10 countries chosen for the UN Millennium Project. However, recent MDG progress reviews show that it is unlikely that the maternal health goal will be reached by 2015 and Yemen still has an unacceptably high maternal mortality of 365 per 100000 live births. Because 82% of deaths happen intrapartum, the purpose of this needs assessment was to identify and prioritize constraints in delivery of emergency obstetric care (EmOC). Four district hospitals and 16 health centers in 8 districts were assessed for functional capacity in terms of infrastructure; availability of essential equipment and drugs; EmOC technical competency and training needs; and Health Management Information System. We found poor obstetric services in terms of structure (staffing pattern, equipment, and supplies) and process (knowledge and management skills). The data argue for strengthening the 4 interlinked health system elements-human resources, and access to, use, and quality of services. The Government must address each of these elements to meet the Safe Motherhood MDG.

The role of APACPH (Asia-Pacific Academic Consortium for Public Health) in addressing public health issues in the Asia-Pacific region.

PubMed

Liveris, M

2000-01-01

The paper covers the establishment of APACPH in 1984 and its subsequent development and achievements. The paper outlines the mission and objectives of the Consortium and brief comparisons are drawn with similar organizations in the European and North American regions. Significant achievements of the Consortium and its contribution to the public health debate are presented. The paper then explores strategies for the future in meeting the challenges of emerging public health issues through collaborative efforts in education, training, research and leadership development in public health in the first century of a new millennium.

Women Empowerment and Its Relation with Health Seeking Behavior in Bangladesh

PubMed Central

Mainuddin, AKM; Ara Begum, Housne; Rawal, Lal B.; Islam, Anwar; Shariful Islam, SM

2015-01-01

Objective: Over the last few decades, Bangladesh has made significant progress towards achieving targets for the Millennium Development Goals (MDGs) and women empowerment. This study is aimed at identifying the levels and patterns of women empowerment in relation to health seeking behavior in Bangladesh. Materials and methods: We conducted a cross-sectional study among 200 rural married women in Cox’s Bazar district in Bangladesh using multi stage sampling technique and face-to-face interview. Data was collected on socio-economic characteristics, proxy indicators for women empowerment in mobility and health seeking behavior related decision making. Bivariate and multivariate regression analyses were performed to identify associations between women empowerment in relation to health seeking behavior on mobility and decision making, controlling the effect of other independent variables. Results: The results showed that only 12% women were empowered to decide on their own about seeking healthcare and 8.5% in healthcare seeking for their children. In multivariate analysis women empowerment in health seeking behavior was higher among age group 25-34 years (OR 1.76, [CI = 0.82-3.21]), women’s education, husband’s education, age at marriage > 18 years (OR 6.38, [CI = 0.98-4.21]) and women’s working status (OR 16.44, [CI = 0.79-2.71]). Conclusion: Women empowerment enhances their decision-making authority regarding health seeking behavior. Acknowledging and adopting the implications of these findings are essential for an integrated health and development strategy for Bangladesh and achieving the MDGs. PMID:26175761

Toward a global agenda for research in environmental epidemiology.

PubMed

Soskolne, Colin L; Butler, Colin D; Ijsselmuiden, Carel; London, Leslie; von Schirnding, Yasmin

2007-01-01

The global environment is in critical decline. Whether one's concern about environmental epidemiology stems from the perspectives of environmental health, climate change, ecological collapse, or growing inequity, clear problems exist. Natural capital resources are being depleted; disregard for the integrity of ecosystems is entrenched in current business practices. Indeed, despite increasing rhetoric to the contrary, the disregard displayed by those who hold power globally toward long-term sustainability and, thus, the health and well-being of future generations, could be described as wanton. Six years ago, the Millennium Development Goals were announced by the United Nations as a rallying point for action to achieve a sustainable future, particularly by reducing the gap between the "have mores" and "have nots." The attainment of these Goals is now endangered, as is, apparently, the spirit of optimism and idealism that inspired them at the Millennium Summit. We call for a reinvigoration of both concern about-and action on-sustainability. In particular, we appeal to those engaged in the field of environmental epidemiology (and other specialties with whom they engage) to consider how they might help by incorporating sustainability issues (including global ecological integrity and global environmental justice) into their own research programs. This incorporation would make a vital contribution to protect both present and future generations and to reduce resource and health gaps between North and South. Simply put, we propose that sustainability becomes integral to advancing the science of environmental epidemiology and related environmental disciplines.

The millennium development goals and household energy requirements in Nigeria.

PubMed

Ibitoye, Francis I

2013-01-01

Access to clean and affordable energy is critical for the realization of the United Nations' Millennium Development Goals, or MDGs. In many developing countries, a large proportion of household energy requirements is met by use of non-commercial fuels such as wood, animal dung, crop residues, etc., and the associated health and environmental hazards of these are well documented. In this work, a scenario analysis of energy requirements in Nigeria's households is carried out to compare estimates between 2005 and 2020 under a reference scenario, with estimates under the assumption that Nigeria will meet the millennium goals. Requirements for energy under the MDG scenario are measured by the impacts on energy use, of a reduction by half, in 2015, (a) the number of household without access to electricity for basic services, (b) the number of households without access to modern energy carriers for cooking, and (c) the number of families living in one-room households in Nigeria's overcrowded urban slums. For these to be achieved, household electricity consumption would increase by about 41% over the study period, while the use of modern fuels would more than double. This migration to the use of modern fuels for cooking results in a reduction in the overall fuelwood consumption, from 5 GJ/capita in 2005, to 2.9 GJ/capita in 2015.

Strengthening health information systems to address health equity challenges.

PubMed Central

Nolen, Lexi Bambas; Braveman, Paula; Dachs, J. Norberto W.; Delgado, Iris; Gakidou, Emmanuela; Moser, Kath; Rolfe, Liz; Vega, Jeanette; Zarowsky, Christina

2005-01-01

Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development. PMID:16184279

The Internet and the menopause consultation: menopause management in the third millennium.

PubMed

Cumming, Grant P; Currie, Heather

2005-09-01

The Internet was born in 1969; it was originally developed so that computers could share information on research and development in the scientific and military fields. The original Internet consisted of four university computers networked in the United States. Email became available two years later. The infant Internet initially required complex computing knowledge to be used. However, this was all to change with the development of the World Wide Web in the early 1990s, which made the Internet much more widely accessible. The Internet has since grown at a phenomenal rate and has evolved into a global communications tool. It is by nature anarchic, in that it is an unrestricted broadcast medium. Although this lack of censorship is a strength, it is also a weakness. The quality of information available on the Web is variable and discernment is required. With the growth of e-health, medicine and its allied specialties are faced with the challenges of providing their services in a novel way while maintaining the first principle of medicine, primum non nocere (first, do no harm). This provision of e-health care is in its infancy and this review explores issues arising from the use of the Internet as a medium for organizing menopausal health care in the third millennium.

A review of global progress toward the Millennium Development Goal 1 Hunger Target.

PubMed

Fanzo, Jessica C; Pronyk, Paul M

2011-06-01

The hunger component of the first Millennium Development Goal (MDG) aims to reduce the proportion of people who suffer from hunger by half between 1990 and 2015. In low- and middle-income countries, progress has been mixed, with approximately 925 million people hungry and 125 million and 195 million children underweight and stunted, respectively. To assess global progress on the hunger component of MDG1 and evaluate the success of interventions and country programs in reducing undernutrition. We review global progress on the hunger component of MDG1, examining experience from 40 community-based programs as well as national efforts to move interventions to scale drawn from the published and gray literature, alongside personal interviews with representatives of governments and development agencies. Based on this review, most strategies being implemented and scaled are focusing on treatment of malnutrition and rooted within the health sector. While critical, these programs generally address disease-related effects and emphasize the immediate determinants of undernutrition. Other major strategies to tackle undernutrition rely on the production of staple grains within the agriculture sector. These programs address hunger, as opposed to improving the quality of diets within communities. Strategies that adopt multisectoral programming as crucial to address longer-term determinants of undernutrition, such as poverty, gender equality, and functioning food and health systems, remain underdeveloped and under-researched. This review suggests that accelerating progress toward the MDG1 targets is less about the development of novel innovations and new technologies and more about putting what is already known into practice. Success will hinge on linking clear policies with effective delivery systems in working towards an evidence-based and contextually relevant multisectoral package of interventions that can rapidly be taken to scale.

Using the Lives Saved Tool (LiST) to Model mHealth Impact on Neonatal Survival in Resource-Limited Settings

PubMed Central

Jo, Youngji; Labrique, Alain B.; Lefevre, Amnesty E.; Mehl, Garrett; Pfaff, Teresa; Walker, Neff; Friberg, Ingrid K.

2014-01-01

While the importance of mHealth scale-up has been broadly emphasized in the mHealth community, it is necessary to guide scale up efforts and investment in ways to help achieve the mortality reduction targets set by global calls to action such as the Millennium Development Goals, not merely to expand programs. We used the Lives Saved Tool (LiST)–an evidence-based modeling software–to identify priority areas for maternal and neonatal health services, by formulating six individual and combined interventions scenarios for two countries, Bangladesh and Uganda. Our findings show that skilled birth attendance and increased facility delivery as targets for mHealth strategies are likely to provide the biggest mortality impact relative to other intervention scenarios. Although further validation of this model is desirable, tools such as LiST can help us leverage the benefit of mHealth by articulating the most appropriate delivery points in the continuum of care to save lives. PMID:25014008

Progress in health-related millennium development goals in the WHO South-East Asia Region.

PubMed

Singh, Poonam Khetrapal

2012-01-01

Home to 25% of the world's population and bearing 30% of the Global disease burden, the South-East Asia Region [1] of the World Health Organization has an important role in the progress of global health. Three of the eight million development goal (MDG) goals that relate to health are MDG 4, 5, and 6. There is progress in all three goals within the countries of the region, although the progress varies across countries and even within countries. With concerted and accelerated efforts in some countries and certain specific areas, the region will achieve the targets of the three health MDGs. The key challenges are in sustainable scaling up of evidence-based interventions to improve maternal and child health and controlling communicable diseases. This will require continued focus and investments in strengthening health systems that provide individual and family centered comprehensive package of interventions with equitable reach and that which is provided free at the point of service delivery. Important lessons that have been learnt in implementing the MDG agenda in the past two decades will inform setting up of the post MDG global health agenda. This article provides a snap shot of progress thus far, key challenges and opportunities in WHO South-East Asia Region and lays down the way forward for the global health agenda post 2015.

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

PubMed

Subramanian, Savitha; Naimoli, Joseph; Matsubayashi, Toru; Peters, David H

2011-12-14

There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.

Sexual and reproductive health and rights in the post-2015 development agenda.

PubMed

Sen, Gita

2014-01-01

Women's health is currently shaped by the confluence of two important policy trends - the evolution of health system reform policies and from the early 1990s onwards, a strong articulation of a human rights-based approach to health that has emphasised laws and policies to advance gender equality and sexual and reproductive health and rights (SRHR). The drive for sexual and reproductive rights represents an inclusive trend towards human rights to health that goes beyond the right to health services, directing attention to girls' and women's rights to bodily autonomy, integrity and choice in relation to sexuality and reproduction. Such an expanded concept of the right to health is essential if laws, policies and programmes are to respect, protect and fulfil the health of girls and women. However, this expanded understanding has been ghettoised from the more mainstream debates on the right to health and was only partially included in the Millennium Development Goals. The paper argues in favour of a twofold approach in placing SRHR effectively in the context of the post-2015 development agenda: first, firmly ground it in an inclusive approach to the right to health; and second, drawing on two decades of national-level implementation, propose a forward-looking agenda focusing on quality, equality and accountability in policies and in programmes. This can build on good practice while addressing critical challenges central to the development framework itself.

Professionals with Delivery Skills: Backbone of the Health System and Key to Reaching the Maternal Health Millennium Development Goal

PubMed Central

Wirth, Meg

2008-01-01

The attainment of the fifth Millennium Development Goal requires adequate national reserves of skilled birth attendants. Nurses, midwives, and their equivalents form the frontline of the formal health system are a critical element of global efforts to reduce ill-health and poverty in the poorest areas of the world. Planning and policies supporting these cadres of workers must be placed high on the development agenda and championed by key international and national players. This article first sets forth an argument for the equity and efficiency of nurses, midwives, and their equivalents as the cadre largely responsible for maternal health. Second, it traces the root causes of neglect of this critical cadre, including a vacuum in political will in the context of poverty, lack of protections for frontline workers, the historical political position of the field of midwifery, lack of a pipeline of secondary school graduates, and gender inequity. Investment in the largely female cadre that cares for the majority of the world’s poorer women has simply not been a high enough priority. Key policy recommendations include harnessing political will and adequate metrics, protection of frontline workers’ safety and livelihoods, ensuring an adequate pipeline with a focus on girls’ education and donor support for training and professional organizations. The fifth and final policy recommendation is a call for unified international support of rapid scale-up of cadres of delivery care workers. PMID:18581610

Migration of health workers in the Pacific Islands: a bottleneck to health development.

PubMed

Yamamoto, T S; Sunguya, B F; Shiao, L W; Amiya, R M; Saw, Y M; Jimba, M

2012-07-01

Human resources for health (HRH) are a crucial component of a well-functioning health system. Problems in the global HRH supply and distribution are an obstacle to achieving the health-related Millennium Development Goals and other health outcomes. The Pacific Island region, covering 20,000 to 30,000 islands in the South Pacific Ocean, is suffering a serious HRH crisis. Yet updated evidence and data are not available for the 22 Pacific Island Countries and Territories. The objective of this study was thus to explore the current HRH situation in the Pacific Island region, focusing particularly on the issue of health workforce migration. HRH trends and gaps differ by country, with some showing increases in HRH density over the past 20 years whereas others have made negligible progress. Currently, three Pacific Island countries are facing critical HRH shortages, a worsening of the situation from 2006, when HRH issues were first brought to widespread global attention. In this region, skilled personnel migration is a major issue contributing to the limited availability of HRH. Political commitment from source and destination countries to strengthen HRH would be a key factor toward increasing efforts to train new health personnel and to implement effective retention strategies.

Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium

PubMed Central

Wilson, M E; Pandey, S K; Thakur, J

2003-01-01

Paediatric cataract blindness presents an enormous problem to developing countries in terms of human morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge: treatment is often difficult, tedious, and requires a dedicated team effort. To assure the best long term outcome for cataract blind children, appropriate paediatric surgical techniques need to be defined and adopted by ophthalmic surgeons of developing countries. The high cost of operative equipment and the uneven world distribution of ophthalmologists, paediatricians, and anaesthetists create unique challenges. This review focuses on issues related to paediatric cataract management that are appropriate and suitable for ophthalmic surgeons in the developing world. Practical guidelines and recommendations have also been provided for ophthalmic surgeons and health planners dealing with childhood cataract management in the developing world. PMID:12488254

Child malnutrition and the Millennium Development Goals: much haste but less speed?

PubMed

Oruamabo, Raphael S

2015-02-01

The Millennium Development Goals (MDGs) provide a framework for measuring the progress of nations. Several of these goals relate to child malnutrition, which remains an important contributor to child morbidity and mortality, accounting for approximately 45% of child deaths globally. A high proportion of undernourished children still live in Africa and parts of Asia, and the uneven rate of reduction in the prevalence of various types of child malnutrition among different income groups worldwide is worrying. Attempts to reduce child malnutrition should therefore begin from the grassroots by improving primary healthcare services in developing countries with particular focus on basic requirements. Adequate nutrition should be provided from birth, through infancy, preschool and early childhood to adolescence. The overall strategy should be one of careful and meticulous planning involving all development sectors with an emphasis on a bottom-up approach within a stable and disciplined polity; the MDGs will be only be useful if they are seen not as narrow objectives with unidirectional interventions but as multifaceted and co-ordinated. The setting of deadlines, whether 2015 or 2035, should not be emphasised so as to avoid hasty decision making. The top priority should be the implementation of the essential social services of basic education, primary healthcare, nutrition, reproductive health care, water and sanitation in partnership with the developed economies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Sustainable Development Goals for Monitoring Action to Improve Global Health.

PubMed

Cesario, Sandra K

2016-01-01

Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

The imperative of functional integration for achievement of MDGs.

PubMed

Mohamud, Khalif Bile

2009-09-01

Pakistan launched its Maternal, Neonatal and Child Health (MNCH) programme in 2006 in collaboration with the World Health Organization (WHO) and other partners to bridge gaps and upscale interventions aimed at reducing mortality and achieving the Millennium Development Goals (MDGs). The country will have an uphill task in meeting by 2020, the 2015 targets set for attainment of MDGs 4 and 5. The current Contraceptive Prevalence Rate (CPR) level of 30% is considerably below the 60% target set for 2020 and the current Total Fertility Rate (TFR), estimated at 4, is significantly higher than the set target of 2.1. Similarly, the Infant Mortality Rate (IMR) of 78 per 1,000 live births is lagging behind the MDG target of 40 per 1,000 live births, while the Maternal Mortality Ratio (MMR) of 276 per 105 live births is higher than the MDG target of 140 per 105 live births. With the rural population at an added disadvantage by reporting 82% and 40% higher MMR and IMR respectively-relative to the population of urban and major cities-reducing the current population growth rate of about 1.7% to 1.3% in the envisaged limited timeframe appears challenging. To overcome these programmatic impediments, the existing fragmentation in implementation of MNCH/Reproductive Health (RH) and Family Planning (FP) services needs to be urgently addressed. To respond to this call, the ministries of Health and Population made a joint commitment at the end of 2008 to bring about functional integration by delivering the MNCH/RH/FP services in a unified manner and by setting up effective institutional, strategic and operational mechanisms that can enhance the implementation process. To significantly reduce IMR and MMR and improve RH/FP outcomes, the two ministries must challenge the status quo and promote the coordination of health and population policies, improve MNCH/RF and FP management practices including monitoring and supervision, deploy, train and motivate the health workforce and strengthen the health system. Functional integration must also aim at ensuring use of appropriate technologies and uninterrupted provision of supplies and equipment. This viewpoint, which is related to the Heartfile Report, aims at diagnosing outstanding challenges at the field level, as well as factors contributing to successful implementation of MNCH/RH and FP and their progress towards achieving Millennium Development Goals (MDGs) 4 and 5.

Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study

PubMed Central

2013-01-01

Background The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambia’s MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. Methods A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. Results The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity to hold health workers accountable for the drugs and services. Conclusion The study has shown that building block specific weaknesses had cross cutting effect in other health system building blocks. These linkages emphasised the need to use system wide approaches in assessing the performance of health system strengthening interventions. PMID:23902601

Millennium Restoration and Development Corp. Information Sheet

EPA Pesticide Factsheets

Millennium Restoration and Development Corp. (the Company) is located in St. Louis, Missouri. The settlement involves renovation activities conducted at property constructed prior to 1978, located in St. Louis, Missouri.

Addressing poverty, education, and gender equality to improve the health of women worldwide.

PubMed

Tyer-Viola, Lynda A; Cesario, Sandra K

2010-01-01

The Millennium Development Goals (MDG) that target alleviating poverty, improving primary education, and fostering gender equity are important as a foundation to promote world health. Achieving these goals will create an environment for healthy lives for women and children. Poverty, education, and gender equality, although undeniably linked, need to be addressed individually. Nurses have the capacity and political will to address MDGs and to contribute to the health and well-being of the world population. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Drivers of inequality in Millennium Development Goal progress: a statistical analysis.

PubMed

Stuckler, David; Basu, Sanjay; McKee, Martin

2010-03-02

Many low- and middle-income countries are not on track to reach the public health targets set out in the Millennium Development Goals (MDGs). We evaluated whether differential progress towards health MDGs was associated with economic development, public health funding (both overall and as percentage of available domestic funds), or health system infrastructure. We also examined the impact of joint epidemics of HIV/AIDS and noncommunicable diseases (NCDs), which may limit the ability of households to address child mortality and increase risks of infectious diseases. We calculated each country's distance from its MDG goals for HIV/AIDS, tuberculosis, and infant and child mortality targets for the year 2005 using the United Nations MDG database for 227 countries from 1990 to the present. We studied the association of economic development (gross domestic product [GDP] per capita in purchasing-power-parity), the relative priority placed on health (health spending as a percentage of GDP), real health spending (health system expenditures in purchasing-power-parity), HIV/AIDS burden (prevalence rates among ages 15-49 y), and NCD burden (age-standardised chronic disease mortality rates), with measures of distance from attainment of health MDGs. To avoid spurious correlations that may exist simply because countries with high disease burdens would be expected to have low MDG progress, and to adjust for potential confounding arising from differences in countries' initial disease burdens, we analysed the variations in rates of change in MDG progress versus expected rates for each country. While economic development, health priority, health spending, and health infrastructure did not explain more than one-fifth of the differences in progress to health MDGs among countries, burdens of HIV and NCDs explained more than half of between-country inequalities in child mortality progress (R(2)-infant mortality = 0.57, R(2)-under 5 mortality = 0.54). HIV/AIDS and NCD burdens were also the strongest correlates of unequal progress towards tuberculosis goals (R(2) = 0.57), with NCDs having an effect independent of HIV/AIDS, consistent with micro-level studies of the influence of tobacco and diabetes on tuberculosis risks. Even after correcting for health system variables, initial child mortality, and tuberculosis diseases, we found that lower burdens of HIV/AIDS and NCDs were associated with much greater progress towards attainment of child mortality and tuberculosis MDGs than were gains in GDP. An estimated 1% lower HIV prevalence or 10% lower mortality rate from NCDs would have a similar impact on progress towards the tuberculosis MDG as an 80% or greater rise in GDP, corresponding to at least a decade of economic growth in low-income countries. Unequal progress in health MDGs in low-income countries appears significantly related to burdens of HIV and NCDs in a population, after correcting for potentially confounding socioeconomic, disease burden, political, and health system variables. The common separation between NCDs, child mortality, and infectious syndromes among development programs may obscure interrelationships of illness affecting those living in poor households--whether economic (e.g., as money spent on tobacco is lost from child health expenditures) or biological (e.g., as diabetes or HIV enhance the risk of tuberculosis).

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

PubMed

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Sustaining Health for Wealth: Perspectives for the Post-2015 Agenda

PubMed Central

Armah, Bartholomew K.

2015-01-01

The sustainable development goals (SDGs) offer a unique opportunity for policy-makers to build on the millennium development goals (MDGs) by adopting more sustainable approaches to addressing global development challenges. The delivery of health services is of particular concern. Most African countries are unlikely to achieve the health MDGs, however, significant progress has been made particularly in the area of child and maternal health due in part to significant external support. The weak global recovery, and persistent inequalities in access to healthcare, however, call into question the sustainability of the achievements made. Building on the principles articulated in Binagwaho and Scott, this commentary argues that addressing inequalities and promoting more integrated approaches to health service delivery is vital for consolidating and sustaining the health sector achievements in Africa. PMID:26673177

A Review of Literature to Understand the Complexity of Equity, Ethics and Management for Achieving Public Health Goals in India

PubMed Central

Garg, Pankaj; Nagpal, Jitender

2014-01-01

In the context of inadequate public spending on health care in India (0.9% of the GDP); government liberalized its policies in the form of subsidized lands and tax incentives, resulting in the mushrooming of private hospitals and clinics in India. Paradoxically, a robust framework was not developed for the regulation of these health care providers, resulting in disorganized health sector, inadequate financing models, and lack of prioritization of services, as well as a sub-optimal achievement of the Millennium Development Goals (MDG). We systematically reviewed the evidence base regarding regulation of private hospitals, applicability of private-public mix, state of health insurance and effective policy development for India, while seeking lessons on regulation of private health systems, from South African (a developing country) and Australian (a developed country) health care systems. PMID:24701465

Introduction: Framing 'Post-AIDS' and Global Health Discourses in 2015 and Beyond.

PubMed

O'Connell, Gráinne

2017-05-19

This special issue, entitled "Post-AIDS' and Global Health Discourses: Interdisciplinary Perspectives,' emerged from a one day Medical Humanities symposium at the Leeds Centre for Medical Humanities, at the University of Leeds, England, on February 27th 2015. This special issue focusses on the perceived deprioritising of HIV and AIDS in the Sustainable Development Goals, or SDGs, that were launched in 2015. The SDGs function as policy benchmarks for all entities within the United Nations system and they supersede the Millennium Development Goals, or MDGs, which expired in 2015. As the word millennium indicates, the MDGs were launched in 2000 and 2015 was designated as the benchmark year when the successes and shortcomings of the MDGs would be critically assessed. One key difference between the MDGs and the SDGs, which D'Ambruoso foregrounds (2013), is that the writing process underpinning the SDGs involved lengthy consultations, and feedback, with communities and health care practitioners around the world. By contrast, because the MDGs were mainly written by government officials, policy makers and health care practitioners without consulting wider communities, the processes underpinning the SDGs consultations are more inclusive than the MDGs. What is most critical about the SDGs for this special issue, however, is that they reflect a clear shift away from 'HIV exceptionalism' and towards what critics have described as 'post-AIDS' rhetoric, specifically when one compares the MDG health goal 6 and the SDG health goal 3.

Millennium Development Goals progress: a perspective from sub-Saharan Africa.

PubMed

English, Mike; English, Rex; English, Atti

2015-02-01

Sub-Saharan Africa is a highly diverse geo-political region. Any brief discussion of the progress made over the last 15 years towards the Millennium Development Goals (MDGs) will therefore not do justice to the true complexity of context and events. Our focus will be MDG4-to reduce child mortality by 66% from 1990 levels. We will touch briefly on MDG1, to eradicate extreme poverty and hunger, MDG2, to achieve universal primary education, and MDG5, to improve maternal health, which are inextricably linked with child well-being. We will also draw on an eclectic mix of additional global indicators. Acknowledging the limitations of this approach, we first offer a summary of expected progress and then point to debates on future goals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Health Impact of U.S. Military Service in a Large Population-based Military Cohort: Findings of the Millennium Cohort Study, 2001-2008

DTIC Science & Technology

2011-01-01

Special emphasis was placed on obtaining information on vac- cines , environmental exposures, and combat-related experiences. Electronic deployment...aPercentages rounded up and may not sum to 100. bDeployed in support of the Global War on Terrorism between September 1, 2001, and August 31, 2007

Child Mental Health: Exploring Systems of Care in the New Millennium.

ERIC Educational Resources Information Center

Dosser, David A., Jr., Ed.; Handron, Dorothea, Ed.; McCammon, Susan, Ed.; Powell, John Y., Ed.

Over the past decade, the care of children with serious emotional challenges has evolved toward a system of care encompassing a coordinated spectrum of services and supports responsive to child and family needs. This book is a collection of papers based on work at East Carolina University that examines elements of the system of care in relation to…

A Prospective Study of Depression Following Combat Deployment in Support of the Wars in Iraq and Afghanistan

DTIC Science & Technology

2010-01-01

disor- der.21 Another cross-sectional study utilizing National Comorbidity Survey data found an in- creased risk for major depressive disorders among...Health Questionnaire (PHQ)38 and the Medical Outcomes Study Short Form 36-Item Health Survey for Veterans.39 We used Millennium Cohort Study data to in...was launched in 2001 to collect and evaluate population- based data on behavioral and occupational risks related to military service that may be

Going Beyond the Millennium Ecosystem Assessment: An Index System of Human Well-Being

PubMed Central

Yang, Wu; Dietz, Thomas; Kramer, Daniel Boyd; Chen, Xiaodong; Liu, Jianguo

2013-01-01

Understanding the linkages between ecosystem services (ES) and human well-being (HWB) is crucial to sustain the flow of ES for HWB. The Millennium Ecosystem Assessment (MA) provided a state-of-the-art synthesis of such knowledge. However, due to the complexity of the linkages between ES and HWB, there are still many knowledge gaps, and in particular a lack of quantitative indicators and integrated models based on the MA framework. To fill some of these research needs, we developed a quantitative index system to measure HWB, and assessed the impacts of an external driver – the 2008 Wenchuan Earthquake – on HWB. Our results suggest that our proposed index system of HWB is well-designed, valid and could be useful for better understanding the linkages between ES and HWB. The earthquake significantly affected households' well-being in our demonstration sites. Such impacts differed across space and across the five dimensions of the sub-index (i.e., the basic material for good life, security, health, good social relations, and freedom of choice and action). Since the conceptual framework is based on the generalizable MA framework, our methods should also be applicable to other study areas. PMID:23717635

The New Global Health

PubMed Central

Simone, Patricia M.; Davison, Veronica; Slutsker, Laurence

2013-01-01

Global health reflects the realities of globalization, including worldwide dissemination of infectious and noninfectious public health risks. Global health architecture is complex and better coordination is needed between multiple organizations. Three overlapping themes determine global health action and prioritization: development, security, and public health. These themes play out against a background of demographic change, socioeconomic development, and urbanization. Infectious diseases remain critical factors, but are no longer the major cause of global illness and death. Traditional indicators of public health, such as maternal and infant mortality rates no longer describe the health status of whole societies; this change highlights the need for investment in vital registration and disease-specific reporting. Noncommunicable diseases, injuries, and mental health will require greater attention from the world in the future. The new global health requires broader engagement by health organizations and all countries for the objectives of health equity, access, and coverage as priorities beyond the Millennium Development Goals are set. PMID:23876365

A strategic assessment of unsafe abortion in Malawi.

PubMed

Jackson, Emily; Johnson, Brooke Ronald; Gebreselassie, Hailemichael; Kangaude, Godfrey D; Mhango, Chisale

2011-05-01

As part of efforts to achieve Millennium Development Goal 5--to reduce maternal mortality by 75% and achieve universal access to reproductive health by 2015--the Malawi Ministry of Health conducted a strategic assessment of unsafe abortion in Malawi. This paper describes the findings of the assessment, including a human rights-based review of Malawi's laws, policies and international agreements relating to sexual and reproductive health and data from 485 in-depth interviews about sexual and reproductive health, maternal mortality and unsafe abortion, conducted with Malawians from all parts of the country and social strata. Consensus recommendations to address the issue of unsafe abortion were developed by a broad base of local and international stakeholders during a national dissemination meeting. Malawi's restrictive abortion law, inaccessibility of safe abortion services, particularly for poor and young women, and lack of adequate family planning, youth-friendly and post-abortion care services were the most important barriers. The consensus reached was that to make abortion safe in Malawi, there were four areas for urgent action--abortion law reform; sexuality education and family planning; adolescent sexual and reproductive health services; and post-abortion care services. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Use of human rights to meet the unmet need for family planning.

PubMed

Cottingham, Jane; Germain, Adrienne; Hunt, Paul

2012-07-14

In this report, we describe how human rights can help to shape laws, policies, programmes, and projects in relation to contraceptive information and services. Applying a human rights perspective and recognising the International Conference on Population and Development and Millennium Development Goal commitments to universal access to reproductive health including family planning, we support measurement of unmet need for family planning that encompasses more groups than has been the case until recently. We outline how human rights can be used to identify, reduce, and eliminate barriers to accessing contraception; the ways in which human rights can enhance laws and policies; and governments' legal obligations in relation to contraceptive information and services. We underline the crucial importance of accountability of states and identify some of the priorities for making family planning available that are mandated by human rights. Copyright © 2012 Elsevier Ltd. All rights reserved.

Financing of health systems to achieve the health Millennium Development Goals in low-income countries.

PubMed

Fryatt, Robert; Mills, Anne; Nordstrom, Anders

2010-01-30

Concern that underfunded and weak health systems are impeding the achievement of the health Millennium Development Goals in low-income countries led to the creation of a High Level Taskforce on Innovative International Financing for Health Systems in September, 2008. This report summarises the key challenges faced by the Taskforce and its Working Groups. Working Group 1 examined the constraints to scaling up and costs. Challenges included: difficulty in generalisation because of scarce and context-specific health-systems knowledge; no consensus for optimum service-delivery approaches, leading to wide cost differences; no consensus for health benefits; difficulty in quantification of likely efficiency gains; and challenges in quantification of the financing gap owing to uncertainties about financial commitments for health. Working Group 2 reviewed the different innovative mechanisms for raising and channelling funds. Challenges included: variable definitions of innovative finance; small evidence base for many innovative finance mechanisms; insufficient experience in harmonisation of global health initiatives; and inadequate experience in use of international investments to improve maternal, newborn, and child health. The various mechanisms reviewed and finally recommended all had different characteristics, some focusing on specific problems and some on raising resources generally. Contentious issues included the potential role of the private sector, the rights-based approach to health, and the move to results-based aid. The challenges and disagreements that arose during the work of the Taskforce draw attention to the many issues facing decision makers in low-income countries. International donors and recipient governments should work together to improve the evidence base for strengthening health systems, increase long-term commitments, and improve accountability through transparent and inclusive national approaches. Copyright 2010 Elsevier Ltd. All rights reserved.

22 CFR 1300.2 - Organization.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Organization. 1300.2 Section 1300.2 Foreign Relations MILLENNIUM CHALLENGE CORPORATION ORGANIZATION AND FUNCTIONS OF THE MILLENNIUM CHALLENGE CORPORATION § 1300.2 Organization. (a) MCC's Board consists of: (1) The Secretary of State, the Secretary of...

The Policies and Practice of Preschoolers' Outdoor Play: A Chinese Perspective on Greeting the Millennium

ERIC Educational Resources Information Center

Hu, Bi Ying; Kong, Zhaowei; Roberts, Sherron Killingsworth

2014-01-01

Early childhood education and care (ECEC) scholars and health professionals worldwide share a common concern about the decline in children's physical development and activity due to lack of access to good quality outdoor environments. Early childhood education and care facilities across the world have been affected by trends that are limiting…

Literacy and the Millennium Development Goals: One Step Forward, Two Steps Backwards

ERIC Educational Resources Information Center

Gomez, Sofia Valdivielso

2005-01-01

Traditionally women have been signified to be "for others", never for themselves. This conceptualisation is also present in the discourses about literacy. The traditional discourse justifies women's literacy based on the need to improve family health, well-being, educational access, and so on. Thus, it is seen as a tool for other ends…

CenteringPregnancy-Africa: a pilot of group antenatal care to address Millennium Development Goals.

PubMed

Patil, Crystal L; Abrams, Elizabeth T; Klima, Carrie; Kaponda, Chrissie P N; Leshabari, Sebalda C; Vonderheid, Susan C; Kamanga, Martha; Norr, Kathleen F

2013-10-01

severe health worker shortages and resource limitations negatively affect quality of antenatal care (ANC) throughout sub-Saharan Africa. Group ANC, specifically CenteringPregnancy (CP), may offer an innovative approach to enable midwives to offer higher quality ANC. our overarching goal was to prepare to conduct a clinical trial of CenteringPregnancy-Africa (CP-Africa) in Malawi and Tanzania. In Phase 1, our goal was to determine the acceptability of CP as a model for ANC in both countries. In Phase 2, our objective was to develop CP-Africa session content consistent with the Essential Elements of CP model and with national standards in both Malawi and Tanzania. In Phase 3, our objective was to pilot CP-Africa in Malawi to determine whether sessions could be conducted with fidelity to the Centering process. Phases 1 and 2 took place in Malawi and Tanzania. Phase 3, the piloting of two sessions of CP-Africa, occurred at two sites in Malawi: a district hospital and a small clinic. we used an Action Research approach to promote partnerships among university researchers, the Centering Healthcare Institute, health care administrators, health professionals and women attending ANC to develop CP-Africa session content and pilot this model of group ANC. for Phases 1 and 2, members of the Ministries of Health, health professionals and pregnant women in Malawi and Tanzania were introduced to and interviewed about CP. In Phase 2, we finalised CP-Africa content and trained 13 health professionals in the Centering Healthcare model. In Phase 3, we conducted a small pilot with 24 pregnant women (12 at each site). participants enthusiastically embraced CP-Africa as an acceptable model of ANC health care delivery. The CP-Africa content met both CP and national standards. The pilot established that the CP model could be implemented with process fidelity to the 13 Essential Elements. Several implementation challenges and strategies to address these challenges were identified. preliminary data suggest that CP-Africa is feasible in resource-constrained, low-literacy, high-HIV settings in sub-Saharan Africa. By improving the quality of ANC delivery, midwives have an opportunity to make a contribution towards Millennium Development Goals (MDG) targeting improvements in child, maternal and HIV-related health outcomes (MDGs 4, 5 and 6). A clinical trial is needed to establish efficacy. CP-Africa also has the potential to reduce job-related stress and enhance job satisfaction for midwives in low income countries. If CP can be transferred with fidelity to process in sub-Saharan Africa and retain similar results to those reported in clinical trials, it has the potential to benefit pregnant women and their infants and could make a positive contribution to MGDs 4, 5 and 6. © 2013 Elsevier Ltd. All rights reserved.

Back to the future: what would the post-2015 global development goals look like if we replicated methods used to construct the Millennium Development Goals?

PubMed Central

2014-01-01

Background The Millennium Development Goals (MDGs) were ‘top-down’ goals formulated by policy elites drawing from targets within United Nations (UN) summits and conferences in the 1990s. Contemporary processes shaping the new post-2015 development agenda are more collaborative and participatory, markedly different to the pre-MDG era. This study examines what would the outcome be if a methodology similar to that used for the MDGs were applied to the formulation of the post-2015 development goals (Post-2015DGs), identifying those targets arising from UN summits and conferences since the declaration of the MDGs, and aggregating them into goals. Methods The UN Department of Economic and Social Affairs (DESA) list of major UN summits and conferences from 2001 to 2012 was utilised to examine targets. The DESA list was chosen due to the agency’s core mission to promote development for all. Targets meeting MDG criteria of clarity, conciseness and measurability were selected and clustered into broad goals based on processes outlined by Hulme and Vandemoortele. The Post-2015DGs that were identified were formatted into language congruent with the MDGs to assist in the comparative analysis, and then further compared to the 12 illustrative goals offered by the UN High-Level Panel of Eminent Persons on the Post-2015 Development (High-Level Panel) Agenda’s May 2013 report. Results Ten Post-2015DGs were identified. Six goals expressly overlapped with the current MDGs and four new goals were identified. Health featured prominently in the MDG agenda, and continues to feature strongly in four of the 10 Post-2015DGs. However the Post-2015DGs reposition health within umbrella agendas relating to women, children and the ageing. Six of the 10 Post-2015DGs incorporate the right to health agenda, emphasising both the standing and interconnection of the health agenda in DESA’s summits and conferences under review. Two Post-2015DGs have been extended into six separate goals by the High-Level Panel, and it is these goals that are clearly linked to sustainable development diaspora. Conclusions This study exposes the evolving political agendas underplaying the current post-2015 process, as targets from DESA’s 22 major UN summits and conferences from 2001 to 2012 are not wholly mirrored in the HLP’s 12 goals. PMID:24708796

Back to the future: what would the post-2015 global development goals look like if we replicated methods used to construct the Millennium Development Goals?

PubMed

Brolan, Claire E; Lee, Scott; Kim, David; Hill, Peter S

2014-04-03

The Millennium Development Goals (MDGs) were 'top-down' goals formulated by policy elites drawing from targets within United Nations (UN) summits and conferences in the 1990s. Contemporary processes shaping the new post-2015 development agenda are more collaborative and participatory, markedly different to the pre-MDG era. This study examines what would the outcome be if a methodology similar to that used for the MDGs were applied to the formulation of the post-2015 development goals (Post-2015DGs), identifying those targets arising from UN summits and conferences since the declaration of the MDGs, and aggregating them into goals. The UN Department of Economic and Social Affairs (DESA) list of major UN summits and conferences from 2001 to 2012 was utilised to examine targets. The DESA list was chosen due to the agency's core mission to promote development for all. Targets meeting MDG criteria of clarity, conciseness and measurability were selected and clustered into broad goals based on processes outlined by Hulme and Vandemoortele. The Post-2015DGs that were identified were formatted into language congruent with the MDGs to assist in the comparative analysis, and then further compared to the 12 illustrative goals offered by the UN High-Level Panel of Eminent Persons on the Post-2015 Development (High-Level Panel) Agenda's May 2013 report. Ten Post-2015DGs were identified. Six goals expressly overlapped with the current MDGs and four new goals were identified. Health featured prominently in the MDG agenda, and continues to feature strongly in four of the 10 Post-2015DGs. However the Post-2015DGs reposition health within umbrella agendas relating to women, children and the ageing. Six of the 10 Post-2015DGs incorporate the right to health agenda, emphasising both the standing and interconnection of the health agenda in DESA's summits and conferences under review. Two Post-2015DGs have been extended into six separate goals by the High-Level Panel, and it is these goals that are clearly linked to sustainable development diaspora. This study exposes the evolving political agendas underplaying the current post-2015 process, as targets from DESA's 22 major UN summits and conferences from 2001 to 2012 are not wholly mirrored in the HLP's 12 goals.

Role of Teacher Education in the Achievement of MDGs

ERIC Educational Resources Information Center

Kaur, Amardeep; Singh, Kulwinder

2014-01-01

The Millennium Development Goals (MDGs) which include eight goals have been framed to address the world's major development challenges by 2015. In India, considerable progress has been reported to be made in the field of basic universal education, gender equality in education, economic growth and other human development related aspects. Even…

Sustainable development goals and the human resources crisis.

PubMed

Freer, Joseph

2017-01-01

Achieving universal health coverage by 2030 requires that lessons from the Millennium Development Goals must be heeded. The most important lesson is that the workforce underpins every function of the health system, and is the rate-limiting step. The three dimensions that continue to limit the success of the development agenda are availability, distribution and performance of health workers - and the Sustainable Development Goals cannot be achieved without addressing all three. Hence, the traditional response of scaling up supply is inadequate: a paradigm shift is required in the design of systems that can properly identify, train, allocate and retain health workers. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sustaining Health for Wealth: Perspectives for the Post-2015 Agenda: Comment on "Improving the World's Health Through the Post-2015 Development Agenda: Perspectives From Rwanda".

PubMed

Armah, Bartholomew K

2015-06-06

The sustainable development goals (SDGs) offer a unique opportunity for policy-makers to build on the millennium development goals (MDGs) by adopting more sustainable approaches to addressing global development challenges. The delivery of health services is of particular concern. Most African countries are unlikely to achieve the health MDGs, however, significant progress has been made particularly in the area of child and maternal health due in part to significant external support. The weak global recovery, and persistent inequalities in access to healthcare, however, call into question the sustainability of the achievements made. Building on the principles articulated in Binagwaho and Scott, this commentary argues that addressing inequalities and promoting more integrated approaches to health service delivery is vital for consolidating and sustaining the health sector achievements in Africa. © 2015 by Kerman University of Medical Sciences.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cowlin, S.; Heimiller, D.; Bilello, D.

Approximately 1.6 billion people worldwide do not have access to electricity, and roughly 2.4 billion people rely on traditional biomass fuels to meet their heating and cooking needs. Lack of access to and use of energy - or energy poverty - has been recognized as a barrier to reaching the Millennium Development Goals (MDGs) and other targeted efforts to improve health and quality of life. Reducing reliance on traditional biomass can substantially reduce indoor air pollution-related morbidity and mortality; increasing access to lighting and refrigeration can improve educational and economic opportunities. Though targeted electrification efforts have had success within Latinmore » America and East Asia (reaching electrification rates above 85%), sub-Saharan Africa has maintained electrification rates below 25% (IEA 2004).« less

Neuroscience nursing practice in a new millennium.

PubMed

Hickey, J V; Minton, M S

1999-09-01

Neuroscience nursing practice in the 21st century is considered from two perspectives: 1) scope of care and roles within a collaborative interdisciplinary model of care; and 2) patient-focused care within the challenging health care system. The implications of illness trends for neuroscience nursing practice are discussed, as are the developing changes in the health care delivery system driven by economics. The article focuses on the futuristic role of disease management in shaping practice and the models for practice which will prevail in this new health care environment.

A Millennium Learning Goal for Education Post-2015: A Question of Outcomes or Processes

ERIC Educational Resources Information Center

Barrett, Angeline M.

2011-01-01

As the target year for the current Millennium Development Goal of universal completion of primary education approaches, three World Bank economists have proposed its replacement with a Millennium Learning Goal. This is part of a trend of increased privileging of learning outcomes. The proposal is assessed from the perspective of human rights-based…

Fostering reflective trust between mothers and community health nurses to improve the effectiveness of health and nutrition efforts: An ethnographic study in Ghana, West Africa.

PubMed

Ackatia-Armah, Nana M; Addy, Nii Antiaye; Ghosh, Shibani; Dubé, Laurette

2016-06-01

As the global health agenda shifts from the Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs), the need for effective preventive health efforts has gained prominence, particularly in low-income regions with poor health and nutrition outcomes. To address needs in communities with limited access to health services and personnel, it is important to develop strategies that can improve the effectiveness of nurses as they interact with the populations they serve. We contribute to informing such strategies by explaining how mothers' "reflective trust" in community health nurses develops as a key influencer in their health-related decision-making and behavior. Between December 2012 and June 2013, our ethnographic study gathered data in three adjacent rural and semi-rural communities in Ghana's Eastern Region, using interviews with 39 nursing mothers, three focus groups - with mothers, health-workers, and community leaders - as well as 941 h of participant observation. We focused on interactions between mothers and nurses, highlighting tensions between communities' traditions and messages that nurses bring, which are often based on modern science. We also investigated how mothers come to exhibit reflective trust in the nurses to make sense of traditional and scientific knowledge on infant feeding, and integrate them into their own feeding decisions. Our findings have global implications for effectively sustaining and scaling health and nutrition efforts through community approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

Socioeconomic determinants of infant mortality: a worldwide study of 152 low-, middle-, and high-income countries.

PubMed

Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia

2007-01-01

To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate predictors. To assess the relative importance of major socioeconomic determinants of population health, measured as infant mortality rate (IMR), at country level. National-level data from 152 countries based on World Development Indicators 2003 were used for multivariate linear regression analyses of five socioeconomic predictors of IMR: public spending on health, GNI/capita, poverty rate, income equality (Gini index), and young female illiteracy rate. Analyses were performed on a global level and stratified for low-, middle-, and high-income countries. In order of importance, GNI/capita, young female illiteracy, and income equality predicted 92% of the variation in national IMR whereas public spending on health and poverty rate were non-significant determinants when adjusted for confounding. In low-income countries, female illiteracy was more important than GNI/capita. Income equality (Gini index) was an independent predictor of IMR in middle-income countries only. In high-income countries none of these predictors was significant. The relative importance of major health determinants varies between income levels, thus extrapolating health policies from high- to low-income countries is problematic. Since the size, per se, of public health spending does not independently predict health outcomes, functioning health systems are necessary to make health investments efficient. Potential health gains from improved female education and economic growth should be considered in low- and middle-income countries.

Squaring the circle: health as a bridge to global solidarity in the Sustainable Development Goals.

PubMed

Williams, B; Taylor, S

2017-05-01

The Sustainable Development Goals (SDGs), launched in September 2015 to follow on from the Millennium Development Goals, require action by all countries. The new goals range from traditional areas of health and education to a newer focus on global trade and environmental protection. We discuss how all countries can be incentivised to engage and commit and argue that thoughtful target-setting and benchmarking, a more aggressive focus on equity and an emphasis on the interdependence of health and non-health development goals are key to meaningful progress. Fundamental shared values and aspirations around health, and in particular child health, within SDG3 may, we argue, offer a platform on which to build genuine global solidarity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Global women's health in 2010: facing the challenges.

PubMed

Lester, Felicia; Benfield, Nerys; Fathalla, Mohamed M F

2010-11-01

Women's health is closely linked to a nation's level of development, with the leading causes of death in women in resource-poor nations attributable to preventable causes. Unlike many health problems in rich nations, the cure relies not only on the discovery of new medications or technology but also getting basic services to the people who need them most and addressing underlying injustice. In order to do this, political will and financial resources must be dedicated to developing and evaluating a scaleable approach to strengthen health systems, support community-based programs, and promote widespread campaigns to address gender inequality, including promoting girls' education. The Millennium Development Goals (MDGs) have highlighted the importance of addressing maternal health and promoting gender equality for the overall development strategy of a nation. We must capitalize on the momentum created by this and other international campaigns and continue to advocate for comprehensive strategies to improve global women's health.

Health, equity and the post-2015 agenda: raising the voices of marginalized communities.

PubMed

Ruano, Ana Lorena; Friedman, Eric A; Hill, Peter S

2014-10-10

In September 2012 the United Nations (UN) initiated a process that would extend and enhance the unfinished agenda of the Millennium Development Goals (MDGs), integrating a new vision for sustainable development beyond the year 2015. The initial consultation phase has been completed, with the UN and partner organizations undertaking eleven thematic consultations, including one on health. It is in this context that the European Commission (EC) has tasked the research consortium Goals and Governance for Global Health (Go4Health) with providing recommendations for the post-2015 health-related development goals and including voices that are routinely excluded from health-related decision-making processes. This has not been an easy task. It has led us to question how to define marginalization, how to access marginalized communities, as well as how community members could provide informed consent. The context of the communities we worked with was far removed from the reality of the post-2015 debates, where the MDGs and the new goals are remote and abstract, and where the promise of immediate benefit from participation could not be assured. Given the social, historical, cultural, ethnic and geographical diversity of our chosen community partners, and the diversity of their lived experiences, could their unique situations be generalized in ways that could influence the global debate? In this special issue, we have tried to explore the uniqueness and the commonalities of the issues and barriers that marginalized communities face all over the globe, and present them in individual papers that, together, provide a nuanced and complex picture of the challenges that face the post-2015 health-related agenda setting-process.

Community-based management of acute malnutrition in Bangladesh: feasibility and constraints.

PubMed

Choudhury, Nuzhat; Ahmed, Tahmeed; Hossain, Md Iqbal; Mandal, Barendra Nath; Mothabbir, Golam; Rahman, Mustafizur; Islam, M Munirul; Husain, Mohammad Mushtuq; Nargis, Makhduma; Rahman, Ekhlasur

2014-06-01

To achieve the United Nations Millennium Development Goals, particularly reduction in child mortality (Millennium Development Goal 4), effective interventions to address severe and moderate acute malnutrition (SAM and MAM) among children under 5 years of age must be implemented and brought to scale alongside preventive measures. Bangladesh has an estimated 600,000 children with SAM, for a prevalence of 4%, while 1.8 million children suffer from MAM. To assess the feasibility and constraints of community-based management of acute malnutrition (CMAM), a relatively new approach, in managing SAM and MAM among children in Bangladesh. The methodology involved desk reviews of documents by searching through PubMed and other databases for published literature on CMAM in Bangladesh. We also did a hand search of policy and program documents, including the draft National Nutrition Policy 2013; the Health, Nutrition, Population Sector Development Program document of the Ministry of Health and Family Welfare, Government of Bangladesh; the Sixth Five Year Plan; and the Operational Plans of the National Nutrition Services of Bangladesh. . The conventional approach in Bangladesh has been to treat children suffering from SAM and associated complications in hospital settings. There is no program to take care of children with MAM. There is a dearth of local evidence to operationalize and implement CMAM in the context of Bangladesh. This paper summarizes the scientific literature and rationale for the implementation of CMAM in Bangladesh. It also provides recommendations to improve health strategies related to CMAM, discusses diets being developed that may result in better implementation of CMAM, and offers recommendations for areas of additional necessary research. A recommended approach for Bangladesh on the management of acute malnutrition would be to integrate CMAM into the rollout of the National Nutrition Services so that screening, identification, referral, and treatment of acutely malnourished children could be effectively managed within the community-based health service delivery system. Given that the vast majority of children are suffering from MAM and could be treated with locally developed food supplements, a significant emphasis of the CMAM approach in Bangladesh should be to screen and treat MAM. Over time, this would also result in fewer SAM cases. However, even with this approach, there would still be a small number of children who have SAM and who ideally should be treated with specialized therapeutic foods. While the Government of Bangladesh is awaiting full-scale production of a local ready-to-use therapeutic food (RUTF), an interim strategy is needed to effectively treat these severely wasted children on an outpatient basis.

Impact of training on emergency resuscitation skills: Impact on Millennium Development Goals (MDGs) 4 and 5.

PubMed

Gülmezoglu, A Metin; Lawrie, Theresa A

2015-11-01

Although significant progress has been made towards Millennium Development Goal (MDG) 4 and 5 targets, maternal and neonatal mortality rates remain unacceptably high in low- and middle-income countries (LMICs). The potential for improvements in maternal and neonatal health outcomes with increased facility utilization in these countries is undermined by a lack of appropriate and timely treatment. Skilful emergency resuscitation can be the difference between life and death; therefore, training in emergency resuscitation is essential for health-care practitioners at all levels, with regular refresher sessions to ensure skill retention. Whilst there is little robust evidence on the impact of resuscitation training interventions on practitioner skills or patient outcomes, such training interventions are likely to have the greatest impact if integrated into a broader approach to improve the quality of care. Accelerated investments in training must go hand in hand with ensuring the availability of quality equipment and upgrading infrastructure to reduce the gap between current MDG status and what is achieved by the end of 2015; and to accelerate reductions in mortality rates beyond 2015 towards new Countdown targets. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals.

PubMed

Fisher, Jane Rw; de Mello, Meena Cabral; Izutsu, Takashi; Tran, Tuan

2011-01-07

Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings.In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in women; the consequences of these for child health and development and ameliorative strategies in these contexts.The substantial disparity in rates of perinatal mental disorders between women living in high- and low-income settings, suggests social rather than biological determinants. Risks in resource-constrained contexts include: poverty; crowded living situations; limited reproductive autonomy; unintended pregnancy; lack of empathy from the intimate partner; rigid gender stereotypes about responsibility for household work and infant care; family violence; poor physical health and discrimination. Development is adversely affected if infants lack day-to-day interactions with a caregiver who can interpret their cues, and respond effectively. Women with compromised mental health are less able to provide sensitive, responsive infant care. In resource-constrained settings infants whose mothers are depressed are less likely to thrive and to receive optimal care than those whose mothers are well.The meeting outcome is the Hanoi Expert Statement (Additional file 1). It argues that the Millennium Development Goals to improve maternal health, reduce child mortality, promote gender equality and empower women, achieve universal primary education and eradicate extreme poverty and hunger cannot be attained without a specific focus on women's mental health. It was co-signed by the international expert group; relevant WHO and UNFPA departmental representatives and international authorities. They concur that social rather than medical responses are required. Improvements in maternal mental health require a cross-sectoral response addressing poverty reduction, women's rights, social protection, violence prevention, education and gender in addition to health.

Prevalence of Parent-Reported ASD and ADHD in the UK: Findings from the Millennium Cohort Study

ERIC Educational Resources Information Center

Russell, Ginny; Rodgers, Lauren R.; Ukoumunne, Obioha C.; Ford, Tamsin

2014-01-01

The UK prevalence of parent-reported autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) were estimated from the Millennium Cohort Study. Case definition was if a doctor or health care professional had ever told parents that their child had ASD and/or ADHD. Data were collected in 2008/2009 for 14,043 children. 1.7%…

From Aardvark to Zebra: A New Millennium Analysis of Theory Development in Public Relations Academic Journals. A Top Faculty/Student Research Paper.

ERIC Educational Resources Information Center

Sallot, Lynne M.; Lyon, Lisa J.; Acosta-Alzuru, Carolina; Jones, Karyn Ogata

In a replication and extension of a 1984 study by M. A. Ferguson to investigate the status of theory building by public relations scholars, 748 abstracts and/or articles published in "Public Relations Review,""Journal of Public Relations Research," and its predecessor "Public Relations Research Annual," since their inceptions through the year…

Development and localisation of casemix applications for inpatient hospital activity in EU member states.

PubMed

Wiley, M M

1999-01-01

The successful infiltration of casemix techniques across geographical, systemic and cultural boundaries provides an interesting and timely example of the translation of research evidence into health policy development. This paper explores the specifics of this policy development by reviewing the application of casemix techniques within the acute hospital systems of European Union member states. The fact that experimentation with or application of casemix measures can be reported for the majority of European Union member states would suggest that the deployment of these measures can be expected to continue to expand within these health systems into the new millennium.

Educational Development and Reformation in the Malaysian Education System: Challenges in the New Millennium.

ERIC Educational Resources Information Center

bin Zakaria, Haji Azmi

2000-01-01

Development of the education system in Malaysia is tied to the National Development Policy. Malaysia will address issues related to equity, access, and democratization of education, education quality, efficiency, and values education as the country responds to the demands of being part of the global village while ensuring domestic growth and…

22 CFR 1300.5 - Quorum and voting requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Quorum and voting requirements. 1300.5 Section 1300.5 Foreign Relations MILLENNIUM CHALLENGE CORPORATION ORGANIZATION AND FUNCTIONS OF THE MILLENNIUM CHALLENGE CORPORATION § 1300.5 Quorum and voting requirements. (a) Quorum requirements. A majority of the members of the Board shall constitute a...

Drivers of Inequality in Millennium Development Goal Progress: A Statistical Analysis

PubMed Central

Stuckler, David; Basu, Sanjay; McKee, Martin

2010-01-01

Background Many low- and middle-income countries are not on track to reach the public health targets set out in the Millennium Development Goals (MDGs). We evaluated whether differential progress towards health MDGs was associated with economic development, public health funding (both overall and as percentage of available domestic funds), or health system infrastructure. We also examined the impact of joint epidemics of HIV/AIDS and noncommunicable diseases (NCDs), which may limit the ability of households to address child mortality and increase risks of infectious diseases. Methods and Findings We calculated each country's distance from its MDG goals for HIV/AIDS, tuberculosis, and infant and child mortality targets for the year 2005 using the United Nations MDG database for 227 countries from 1990 to the present. We studied the association of economic development (gross domestic product [GDP] per capita in purchasing-power-parity), the relative priority placed on health (health spending as a percentage of GDP), real health spending (health system expenditures in purchasing-power-parity), HIV/AIDS burden (prevalence rates among ages 15–49 y), and NCD burden (age-standardised chronic disease mortality rates), with measures of distance from attainment of health MDGs. To avoid spurious correlations that may exist simply because countries with high disease burdens would be expected to have low MDG progress, and to adjust for potential confounding arising from differences in countries' initial disease burdens, we analysed the variations in rates of change in MDG progress versus expected rates for each country. While economic development, health priority, health spending, and health infrastructure did not explain more than one-fifth of the differences in progress to health MDGs among countries, burdens of HIV and NCDs explained more than half of between-country inequalities in child mortality progress (R 2-infant mortality  = 0.57, R 2-under 5 mortality  = 0.54). HIV/AIDS and NCD burdens were also the strongest correlates of unequal progress towards tuberculosis goals (R 2 = 0.57), with NCDs having an effect independent of HIV/AIDS, consistent with micro-level studies of the influence of tobacco and diabetes on tuberculosis risks. Even after correcting for health system variables, initial child mortality, and tuberculosis diseases, we found that lower burdens of HIV/AIDS and NCDs were associated with much greater progress towards attainment of child mortality and tuberculosis MDGs than were gains in GDP. An estimated 1% lower HIV prevalence or 10% lower mortality rate from NCDs would have a similar impact on progress towards the tuberculosis MDG as an 80% or greater rise in GDP, corresponding to at least a decade of economic growth in low-income countries. Conclusions Unequal progress in health MDGs in low-income countries appears significantly related to burdens of HIV and NCDs in a population, after correcting for potentially confounding socioeconomic, disease burden, political, and health system variables. The common separation between NCDs, child mortality, and infectious syndromes among development programs may obscure interrelationships of illness affecting those living in poor households—whether economic (e.g., as money spent on tobacco is lost from child health expenditures) or biological (e.g., as diabetes or HIV enhance the risk of tuberculosis). Please see later in the article for the Editors' Summary PMID:20209000

The global distribution of risk factors by poverty level.

PubMed Central

Blakely, Tony; Hales, Simon; Kieft, Charlotte; Wilson, Nick; Woodward, Alistair

2005-01-01

OBJECTIVE: To estimate the individual-level association of income poverty with being underweight, using tobacco, drinking alcohol, having access only to unsafe water and sanitation, being exposed to indoor air pollution and being obese. METHODS: Using survey data for as many countries as possible, we estimated the relative risk association between income or assets and risk factors at the individual level within 11 medium- and low-income subregions of WHO. WHO and The World Bank data on the prevalence of risk factors and income poverty (defined as living on < US$ 1.00 per day, US$ 1-2.00 per day and > US$ 2.00 per day) were analysed to impute the association between poverty and risk factors for each subregion. The possible effect of poverty reduction on the prevalence of risk factors was estimated using population-attributable risk percentages. FINDINGS: There were strong associations between poverty and malnutrition among children, having access only to unsafe water and sanitation, and being exposed to indoor air pollution within each subregion (relative risks were twofold to threefold greater for those living on < US$ 1.00 per day compared with those living on > US$ 2.00 per day). Associations between poverty and obesity, tobacco use and alcohol use varied across subregions. If everyone living on < US$ 2.00 per day had the risk factor profile of those living on > US$ 2.00 per day, 51% of exposures to unimproved water and sanitation could be avoided as could 37% of malnutrition among children and 38% of exposure to indoor air pollution. The more realistic, but still challenging, Millennium Development Goal of halving the number of people living on < US$ 1.00 per day would achieve much smaller reductions. CONCLUSION: To achieve large gains in global health requires both poverty eradication and public health action. The methods used in this study may be useful for monitoring pro-equity progress towards Millennium Development Goals. PMID:15744404

"Everywhere but not specifically somewhere": a qualitative study on why the right to health is not explicit in the post-2015 negotiations.

PubMed

Brolan, Claire E; Hill, Peter S; Ooms, Gorik

2015-08-21

The Millennium Development Goals expire at the end of 2015 and global negotiations are underway to finalise the post-2015 Sustainable Development Goals. Much activism has occurred encouraging a post-2015 health and development goal embedded in the highest attainable standard of health ('right to health'). Despite this, the right to health was absent in three key post-2015 intergovernmental Sustainable Development Goal proposals in 2014, one of which was reinforced by the United Nations General Assembly in September 2014 as the guiding document for ongoing interstate negotiations. This article examines why it appears the right to health, so far, is not gaining direct expression in post-2015 discussion. This qualitative research is part of a broader study using thematic and discourse analysis examining the high-level policy debate on health goals in the discourse of the formulation of the post-2015 Sustainable Development Goals. Key-informant interviews were conducted in two interview rounds in 2013 and 2014, with participants from multilateral and other organisations (government, academia, civil society and philanthropy) responsible for health in the post-2015 development agenda (or the post-2015 development agenda more broadly). This study synthesises data from both interview rounds on Health and Human Rights in post-2015 Sustainable Development Goal negotiations. Six reasons why the right to health may not have gained effective traction in the unfolding post-2015 Member State negotiations were found. The first three reasons relate to broader issues surrounding human rights' (including sexual and reproductive health and rights) positioning within international relations discourse, and the second three relate to the challenges of transforming the human right to health into a practically applied post-2015 health goal. This paper reports the views of participants, many of who sit at the interface of United Nations and Member State negotiations, on the right to health's location (and projected trajectory) at two temporal junctions in evolving post-2015 negotiations. The interviews provide insight into high-level hesitancy that the right to health be expressly incorporated in the final post-2015 health and development goal, as well as documents participants' doubt that rights language will explicitly frame the broader Sustainable Development Goals, their targets and indicators.

Promoting people's health: challenges and opportunities.

PubMed

Heitkamp, P

1998-01-01

Promoting health underlines the right of each individual to the highest attainable standard of health. It stresses the importance of the participation of people and recognizes different sociocultural values and beliefs that are prevalent throughout the world. Working on health development has a sustainable effect only when done comprehensively: personal development, community development, organizational development, and political development. The international conferences that have marked the way of health promotion have been goal posts of an energetic movement to strengthen health worldwide. The Ottawa Charter on Health Promotion has been a worldwide source of guidance for health promotion through its five strategies: building health policy, creating supportive elements, strengthening community action, developing personal skills, and reorienting health services. Moreover, the Jakarta Declaration on "Leading Health Promotion into the 21st Century" identifies five priorities in the next millennium: 1) promote social responsibility for health; 2) increase investments for health development; 3) consolidate and expand partnerships for health; 4) increase community capacity and empower the individual in matters of health; and 5) secure an infrastructure for health promotion. Increasing the investment in health development calls for the need to find new mechanisms for funding as well as reorienting existing resources towards health promotion and health education.

Learning for Development: The Commonwealth of Learning and the Millennium Development Goals

ERIC Educational Resources Information Center

Commonwealth of Learning, 2011

2011-01-01

World leaders, meeting at the United Nations in 2000, set eight Millennium Development Goals (MDGs) that aim to transform the condition of humankind in the 21st century. These Goals now guide the policies of governments and the priorities of development agencies. These eight goals are: (1) Eradicate extreme poverty and hunger; (2) Achieve…

The Role of Public Health Nutrition in Achieving the Sustainable Development Goals in the Asia Pacific Region.

PubMed

Binns, Colin; Lee, Mi Kyung; Low, Wah Yun; Zerfas, Alfred

2017-10-01

The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger-food), 3 (good health and well-being-healthy life), and 12 (responsible consumption and production-sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender-education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is "good health and well-being," which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of APACPH in education and advocacy and in fulfilling the educational needs of public health students in public health nutrition.

Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience

PubMed Central

Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

2015-01-01

Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies. PMID:26673477

Public sector health financing in Pakistan: a retrospective study.

PubMed

Mohammad, Khalif Bile; Hafeez, Assad; Nishter, Sania

2007-06-01

To assess the existing situation relating to investments made by development partners in the health sector in Pakistan. This was a retrospective study completed over a period of 6 months in which financial data for the year July 2004 to June 2005 was collected. A uniform matrix was circulated to all the stakeholders in public sector and international donors who had a stake in health. Details of expenses in health over the last 5 years and plans for the next 10 years were requested. Initial draft was shared with all concerned for concurrence before finalization. Simple analysis was carried out on the collected data. About 80% of the financial resources in the public sector are provided by the Government of Pakistan with non-development and recurring expenses predominating in these allocations. The study shows that Pakistan's per capita spending on health by the public sector is Rs 375.00 (US$ 6.4) out of which Rs 80 (US$ 1.3) is being contributed by the partners. Majority of the partners contributions are used for development projects. The study concludes that an additional amount of about 250 billion rupees per year (keeping in mind the recommendations of Commission for Macroeconomics and Health) are required by the health sector. This can only be achieved by allocating at least 50% more for health every year for next 10 years in order to catch up on the lagging targets set by Millennium Development Goals for Pakistan.

Developing and sustaining human resources in the health supply chain in Ethiopia: barriers and enablers.

PubMed

Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba; Mekasha Habtegiorgis, Bitsatab; Teshome Gebregeorgise, Dawit; Essah, Nana Am; Khan, Sara A; Brown, Andrew N

2016-01-01

The health supply chain is often the weakest link in achieving the health-related Millennium Development Goals and universal health coverage, requiring trained professionals who are often unavailable. In Ethiopia there have been recent developments in the area of health supply chain management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. A series of face-to-face interviews with key stakeholders was carried out in 2014. The interviews were conducted using a semi-structured interview guide. The interview guide comprised 51 questions. A qualitative analysis of transcripts was made. A total of 25 interviews were conducted. Three themes were identified: General changes: recognition, commitment and resources, Education and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. Ethiopia is on the way to developing a nationwide viable system for health supply chain management. However, there are still challenges. Short-term challenges include the importance of highlighting strategies and programs for human resources in health supply chain management. In the long term, commitments to financial support must be obtained. A strategy is needed for the further development and sustainability of human resources in the health supply chain in Ethiopia.

Human resources and access to maternal health care.

PubMed

ten Hoope-Bender, P; Liljestrand, J; MacDonagh, S

2006-09-01

The lack of human resources is one of the main bottlenecks to achieving the Millennium Development Goals on maternal and child health. A coherent national policy, recognized across government, needs to be in place to overcome this especially in countries severely affected by HIV/AIDS. Such a policy should cover selection of pre-service students, the qualifications of trainers and training sites, supportive supervision, career path development, a package of carefully thought-out incentives for the retention of staff, strategies for interaction with communities, and an agreed-upon health staff HIV/AIDS policy. Without such coherent human resource planning, a large number of countries will fail to reduce maternal and newborn mortality.

Nature versus nurture segues to choice versus circumstance in the new millennium: one consideration for an integrative biopsychosocial philosophy, art, and science of chiropractic.

PubMed

Smith, Monica

2009-12-01

This commentary discusses the evolving sociocultural roles and sociocultural authority of chiropractic. The complex interconnectivity of the biological, psychological, and social aspects of our individual and collective well-being has occupied centuries of "nature versus nurture" philosophical debate, creative art, and scientific work. What has emerged is a better understanding of how our human development is affected by the circumstances of what we are born with (ie, nature) and how we are shaped by the circumstances that we are born into (ie, nurture). In the new millennium, a cumulative challenge to the emerging integrative biopsychosocial health care disciplines is one of reconciling "circumstance versus choice"; that is, advancing individually and collectively the fullest actualization of human potential through the philosophy, art, and science of autonomy and empowerment.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana

PubMed Central

Mupara, Lucia U.; Lubbe, Johanna C.

2016-01-01

Background Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. Design A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. Results The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. Conclusions The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana. PMID:26899774

The Millennium Villages Project: a retrospective, observational, endline evaluation.

PubMed

Mitchell, Shira; Gelman, Andrew; Ross, Rebecca; Chen, Joyce; Bari, Sehrish; Huynh, Uyen Kim; Harris, Matthew W; Sachs, Sonia Ehrlich; Stuart, Elizabeth A; Feller, Avi; Makela, Susanna; Zaslavsky, Alan M; McClellan, Lucy; Ohemeng-Dapaah, Seth; Namakula, Patricia; Palm, Cheryl A; Sachs, Jeffrey D

2018-05-01

The Millennium Villages Project (MVP) was a 10 year, multisector, rural development project, initiated in 2005, operating across ten sites in ten sub-Saharan African countries to achieve the Millennium Development Goals (MDGs). In this study, we aimed to estimate the project's impact, target attainment, and on-site spending. In this endline evaluation of the MVP, we retrospectively selected comparison villages that best matched the project villages on possible confounding variables. Cross-sectional survey data on 40 outcomes of interest were collected from both the project and the comparison villages in 2015. Using these data, as well as on-site spending data collected during the project, we estimated project impacts as differences in outcomes between the project and comparison villages; target attainment as differences between project outcomes and prespecified targets; and on-site spending as expenditures reported by communities, donors, governments, and the project. Spending data were not collected in the comparison villages. Averaged across the ten project sites, we found that impact estimates for 30 of 40 outcomes were significant (95% uncertainty intervals [UIs] for these outcomes excluded zero) and favoured the project villages. In particular, substantial effects were seen in agriculture and health, in which some outcomes were roughly one SD better in the project villages than in the comparison villages. The project was estimated to have no significant impact on the consumption-based measures of poverty, but a significant favourable impact on an index of asset ownership. Impacts on nutrition and education outcomes were often inconclusive (95% UIs included zero). Averaging across outcomes within categories, the project had significant favourable impacts on agriculture, nutrition, education, child health, maternal health, HIV and malaria, and water and sanitation. A third of the targets were met in the project sites. Total on-site spending decreased from US$132 per person in the first half of the project (of which $66 was from the MVP) to $109 per person in the second half of the project (of which $25 was from the MVP). The MVP had favourable impacts on outcomes in all MDG areas, consistent with an integrated rural development approach. The greatest effects were in agriculture and health, suggesting support for the project's emphasis on agriculture and health systems strengthening. The project conclusively met one third of its targets. The Open Society Foundations, the Islamic Development Bank, and the governments of Japan, South Korea, Mali, Senegal, and Uganda. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

An evaluation of the current state of sexual and reproductive health and rights of women in Ghana.

PubMed

Adjei, Bismark; Wolterbeek, Ron; Peters, Alexander A W

2015-01-01

To provide a current account of women's sexual and reproductive health and rights (SRHR) in Ghana (West Africa), a priority area in achieving the World Health Organization's Millennium Development Goals. The study was observational. Three-hundred ninety Ghanaian women attending cervical cancer screening were surveyed about their SRHR. The data were analyzed with chi-squared test (p ≤ 0.05, two-sided). 22.1% had a life-time history of non-consensual sexual experience and 55.4% a previous history of abortion, mostly using services of a registered clinic (68.5%). Experience of sexual violence increased life-time risk of abortion (p = 0.018). The overall use of contraceptives was high (>60%); however, condom use during sexual intercourse with a new partner was low (23%), even among the highly educated women (32.7%) and women who stated to have received information on the risks and benefits of condom use (26.0%). Although condom use among the highly educated women was low, it was still 2 times higher than among the lower educated women, 15.7% (p < 0.001). There was also less condom use among the women with multiple sexual partners compared to single-partnered women (p = 0.001). More than a decade after the inception of the Millennium Development Goals, there is still work to be done in Ghana, especially on education and sexual violence.

Addressing inequity to achieve the maternal and child health millennium development goals: looking beyond averages.

PubMed

Ruhago, George M; Ngalesoni, Frida N; Norheim, Ole F

2012-12-27

Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania. We used the Lives Saved Tool (LiST) to estimate potential reductions in maternal and child mortality and the number of lives saved across wealth quintiles and between rural and urban settings. High impact maternal and child health interventions were modelled for a five-year scale up, by linking intervention coverage, effectiveness and cause of mortality using data from Tanzania. Concentration curves were drawn and the concentration index estimated to measure the equity impact of the scale up. In the poorest population quintiles in Tanzania, the lives of more than twice as many mothers and under-fives were likely to be saved, compared to the richest quintile. Scaling up coverage to equal levels across quintiles would reduce inequality in maternal and child mortality from a pro rich concentration index of -0.11 (maternal) and -0.12 (children) to a more equitable concentration index of -0,03 and -0.03 respectively. In rural areas, there would likely be an eight times greater reduction in maternal deaths than in urban areas and a five times greater reduction in child deaths than in urban areas. Scaling up priority maternal and child health interventions to equal levels would potentially save far more lives in the poorest populations, and would accelerate equitable progress towards maternal and child health MDGs.

Addressing inequity to achieve the maternal and child health millennium development goals: looking beyond averages

PubMed Central

2012-01-01

Background Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania. Methods We used the Lives Saved Tool (LiST) to estimate potential reductions in maternal and child mortality and the number of lives saved across wealth quintiles and between rural and urban settings. High impact maternal and child health interventions were modelled for a five-year scale up, by linking intervention coverage, effectiveness and cause of mortality using data from Tanzania. Concentration curves were drawn and the concentration index estimated to measure the equity impact of the scale up. Results In the poorest population quintiles in Tanzania, the lives of more than twice as many mothers and under-fives were likely to be saved, compared to the richest quintile. Scaling up coverage to equal levels across quintiles would reduce inequality in maternal and child mortality from a pro rich concentration index of −0.11 (maternal) and −0.12 (children) to a more equitable concentration index of −0,03 and −0.03 respectively. In rural areas, there would likely be an eight times greater reduction in maternal deaths than in urban areas and a five times greater reduction in child deaths than in urban areas. Conclusions Scaling up priority maternal and child health interventions to equal levels would potentially save far more lives in the poorest populations, and would accelerate equitable progress towards maternal and child health MDGs. PMID:23270489

After Muskoka.

PubMed

Landrivon, G; Aboubaker, S; Nkurunziza, T; Habimana, P; Grimaldi, C

2016-11-01

Substantial progress has been accomplished in reducing maternal, neonatal, and infant mortality, but the work to meet the Millennium Development Goals, boosted by numerous initiatives, including Muskoka, is far from finished. Since 2016, the Sustainable Development Goals, as well as the International Strategy for Women's, Children's, and Adolescent Health 2016 - 2030, have provided to the countries and development partners a consistent framework for action enlarged to all of the dimensions of human development, while keeping women, children, and adolescents at its heart. In this context, the Muskoka program, after an initial 5-year cycle, will continue in 2017.

A Dime a Day: The Possibilities and Limits of Private Schooling in Pakistan

ERIC Educational Resources Information Center

Andrabi, Tahir; Das, Jishnu; Khwaja, Asim Ijaz

2008-01-01

The authors of this article state that Pakistan is severely offtrack in its progress toward the Millennium Development Goals relating to education for all. Its educational performance is poor, both in absolute terms and relative to the average income of the country. Pakistan has received global attention because of the widespread perception that…

Global Inequality, Capabilities, Social Justice: The Millennium Development Goal for Gender Equality in Education

ERIC Educational Resources Information Center

Unterhalter, E.

2005-01-01

The Millennium Development Goal (MDG) for gender equality in education by 2005 has been criticised for its grandiose ambition, its failure to adequately conceptualise the nature of gender inequality or the diverse forms this takes, the inadequate policies developed to put the goal into practice and the limited measurements used for monitoring. The…

Implementation of the Millennium Development Goals in Nigeria through Non-Formal Education Curriculum

ERIC Educational Resources Information Center

Akpama, Simon Ibor; Asor, Love Joseph; Erim, Costly M.; Adekola, G.

2012-01-01

Nigeria is a signatory to the Millennium Development Goals (MDGs) declaration but till now she has not made any significant milestones in actualizing these human development goals. In spite of the coordinated efforts towards mobilizing those in the formal education system to partially address its implementation challenges, serious gaps still exit…

Developing an Educational Performance Indicator for New Millennium Learners

ERIC Educational Resources Information Center

Kang, Myunghee; Heo, Heeok; Jo, Il-Hyun; Shin, Jongho; Seo, Jeonghee

2012-01-01

Educational performance based on the learning outcomes of formal schooling in a future knowledge society could be significantly different from that of today. This study investigates the possibilities of developing an educational performance indicator for new-millennium learners (NMLs). The researchers conducted literature reviews, a meeting of…

Towards a Framework Convention on Global Health: a transformative agenda for global health justice.

PubMed

Gostin, Lawrence O; Friedman, Eric A

2013-01-01

Global health inequities cause nearly 20 million deaths annually, mostly among the world's poor. Yet international law currently does little to reduce the massive inequalities that underlie these deaths. This Article offers the first systematic account of the goals and justifications, normative foundations, and potential construction of a proposed new global health treaty, a Framework Convention on Global Health (FCGH), grounded in the human right to health. Already endorsed by the United Nations Secretary-General, the FCGH would reimagine global governance for health, offering a new, post-Millennium Development Goals vision. A global coalition of civil society and academics has formed the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI) to advance the FCGH.

A position statement on mental health in the post-2015 development agenda

PubMed Central

2014-01-01

Background The Millennium Development Goals have guided development co-operation in the 15 years up to 2015, achieving some significant progress in the priorities on which they focused. As the framework for the post-2015 development agenda is negotiated, this article reviews the evidence for the place of mental health in broader development issues that have already been outlined in the run-up to 2015. Discussion If mental health is going to be recognised as having an essential role in development, there needs to be a consensus on priorities for advocacy. Various key issues emerged from a survey of stakeholders in the Movement for Global Mental Health (MGMH), leading to a Position Statement, which is now available for use by advocates. The priorities that emerged were increasing access to mental health services, and addressing human rights abuse, stigma, and exclusion. Summary Mental health is a cross-cutting issue, and including it in frameworks for action will increase the likelihood of achieving global priorities for development such as poverty reduction, economic development, improved health, and ensuring the most vulnerable in society are not left behind. PMID:25050137

Limited Representation of Individuals with Disabilities in Early Childhood Classes: Alarming or Status Quo?

ERIC Educational Resources Information Center

Favazza, Paddy C.; Ostrosky, Michaelene M.; Meyer, Lori E.; Yu, SeonYeong; Mouzourou, Chryso

2017-01-01

UNICEF's new Millennium Development Goals and Beyond (2015. http://www.un.org/millenniumgoals/) focus on the needs of the largest marginalised minority, individuals with disabilities, challenging us to examine issues related to exclusion and develop strategies for making an authentic sense of belonging and high-quality early childhood education a…

Perinatal pathology: practice suggestions for limited-resource settings.

PubMed

Roberts, Drucilla J

2013-06-01

The practice of perinatal pathology in much of the world suffers, as do all subspecialties of anatomic pathology, from inadequate resources (equipment, consumables, and both professional and technical personnel), from lack of education (not only of the pathologist but also of the clinicians responsible for sending the specimens, and the technicians processing the specimens), and from lack of appropriate government sector support. Perinatal pathology has significant public health-related utility and should be championing its service by providing maternal and fetal/infant mortality and morbidity data to governmental health ministries. It is with this pathologic data that informed decisions can be made on health-related courses of action and allocation of resources. These perinatal pathology data are needed to develop appropriate public health initiatives, specifically toward achieving the Millennium Developmental Goals as the best way to effectively decrease infant and maternal deaths and to determine causes of perinatal mortality and morbidity. The following overview will focus on the utility of perinatal pathology specifically as related to its public health function and will suggest methods to improve its service in resource-poor settings. This article is offered not as a critique of the current practice that most pathologists find themselves working in globally, but to provide suggestions for improving perinatal pathology services, which could be implemented with the limited available resources and manpower most pathology departments currently have. In addition, we offer suggestions for graded improvements ("ramping up") over time.

Developing a Model of Compulsory Basic Education Completion Acceleration in Support of Millennium Development Goals in Magelang, Indonesia

ERIC Educational Resources Information Center

Sukarno; Haryati, Sri

2015-01-01

This article reports Year One of a two-year study to develop a model to accelerate compulsory basic education completion toward Millennium Development Goals (MDGs) in Magelang, Indonesia. The study focuses on five issues: (1) profile of MDGs in Magelang, (2) achievement of MDGs, (3) problems in MDGs implementation, (4) model of compulsary basic…

[Using the concept of universal health coverage to promote the health system reform in China].

PubMed

Hu, S L

2016-11-06

The paper is systematically explained the definition, contents of universal health coverage (UHC). Universal health coverage calls for all people to have access to quality health services they need without facing undue financial burden. The relationship between five main attributes, i.e., quality, efficiency, equity, accountability and resilience, and their 15 action plans has been explained. The nature of UHC is belonged to the State and government. The core function is commitment with equality. The whole-of-system method is used to promoting the health system reform. In China, the universal health coverage has been reached to the preliminary achievements, which include universal coverage of social medical insurance, basic medical services, basic public health services, and the provision of essential medicines. China has completed millennium development goals (MDG) and is being stepped to the sustainable development goals (SDG).

Planning for successful outcomes in the new millennium.

PubMed

Matthews, P

2000-02-01

The complexity of the health care environment will increase in the next millennium. Organizations must adopt an approach of selecting outcomes management solutions that are focused on data capture, analysis, and comparative reviews and reporting. They must decisively and creatively implement, in a phased approach, integrated solutions from existing robust systems, while considering future systems targeted for implementation. Outcomes management solutions must be integrated with the organization's information systems strategic plan. The successful organization must be able to turn business-critical data into information that supports both business and clinical decision-making activities. In short, health care organizations will have to become information-driven.

[Spanish international cooperation in health].

PubMed

Mazarrasa-Alvear, Lucía; Montero-Corominas, María José

2004-05-01

In this chapter, there is a view of the relationships between the Spanish policy for international cooperation aid and the main health problems of the developing world, with a gender perspective. The population health is a result of the development inequity between rich and poor countries. The international institutions have established the frame and priorities of the cooperation aid, being poverty eradication the main priority. The compromise of the Millennium Conference was to reduce in 2/3 child mortality and 3/4 maternal mortality before year 2015, to stop and reduce HIV-AIDS, malaria and others serious diseases as tuberculosis and to facilitate developing countries the access to drugs. Although the resources allocated, the total amount for cooperation has been reduced 30% during the last years. The Spanish AOD in health is difficult to account because it is considered among social basic services and it is not addressed to solve the main health problems in the poorest countries.

Responsive parenting: interventions and outcomes.

PubMed Central

Eshel, Neir; Daelmans, Bernadette; de Mello, Meena Cabral; Martines, Jose

2006-01-01

In addition to food, sanitation and access to health facilities children require adequate care at home for survival and optimal development. Responsiveness, a mother's/caregiver's prompt, contingent and appropriate interaction with the child, is a vital parenting tool with wide-ranging benefits for the child, from better cognitive and psychosocial development to protection from disease and mortality. We examined two facets of responsive parenting -- its role in child health and development and the effectiveness of interventions to enhance it -- by conducting a systematic review of literature from both developed and developing countries. Our results revealed that interventions are effective in enhancing maternal responsiveness, resulting in better child health and development, especially for the neediest populations. Since these interventions were feasible even in poor settings, they have great potential in helping us achieve the Millennium Development Goals. We suggest that responsiveness interventions be integrated into child survival strategies. PMID:17242836

Positively essential: traditional birth attendants in Malawi.

PubMed

Stronge, Shirley

2011-06-01

One of the biggest challenges for healthcare professionals working in developing countries is the lack of trained personnel to carry out much needed health care provision. Shirley Stronge worked as a nurse/midwife tutor in a rural area in the north of Malawi. Millennium Development Goals four and five have focused our attention on the care required by mothers and newborns. Shirley has chosen to reflect on the role of Traditional Birth Attendants in the north of Malawi and their positive impact on maternity services in this area.

Curriculum-Making in South Africa: Promoting Gender Equality and Empowering Women (?)

ERIC Educational Resources Information Center

Simmonds, Shan

2014-01-01

The United Nations Millennium Development Goals (2000-2015) are clearly embedded in South Africa's education policy documents. However, they are not adequately infused into the curriculum. This article focuses specifically on the third Millennium Development Goal (MDG) - promoting gender equality and empowering women - and the need to place this…

Poverty, Education, Gender and the Millennium Development Goals: Reflections on Boundaries and Intersectionality

ERIC Educational Resources Information Center

Unterhalter, Elaine

2012-01-01

The article considers the Millennium Development Goals (MDGs) concerned with poverty, education and gender (MDG 1, MDG 2 and MDG 3). Despite considerable achievements associated with the MDG approach, which entails international and national target setting and monitoring, a sharp distinction between areas of social policy is entailed. In addition…

Correlates of healthy life expectancy in low- and lower-middle-income countries.

PubMed

Islam, Md Shariful; Mondal, Md Nazrul Islam; Tareque, Md Ismail; Rahman, Md Aminur; Hoque, Md Nazrul; Ahmed, Md Munsur; Khan, Hafiz T A

2018-04-11

Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries. In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives. The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors. To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam

PubMed Central

Ha, Bui Thi Thu; Mirzoev, Tolib; Mukhopadhyay, Maitrayee

2015-01-01

Background: Maternal health remains a central policy concern in Vietnam. With a commitment to achieving the Millennium Development Goal (MDG) 5 target of maternal mortality rate (MMR) of 70/100 000 by 2015, the Ministry of Health (MoH) issued the National Plan for Safe Motherhood (NPSM) 2003-2010. In 2008, reproductive health, including safe motherhood (SM) became a national health target program with annual government funding. Methods: A case study of how SM emerged as a political priority in Vietnam over the period 2001-2008, drawing on Kingdon’s theory of agenda-setting was conducted. A mixed method was adopted for this study of the NPSM. Results: Three related streams contributed to SM priority in Vietnam: (1) the problem of high MMR was officially recognized from high-quality research, (2) the strong roles of policy champion from MoH in advocating for the needs to reducing MMR as well as support from government and donors, and (3) the national and international events, providing favorable context for this issue to emerge on policy agenda. Conclusion: This paper draws on the theory of agenda-setting to analyze the Vietnam experience and to develop guidance for SM a political priority in other high maternal mortality communities. PMID:26673334

"Girl Power!": The Relationship between Women's Autonomy and Children's Immunization Coverage in Ethiopia.

PubMed

Ebot, Jane O

2015-09-18

Although immunizations are efficient and cost effective methods of reducing child mortality, worldwide, approximately 2 million children die yearly of vaccine-preventable diseases. Researchers and health organizations have detailed information on the positive relationship between women's autonomy and children's health outcomes in developing countries. This study investigates the links between women's household autonomy and children's immunization status using data from a nationally representative sample of children aged 12-30 months (N = 2941) from the 2011 Ethiopia Demographic and Health Survey. The results showed that women's socioeconomic status and household autonomy were significantly associated with children's immunization status. Overall, the implications of this study align with those of the Millennium Development Goal #3: improvements in women's household autonomy are linked to more positive child health outcomes.

Lifelong Learning and the Attainment of the Education-Related Millennium Development Goals 2 and 3 in Ghana. Is There a Critical Nexus?

ERIC Educational Resources Information Center

Tagoe, Michael

2011-01-01

In an environment of rapid technological change, countries in the developed and developing worlds need to improve the population's skills and competences. Since 1992, education reforms and various education sector documents and policy frameworks have been implemented to improve quality of education by getting more children into school through the…

Can innovative health financing policies increase access to MDG-related services? Evidence from Rwanda.

PubMed

Sekabaraga, Claude; Diop, Francois; Soucat, Agnes

2011-11-01

Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved financial access for the poor, increased utilization of health services and reduced out-of-pocket payments for health care. Poor groups' utilization has increased for all health services, sometimes dramatically. Use of assisted deliveries, for example, increased from 12.1% to 42.7% among the poorest quintile; payments at the point of delivery have also been reduced; and catastrophic expenditures have declined. Part of these achievements is likely linked to innovative health financing policies, particularly the expansion of micro-insurance ('mutuelles') and performance-based financing. The paper concludes that the Rwanda experience provides a useful example of effective implementation of policies that reduce the financial barrier to health services, hereby contributing to the health MDGs. Today's main challenge is to build the sustainability of this system. Finally, the paper proposes a simple set of rigorous metrics to assess the impact of health financing policies and calls for implementing rigorous impact evaluation of health care financing policies in low-income countries.

Progress towards millennium development goal 1 in northern rural Nicaragua: Findings from a health and demographic surveillance site

PubMed Central

2012-01-01

Background Millennium Development Goal 1 encourages local initiatives for the eradication of extreme poverty. However, monitoring is indispensable to insure that actions performed at higher policy levels attain success. Poverty in rural areas in low- and middle-income countries remains chronic. Nevertheless, a rural area (Cuatro Santos) in northern Nicaragua has made substantial progress toward poverty eradication by 2015. We examined the level of poverty there and described interventions aimed at reducing it. Methods Household data collected from a Health and Demographic Surveillance System was used to analyze poverty and the transition out of it, as well as background information on family members. In the follow-up, information about specific interventions (i.e., installation of piped drinking water, latrines, access to microcredit, home gardening, and technical education) linked them to the demographic data. A propensity score was used to measure the association between the interventions and the resulting transition from poverty. Results Between 2004 and 2009, poverty was reduced as a number of interventions increased. Although microcredit was inequitably distributed across the population, combined with home gardening and technical training, it resulted in significant poverty reduction in this rural area. Conclusions Sustainable interventions reduced poverty in the rural areas studied by about one- third. PMID:22894144

Progress towards Millennium Development Goal 1 in northern rural Nicaragua: findings from a health and demographic surveillance site.

PubMed

Pérez, Wilton; Blandón, Elmer Zelaya; Persson, Lars-Åke; Peña, Rodolfo; Källestål, Carina

2012-08-15

Millennium Development Goal 1 encourages local initiatives for the eradication of extreme poverty. However, monitoring is indispensable to insure that actions performed at higher policy levels attain success. Poverty in rural areas in low- and middle-income countries remains chronic. Nevertheless, a rural area (Cuatro Santos) in northern Nicaragua has made substantial progress toward poverty eradication by 2015. We examined the level of poverty there and described interventions aimed at reducing it. Household data collected from a Health and Demographic Surveillance System was used to analyze poverty and the transition out of it, as well as background information on family members. In the follow-up, information about specific interventions (i.e., installation of piped drinking water, latrines, access to microcredit, home gardening, and technical education) linked them to the demographic data. A propensity score was used to measure the association between the interventions and the resulting transition from poverty. Between 2004 and 2009, poverty was reduced as a number of interventions increased. Although microcredit was inequitably distributed across the population, combined with home gardening and technical training, it resulted in significant poverty reduction in this rural area. Sustainable interventions reduced poverty in the rural areas studied by about one-third.

Enhancing global health and education in Malawi, Zambia, and the United States through an interprofessional global health exchange program.

PubMed

Wilson, Lynda Law; Somerall, D'Ann; Theus, Lisa; Rankin, Sally; Ngoma, Catherine; Chimwaza, Angela

2014-05-01

This article describes participant outcomes of an interprofessional collaboration between health professionals and faculty in Malawi, Zambia, and the United States (US). One strategy critical for improving global health and addressing Millennium Development goals is promotion of interprofessional education and collaboration. Program participants included 25 health professionals from Malawi and Zambia, and 19 faculty/health professionals from Alabama and California. African Fellows participated in a 2 week workshop on Interprofessional Education in Alabama followed by 2 weeks working on individual goals with faculty collaborators/mentors. The US Fellows also spent 2 weeks visiting their counterparts in Malawi and Zambia to develop plans for sustainable partnerships. Program evaluations demonstrated participants' satisfaction with the program and indicated that the program promoted interprofessional and cross-cultural understanding; fostered development of long-term sustainable partnerships between health professionals and educators in Zambia and the US; and created increased awareness and use of resources for global health education. © 2014.

Preliminary data on ASP2215: tolerability and efficacy in acute myeloid leukemia patients.

PubMed

Thom, Claire

2015-09-01

Claire Thom speaks to Gemma Westcott, Commissioning Editor: Claire Thom joined Astellas in 2013 as the Therapeutic Area Head for Oncology in Global Development. In that role, she also serves as the STAR leader for Oncology for Astellas. Prior to Astellas, she spent 12 years with Takeda. Her last position was Senior Vice President, Portfolio Management, Drug Development Management and Medical Informatics and Strategic Operations within the Medical Division (the Division within Millennium responsible for oncology clinical drug development within Takeda). During her 4 years at Millennium, at various times, she had responsibility within the Medical Division for leading portfolio management, business operations (medical finance, annual and mid-range financial planning, space planning and operations, headcount resourcing, development goals process), clinical development operations (clinical operations, programming, data management, statistics, medical writing, clinical outsourcing), drug development management (project management), medical informatics (technology support for the division) and the strategic project management office for the division. Prior to joining Millennium, Claire Thom spent 18 months working in Osaka, Japan, during which she was responsible for developing the oncology strategy for Takeda that culminated in the acquisition of Millennium. Before going to Japan, she held positions of varying responsibility within the Takeda US development organization including the management of regulatory affairs, safety, biometrics and data management, clinical research and quality assurance. Claire Thom has particular expertise in organizational design and efficiency; she has successfully worked through integrations across multiple functions and redesigned business processes. She has a PharmD from University of Illinois (IL, USA) and over 20 years of pharmaceutical experience including positions in medical affairs and new product planning (over 11 years at Searle) and drug development (over 12 years at Takeda/Millennium).

Nature versus nurture segues to choice versus circumstance in the new millennium: one consideration for an integrative biopsychosocial philosophy, art, and science of chiropractic

PubMed Central

Smith, Monica

2010-01-01

Objective This commentary discusses the evolving sociocultural roles and sociocultural authority of chiropractic. Discussion The complex interconnectivity of the biological, psychological, and social aspects of our individual and collective well-being has occupied centuries of “nature versus nurture” philosophical debate, creative art, and scientific work. What has emerged is a better understanding of how our human development is affected by the circumstances of what we are born with (ie, nature) and how we are shaped by the circumstances that we are born into (ie, nurture). Conclusion In the new millennium, a cumulative challenge to the emerging integrative biopsychosocial health care disciplines is one of reconciling “circumstance versus choice”; that is, advancing individually and collectively the fullest actualization of human potential through the philosophy, art, and science of autonomy and empowerment. PMID:22693464

Maternal and perinatal health research priorities beyond 2015: an international survey and prioritization exercise.

PubMed

Souza, Joao Paulo; Widmer, Mariana; Gülmezoglu, Ahmet Metin; Lawrie, Theresa Anne; Adejuyigbe, Ebunoluwa Aderonke; Carroli, Guillermo; Crowther, Caroline; Currie, Sheena M; Dowswell, Therese; Hofmeyr, Justus; Lavender, Tina; Lawn, Joy; Mader, Silke; Martinez, Francisco Eulógio; Mugerwa, Kidza; Qureshi, Zahida; Silvestre, Maria Asuncion; Soltani, Hora; Torloni, Maria Regina; Tsigas, Eleni Z; Vowles, Zoe; Ouedraogo, Léopold; Serruya, Suzanne; Al-Raiby, Jamela; Awin, Narimah; Obara, Hiromi; Mathai, Matthews; Bahl, Rajiv; Martines, José; Ganatra, Bela; Phillips, Sharon Jelena; Johnson, Brooke Ronald; Vogel, Joshua P; Oladapo, Olufemi T; Temmerman, Marleen

2014-08-07

Maternal mortality has declined by nearly half since 1990, but over a quarter million women still die every year of causes related to pregnancy and childbirth. Maternal-health related targets are falling short of the 2015 Millennium Development Goals and a post-2015 Development Agenda is emerging. In connection with this, setting global research priorities for the next decade is now required. We adapted the methods of the Child Health and Nutrition Research Initiative (CHNRI) to identify and set global research priorities for maternal and perinatal health for the period 2015 to 2025. Priority research questions were received from various international stakeholders constituting a large reference group, and consolidated into a final list of research questions by a technical working group. Questions on this list were then scored by the reference working group according to five independent and equally weighted criteria. Normalized research priority scores (NRPS) were calculated, and research priority questions were ranked accordingly. A list of 190 priority research questions for improving maternal and perinatal health was scored by 140 stakeholders. Most priority research questions (89%) were concerned with the evaluation of implementation and delivery of existing interventions, with research subthemes frequently concerned with training and/or awareness interventions (11%), and access to interventions and/or services (14%). Twenty-one questions (11%) involved the discovery of new interventions or technologies. Key research priorities in maternal and perinatal health were identified. The resulting ranked list of research questions provides a valuable resource for health research investors, researchers and other stakeholders. We are hopeful that this exercise will inform the post-2015 Development Agenda and assist donors, research-policy decision makers and researchers to invest in research that will ultimately make the most significant difference in the lives of mothers and babies.

Five Ways the Sustainable Development Goals Are Better than the Millennium Development Goals and Why Every Educationalist Should Care

ERIC Educational Resources Information Center

Caprani, Lily

2016-01-01

For 15 years the millennium development goals (MDGs) were a guiding force for many issues affecting the lives of children and young people around the world. Agreed by UN member states in 2001, the eight MDGs were designed as a framework around which states were expected to develop policy priorities and shape their overseas aid spending plans. The…

The effect of changes in health sector resources on infant mortality in the short-run and the long-run: a longitudinal econometric analysis.

PubMed

Farahani, Mansour; Subramanian, S V; Canning, David

2009-06-01

While countries with higher levels of human resources for health typically have better population health, the evidence that increases in the level of human resources for health leads to improvements in population health is limited. We use a dynamic regression model to obtain estimates of both the short-run and long-term effects of changes in physicians per capita, our measure of health system resources, on infant mortality. Using a dataset of 99 countries at 5-year intervals from 1960-2000, we estimate that increasing the number of physicians by one per 1000 population (roughly a doubling of current levels of provision) decreases the infant mortality rate by 15% within 5 years and by 45% in the long-run with half the long-run gain being achieved in 15 years. We conclude that the long-run effects of heath system resources are substantially larger than previously estimated. Our results suggest, however, that countries that have delayed action on the Millennium Development Goal of reducing infant and child mortality rate by two-thirds by 2015 (relative to 1990) may have difficulty meeting this goal even if they rapidly increase resources now.

The quality of the maternal health system in Eritrea.

PubMed

Sharan, Mona; Ahmed, Saifuddin; Ghebrehiwet, Mismay; Rogo, Khama

2011-12-01

To examine the quality of the maternal health system in Eritrea to understand system deficiencies and its relevance to maternal mortality within the context of Millennium Development Goal (MDG) 5. A sample of 118 health facilities was surveyed. Data were collected on 5 dimensions of health system quality: availability; accessibility; management; infrastructure; and process indicators. Data on the causes of hospital admissions for obstetric patients and maternal deaths were extracted from medical records. Eritrea has only 11 comprehensive emergency obstetric care (CEmOC) facilities, all of which are grossly understaffed. There is considerable pressure on the infrastructure and health providers at hospitals. Compliance with clinical care standards and availability of supplies were optimal. As a result, the case fatality rate of 0.65% was low. In total, 45.6% of obstetric admissions and 19.5% of maternal deaths were attributed to abortion complications. In Eritrea, critical gaps in the health system-especially those related to human resources-will impede progress toward MDG 5, and it will not be possible to reduce maternal mortality without addressing the high burden of abortion. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Emerging health issues: the widening challenge for population health promotion.

PubMed

McMichael, Anthony J; Butler, Colin D

2006-12-01

The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the development, human rights and environmental movements. The big task is to promote sustainable environmental and social conditions that bring enduring and equitable health gains.

Private Schools and the Millennium Development Goal of Universal Primary Education: A Census and Comparative Survey in Hyderabad, India

ERIC Educational Resources Information Center

Tooley, James; Dixon, Pauline; Gomathi, S. V.

2007-01-01

Development literature suggests that private schools serving the poor are not part of the solution to meeting the Millennium Development Goal (MDG) of universal primary education. The study conducted a census and survey of schools in notified slums of Hyderabad, India, to contribute to the sparse literature on the nature and extent of private…

No Pending National Elections, Who Cares? What Newspaper Publications Reveal about Local Efforts Towards Millennium Development Goal 3

ERIC Educational Resources Information Center

Arku, Frank S.; Arku, Cynthia

2013-01-01

The Millennium Development Goals (MDGs) has become a catch phrase in development discourse. This study is an assessment of the MDG 3: to promote gender equality at all levels of education in Ghana. The Daily Graphic (a newspaper in Ghana) which is Ghana's prominent newspaper was reviewed from 2000 to 2011 to determine the frequency of articles…

Multidisciplinary and participatory workshops with stakeholders in a community of extreme poverty in the Peruvian Amazon: Development of priority concerns and potential health, nutrition and education interventions

PubMed Central

Casapia, Martin; Joseph, Serene A; Gyorkos, Theresa W

2007-01-01

Background Communities of extreme poverty suffer disproportionately from a wide range of adverse outcomes, but are often neglected or underserved by organized services and research attention. In order to target the first Millennium Development Goal of eradicating extreme poverty, thereby reducing health inequalities, participatory research in these communities is needed. Therefore, the purpose of this study was to determine the priority problems and respective potential cost-effective interventions in Belen, a community of extreme poverty in the Peruvian Amazon, using a multidisciplinary and participatory focus. Methods Two multidisciplinary and participatory workshops were conducted with important stakeholders from government, non-government and community organizations, national institutes and academic institutions. In Workshop 1, participants prioritized the main health and health-related problems in the community of Belen. Problem trees were developed to show perceived causes and effects for the top six problems. In Workshop 2, following presentations describing data from recently completed field research in school and household populations of Belen, participants listed potential interventions for the priority problems, including associated barriers, enabling factors, costs and benefits. Results The top ten priority problems in Belen were identified as: 1) infant malnutrition; 2) adolescent pregnancy; 3) diarrhoea; 4) anaemia; 5) parasites; 6) lack of basic sanitation; 7) low level of education; 8) sexually transmitted diseases; 9) domestic violence; and 10) delayed school entry. Causes and effects for the top six problems, proposed interventions, and factors relating to the implementation of interventions were multidisciplinary in nature and included health, nutrition, education, social and environmental issues. Conclusion The two workshops provided valuable insight into the main health and health-related problems facing the community of Belen. The participatory focus of the workshops ensured the active involvement of important stakeholders from Belen. Based on the results of the workshops, effective and essential interventions are now being planned which will contribute to reducing health inequalities in the community. PMID:17623093

The Use of ICT in Achieving the Millennium Development Goals (MDGs) in Universities

ERIC Educational Resources Information Center

Kaino, L. M.

2012-01-01

The contribution of Information and Communication Technology (ICT) in achieving the Millennium Development Goals (MDGs) and the contribution of higher education institutions in achieving these have been emphasized. This study sought to find out the extent to which university-based researches on ICTs addressed and impacted the three MDGs of gender…

Knowledge of Millennium Development Goals among University Faculty in Uganda and Kenya

ERIC Educational Resources Information Center

Wamala, Robert; Nabachwa, Mary Sonko; Chamberlain, Jean; Nakalembe, Eva

2012-01-01

This article examines the level of knowledge of the Millennium Development Goals (MDGs) among university faculty. The assessment is based on data from 197 academic unit or faculty heads randomly selected from universities in Uganda and Kenya. Frequency distributions and logistic regression were used for analysis. Slightly more than one in three…

ICTs and Indigenous Languages as Agents for the Actualization of Millennium Development Goals in Nigeria

ERIC Educational Resources Information Center

Olise, Festus Prosper

2013-01-01

This paper advocates for the use of Information and Communication Technologies (ICTs) and indigenous languages for the actualization of Millennium Development Goals (MDGs) in Nigeria because both tools are capable of transforming the rural and urban populace. It explores the MDGs so as to unravel the ways ICTs and indigenous languages can…

Life in a landfill slum, children's health, and the Millennium Development Goals.

PubMed

Shibata, Tomoyuki; Wilson, James L; Watson, Lindsey M; Nikitin, Ivan V; Ansariadi; La Ane, Ruslan; Maidin, Alimin

2015-12-01

People living in slums can be considered left behind with regard to national successes in achieving Millennium Development Goals (MDGs). The objective of this study was to evaluate the living and working conditions of waste pickers and their children in a landfill slum located in the largest city in eastern Indonesia. A total of 113 people from the landfill slum and 1184 people from the general population participated in face-to-face interviews. Municipal solid waste (MSW) was analyzed for metals, metalloids and fecal indicator bacteria. Ambient air quality including particulate matter was measured in the landfill. Households in the landfill slum were 5.73 (p=0.04) times more likely to be below the international poverty line (MDG 1: Poverty) and 15.6 times (p<0.01) more likely to have no one in the household possessing a primary education (MDG 2: Universal Education), and 107 times (p<0.01) more likely not to have improved sanitation facilities (MDG 7: Environmental Sustainability) when compared to the general population. Diarrhea is one of the leading causes of death in children under five in Indonesia. Young children living in the landfill slum were 2.87 times (p=0.02) more likely to develop diarrhea than their general population counterparts. Other survey results and environmental measurements suggest that landfill slum children have additional adverse health effects (e.g. infections and poisoning). Poverty underlies several MDG issues that directly or indirectly affect child health. Therefore, eradicating extreme poverty will continue to be the most critical challenge for the MDGs beyond 2015. Copyright © 2015 Elsevier B.V. All rights reserved.

Building the Nightingale Initiative for Global Health--NIGH: can we engage and empower the public voices of nurses worldwide?

PubMed

Beck, Deva-Marie; Dossey, Barbara M; Rushton, Cynda H

2013-10-01

The Nightingale Initiative for Global Health (NIGH) is a major grassroots-to-global movement of "daring, caring and sharing" of nursing and others around the world inspired by the outstanding legacy of Florence Nightingale. The Nightingale Initiative envisions and emulates what Nightingale might have accomplished if she lived in the digital age and with international agencies such as the United Nations and World Health Organization. It challenges nurses everywhere to think and act both locally and globally, to raise their voices about the contribution of nursing, and to become authentic advocates, particularly in addressing the United Nations Millennium Development Goals.

Analysis of misoprostol and chlorhexidine policy gains in Pakistan: the advocacy experience of Mercy Corps Pakistan.

PubMed

Sarwar, Zahida; Cutherell, Andrea; Noor, Arif; Naureen, Farah; Norman, Jennifer

2015-11-25

While Pakistan has made progress toward achieving Millennium Development Goal 5 for maternal health, it is unlikely to achieve the target; further, it is also not on track for Millennium Development Goal 4 regarding child health. Two low-cost, temperature stable and life-saving drugs, misoprostol and chlorhexidine, can respectively avert maternal and newborn deaths, and are particularly pertinent for poor and marginalized areas which bear the brunt of maternal and newborn deaths in Pakistan. In response, Mercy Corps led focused advocacy efforts to promote changes in policies, protocols, and regulatory environments for misoprostol (2012-2014) and for chlorhexidine (2014). These short-duration advocacy projects facilitated significant policy gains, such as inclusion of misoprostol and chlorhexidine into province-specific essential drug lists, development and endorsement of clinical protocols for the two drugs by provincial health departments, inclusion of misoprostol into pre-service training curriculum for several health cadres, and application for registration of chlorhexidine (at the concentration required for newborn care) by two pharmaceutical companies. These results were achieved by a consultative and evidence-based process which generated feedback from community members, program implementers, and policymakers, and ultimately put the government in the driver's seat to facilitate change. Community Action Dialogue forums were linked with provincial-level Technical Working Groups and Provincial Steering Committees, who passed on endorsed recommendations to the Health Secretary. The key factors which facilitated change were the identification of champions within the provincial health departments, prioritization of relationship building and follow-up, focus on concrete advocacy aims rather than broad objectives, and the use of multi-stakeholder forums to secure an enabling environment for the policy changes to take root. While these advocacy initiatives resulted in significant policy changes in Pakistan's devolved health system, to ensure these policy changes have an impact on health outcomes, Pakistan should focus on the scale-up of appropriate use of chlorhexidine and misoprostol. Further, future policy initiatives in Pakistan should make use of similar multi-stakeholder policy forums, while ensuring a third party to facilitate the process so that civil society and community voices are not lost in the policy development discussion.

Assessing Household Solid Fuel Use: Multiple Implications for the Millennium Development Goals

PubMed Central

Rehfuess, Eva; Mehta, Sumi; Prüss-Üstün, Annette

2006-01-01

Objective The World Health Organization is the agency responsible for reporting the Millennium Development Goal (MDG) indicator “percentage of population using solid fuels.” In this article, we present the results of a comprehensive assessment of solid fuel use, conducted in 2005, and discuss the implications of our findings in the context of achieving the MDGs. Methods For 93 countries, solid fuel use data were compiled from recent national censuses or household surveys. For the 36 countries where no data were available, the indicator was modeled. For 52 upper-middle or high-income countries, the indicator was assumed to be < 5%. Results According to our assessment, 52% of the world’s population uses solid fuels. This percentage varies widely between countries and regions, ranging from 77%, 74%, and 74% in Sub-Saharan Africa, Southeast Asia, and the Western Pacific Region, respectively, to 36% in the Eastern Mediterranean Region, 16% in Latin America and the Caribbean and in Central and Eastern Europe. In most industrialized countries, solid fuel use falls to the < 5% mark. Discussion Although the “percentage of population using solid fuels” is classified as an indicator to measure progress towards MDG 7, reliance on traditional household energy practices has distinct implications for most of the MDGs, notably MDGs 4 and 5. There is an urgent need for development agendas to recognize the fundamental role that household energy plays in improving child and maternal health and fostering economic and social development. PMID:16507460

Do piped water and flush toilets prevent child diarrhea in rural Philippines?

PubMed

Capuno, Joseph J; Tan, Carlos Antonio R; Fabella, Vigile Marie

2015-03-01

Similar to other developing countries, diarrhea in the Philippines continues to be among the top causes of child mortality and morbidity. In pursuit of its Millennium Development Goals, the Philippine government commits to reduce child deaths and provide water and sanitation services to more rural households by 2015. Applying propensity score matching on the 1993, 1998, 2003, and 2008 rounds of the National Demographic and Health Survey to estimate the average treatment effect on the treated, it is found that the incidence of diarrhea among under-5 children is lower by as much as 4.5% in households with access to piped water and 10% in those with their own flush toilets, relative to comparable households. These findings underscore the need to ensure the quality of drinking water from the pipe or from other improved sources at the point of use, and the provision of improved and own sanitation facilities. © 2011 APJPH.

A Prospective Study of Lupus and Rheumatoid Arthritis in Relation to Deployment in Support of Iraq and Afghanistan: The Millennium Cohort Study

DTIC Science & Technology

2011-01-01

personnel may experience several environmental and occupational expo- sures, including pesticides (environmental and topical), paints, solvents, and...uniform treatments) and environmental pesticides . 2.3. Outcomes. Lupus and RA were investigated using the baseline survey question “Has your doctor or...to newly report lupus were female , non- Hispanic black and Hispanic, not married, and of lower mental and physical health. The following variables

The New Millennium Program power technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chmielewski, A.B.; Das, A.; Cassapakis, C.

1996-12-31

The New Millennium Program (NMP) has been established to accelerate the infusion of breakthrough technologies into NASA space science missions. The goal of this technology infusion is to fulfill the NASA vision of frequent, low-cost missions to deep space and to plant Earth. Power is one of the most important keys to cost-effective space science missions. The power subsystem comprises over 25 percent of the mass of a typical space orbiter type spacecraft. The problems of power will become even more acute in the new millennium as deep space missions are asked to go farther from the Sun and getmore » to their destinations faster. Several power technology proposals were submitted to the NMP through its Modular and Multifunctional Systems Integrated Product Development Team (IPDT). The proposals described in this paper received the most consideration and in several cases resulted in the technology being selected for flight on one of the NMP missions. The technologies discussed here are: SCARLET array, Light Flexible array, lithium ion battery, cold temperature battery, inflatable concentrators and a related technology -- Multifunctional Structures.« less

Alemtuzumab (Millennium/ILEX).

PubMed

Dumont, F J

2001-01-01

Alemtuzumab, a lymphocyte-depleting humanized monoclonal antibody, is being developed by Millennium Pharmaceuticals Inc and ILEX Oncology for the potential treatment of chronic lymphocytic leukemia (CLL) [274580]. The utility of the compound for treating bone marrow (BM) stem cell transplantation-associated graft-versus-host disease (GVHD) [372946] and for ex vivo purging of BM to remove malignant T-cells [244056] is also being investigated. Additional potential therapeutic areas for which clinical trials are planned or ongoing include vasculitis, multiple sclerosis [288762] and organ transplantation [338304]. A Biologics License Application (BLA) was filed with the FDA in December 1999 by ILEX and Millennium [351523], [351524], [373873]. The FDA accepted the application for filing in February 2000 [355775] and returned a complete response letter in June 2000 [372172]. Millennium and ILEX submitted a response to the FDA in August 2000 [379766]. Alemtuzumab has received Fast Track designation [304771] and orphan drug status from the FDA [288762], and the drug was reviewed by the FDA's Oncologic Drugs Advisory Committee on 14 December, 2000 [387228]. The committee voted 14 to 1 to recommend accelerated approval of alemtuzumab for patients with CLL who have been treated with alkylating agents and who have failed fludarabine therapy [393778], [393894]. In March 2000, Millennium and ILEX also submitted a Marketing Authorization Application (MAA) for alemtuzumab to the European Agency for the Evaluation of Medicinal Products (EMEA) [363595]. In October 2000, EMEA accepted the MAA for alemtuzumab under the agency's centralized approval procedure [387228]. Alemtuzumab was originally synthesized by Herman Waldmann and colleagues at Cambridge University and licensed to Burroughs Wellcome (BW) via the British Technology Group (BTG) [162622]. BW conducted phase I and II trials for a broad range of indications, but then discontinued development because of disappointing results in phase II rheumatoid arthritis trials [326848]. In April 1997, LeukoSite licensed rights to the antibody from BTG for the treatment of CLL and prolymphocytic leukemia, plus an option to develop it for other indications. BW agreed to supply LeukoSite with intellectual property [244056], [326848]. In May 1997, LeukoSite entered into a joint venture with ILEX Oncology for the further development of alemtuzumab [245986]. By the end of 1999, Millennium acquired LeukoSite with commitment to pursue development of the compound through the joint venture Millennium & ILEX Partners LP [351523], [370237]. In August 1999, Schering AG and its US affiliate Berlex Laboratories obtained exclusive worldwide marketing rights for alemtuzumab, excluding Japan and East Asia. In the US, Berlex, Millennium and ILEX will divide profits from alemtuzumab sales equally [337702], [338837].

A meta-analysis of socio-demographic factors predicting birth in health facility.

PubMed

Berhan, Yifru; Berhan, Asres

2014-09-01

The low proportion of health facility delivery in developing countries is one of the main challenges in achieving the Millennium Development Goal of a global reduction of maternal deaths by 75% by 2015. There are several primary studies which identified socio-demographic and other predictors of birth in health facility. However, there are no efforts to synthesis the findings of these studies. The objective of this meta-analysis was to determine the strength of the association of birth in the health facility with selected sociodemographic factors. A meta-analysis of Mantel-Haenszel odds ratios was conducted by including 24 articles which were reported between 2000 and 2013 from developing countries. A computer-based search was done from MEDLINE, African Journals Online, Google Scholar and HINARI databases. Included studies did compare the women's' health facility delivery in relation to their selected socio-demographic characteristics. The pooled analysis demonstrated association of health facility delivery with living in urban areas (OR = 9.8), secondary and above educational level of the parents (OR = 5.0), middle to high wealth status (OR = 2.3) and first time pregnancy (OR = 2.8). The risk of delivering outside the health facility was not significantly associated with maternal age (teenage vs 20 years and above) and marital status. The distance of pregnant women's residence from the health facility was found to have an inverse relation to the proportion of health facility delivery. Although the present meta-analysis identified several variables which were associated with an increase in health facility delivery, the most important predictor of birth in the health facility amenable to intervention is educational status of the parents to be. Therefore, formal and informal education to women and family members on the importance of health facility delivery needs to be strengthened. Improving the wealth status of the population across the world may not be achieved soon, but should be in the long-term strategy to increase the birth rate in the health facility.

Space and place for WHO health development dialogues in the African Region.

PubMed

Kirigia, Joses Muthuri; Nabyonga-Orem, Juliet; Dovlo, Delanyo Yao Tsidi

2016-07-18

Majority of the countries in the World Health Organization (WHO) African Region are not on track to achieve the health-related Millennium Development Goals, yet even more ambitious Sustainable Development Goals (SDGs), including SDG 3 on heath, have been adopted. This paper highlights the challenges - amplified by the recent Ebola virus disease (EVD) outbreak in West Africa - that require WHO and other partners' dialogue in support of the countries, and debate on how WHO can leverage the existing space and place to foster health development dialogues in the Region. To realise SDG 3 on ensuring healthy lives and promoting well-being for all at all ages, the African Region needs to tackle the persistent weaknesses in its health systems, systems that address the social determinants of health and national health research systems. The performance of the third item is crucial for the development and innovation of systems, products and tools for promoting, maintaining and restoring health in an equitable manner. Under its new leadership, the WHO Regional Office for Africa is transforming itself to galvanise existing partnerships, as well as forging new ones, with a view to accelerating the provision of timely and quality support to the countries in pursuit of SDG 3. WHO in the African Region engages in dialogues with various stakeholders in the process of health development. The EVD outbreak in West Africa accentuated the necessity for optimally exploiting currently available space and place for health development discourse. There is urgent need for the WHO Regional Office for Africa to fully leverage the space and place arenas of the World Health Assembly, WHO Regional Committee for Africa, African Union, Regional economic communities, Harmonization for Health in Africa, United Nations Economic Commission for Africa, African Development Bank, professional associations, and WHO African Health Forum, when it is created, for dialogues to mobilise the required resources to give the African Region the thrust it needs to attain SDG 3. The pursuit of SDG 3 amidst multiple challenges related to political leadership and governance, weak health systems, sub-optimal systems for addressing the socioeconomic determinants of health, and weak national health research systems calls for optimum use of all the space and place available for regional health development dialogues to supplement Member States' efforts.

Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities.

PubMed

Bhutta, Zulfiqar A; Hafeez, Assad; Rizvi, Arjumand; Ali, Nabeela; Khan, Amanullah; Ahmad, Faatehuddin; Bhutta, Shereen; Hazir, Tabish; Zaidi, Anita; Jafarey, Sadequa N

2013-06-22

Globally, Pakistan has the third highest burden of maternal, fetal, and child mortality. It has made slow progress in achieving the Millennium Development Goals (MDGs) 4 and 5 and in addressing common social determinants of health. The country also has huge challenges of political fragility, complex security issues, and natural disasters. We undertook an in-depth analysis of Pakistan's progress towards MDGs 4 and 5 and the principal determinants of health in relation to reproductive, maternal, newborn, and child health and nutrition. We reviewed progress in relation to new and existing public sector programmes and the challenges posed by devolution in Pakistan. Notwithstanding the urgent need to tackle social determinants such as girls' education, empowerment, and nutrition in Pakistan, we assessed the effect of systematically increasing coverage of various evidence-based interventions on populations at risk (by residence or poverty indices). We specifically focused on scaling up interventions using delivery platforms to reach poor and rural populations through community-based strategies. Our model indicates that with successful implementation of these strategies, 58% of an estimated 367,900 deaths (15,900 maternal, 169,000 newborn, 183,000 child deaths) and 49% of an estimated 180,000 stillbirths could be prevented in 2015. Copyright © 2013 Elsevier Ltd. All rights reserved.

Update on Key Studies - The Millennium Cohort Study, The STAMPEDE Study, The Million Veteran Program, and The National Health Study for a New Generation of US Veterans

DTIC Science & Technology

2015-01-01

Department of Defense Chair, Staff Physician, Pulmonary /Critical Care Medicine and Assistant Program Director, Internal Medicine Residency, San... Pulmonary /Critical Care Medicine, William Beaumont Army Medical Center, Fort Bliss, 5005 North Piedras Street, El Paso, Texas 79920 §Colonel (Retired...and veterans are reviewed. These studies include • the Millennium Cohort Study (MCS), • STAMPEDE (Study of Active Duty Military for Pulmonary

Global eHealth, Social Business and Citizen Engagement.

PubMed

Liaw, Siaw-Teng; Ashraf, Mahfuz; Ray, Pradeep

2017-01-01

The UNSW WHO Collaborating Centre (WHOCC) in eHealth was established in 2013. Its designated activities are: mHealth and evidence-based evaluation, including use case analyses. The UNSW Yunus Social Business Health Hub (YSBHH), established in 2015 to build on the Yunus Centre/Grameen Bank eHealth initiatives, added social business and community participation dimensions to the UNSW global eHealth program. The Grameen Bank is a social business built around microcredit, which are small loans to poor people to enable them to "produce something, sell something, earn something to develop self-reliance and a life of dignity". The vision revolves around global partnerships for development, Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). The scope includes mHealth implementation and evaluation in the context of the Internet of Things (IoT), with a growing focus on social business and citizen engagement approaches. This paper summarises a critical case study of the UNSW WHOCC (eHealth) designated activities in collaboration with Bangladesh institutions (International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) and Yunus Centre). Issues and challenges are highlighted.

Global consequences of unsafe abortion.

PubMed

Singh, Susheela

2010-11-01

Unsafe abortion is a significant cause of death and ill health in women in the developing world. A substantial body of research on these consequences exists, although studies are of variable quality. However, unsafe abortion has a number of other significant consequences that are much less widely recognized. These include the economic consequences, the immediate costs of providing medical care for abortion-related complications, the costs of medical care for longer-term health consequences, lost productivity to the country, the impact on families and the community, and the social consequences that affect women and families. This article will review the scientific evidence on the consequences of unsafe abortion, highlight gaps in the evidence base, suggest areas where future research efforts are needed, and speculate on the future situation regarding consequences and evidence over the next 5-10 years. The information provided is useful and timely given the current heightened interest in the issue of unsafe abortion, growing from the recent focus of national and international agencies on reducing maternal mortality by 75% by 2015 (as one of the Millennium Development Goals established in 2000).

Earth Observations taken by the Expedition 20 crew

NASA Image and Video Library

2009-07-01

ISS020-E-016279 (1 July 2009) --- Millennium Island is featured in this image photographed by an Expedition 20 crew member on the International Space Station. Millennium Island ? known as Caroline Island prior to 2000 ? is located at the southern end of the Line Islands in the South Pacific Ocean. This uninhabited island is part of the Republic of Kiribati, an island nation comprised of 32 atolls (including Millennium Island) and one raised coral island. Millennium Island is formed from a number of smaller islets built on coral reefs. The coral reefs grew around a now-submerged volcanic peak, leaving a ring of coral around an inner lagoon. The islands above the waterline are composed primarily of limestone rock and sand derived from the reefs. At a maximum height of approximately 6 m above sea level, Millennium Island has been identified as being at great risk from sea level rise by the United Nations. The islets of Millennium Island are readily visible in this photograph as irregular green vegetated areas surrounding the inner lagoon. The shallow lagoon waters are a lighter blue than the deeper surrounding ocean water; tan linear ?fingers? within the lagoon are the tops of corals. The two largest islets are Nake Islet and South Islet, located at the north and south ends of Millennium Island respectively. The ecosystem of Millennium Island is considered to be relatively pristine despite periods of human habitation, guano mining, and agricultural activities, and the island has been recommended as both a World Heritage site and Biosphere Reserve.

Risk factors for relapse to problem drinking among current and former US military personnel: a prospective study of the Millennium Cohort.

PubMed

Williams, Emily C; Frasco, Melissa A; Jacobson, Isabel G; Maynard, Charles; Littman, Alyson J; Seelig, Amber D; Crum-Cianflone, Nancy F; Nagel, Anna; Boyko, Edward J

2015-03-01

Military service members may be prone to relapse to problem drinking after remission, given a culture of alcohol use as a coping mechanism for stressful or traumatic events associated with military duties or exposures. However, the prevalence and correlates of relapse are unknown. We sought to identify socio-demographic, military, behavioral, and health characteristics associated with relapse among current and former military members with remittent problem drinking. Participants in the longitudinal Millennium Cohort Study who reported problem drinking at baseline (2001-2003) and were remittent at first follow-up (2004-2006) were included (n=6909). Logistic regression models identified demographic, military service, behavioral, and health characteristics that predicted relapse (report of ≥1 past-year alcohol-related problem on the validated Patient Health Questionnaire) at the second follow-up (2007-2008). Sixteen percent of those with remittent problem drinking relapsed. Reserve/National Guard members compared with active-duty members (odds ratio [OR]=1.71, 95% confidence interval [CI]: 1.45-2.01), members separated from the military during follow-up (OR=1.46, 95% CI: 1.16-1.83), and deployers who reported combat exposure (OR=1.32, 95% CI: 1.07-1.62, relative to non-deployers) were significantly more likely to relapse. Those with multiple deployments were significantly less likely to relapse (OR=0.73, 95% CI: 0.58-0.92). Behavioral factors and mental health conditions also predicted relapse. Relapse was common and associated with military and non-military factors. Targeted intervention to prevent relapse may be indicated for military personnel in particular subgroups, such as Reservists, veterans, and those who deploy with combat exposure. Copyright © 2015. Published by Elsevier Ireland Ltd.

Nothing but the Truth? The United Nations and the Millennium Development Goals

ERIC Educational Resources Information Center

Porter, Shirley

2014-01-01

The United Nations established eight Millennium Development Goals (MDGs) in 2000, with the target for achievement set at 2015. On the UN website a special section is devoted to the MDGs. In this article the website as it was presented in late 2013 is examined. Although the website was easy to negotiate, it was difficult to ascertain any…

The Economic and Human Development Costs of Missing the Millennium Development Goal on Gender Equity.

ERIC Educational Resources Information Center

Abu-Ghaida, Dina; Klasen, Stephan

2004-01-01

At the Millennium Summit, the world community pledged to promote gender equality and chose as a specific target the achievement of gender equity in primary and secondary education by the year 2005 in every country of the world. Based on the findings from a growing empirical literature that suggests that gender equity in education promotes economic…

Public Perception of the Millennium Development Goals on Access to Safe Drinking Water in Cross River State, Nigeria

ERIC Educational Resources Information Center

Eni, David D.; Ojong, William M.

2014-01-01

This study evaluated the public perception of Millennium Development Goals (MDGs) of environmental sustainability with focus on the MDG target which has to do with reducing the proportion of people without access to safe drinking water in Cross River State, Nigeria. The stratified and systematic sampling techniques were adopted for the study,…

Neonatal Mortality and Inequalities in Bangladesh: Differential Progress and Sub-national Developments.

PubMed

Minnery, Mark; Firth, Sonja; Hodge, Andrew; Jimenez-Soto, Eliana

2015-09-01

A rapid reduction in under-five mortality has put Bangladesh on-track to reach Millennium Development Goal 4. Little research, however, has been conducted into neonatal reductions and sub-national rates in the country, with considerable disparities potentially masked by national reductions. The aim of this paper is to estimate national and sub-national rates of neonatal mortality to compute relative and absolute inequalities between sub-national groups and draw comparisons with rates of under-five mortality. Mortality rates for under-five children and neonates were estimated directly for 1980-1981 to 2010-2011 using data from six waves of the Demographic and Health Survey. Rates were stratified by levels of rural/urban location, household wealth and maternal education. Absolute and relative inequalities within these groups were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. National mortality was shown to have decreased dramatically although at differential rates for under-fives and neonates. Across all equity markers, a general pattern of declining absolute but constant relative inequalities was found. For mortality rates stratified by education and wealth mixed evidence suggests that relative inequalities may have also fallen. Although disparities remain, Bangladesh has achieved a rare combination of substantive reductions in mortality levels without increases in relative inequalities. A coalescence of substantial increases in coverage and equitable distribution of key child and neonatal interventions with widespread health sectoral and policy changes over the last 30 years may in part explain this exceptional pattern.

What will it take to maintain the maternal and child health gains made in Haiti prior to the 2010 earthquake?: an analysis of past progress, trends, and the prospects for the realization of the United Nations Millennium Development Goals 4 and 5.

PubMed

Amibor, Paulson

2013-10-01

This report assesses the commendable progress made in maternal and child mortality reductions in Haiti prior to the January 2010 earthquake. Suggested measures that the Haitian government and international donor community can take to maintain these gains are also made. With the Millennium Development Goals (MDGs) deadline of 2015 drawing nearer, the likelihood that Haiti will achieve MDG's 4 and 5 of reducing child and maternal mortality by two-thirds and three-quarters, respectively, by the end of this target year, remain questionable. In particular, the destruction inflicted on the country's health care system and health infrastructure by the 2010 earthquake have already resulted in a slowing of these gains and could potentially threaten an actual reversal of these trends. The country's Soins Obstétricaux Gratuits and Soins Infantiles Gratuits schemes established in 2008 and 2010, which provide free health care to women, newborns and children under 5, represent examples of measures that will need to be sustained and scaled up if the country is to meet its MDG 4 and 5 targets. The Haitian government's endorsement of an increased continuum of care approach to maternal and newborn health will also be vital for future initiatives. Post-quake public health and social service reconstruction efforts will need to incorporate maternal and child health-friendly services into their designs. It also remains critical that international donors continue to meet their pledges to Haiti. The Haitian government should also take more strides to clearly delineate the maternal and child health interventions it implements, both in order to facilitate greater national learning, as well as to improve the likelihood of future replication.

Can donor aid for health be effective in a poor country? Assessment of prerequisites for aid effectiveness in Uganda.

PubMed

Juliet, Nabyonga Orem; Freddie, Ssengooba; Okuonzi, Sam

2009-10-22

Inadequate funding for health is a challenge to attaining health-related Millennium Development Goals. Significant increase in health funding was recommended by the Commission for Macroeconomics and Health. Indeed Official Development Assistance has increased significantly in Uganda. However, the effectiveness of donor aid has come under greater scrutiny. This paper scrutinizes the prerequisites for aid effectiveness. The objective of the study was to assess the prerequisites for effectiveness of donor aid, specifically, its proportion to overall health funding, predictability, comprehensiveness, alignment to country priorities, and channeling mechanisms. Secondary data obtained from various official reports and surveys were analyzed against the variables mentioned under objectives. This was augmented by observations and participation in discussions with all stakeholders to discuss sector performance including health financing. Between 2004-2007, the level of aid increased from US$6 per capita to US$11. Aid was found to be unpredictable with expenditure varying between 174-8722;360 percent from budgets. More than 50% of aid was found to be off budget and unavailable for comprehensive planning. There was disproportionate funding for some items such as drugs. Key health system elements such as human resources and infrastructure have not been given due attention in investment. The government's health funding from domestic sources grew only modestly which did not guarantee fiscal sustainability. Although donor aid is significant there is need to invest in the prerequisites that would guarantee its effective use.

CNN Newsroom Classroom Guides. January 2000.

ERIC Educational Resources Information Center

Cable News Network, Atlanta, GA.

These guides, designed to accompany the daily Cable News Network (CNN) Newsroom broadcasts for January 3-28, 2000, provide program rundowns, suggestions for class activities and discussion, links to relevant World Wide Web sites, and a list of related news terms. Top stories include: issues of the Millennium, 100 hours of the Millennium, Mideast…

The long-term dynamics of mortality benefits from improved water and sanitation in less developed countries.

PubMed

Jeuland, Marc A; Fuente, David E; Ozdemir, Semra; Allaire, Maura C; Whittington, Dale

2013-01-01

The problem of inadequate access to water, sanitation and hygiene (WASH) in less-developed nations has received much attention over the last several decades (most recently in the Millennium Development Goals), largely because diseases associated with such conditions contribute substantially to mortality in poor countries. We present country-level projections for WASH coverage and for WASH-related mortality in developing regions over a long time horizon (1975-2050) and provide dynamic estimates of the economic value of potential reductions in this WASH-related mortality, which go beyond the static results found in previous work. Over the historical period leading up to the present, our analysis shows steady and substantial improvements in WASH coverage and declining mortality rates across many developing regions, namely East Asia and the Pacific, Latin America and the Caribbean, Eastern Europe and the Middle East. The economic value of potential health gains from eliminating mortality attributable to poor water and sanitation has decreased substantially, and in the future will therefore be modest in these regions. Where WASH-related deaths remain high (in parts of South Asia and much of Sub-Saharan Africa), if current trends continue, it will be several decades before economic development and investments in improved water and sanitation will result in the capture of these economic benefits. The fact that health losses will likely remain high in these two regions over the medium term suggests that accelerated efforts are needed to improve access to water and sanitation, though the costs and benefits of such efforts in specific locations should be carefully assessed.

The Long-Term Dynamics of Mortality Benefits from Improved Water and Sanitation in Less Developed Countries

PubMed Central

Jeuland, Marc A.; Fuente, David E.; Ozdemir, Semra; Allaire, Maura C.; Whittington, Dale

2013-01-01

The problem of inadequate access to water, sanitation and hygiene (WASH) in less-developed nations has received much attention over the last several decades (most recently in the Millennium Development Goals), largely because diseases associated with such conditions contribute substantially to mortality in poor countries. We present country-level projections for WASH coverage and for WASH-related mortality in developing regions over a long time horizon (1975–2050) and provide dynamic estimates of the economic value of potential reductions in this WASH-related mortality, which go beyond the static results found in previous work. Over the historical period leading up to the present, our analysis shows steady and substantial improvements in WASH coverage and declining mortality rates across many developing regions, namely East Asia and the Pacific, Latin America and the Caribbean, Eastern Europe and the Middle East. The economic value of potential health gains from eliminating mortality attributable to poor water and sanitation has decreased substantially, and in the future will therefore be modest in these regions. Where WASH-related deaths remain high (in parts of South Asia and much of Sub-Saharan Africa), if current trends continue, it will be several decades before economic development and investments in improved water and sanitation will result in the capture of these economic benefits. The fact that health losses will likely remain high in these two regions over the medium term suggests that accelerated efforts are needed to improve access to water and sanitation, though the costs and benefits of such efforts in specific locations should be carefully assessed. PMID:24116011

[Meeting the Abuja and Millennium Development Goals: the state more than ever].

PubMed

Boidin, B

2013-01-01

In the 1980s and 1990s, healthcare policies in poor countries were largely based on the privatization of the healthcare supply. Over the past decade, this trend has led to the expansion of private initiatives in both the nonprofit and profit-seeking sectors. Assessments of these initiatives show mixed results and sometimes pernicious effects. It is accordingly necessary to review and redesign policies to enable public entities and States to once again become leaders in the development of integrated and socially inclusive health policies.

Problems Faced by Distance Learners in Using Web-Based Facilities

ERIC Educational Resources Information Center

Dharankar, Madhavi

2012-01-01

Countries like India are engaged in exploring appropriate ways of tackling the urgent problem of educating their large and growing populations in relatively little time and with limited resources. Against this background, achieving universal primary education is a major concern. If this Millennium Development Goal is to be achieved, the…

Developments in Australian Agricultural and Related Education

ERIC Educational Resources Information Center

McSweeney, Peter; Rayner, John

2011-01-01

While the calm waters metaphor might explain the changes navigated by Australian agricultural education through most of its history, the last 20 or so years have been very turbulent. Now, the new millennium sees agricultural education in both Australia and the Western world facing a different and less certain future. This paper analyses some of…

Education, Skills, Sustainability and Growth: Complex Relations

ERIC Educational Resources Information Center

King, Kenneth

2009-01-01

The global education agenda, embedded in the Education for All (EFA) Goals, and the Millennium Development Goals, has emphasised the importance of reaching EFA rather than sustaining this achievement. As a corollary, the emphasis for external aid has also been on increasing aid to secure EFA rather than on the dangers of aid dependency in securing…

What can Pakistan do to address maternal and child health over the next decade?

PubMed

Bhutta, Zulfiqar A; Hafeez, Assad

2015-11-25

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents a range of actions needed for change within the health and social sectors, including primary care, social determinants, strategies to reach the unreached, and accountability.

Science-based health innovation in Uganda: creative strategies for applying research to development.

PubMed

Kamunyori, Sheila; Al-Bader, Sara; Sewankambo, Nelson; Singer, Peter A; Daar, Abdallah S

2010-12-13

Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities - Makerere and Mbarara - stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development. Nevertheless, there is political will for the development of STI in Uganda, demonstrated through personal initiatives of the President and the government's willingness to invest heavily for the long term in support of STI through the Millennium Science Initiative. Activities to support technology transfer and private-public collaboration have been put in motion; these need to be monitored, coordinated, and learned from. In the private sector, there are examples of incremental innovation to address neglected diseases driven by entrepreneurial individuals and South-South collaboration. Lessons can be learned from their experience that will help support Ugandan health innovation.

Science-based health innovation in Uganda: creative strategies for applying research to development

PubMed Central

2010-01-01

Background Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Results Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities – Makerere and Mbarara – stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Conclusions Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development. Nevertheless, there is political will for the development of STI in Uganda, demonstrated through personal initiatives of the President and the government’s willingness to invest heavily for the long term in support of STI through the Millennium Science Initiative. Activities to support technology transfer and private-public collaboration have been put in motion; these need to be monitored, coordinated, and learned from. In the private sector, there are examples of incremental innovation to address neglected diseases driven by entrepreneurial individuals and South-South collaboration. Lessons can be learned from their experience that will help support Ugandan health innovation. PMID:21144076

Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

2016-12-01

The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015. To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health care in health facilities accredited by the National Health Insurance Authority in Ghana. This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health care standards. Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts in urban facilities (p < 0.05), quality of health care and patient safety standards were relatively better in rural facilities. For Ghana to attain the newly formulated sustainable development goals on health, there is the need for health authorities to address the existing rural-urban imbalances in health worker motivation and quality health care standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the National Health Insurance Authority.

Challenges in Achieving Food Security in India

PubMed Central

Upadhyay, R Prakash; Palanivel, C

2011-01-01

First Millennium Development Goal states the target of “Halving hunger by 2015”. Sadly, the recent statistics for India present a very gloomy picture. India currently has the largest number of undernourished people in the world and this is in spite of the fact that it has made substantial progress in health determinants over the past decades and ranks second worldwide in farm output. The causes of existing food insecurity can be better viewed under three concepts namely the: ‘traditional concept’ which includes factors such as unavailability of food and poor purchasing capacity; ‘socio-demographic concept’ which includes illiteracy, unemployment, overcrowding, poor environmental conditions and gender bias; ‘politico-developmental concept’ comprising of factors such as lack of intersectoral coordination and political will, poorly monitored nutritional programmes and inadequate public food distribution system. If the Millennium Development Goal is to be achieved by 2015, efforts to improve food and nutrition security have to increase considerably. Priority has to be assigned to agriculture and rural development along with promoting women empowerment, ensuring sustainable employment and improving environmental conditions (water, sanitation and hygiene). As the problem is multi-factorial, so the solution needs to be multi-sectoral. PMID:23113100

Materials and Processes for the New Millennium

NASA Technical Reports Server (NTRS)

Hayes, Paul W.; Richardson, Rod W.

2004-01-01

The single greatest threat to material availability over the last decade has been Compliance to New Environmental Regulations. Federal Regulations: a) Clean Air Acts Amendments - 1990 - Titles I, III and VI; b) NASA Interim Policy- 1995 end date; c) Montreal Protocol - 2000 and 2005 end dates; d) Industrial Toxics Project - HAP emissions by 1995; e) Florida DER - VOC limits by 1995 (CA); f) OSHA Health Related Regulations 1) Carcinogens 2) Mutagens 3). Material availability is complicated by local and state regulations and their own compliance schedules.

A global social contract to reduce maternal mortality: the human rights arguments and the case of Uganda.

PubMed

Ooms, Gorik; Mulumba, Moses; Hammonds, Rachel; Latif Laila, Abdul; Waris, Attiya; Forman, Lisa

2013-11-01

Progress towards Millennium Development Goal 5a, reducing maternal deaths by 75% between 1990 and 2015, has been substantial; however, it has been too slow to hope for its achievement by 2015, particularly in sub-Saharan Africa, including Uganda. This suggests that both the Government of Uganda and the international community are failing to comply with their right-to-health-related obligations towards the people of Uganda. This country case study explores some of the key issues raised when assessing national and international right-to-health-related obligations. We argue that to comply with their shared obligations, national and international actors will have to take steps to move forward together. The Government of Uganda should not expect additional international assistance if it does not live up to its own obligations; at the same time, the international community must provide assistance that is more reliable in the long run to create the 'fiscal space' that the Government of Uganda needs to increase recurrent expenditure for health - which is crucial to addressing maternal mortality. We propose that the 'Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa', adopted by the African Union in July 2012, should be seen as an invitation to the international community to conclude a global social contract for health. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Responding to the Gender and Education Millennium Development Goals in South Africa and Kenya: Reflections on Education Rights, Gender Equality, Capabilities and Global Justice

ERIC Educational Resources Information Center

Unterhalter, Elaine; North, Amy

2011-01-01

This paper explores understandings of gender equality and education and the nature of global goal and target setting, drawing on empirical data collected in central and local government departments in Kenya and South Africa reflecting on their implementation of Millennium Development Goal (MDG) 1, concerned with poverty, MDG 2, concerned with…

Extent of Implementation of Minimum Standards of Basic Education for the Realisation of the Second Millennium Development Goal in Bayelsa State

ERIC Educational Resources Information Center

Ogochukwu, Emeka; Gbendu, Olaowei Godiva

2015-01-01

The study was carried out in Salga Education Zone of Bayelsa State specifically to determine the extent of implementation of the minimum standards for basic education in order to ensure the realization of the second millennium development goal. The study adopted the descriptive research design. The population of the study comprised of all the…

Strategies to avert preventable mortality among mothers and children in the Eastern Mediterranean Region: new initiatives, new hope.

PubMed

Akseer, N; Kamali, M; Husain, S; Mirza, M; Bakhache, N; Bhutta, Z A

2015-08-27

We conducted an assessment of maternal, newborn and child health and progress towards achieving Millennium Development Goals (MDG) 4 and 5 in the Eastern Mediterranean Region (EMR). We provide recommendations for scaling up and sustaining gains post-2015. Data were obtained from global data repositories. We constructed time trends from 1990 to 2013 and evaluated inequities across the Region. Under-5, neonatal and maternal mortality rates decreased 46%, 35%, and 50% respectively from 1990 to 2013. Pneumonia and diarrhoea accounted for 50% of all post-neonatal deaths; pregnancy- and delivery-related complications were the leading causes of neonatal and maternal deaths. Coverage of maternal, newborn and child health interventions is suboptimal, and poverty, food insecurity and conflict are pervasive across the Region. The EMR has made progress but is unlikely to attain MDG 4 and 5 targets. To sustain and further accelerate gains, the Region must reduce inequities and scale up implementation of recommendations made by the independent Expert Review Group.

Forecasting the progress towards the target of Millennium Development Goal 1C in children under 5 years of age in Bangladesh.

PubMed

Hasan, Md Tanvir; Soares Magalhaes, Ricardo J; Williams, Gail M; Mamun, Abdullah A

2015-07-01

To estimate the average annual rates of reduction of stunting, underweight and wasting for the period 1996 to 2011, and to evaluate whether Bangladesh will be expected to achieve the target of Millennium Development Goal 1C of reducing the prevalence of underweight by half by 2015. We used five nationwide, cross-sectional, Demographic and Health Survey data sets to estimate prevalence of undernutrition defined by stunting, underweight and wasting among children under 5 years of age using the WHO child growth standards. We then computed the average annual rates of reduction of prevalence of undernutrition using the formula derived by UNICEF. Finally, we projected the prevalence of undernutrition for the year 2015 using the estimated average annual rates of reduction. Nationwide covering Bangladesh. Children under 5 years of age (n 28,941). The prevalence of stunting decreased by 18.8% (from 60.0% to 41.2%), underweight by 16.0% (from 52.2% to 36.2%) and wasting by 5.1% (from 20.6% to 15.5%) during 1996 to 2011. The overall average annual rates of reduction were 2.84%, 2.69 % and 2.47%, respectively, for stunting, underweight and wasting. We forecast that in 2015, the prevalence of stunting, underweight and wasting will be 36.7%, 32.5% and 14.0%, respectively, at the national level. The prevalence of undernutrition is likely to remain high in rural areas, in the Sylhet division and in the poorest wealth quintile. Bangladesh is likely to achieve the Millennium Development Goal 1C target of reducing the prevalence of underweight by half by 2015. However, it is falling behind in reducing stunting and further investment is needed to reduce individual, household and environmental determinants of stunting in Bangladesh.

Effectiveness of health sector reforms in reducing disparities in utilization of skilled birth attendants in Tanzania.

PubMed

Kengia, James Tumaini; Igarashi, Isao; Kawabuchi, Koichi

2013-08-01

Improving maternal health is a Millennium Development Goal adopted at the 2000 Millennium Summit of the United Nations. As part of the improving maternal health in Tanzania, it has been recommended that skilled birth attendants be present at all births to help reduce the high maternal mortality ratio. However, utilization of these attendants varies across socio-economic groups. The government of Tanzania has repeatedly attempted to carry out health sector reforms (HSRs) to alleviate disparities in health service utilization. In particular, around 1999, HSRs were incorporated into two approaches, including Decentralization by Devolution and Sector Wide Approach. This study aims to clarify the unresolved questions with little published evidence on the effect of HSRs on reducing disparities in utilization of skilled birth attendants across socio-economic groups over time. We used four cross-sectional datasets from the Tanzania Demographic and Health Survey: 1992, 1996, 1999, and 2004/05. Subjects included 14,752 women of reproductive age (15-49 years) and data on the most recent birth in the 5 years before each survey. Logistic regression analysis was performed with the dependent variable of whether respondents utilized skilled birth attendants or not, and with the main independent variables of time and socio-economic group. Results showed that the disparity in utilization of skilled birth attendants was significantly decreased from 1999 to 2004/05. These findings suggest that the two strategies, Decentralization by Devolution and Sector Wide Approach, in the process of HSRs are effective in reducing the disparities in utilization of skilled birth attendants among socio-economic groups.

Making the post-MDG global health goals relevant for highly inequitable societies: findings from a consultation with marginalized populations in Guatemala.

PubMed

Ruano, Ana Lorena; Sánchez, Silvia; Jerez, Fernando José; Flores, Walter

2014-10-10

The United Nations presented a set of Millennium Development Goals that aimed to improve social and economic development and eradicate poverty by 2015. Most low and middle-income countries will not meet these goals and today there is a need to set new development agenda, especially when it comes to health. The paper presents the findings from a community consultation process carried out within the Goals and Governance for Global Health (GO4Health) research consortium in Guatemala, which aims to identify community needs and expectations around public policies and health services. Through a participative and open consultation process with experts, civil society organizations and members of the research team, the municipalities of Tectitan and Santa Maria Nebaj were selected. A community consultation process was undertaken with community members and community leaders. Group discussions and in-depth interviews were conducted and later analyzed using thematic analysis, a qualitative method that can be used to analyze data in a way that allows for the identification of recurrent patterns that can be grouped into categories and themes, was used. Following the Go4Health framework's domains for understanding health-related needs, the five themes identified were health, social determinants of health, essential health needs and their provision, roles and responsibilities of relevant stakeholders and community participation in decision-making. Participants reported high levels of discrimination related to ethnicity, to being poor and to living in rural areas. Ethnicity played a major role in how community members feel they are cared for in the health system. Achieving health goals in a context of deep-rooted inequality and marginalization requires going beyond the simple expansion of health services and working with developing trusting relationships between health service providers and community members. Involving community members in decision-making processes that shape policies will contribute to a larger process of community empowerment and democratization. Still, findings from the region show that tackling these issues may prove complicated and require going beyond the health system, as this lack of trust and discrimination has permeated to all public policies that deal with indigenous and rural populations.

Effect of bottle height and aspiration rate on postocclusion surge in Infiniti and Millennium peristaltic phacoemulsification machines.

PubMed

Ward, Matthew S; Georgescu, Dan; Olson, Randall J

2008-08-01

To assess how flow and bottle height affect postocclusion surge in the Infiniti (Alcon, Inc.) and Millennium (Bausch & Lomb) peristaltic machines. John A. Moran Eye Center Clinical Laboratories, University of Utah, Salt Lake City, Utah. Postocclusion anterior chamber depth changes were measured in human eye-bank eyes using A-scan. Surge was simulated by clamping the aspiration tubing and releasing it at maximum vacuum. In both machines, surge was measured (1) with aspiration held constant at 12 mL/min and bottle heights at 60, 120, and 180 cm and (2) with bottle height held constant at 60 cm and aspiration rates at 12, 24, and 36 mL/min. Surge decreased approximately 40% with each 60 cm increase in bottle height in the Infiniti. It was constant at all bottle heights in the Millennium. At 12 and 24 mL/min aspiration rates, surge in the Millennium was less than half that in the Infiniti (P<.001). Postocclusion surge decreased linearly with increasing bottle height in the Infiniti system and was relatively constant with increasing bottle height in the Millennium system. The Millennium may offer a more stable phacoemulsification platform with respect to surge at a higher aspiration rate.

A Longitudinal Analysis of Publications on Maternal Mortality.

PubMed

de Groot, Christianne J M; van Leeuwen, Thed; Mol, Ben Willem J; Waltman, Ludo

2015-11-01

The fifth Millennium Development Goal formulated by the WHO in 2000 aimed to reduce global maternal mortality by 75% in 2015. We studied the extent to which medical research has supported this by studying maternal mortality. We performed a bibliometric analysis of the literature on maternal mortality and of the development of this literature over time. We searched for publications on maternal mortality in the Web of Science database in the period 1994-2013. We visualised the subjects of these publications using a term map showing the most significant terms occurring in the titles and abstracts of publications on maternal mortality. We identified 3794 publications on maternal mortality in Web of Science. The annual number increased from 87 in 1994 to 397 in 2013. The largest number of maternal mortality publications was found in the field of Obstetrics and Gynecology, followed by the Public, Environmental, and Occupational Health field (increase from 1994 until 2013 of 300% and 700%, respectively). In both fields, the number of maternal mortality publications has increased at a much higher rate than the overall number of publications in the field. In line with the focus of the fifth Millennium Development Goal on reducing maternal mortality, during the past 20 years, there has been a steady increase in the amount of attention paid to maternal mortality in the medical literature. This is largely driven by an increase, mainly in recent years, in public health research on maternal mortality. © 2015 John Wiley & Sons Ltd.

Capacity development for community health nurses in Pakistan: the assistant manager role.

PubMed

Gulzar, S A; Mistry, R; Upvall, M J

2011-09-01

Community health nurses (CHNs), as leaders in developing countries, can promote successful outcomes in meeting the targets of the Millennium Development Goals. A community-based organization in Pakistan is striving to achieve the goals of maternal and child health through the development of the assistant manager role for community health nursing. The purpose of this study was to assess the perception of the role of the CHN assistant manager, with the goal of strengthening that role. This interpretive, qualitative study included 13 participants already familiar with CHNs in Pakistan. Interviewing was utilized to explore perceptions of the assistant manager role and to uncover challenges currently existing within this new role. Content analysis revealed the following themes: 'role perceptions', 'expectations of the role' and 'collaboration with other community healthcare providers'. Changes to the role are necessary including increased education of the assistant manager CHNs and preparing administration to work with the assistant mangers for effective leadership. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Data resource profile: United Nations Children's Fund (UNICEF).

PubMed

Murray, Colleen; Newby, Holly

2012-12-01

The United Nations Children's Fund (UNICEF) plays a leading role in the collection, compilation, analysis and dissemination of data to inform sound policies, legislation and programmes for promoting children's rights and well-being, and for global monitoring of progress towards the Millennium Development Goals. UNICEF maintains a set of global databases representing nearly 200 countries and covering the areas of child mortality, child health, maternal health, nutrition, immunization, water and sanitation, HIV/AIDS, education and child protection. These databases consist of internationally comparable and statistically sound data, and are updated annually through a process that draws on a wealth of data provided by UNICEF's wide network of >150 field offices. The databases are composed primarily of estimates from household surveys, with data from censuses, administrative records, vital registration systems and statistical models contributing to some key indicators as well. The data are assessed for quality based on a set of objective criteria to ensure that only the most reliable nationally representative information is included. For most indicators, data are available at the global, regional and national levels, plus sub-national disaggregation by sex, urban/rural residence and household wealth. The global databases are featured in UNICEF's flagship publications, inter-agency reports, including the Secretary General's Millennium Development Goals Report and Countdown to 2015, sector-specific reports and statistical country profiles. They are also publicly available on www.childinfo.org, together with trend data and equity analyses.

The role of international NGOs in health systems strengthening: the case of Timor-Leste.

PubMed

Mercer, Mary Anne; Thompson, Susan M; de Araujo, Rui Maria

2014-01-01

Achieving the United Nations Millennium Development Goals for health will require that programs supporting health in developing countries focus on strengthening national health care systems. However, the dominant neoliberal model of development mandates reduced public spending on health and other social services, often resulting in increased funding for nongovernmental organizations (NGOs) at the expense of support for government systems. East Timor, later Timor-Leste, is an example of a post-crisis country where international NGO efforts were initially critical to providing relief efforts to a traumatized population. Those groups were not prepared to help develop and support a standardized Timorese national health plan, however, and the cost of their support was unsustainable in the long term. In response, local authorities designed and implemented a post-crisis NGO phase-over plan that addressed risks to service disruption and monitored the process. Since then, some NGOs have worked collaboratively with the Ministry of Health to support specific efforts and initiatives under a framework provided by the ministry. Timor-Leste has shown that ministries of health can facilitate an effective transition of NGO support from crisis to development if they are allowed to plan and manage the process.

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa.

PubMed

Bradshaw, Debbie; Chopra, Mickey; Kerber, Kate; Lawn, Joy E; Bamford, Lesley; Moodley, Jack; Pattinson, Robert; Patrick, Mark; Stephen, Cindy; Velaphi, Sithembiso

2008-04-12

South Africa is one of the few developing countries with a national confidential inquiry into maternal deaths. 164 health facilities obtain audit data for stillbirths and neonatal deaths, and a new audit network does so for child deaths. Three separate reports have been published, providing valuable information about avoidable causes of death for mothers, babies, and children. These reports make health-system recommendations, many of which overlap and are intertwined with the scarcity of progress in addressing HIV/AIDS. The leaders of these three reports have united to prioritise actions to save the lives of South Africa's mothers, babies, and children. The country is off-track for the health-related Millennium Development Goals. Mortality in children younger than 5 years has increased, whereas maternal and neonatal mortality remain constant. This situation indicates the challenge of strengthening the health system because of high inequity and HIV/AIDS. Coverage of services is fairly high, but addressing the gaps in quality and equity is essential to increasing the number of lives saved. Consistent leadership and accountability to address crosscutting health system and equity issues, and to prevent mother-to-child transmission of HIV, would save tens of thousands of lives every year. Audit is powerful, but only if the data lead to action.

Technology readiness levels for the new millennium program

NASA Technical Reports Server (NTRS)

Moynihan, P. I.; Minning, C. P.; Stocky, J. F.

2003-01-01

NASA's New Millennium Program (NMP) seeks to advance space exploration by providing an in-space validating mechanism to verify the maturity of promising advanced technologies that cannot be adequately validated with Earth-based testing alone. In meeting this objective, NMP uses NASA Technology Readiness Levels (TRL) as key indicators of technology advancement and assesses development progress against this generalized metric. By providing an opportunity for in-space validation, NMP can mature a suitable advanced technology from TRL 4 (component and/or breadboard validation in laboratory environment) to a TRL 7 (system prototype demonstrated in an Earth-based space environment). Spaceflight technology comprises a myriad of categories, types, and functions, and as each individual technology emerges, a consistent interpretation of its specific state of technological advancement relative to other technologies is problematic.

NGOs and government partnership for health systems strengthening: A qualitative study presenting viewpoints of government, NGOs and donors in Pakistan

PubMed Central

2011-01-01

Background Health systems are expected to serve the population needs in an effective, efficient and equitable manner. Therefore, the importance of strengthening of public, private and community health systems has been emphasized time and again. In most of the developing countries, certain weaknesses and gaps in the government health systems have been hampering the achievement of improved health outcomes. Public sector in Pakistan has been deficient in the capacity to deliver equitable and quality health services and thus has been grossly underutilized. Methods A qualitative study comprising in-depth interviews was conducted capturing the perceptions of the government functionaries, NGO representatives and donor community about the role and position of NGOs in health systems strengthening in Pakistan's context. Analysis of the data was done manually to generate nodes, sub-nodes and themes. Results Since many years, international and local non-governmental organizations (NGOs) have endeavored to fill the gaps in health service delivery, research and advocacy. NGOs have relatively performed better and achieved the results because of the flexible planning and the ability to design population based projects on health education, health promotion, social marketing, community development and advocacy. This paper captures the need and the opportunity of public private partnership in Pakistan and presents a framework for a meaningful engagement of the government and the private and nonprofit NGOs. Conclusion Involving the NGOs for health system strengthening may eventually contribute to create a healthcare system reflecting an increased efficiency, more equity and good governance in the wake of the Millennium Development Goals. Nevertheless, few questions need to be answered and pre-requisites have to be fulfilled before moving on. PMID:21609480

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This paper responds to the Development Committee Communique of April 2006 requesting the World Bank to review existing financial instruments and explore the potential value of new financial instruments to accelerate investment in clean energy. It builds on the report 'Clean Energy and Development: Towards an Investment Framework' that was presented to the Development Committee at the April 2006 Spring Meeting and concludes: The major financing gap for the energy for development and energy access agendas can be met by deepening and broadening energy sector policy reform to attract private sector investments and additional public sector financing. A long-term stablemore » global regulatory framework, with differentiated responsibilities, is needed to stimulate private investments and provide predictability. The Bank proposes the development of a number of options to accelerate the transition to a low carbon economy. Risks of weather-related disasters need to be integrated into poverty and sustainable development strategies with a combination of public and private sector resources. Clean energy will address the following issues that affect poor people and undermine progress on many of the Millennium Development Goals: Pollution at the household level, especially indoor air pollution, which adversely affects human health; Environmental impacts at the local, national and regional level, including urban air pollution and acid deposition, which affects human health and ecological systems; and The adverse impacts of greenhouse gas emissions from the production of energy on agricultural productivity, water resources, human health, human settlements and ecological systems. 11 figs., 2 tabs., 2 annexes.« less

Healthy Cities in a global and regional context.

PubMed

Lawrence, Roderick J; Fudge, Colin

2009-11-01

Since the beginning of the WHO European Healthy Cities Network in 1987, the global and regional contexts for the promotion of health and well-being have changed in many ways. First, in 2000, the United Nations Millennium Goals explicitly and implicitly addressed health promotion and prevention at the global and regional levels. Second, the concern for sustainable development at the Rio Conference in 1992 was confirmed at the World Summit in Johannesburg in 2002. During the same period, in many regions including Europe, the redefinition of the roles and responsibilities of national, regional and local governments, reductions in budgets of public administrations, the privatization of community and health services, the instability of world trade, the financial system and employment, migration flows, relatively high levels of unemployment (especially among youth and young adults) have occurred in many countries in tandem with negative impacts on specific policies and programmes that are meant to promote health. Since 1990, the European Commission has been explicitly concerned about the promotion of health, environment and social policies by defining strategic agendas for the urban environment, sustainable development and governance. However, empirical studies during the 1990s show that urban areas have relatively high levels of tuberculosis, respiratory and cardiovascular diseases, cancer, adult obesity, malnutrition, tobacco smoking, poor mental health, alcohol consumption and drug abuse, sexually transmitted diseases (including AIDS), crime, homicide, violence and accidental injury and death. In addition, there is evidence that urban populations in many industrialized countries are confronted with acute new health problems stemming from exposure to persistent organic pollutants, toxic substances in building structures, radioactive waste and increasing rates of food poisoning. These threats to public health indicate an urgent need for new strategic policies and research agendas that address the complex interrelations between urban ecosystems, sustainable development, human health and well-being. The WHO Healthy Cities project is one important vector for achieving this objective at both global and regional levels.

Setting the global health agenda: The influence of advocates and ideas on political priority for maternal and newborn survival.

PubMed

Smith, Stephanie L; Shiffman, Jeremy

2016-10-01

This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Correlates of Mental Illness and Wellbeing in Children: Are They the Same? Results From the UK Millennium Cohort Study.

PubMed

Patalay, Praveetha; Fitzsimons, Emla

2016-09-01

To investigate a framework of correlates of both mental illness and wellbeing in a large, current, and nationally representative sample of children in the United Kingdom. An ecologic framework of correlates including individual (sociodemographic and human capital), family, social, and wider environmental factors were examined in 12,347 children aged 11 years old from the UK Millennium Cohort Study. Mental illness and wellbeing scores were standardized to allow comparisons, and the variance explained by the different predictors was estimated. Mental illness and wellbeing were weakly correlated in children (r = 0.2), and their correlates were similar in some instances (e.g., family structure, sibling bullying, peer problems) but differed in others (e.g., family income, perceived socioeconomic status, cognitive ability, health status, neighborhood safety). The predictors included in the study explained 47% of the variance in symptoms of mental illness, with social relationships, home environment, parent health, cognitive ability, socioeconomic status, and health factors predicting large amounts of variance. A comparatively lower 26% of the variance in wellbeing was explained by the study variables, with wider environment, social relationships, perceived socioeconomic status, and home environment predicting the most variance. Correlates of children's mental illness and wellbeing are largely distinct, stressing the importance of considering these concepts separately and avoiding their conflation. This study highlights the relevance of these findings for understanding social gradients in mental health through the life course and the conceptualization and development of mental illness and wellbeing in childhood as precursors to lifelong development in these domains. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Girls' Access to Education in China: Actors, Cultures and the Windmill of Development Management. CREATE Pathways to Access. Research Monograph No. 39

ERIC Educational Resources Information Center

Wang, Xiaojun Grace

2010-01-01

The world has a mixed record towards achieving EFA [Education for All] and the MDGs [Millennium Development Goals] in relation to the targets on gender equity in basic education. For researchers and practitioners, this raises the question of which factors influence the processes leading to the improvement of access and quality of girls' education…

Application of system thinking concepts in health system strengthening in low-income settings: a proposed conceptual framework for the evaluation of a complex health system intervention: the case of the BHOMA intervention in Zambia.

PubMed

Mutale, Wilbroad; Balabanova, Dina; Chintu, Namwinga; Mwanamwenge, Margaret Tembo; Ayles, Helen

2016-02-01

The current drive to strengthen health systems provides an opportunity to develop new strategies that will enable countries to achieve targets for millennium development goals. In this paper, we present a proposed framework for evaluating a new health system strengthening intervention in Zambia known as Better Health Outcomes through Mentoring and Assessment. We briefly describe the intervention design and focus on the proposed evaluation approach through the lens of systems thinking. In this paper, we present a proposed framework to evaluate a complex health system intervention applying systems thinking concepts. We hope that lessons learnt from this process will help to adapt the intervention and limit unintended negative consequences while promoting positive effects. Emphasis will be paid to interaction and interdependence between health system building blocks, context and the community. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Integrating microfinance and health strategies: examining the evidence to inform policy and practice.

PubMed

Leatherman, Sheila; Metcalfe, Marcia; Geissler, Kimberley; Dunford, Christopher

2012-03-01

Single solutions continue to be inadequate in confronting the prevalent problems of poverty, ill health and insufficient health system capacity worldwide. The poor need access to an integrated set of financial and health services to have income security and better health. Over 3500 microfinance institutions (MFIs) provide microcredit and financial services to more than 155 million households worldwide. Conservative estimates indicate that at least 34 million of these households are very poor by the definition in the Millennium Development Goals, representing around 170 million people, many in remote areas beyond the reach of health agencies, both private and governmental. A small but increasing number of MFIs offer health-related services, such as education, clinical care, community health workers, health-financing and linkages to public and private health providers. Multiple studies indicate the effectiveness of microfinance and its impact on poverty. A small but growing number of studies also attempt to show that MFIs are capable of contributing to health improvement by increasing knowledge that leads to behavioural changes, and by enhancing access to health services through addressing financial, geographic and other barriers. While these studies are of uneven quality, they indicate positive health benefits in diverse areas such as maternal and child health, malaria and other infectious disease, and domestic violence. While more rigorous research is needed to inform policy and guide programme implementation to integrate microfinance and health interventions that can reliably enhance the well-being of the poor, there is useful evidence to support the design and delivery of integrated programmes now. Worldwide, current public health programmes and health systems are proving to be inadequate to meet population needs. The microfinance sector offers an underutilized opportunity for delivery of health-related services to many hard-to-reach populations.

A World Fit for Children: Millennium Development Goals; Special Session on Children Documents; The Convention on the Rights of the Child.

ERIC Educational Resources Information Center

United Nations Children's Fund, New York, NY.

In May 2002, participants at the United Nations General Assembly's Special Session on Children committed to a set of specific goals for children and youth and a basic framework for meeting these goals. This report compiles the commitments that were part of the Special Session: (1) the Millennium Development Goals, earlier pledged to by all 189…

[Analysis of HIV/AIDS mortality in Mexico from 1990 to 2013: An assessment of the feasibility of millennium development goals by 2015].

PubMed

Bravo-García, Enrique; Ortiz-Pérez, Hilda

We aimed to assess the feasibility of achieving the goal of Mexican AIDS mortality in the Millennium Development Goals, nationally and by state. For the period 1990-2013, we estimated annual rates of decline/increase in AIDS mortality according to five-year interval, using published data from the Mexican Instituto Nacional de Estadística y Geografía and Consejo Nacional de Población. Subsequently, we analyzed the feasibility of achieving the Millennium Development Goals target by 2015 by estimating the year in which the country and each state could achieve them. We estimated that only 13/32 states (40%) would achieve the goal established for AIDS mortality by Millennium Development Goals. Mexico, as a country, and the remaining 19 states (60%) did not will attain it. It is important to emphasize that seven states, rather than decrease, had an upward trend in mortality in the last five years analyzed. The free and universal access to antiretroviral treatment against HIV/AIDS has failed to reduce mortality as expected in Mexico. It is urgent to improve access to HIV testing by using more aggressive strategies. Also, it is necessary to apply interventions to link and retain persons in care until they are virologically suppressed.

Can paying for results help to achieve the Millennium Development Goals? Overview of the effectiveness of results-based financing.

PubMed

Oxman, Andrew D; Fretheim, Atle

2009-05-01

Results-based financing and pay-for-performance refer to the transfer of money or material goods conditional on taking a measurable action or achieving a predetermined performance target. Results-based financing is widely advocated for achieving health goals, including the Millennium Development Goals. We undertook an overview of systematic reviews of the effectiveness of RBF. We searched the Cochrane Library, EMBASE, and MEDLINE (up to August 2007). We also searched for related articles in PubMed, checked the reference lists of retrieved articles, and contacted key informants. We included reviews with a methods section that addressed the effects of any results-based financing in the health sector targeted at patients, providers, organizations, or governments. We summarized the characteristics and findings of each review using a structured format. We found 12 systematic reviews that met our inclusion criteria. Based on the findings of these reviews, financial incentives targeting recipients of health care and individual healthcare professionals are effective in the short run for simple and distinct, well-defined behavioral goals. There is less evidence that financial incentives can sustain long-term changes. Conditional cash transfers to poor and disadvantaged groups in Latin America are effective at increasing the uptake of some preventive services. There is otherwise very limited evidence of the effects of results-based financing in low- or middle-income countries. Results-based financing can have undesirable effects, including motivating unintended behaviors, distortions (ignoring important tasks that are not rewarded with incentives), gaming (improving or cheating on reporting rather than improving performance), widening the resource gap between rich and poor, and dependency on financial incentives. There is limited evidence of the effectiveness of results-based financing and almost no evidence of the cost-effectiveness of results-based financing. Based on the available evidence and likely mechanisms through which financial incentives work, they are more likely to influence discrete individual behaviors in the short run and less likely to create sustained changes. © 2009 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Building health research systems to achieve better health

PubMed Central

Hanney, Stephen R; González Block, Miguel A

2006-01-01

Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above priorities on which we hope to feature further articles in HARPS and thus contribute to an informed debate on how best to achieve such progress. PMID:17087830

Environmental Gerontology at the Beginning of the New Millennium: Reflections on Its Historical, Empirical, and Theoretical Development

ERIC Educational Resources Information Center

Wahl, Hans-Werner; Weisman, Gerald D.

2003-01-01

Over the past four decades the environmental context of aging has come to play an important role in gerontological theory, research, and practice. Environmental gerontology (EG)--focused on the description, explanation, and modification or optimization of the relation between elderly persons and their sociospatial surroundings--has emerged as a…

Parent Partnership in Literacy Education in the New Millennium: The Past, the Present, the Future.

ERIC Educational Resources Information Center

Hartley, Marion

It is widely recognized that parents play a vital role in education, particularly in the literacy development of their children. Related research literature indicates that in terms of parent partnership in literacy education in New Zealand, partnership arrangements in the past have been inconsistent, and literacy initiatives at times have been…

Framing health and foreign policy: lessons for global health diplomacy.

PubMed

Labonté, Ronald; Gagnon, Michelle L

2010-08-22

Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do not appear to dominate practice. While political momentum for health as a foreign policy goal persists, the framing of this goal remains a contested issue. The analysis offered in this article may prove helpful to those engaged in global health diplomacy or in efforts to have global governance across a range of sectoral interests pay more attention to health equity impacts.

Framing health and foreign policy: lessons for global health diplomacy

PubMed Central

2010-01-01

Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do not appear to dominate practice. While political momentum for health as a foreign policy goal persists, the framing of this goal remains a contested issue. The analysis offered in this article may prove helpful to those engaged in global health diplomacy or in efforts to have global governance across a range of sectoral interests pay more attention to health equity impacts. PMID:20727211

Developmental origins of health and disease--global public health implications.

PubMed

Hanson, M A; Gluckman, P D

2015-01-01

The rapidly rising prevalence of non-communicable diseases (NCDs) represents a major challenge to public health and clinical medicine globally. NCDs are increasing rapidly in high-income countries, but even more rapidly in some low-middle-income countries with insufficient resources to meet the challenge. Whilst not identified in the Millennium Development Goals, there is much attention paid to NCDs in the discussions at many levels on the Sustainable Development Goals, as they underpin economic, social and environmental development in the post-2015 era. In this article, we discuss how a life-course approach to health, commencing of necessity in early development, can provide new opportunities for addressing this challenge. The approach can leverage human health capital throughout life and across generations. New insights into mechanisms, especially those processes by which the developmental environment affects epigenetic processes in the developing offspring, offer the prospect of identifying biomarkers of future risks. New interventions to promote health literacy, lifestyle and physical fitness in adolescents, young adults and their children hold great promise. In this respect, health-care professionals concerned with preconceptional, pregnancy and newborn care will have a vital role to play. Copyright © 2014 Elsevier Ltd. All rights reserved.

Integration of Multiplex Bead Assays for Parasitic Diseases into a National, Population-Based Serosurvey of Women 15-39 Years of Age in Cambodia

PubMed Central

Priest, Jeffrey W.; Jenks, M. Harley; Moss, Delynn M.; Mao, Bunsoth; Buth, Sokhal; Wannemuehler, Kathleen; Soeung, Sann Chan; Lucchi, Naomi W.; Udhayakumar, Venkatachalam; Gregory, Christopher J.; Huy, Rekol; Muth, Sinuon; Lammie, Patrick J.

2016-01-01

Collection of surveillance data is essential for monitoring and evaluation of public health programs. Integrated collection of household-based health data, now routinely carried out in many countries through demographic health surveys and multiple indicator surveys, provides critical measures of progress in health delivery. In contrast, biomarker surveys typically focus on single or related measures of malaria infection, HIV status, vaccination coverage, or immunity status for vaccine-preventable diseases (VPD). Here we describe an integrated biomarker survey based on use of a multiplex bead assay (MBA) to simultaneously measure antibody responses to multiple parasitic diseases of public health importance as part of a VPD serological survey in Cambodia. A nationally-representative cluster-based survey was used to collect serum samples from women of child-bearing age. Samples were tested by MBA for immunoglobulin G antibodies recognizing recombinant antigens from Plasmodium falciparum and P. vivax, Wuchereria bancrofti, Toxoplasma gondii, Taenia solium, and Strongyloides stercoralis. Serologic IgG antibody results were useful both for generating national prevalence estimates for the parasitic diseases of interest and for confirming the highly focal distributions of some of these infections. Integrated surveys offer an opportunity to systematically assess the status of multiple public health programs and measure progress toward Millennium Development Goals. PMID:27136913

Mobile-health tool to improve maternal and neonatal health care in Bangladesh: a cluster randomized controlled trial.

PubMed

Tobe, Ruoyan Gai; Haque, Syed Emdadul; Ikegami, Kiyoko; Mori, Rintaro

2018-04-16

In Bangladesh, the targets on reduction of maternal mortality and utilization of related obstetric services provided by skilled health personnel in Millennium Development Goals 5 remains unmet, and the progress in reduction of neonatal mortality lag behind that in the reduction of infant and under-five mortalities, remaining as an essential issue towards the achievement of maternal and neonatal health targets in health related Sustainable Development Goals (SDGs). As access to appropriate perinatal care is crucial to reduce maternal and neonatal deaths, recently several mobile platform-based health programs sponsored by donor countries and Non-Governmental Organizations have targeted to reduce maternal and child mortality. On the other hand, good health-care is necessary for the development. Thus, we designed this implementation research to improve maternal and child health care for targeting SDGs. This cluster randomized trial will be conducted in Lohagora of Narail District and Dhamrai of Dhaka District. Participants are pregnant women in the respective areas. The total sample size is 3000 where 500 pregnant women will get Mother and Child Handbook (MCH) and messages using mobile phone on health care during pregnancy and antenatal care about one year in each area. The other 500 in each area will get health education using only MCH book. The rest 1000 participants will be controlled; it means 500 in each area. We randomly assigned the intervention and controlled area based on smallest administrative area (Unions) in Bangladesh. The data collection and health education will be provided through trained research officers starting from February 2017 to August 2018. Each health education session is conducting in their house. The study proposal was reviewed and approved by NCCD, Japan and Bangladesh Medical Research Council (BMRC), Bangladesh. The data will be analyzed using STATA and SPSS software. For the improvement of maternal and neonatal care, this community-based intervention using mobile phone and handbook will do great contribution. Thus, a developing country where resources are limited received the highest benefit. Such intervention will guide to design for prevention of other diseases too. UMIN000025628 Registered June 13, 2016.

Non-communicable diseases and global health governance: enhancing global processes to improve health development

PubMed Central

Magnusson, Roger S

2007-01-01

This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy. PMID:17519005

Non-communicable diseases and global health governance: enhancing global processes to improve health development.

PubMed

Magnusson, Roger S

2007-05-22

This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.

Requirements model for an e-Health awareness portal

NASA Astrophysics Data System (ADS)

Hussain, Azham; Mkpojiogu, Emmanuel O. C.; Nawi, Mohd Nasrun M.

2016-08-01

Requirements engineering is at the heart and foundation of software engineering process. Poor quality requirements inevitably lead to poor quality software solutions. Also, poor requirement modeling is tantamount to designing a poor quality product. So, quality assured requirements development collaborates fine with usable products in giving the software product the needed quality it demands. In the light of the foregoing, the requirements for an e-Ebola Awareness Portal were modeled with a good attention given to these software engineering concerns. The requirements for the e-Health Awareness Portal are modeled as a contribution to the fight against Ebola and helps in the fulfillment of the United Nation's Millennium Development Goal No. 6. In this study requirements were modeled using UML 2.0 modeling technique.

World Bank predicts development for next century.

PubMed

Ahmad, K

1999-09-18

The World Bank reports that localization and globalization will be the two primary forces that will dominate the trend in the next millennium. These trends could either revolutionize human development or lead to greater chaos and suffering. The report further examines three aspects of globalization: trade, capital flows and environment; and three aspects of localization: decentralization, cities and making livable cities. It focuses on the impact of these two forces on the poor and their health. It stated that economic growth in the past 30 years had little impact on indicators of real development such as political stability, education, life expectancy, and gender equality. Moreover, a weak correlation between income and standard of living exists because countries and communities placed different priorities on education and health. The recommendations of the bank include the need for macroeconomic stability and a socially flexible sustained development.

Learning Societies in the New Millennium: Creativity, Caring & Commitments. International Conference on Computers in Education/International Conference on Computer Assisted Instruction (Taipei, Taiwan, November 21-24, 2000).

ERIC Educational Resources Information Center

Association for the Advancement of Computing in Education. Asia-Pacific Chapter.

This conference addressed pedagogical, social, and technological issues related to computers in education. The conference theme, "Learning Societies in the New Millennium: Creativity, Caring & Commitments," focused on creative learning, caring for diverse cultures and global issues, and committing oneself to a new way of…

Skills for the New Millennium. Paper Presentations: Session G.

ERIC Educational Resources Information Center

2000

This document contains 14 papers from the skills for the new millennium section of an international conference on vocational education and training (VET) for lifelong learning in the information era. The following papers are included: "Research on Vocational Education and Training as a Field for Knowledge Development--Starting Points for the…

A Guide for Education in the Third Millennium.

ERIC Educational Resources Information Center

Whiddon, Tom; Wirth, Rex; Pool, Harbison

This paper examines the philosophical approaches to knowledge that have governed education and concludes that a new paradigm is needed for the new millennium. Education is subdivided into a three-level hierarchy, including: (1) the accumulation of factoids as knowledge; (2) the development of knowledge into theories and models for the purpose of…

Acute respiratory infection in children from developing nations: a multi-level study.

PubMed

Pinzón-Rondón, Ángela María; Aguilera-Otalvaro, Paula; Zárate-Ardila, Carol; Hoyos-Martínez, Alfonso

2016-05-01

Worldwide, acute respiratory infections (ARI) are the leading cause of death of children under 5 years of age. To assess the accomplishment of the Millennium Development Goal on under-5 mortality particularly related to ARI in developing countries, and to explore the associations between country characteristics and ARI in children under 5 taking into account child, mother and household attributes. The study included a representative sample of 354,633 children under 5 years from 40 developing nations. A multilevel analysis of data from the Demographic and Health Surveys and the World Bank was conducted. The prevalence of ARI was 13%. Country inequalities were associated with the disease - GINI index (95% CI 1.01-1.04). The country's per capita gross domestic product (GDP) (95% CI 1.00-1.01) and health expenditure (95% CI 1.01-1.01) affected the relationship between immunization and ARI, while inequalities influenced the relationship between household wealth (95% CI 0.99-0.99) and the disease. Other factors positively associated with ARI were male gender, low birthweight, working mothers and a high-risk indoor environment. Factors associated with ARI reduction were older children, immunization, breastfeeding for more than 6 months, older maternal age, maternal education and planned pregnancy. In developing countries, public health campaigns to target ARI should consider the country's macro characteristics. At country level, inequalities but not health expenditure or GDP were associated with the disease and were independent of child, family and household characteristics. The effect of immunization on reducing ARI is greater in countries with a higher GDP and health expenditure. The effect of household wealth on ARI is less in countries with fewer inequalities. Reduction of inequalities is an important measure to decrease ARI in developing countries.

Bringing evidence to policy to achieve health-related MDGs for all: justification and design of the EPI-4 project in China, India, Indonesia, and Vietnam.

PubMed

Thomsen, Sarah; Ng, Nawi; Biao, Xu; Bondjers, Göran; Kusnanto, Hari; Liem, Nguyen Tanh; Mavalankar, Dileep; Målqvist, Mats; Diwan, Vinod

2013-03-13

The Millennium Development Goals (MDGs) are monitored using national-level statistics, which have shown substantial improvements in many countries. These statistics may be misleading, however, and may divert resources from disadvantaged populations within the same countries that are showing progress. The purpose of this article is to set out the relevance and design of the "Evidence for Policy and Implementation project (EPI-4)". EPI-4 aims to contribute to the reduction of inequities in the achievement of health-related MDGs in China, India, Indonesia and Vietnam through the promotion of research-informed policymaking. Using a framework provided by the Commission on the Social Determinants of Health (CSDH), we compare national-level MDG targets and results, as well as their social and structural determinants, in China, India, Indonesia and Vietnam. To understand country-level MDG achievements it is useful to analyze their social and structural determinants. This analysis is not sufficient, however, to understand within-country inequities. Specialized analyses are required for this purpose, as is discussion and debate of the results with policymakers, which is the aim of the EPI-4 project. Reducing health inequities requires sophisticated analyses to identify disadvantaged populations within and between countries, and to determine evidence-based solutions that will make a difference. The EPI-4 project hopes to contribute to this goal.

Telemedicine: barriers and opportunities in the 21st century.

PubMed

Stanberry, B

2000-06-01

This paper aims to examine how health telematics will develop in the first 10 years of the new millennium and, in particular, to assess what operational, ethical and legal barriers may lie in the way of this development. A description of the key principles and concepts involved in telemedicine and a short historical overview of telemedicine's evolution over the past century are followed by consideration of why empirical research into 'info-ethics' and other deontological and legal issues relating to telemedicine is being necessarily catalysed by, amongst others, the European Commission. Four evolving health telematics applications are examined in some detail: electronic health records; the transmission of visual media in disciplines such as teleradiology, teledermatology, telepathology and teleophthalmology; telesurgery and robotics and the use of call centres and decision-support software. These are discussed in the light of their moral, ethical and cultural implications for clinicians, patients and society at large. The author argues that telemedicine presents unique opportunities for both patients and clinicians where it is implemented in direct response to clear clinical needs, but warns against excessive reliance upon technology to the detriment of traditional clinician-patient relationships and against complacency regarding the risks and responsibilities - many of which are as yet unknown - that distant medical intervention, consultation and diagnosis carry.

Millennium milestones: looking back, moving forward in your research career.

PubMed

Harden, J T

2000-01-01

The author discusses the mission of the National Institute on Aging (NIA), Office of Special Populations, the trends in appropriations, use of census data and the need to disentangle the social and political meaning of race from the presumed biological meaning, the potential effect of slavery on the health of African Americans, Federal racial and ethnic minority initiatives, definitions of race, culture, ethnicity, class and racism; formal recommendations from the NIA review of minority aging research; and NIA training and career development opportunities for minorities. Lastly, the author discusses minority aging research, health disparities and strategies for recruiting minorities into aging research.

Facilitating health and wellbeing is "everybody's role": youth perspectives from Vanuatu on health and the post-2015 sustainable development goal agenda.

PubMed

Sheridan, Simon A; Brolan, Claire E; Fitzgerald, Lisa; Tasserei, John; Maleb, Marie-France; Rory, Jean-Jacques; Hill, Peter S

2014-10-10

Progress towards achievement of the Millennium Development Goals (MDGs) amongst Pacific island countries (PICs) has seen mixed results. As focus shifts to formulation of new health-related development goals beyond 2015, there is a need for bringing community consultation into this process. For this purpose, Go4Health is a global consortium examining the development of these goals, with Work Package 2 capturing viewpoints of marginalised populations regarding health. This paper examines the perspectives of youth in Vanuatu on essential health needs in the context of the post-2015 development agenda, to make these concerns more visible for their communities, stakeholders and health policy decision makers. As part of a larger investigation undertaken in Vanuatu involving 100 residents from various rural and urban communities, this paper explores the perspectives of twenty 17-year old secondary school students gathered through two focus group discussions during September 2013. Questions sought viewpoints across areas including health ideals, essential needs, responsibility for health services and their governance. Focus group discussions were conducted in English and digitally recorded, with resulting transcripts subjected to thematic analysis. This youth cohort from Vanuatu had a strong understanding of the social determinants of health. They placed value on all aspects of health, indicating the need for youth to have access to positive lifestyle opportunities (sport, community participation) and also increased protection from the impact of harmful substances and causes of chronic illness. Participants identified barriers to health due to unevenly distributed health services throughout Vanuatu, with members at all levels of society ultimately perceived as responsible for improving health throughout the nation. Against a background of a weak health system and significant challenges to public health, young people are acutely aware that improving Vanuatu's health status requires a communal effort. While contributing factors to health depend on actions taken at individual, local, national and global levels, no single actor currently provides enough support to cover all essential health needs. As a consequence, they see health in the Pacific as "everybody's role", of importance for the post-2015 sustainable development goal agenda and health policy makers in general.

3 CFR - Coordination of Policies and Programs To Promote Gender Equality and Empower Women and Girls...

Code of Federal Regulations, 2014 CFR

2014-01-01

..., are free from violence, and have equal access to education, economic opportunity, and health care... Equality and Female Empowerment Policy. The Millennium Challenge Corporation issued Gender Integration..., Defense, Justice, Agriculture, Commerce, Labor, Health and Human Services, Education, and Homeland...

Hemispherically Asymmetric Volcanic Forcing of Tropical Hydroclimate During the Last Millennium

NASA Technical Reports Server (NTRS)

Colose, Christopher M.; Legrande, Allegra N.; Vuille, Mathias

2016-01-01

Volcanic aerosols exert the most important natural radiative forcing of the last millennium. State-of-the-art paleoclimate simulations of this interval are typically forced with diverse spatial patterns of volcanic forcing, leading to different responses in tropical hydroclimate. Recently, theoretical considerations relating the intertropical convergence zone (ITCZ) position to the demands of global energy balance have emerged in the literature, allowing for a connection to be made between the paleoclimate simulations and recent developments in the understanding of ITCZ dynamics. These energetic considerations aid in explaining the well-known historical, paleoclimatic, and modeling evidence that the ITCZ migrates away from the hemisphere that is energetically deficient in response to asymmetric forcing. Here we use two separate general circulation model (GCM) suites of experiments for the last millennium to relate the ITCZ position to asymmetries in prescribed volcanic sulfate aerosols in the stratosphere and related asymmetric radiative forcing. We discuss the ITCZ shift in the context of atmospheric energetics and discuss the ramifications of transient ITCZ migrations for other sensitive indicators of changes in the tropical hydrologic cycle, including global streamflow. For the first time, we also offer insight into the large-scale fingerprint of water isotopologues in precipitation (delta sup 18 Op) in response to asymmetries in radiative forcing. The ITCZ shifts away from the hemisphere with greater volcanic forcing. Since the isotopic composition of precipitation in the ITCZ is relatively depleted compared to areas outside this zone, this meridional precipitation migration results in a large-scale enrichment (depletion) in the isotopic composition of tropical precipitation in regions the ITCZ moves away from (toward). Our results highlight the need for careful consideration of the spatial structure of volcanic forcing for interpreting volcanic signals in proxy records and therefore in evaluating the skill of Common Era climate model output.

Integrated Approaches to Address the Social Determinants of Health for Reducing Health Inequity

PubMed Central

Mitlin, Diana; Mulholland, Catherine; Hardoy, Ana; Stern, Ruth

2007-01-01

The social and physical environments have long since been recognized as important determinants of health. People in urban settings are exposed to a variety of health hazards that are interconnected with their health effects. The Millennium Development Goals (MDGs) have underlined the multidimensional nature of poverty and the connections between health and social conditions and present an opportunity to move beyond narrow sectoral interventions and to develop comprehensive social responses and participatory processes that address the root causes of health inequity. Considering the complexity and magnitude of health, poverty, and environmental issues in cities, it is clear that improvements in health and health equity demand not only changes in the physical and social environment of cities, but also an integrated approach that takes into account the wider socioeconomic and contextual factors affecting health. Integrated or multilevel approaches should address not only the immediate, but also the underlying and particularly the fundamental causes at societal level of related health issues. The political and legal organization of the policy-making process has been identified as a major determinant of urban and global health, as a result of the role it plays in creating possibilities for participation, empowerment, and its influence on the content of public policies and the distribution of scarce resources. This paper argues that it is essential to adopt a long-term multisectoral approach to address the social determinants of health in urban settings. For comprehensive approaches to address the social determinants of health effectively and at multiple levels, they need explicitly to tackle issues of participation, governance, and the politics of power, decision making, and empowerment. PMID:17393340

Universal Health Coverage’s evolving location in the post-2015 development agenda: Key informant perspectives within multilateral and related agencies during the first phase of post-2015 negotiations

PubMed Central

Brolan, Claire E; Hill, Peter S

2016-01-01

In 2001, technocrats from four multilateral organizations selected the Millennium Development Goals mainly from the previous decade of United Nations (UN) summits and conferences. Few accounts are available of that significant yet cloistered synthesis process: none contemporaneous. In contrast, this study examines health’s evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related agencies. Using discourse analysis, this article reports the results and analysis of a Universal Health Coverage (UHC) theme: contextualizing UHC’s positioning within the post-2015 agenda-setting process immediately after the Global Thematic Consultation on Health and High-Level Panel of Eminent Persons on the Post-2015 Development Agenda (High-Level Panel) released their post-2015 health and development goal aspirations in April and May 2013, respectively. After the findings from the interview data analysis are presented, the Results will be discussed drawing on Shiffman and Smith (Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet 2007; 370: 1370–79) agenda-setting analytical framework (examining ideas, issues, actors and political context), modified by Benzian et al. (2011). Although more participants support the High-Level Panel’s May 2013 report’s proposal—‘Ensure Healthy Lives’—as the next umbrella health goal, they nevertheless still emphasize the need for UHC to achieve this and thus be incorporated as part of its trajectory. Despite UHC’s conceptual ambiguity and cursory mention in the High-Level Panel report, its proponents suggest its re-emergence will occur in forthcoming State led post-2015 negotiations. However, the final post-2015 SDG framework for UN General Assembly endorsement in September 2015 confirms UHC’s continued distillation in negotiations, as UHC ultimately became one of a litany of targets within the proposed global health goal. PMID:26494847

Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges.

PubMed

Fowkes, Freya J I; Draper, Bridget L; Hellard, Margaret; Stoové, Mark

2016-12-12

The global health community is currently transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Unfortunately, progress towards maternal, newborn and infant health MDGs has lagged significantly behind other key health goals, demanding a renewed global effort in this key health area. The World Health Organization and other institutions heralded integrated antenatal care (ANC) as the best way to address the inter-related health issues of HIV, tuberculosis (TB) and malaria in the high risk groups of pregnant women and infants; integrated ANC services also offer a mechanism to address slow progress towards improved maternal health. There is remarkably limited evidence on best practice approaches of program implementation, acceptability and effectiveness for integrated ANC models targeting multiple diseases. Here, we discuss current integrated ANC global guidelines and the limited literature describing integrated ANC implementation and evidence for their role in addressing HIV, malaria and TB during pregnancy in sub-Saharan Africa. We highlight the paucity of data on the effectiveness of integrated ANC models and identify significant structural barriers in the health system (funding, infrastructure, distribution, human resources), the adoption system (limited buy-in from implementers, leadership, governance) and, in the broader context, patient-centred barriers (fear, stigma, personal burdens) and barriers in funding structures. We highlight recommendations for action and discuss avenues for the global health community to develop systems to integrate multiple disease programs into ANC models of care that better address these three priority infectious diseases. With the current transition to the SDGs and concerns regarding the failure to meet maternal health MDGs, the global health community, researchers, implementers and funding bodies must work together to ensure the establishment of quality operational and implementation research to inform integrated ANC models. It is imperative that the global health community engages in a timely discussion about such implementation innovations and instigates appropriate actions to ensure advances in maternal health are sufficient to meet applicable SDGs.

Barriers of modern contraceptive practices among Asian women: a mini literature review.

PubMed

Najafi-Sharjabad, Fatemeh; Zainiyah Syed Yahya, Sharifah; Abdul Rahman, Hejar; Hanafiah Juni, Muhamad; Abdul Manaf, Rosliza

2013-07-22

Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women.

Barriers of Modern Contraceptive Practices among Asian Women: A Mini Literature Review

PubMed Central

Najafi-Sharjabad, Fatemeh; Syed Yahya, Sharifah Zainiyah; Rahman, Hejar Abdul; Hanafiah, Muhamad; Abdul Manaf, Rosliza

2013-01-01

Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women. PMID:23985120

Stagnant neonatal mortality and persistent health inequality in middle-income countries: a case study of the Philippines.

PubMed

Kraft, Aleli D; Nguyen, Kim-Huong; Jimenez-Soto, Eliana; Hodge, Andrew

2013-01-01

The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country's socioeconomic-related child health inequality. Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education), regional location, and access to health services, such as facility-based delivery. The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality--that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system--to re-start the long term decline in neonatal mortality and to reduce persistent within-country inequalities in child health.

Criterion-based clinical audit in obstetrics: bridging the quality gap?

PubMed

Graham, W J

2009-06-01

The Millennium Development Goal 5 - reducing maternal mortality by 75% - is unlikely to be met globally and for the majority of low-income countries. At this time of heightened concern to scale-up services for mothers and babies, it is crucial that not only shortfalls in the quantity of care - in terms of location and financial access - are addressed, but also the quality. Reductions in maternal and perinatal mortality in the immediate term depend in large part on the timely delivery of effective practices in the management of life-threatening complications. Such practices require a functioning health system - including skilled and motivated providers engaged with the women and communities whom they serve. Assuring the quality of this system, the services and the care that women receive requires many inputs, including effective and efficient monitoring mechanisms. The purpose of this article is to summarise the practical steps involved in applying one such mechanism, criterion-based clinical audit (CBCA), and to highlight recent lessons from its application in developing countries. Like all audit tools, the ultimate worth of CBCA relates to the action it stimulates in the health system and among providers.

Vision 2000: Strategies for a New Millennium, Proceedings: Military Librarians Workshop 󈨥. 41st Annual Military Librarians Workshop, 18-20 November 1997, Marriott Hotel, Dayton, Ohio.

DTIC Science & Technology

1997-12-01

Science Foundation, the development of a topography of STI systems for the Library of Congress, and the development of a system to provide input to...Information System’s Database and a project to develop a reference catalog of Internet resources in area studies. She is consultant to foreign and...interface development for non-US data. Prior to this, she served as the Director of Corporate Librarian Relations, developing marketing, support, and new

Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): The case of Zambia

PubMed Central

Hangoma, Peter; Aakvik, Arild; Robberstad, Bjarne

2017-01-01

Background Child health interventions were drastically scaled up in the period leading up to 2015 as countries aimed at meeting the 2015 target of the Millennium Development Goals (MDGs). MDGs were defined in terms of achieving improvements in average health. Significant improvements in average child health are documented, but evidence also points to rising inequality. It is important to investigate factors that drive the increasing disparities in order to inform the post-2015 development agenda of reducing inequality, as captured in the Sustainable Development Goals (SDGs). We investigated changes in socioeconomic inequality in stunting and fever in Zambia in 2007 and 2014. Unlike the huge literature that seeks to quantify the contribution of different determinants on the observed inequality at any given time, we quantify determinants of changes in inequality. Methods Data from the 2007 and 2014 waves of the Zambia Demographic and Health Survey (DHS) were utilized. Our sample consisted of children aged 0–5 years (n = 5,616 in 2007 and n = 12,714 in 2014). We employed multilevel models to assess the determinants of stunting and fever, which are two important child health indicators. The concentration index (CI) was used to measure the magnitude of inequality. Changes in inequality of stunting and fever were investigated using Oaxaca-type decomposition of the CI. In this approach, the change in the CI for stunting/fever is decomposed into changes in CI for each determinant and changes in the effect—measured as an elasticity—of each determinant on stunting/fever. Results While average rates of stunting reduced in 2014 socioeconomic inequality in stunting increased significantly. Inequality in fever incidence also increased significantly, but average rates of fever did not reduce. The increase in the inequality (CI) of determinants accounted for the largest part (42.5%) of the increase in inequality of stunting, while the increase in the effect of determinants explained 35% of the increase. The determinants with the greatest total contribution (change in CI plus change in effect) to the increase in inequality of stunting were mother’s height and weight, wealth, birth order, facility delivery, duration of breastfeeding, and maternal education. For fever, almost all (86%) the increase in inequality was accounted for by the increase in the effect of determinants of fever, while the distribution of determinants mattered less. The determinants with the greatest total contribution to the increase in inequality of fever were wealth, maternal education, birth order and breastfeeding duration. In the multilevel model, we found that the likelihood of a child being stunted or experiencing fever depends on the community in which they live. Conclusions To curb the increase in inequality of stunting and fever, policy may focus on improving levels of, and reducing inequality in, access to facility deliveries, maternal nutrition (which may be related to maternal weight and height), complementary feeding (for breastfed children), wealth, maternal education, and child care (related to birth order effects). Improving overall levels of these determinants contribute to the persistence of inequality if these determinants are unequally concentrated on the well off to begin with. PMID:28170442

Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): The case of Zambia.

PubMed

Hangoma, Peter; Aakvik, Arild; Robberstad, Bjarne

2017-01-01

Child health interventions were drastically scaled up in the period leading up to 2015 as countries aimed at meeting the 2015 target of the Millennium Development Goals (MDGs). MDGs were defined in terms of achieving improvements in average health. Significant improvements in average child health are documented, but evidence also points to rising inequality. It is important to investigate factors that drive the increasing disparities in order to inform the post-2015 development agenda of reducing inequality, as captured in the Sustainable Development Goals (SDGs). We investigated changes in socioeconomic inequality in stunting and fever in Zambia in 2007 and 2014. Unlike the huge literature that seeks to quantify the contribution of different determinants on the observed inequality at any given time, we quantify determinants of changes in inequality. Data from the 2007 and 2014 waves of the Zambia Demographic and Health Survey (DHS) were utilized. Our sample consisted of children aged 0-5 years (n = 5,616 in 2007 and n = 12,714 in 2014). We employed multilevel models to assess the determinants of stunting and fever, which are two important child health indicators. The concentration index (CI) was used to measure the magnitude of inequality. Changes in inequality of stunting and fever were investigated using Oaxaca-type decomposition of the CI. In this approach, the change in the CI for stunting/fever is decomposed into changes in CI for each determinant and changes in the effect-measured as an elasticity-of each determinant on stunting/fever. While average rates of stunting reduced in 2014 socioeconomic inequality in stunting increased significantly. Inequality in fever incidence also increased significantly, but average rates of fever did not reduce. The increase in the inequality (CI) of determinants accounted for the largest part (42.5%) of the increase in inequality of stunting, while the increase in the effect of determinants explained 35% of the increase. The determinants with the greatest total contribution (change in CI plus change in effect) to the increase in inequality of stunting were mother's height and weight, wealth, birth order, facility delivery, duration of breastfeeding, and maternal education. For fever, almost all (86%) the increase in inequality was accounted for by the increase in the effect of determinants of fever, while the distribution of determinants mattered less. The determinants with the greatest total contribution to the increase in inequality of fever were wealth, maternal education, birth order and breastfeeding duration. In the multilevel model, we found that the likelihood of a child being stunted or experiencing fever depends on the community in which they live. To curb the increase in inequality of stunting and fever, policy may focus on improving levels of, and reducing inequality in, access to facility deliveries, maternal nutrition (which may be related to maternal weight and height), complementary feeding (for breastfed children), wealth, maternal education, and child care (related to birth order effects). Improving overall levels of these determinants contribute to the persistence of inequality if these determinants are unequally concentrated on the well off to begin with.

The mis-measurement of extreme global poverty: A case study in the Pacific Islands

PubMed Central

Gubhaju, Bina

2015-01-01

Debate over the measurement of global poverty in low- and middle-income countries continues unabated. There is considerable controversy surrounding the ‘dollar a day’ measure used to monitor progress against the Millennium Development Goals. This article shines fresh light on the debate with new empirical analyses of poverty (including child poverty), inequality and deprivation levels in the Pacific island state of Vanuatu. The study focuses not only on economic and monetary metrics and measures, but also the measures of deprivation derived from sociology in relation to shelter, sanitation, water, information, nutrition, health and education. Until recently, there had been few, if any, attempts to study poverty and deprivation disparities among children in this part of the world. Different measures yield strikingly different estimates of poverty. The article, therefore, attempts to situate the study findings in the broader international context of poverty measurement and discusses their implications for future research and the post-2015 development agenda. PMID:26336359

The current crisis in human resources for health in Africa: the time to adjust our focus is now.

PubMed

Dalton, Simon C

2014-09-01

The challenges as we strive towards universal health coverage are many, but the need for an improved health workforce is chief among them. Unfortunately the global deficit in skilled professionals continues to increase. Nevertheless, there are potential solutions, and success stories are well documented when the approach is on system building and sustainability. As we approach 2015 and the Millennium Development Goals, we must shift our focus to a more distant time point in order to achieve the dramatic gains in global health that are possible. However, we must understand that there can be no health without a workforce. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sexual and reproductive health and rights in the sustainable development goals and the post-2015 development agenda: less than a year to go.

PubMed

Haslegrave, Marianne

2014-11-01

Since the International Conference on Population and Development (ICPD) in Cairo in 1994 there have been significant achievements in moving towards the goal of sexual and reproductive health and rights. Yet there have also been disappointments, as demonstrated in the Millennium Development Goals, even though in 2007 a target on reproductive health was added. Most recently, the 20-year review of the implementation of the ICPD Programme of Action, ICPD Beyond 2014, has taken place, which has moved forward the sexual and reproductive health and rights agenda. But, the main arena for future negotiations has changed and the UN is in the process of negotiating the post-2015 development agenda and the sustainable development goals (SDGs). This paper assesses what has been taking place since 2013 and provides information as to how the process for the post-2015 development agenda and the SDGs are likely to move forward. An understanding of what has been achieved, the processes as they are now proceeding and their future development are important for moving towards the ultimate goal of achieving sexual and reproductive health and rights in the next 15 years. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

The Millennium Cohort Family Study: A Prospective Evaluation of the Health and Well-Being of Military Service Members and Their Families

DTIC Science & Technology

2014-06-10

psychology , family, military, epidemiology, mental health, deployments Correspondence Nancy Crum-Cianflone, Deployment Health Research Department...American Psychological Association, 2007; Siegel et al., 2013; US Army Medical Research and Materiel Command, 2013). Although studies on military...functional health Modules on common types of mental disorders: depression, anxiety, panic syndrome, somatoform symptoms, alcohol abuse, bulimia nervosa

Development assistance for health: donor commitment as a critical success factor.

PubMed

White, Franklin

2011-01-01

In 1970, led by Canada, the world's richest nations pledged 0.7% of their gross national income (GNI) to official development assistance (ODA). Although this pledge has been renewed several times, with the exception of only five countries, ODA allocations have lagged chronically behind this commitment. Put more bluntly, our rhetoric outpaces our actions. For example, spending only 0.3% GNI on development, Canada performs at about 40% of its pledge. The good news is that development assistance for health has improved over the past two decades, mostly due to private development assistance (PDA) and favourable shifts within bilateral and multilateral funding, but clearly more must be done to enhance this effort. Actions in support of the Millennium Development Goals and the Paris Declaration on Aid Effectiveness should make a difference, subject to monitoring and evaluation, and Canada's Muskoka Initiative also is a step in the right direction. However, while success in meeting international development and global health goals depends on donor and recipient nations working as partners through such mechanisms, the relevance of the developed world as a force for global health will be measured in part by how well its governments keep their development commitments.

Leaving no one behind: a neglected tropical disease indicator and tracers for the Sustainable Development Goals.

PubMed

Fitzpatrick, Christopher; Engels, Dirk

2016-03-01

The Sustainable Development Goals (SDGs) have emerged as a global pledge to 'leave no one behind'. Under SDG 3, 'Ensure healthy lives and promote wellbeing for all', target 3.3 extends the Millennium Development Goals (MDGs) beyond HIV, TB and malaria to 'end the epidemic' of neglected tropical diseases (NTDs) by 2030. Other targets are also relevant to NTDs, especially 3.8 (Universal Health Coverage), 6.1 (water) and 6.2 (sanitation). This commentary summarises the proposed NTD indicator (3.3) and tracers (3.8 and 6.1/6.2). These will help ensure that the world's poorest and most marginalized people are prioritized at every step on the path towards SDG targets. © The author 2016. The World Health Organization has granted Oxford University Press permission for the reproduction of this article..

Progress towards the Millennium Development Goals in a community of extreme poverty: local vs. national disparities in Peru.

PubMed

Gyorkos, Theresa W; Joseph, Serene A; Casapía, Martin

2009-06-01

Standard indicators are being used worldwide to track progress towards achieving the Millennium Development Goals (MDGs). These are usually at country level and do not accurately reflect within-country variability of progress towards the targets. This may lead to lack of attention and under-resourcing of the most vulnerable populations. Therefore, the objective of this study was to compare selected standard MDG indicators at country level and community level in Peru. As MDG indicators we selected: (i) moderate to severe and severe underweight in children under 5 years old; (ii) immunization against measles in 1-year olds; (iii) births attended by skilled health professionals and (iv) youth unemployment. Country-level data for Peru were obtained from United Nations published sources. Community-level data were obtained from a household survey conducted in 2005-2006 in Belén, a community of extreme poverty in the Amazon region. Belén indicators were consistently less favourable than country-level indicators, and indicators even differed between zones of high and low socioeconomic status within Belén itself. Compared to MDG indicators at the national level in Peru, the population of Belén experiences intra-country regional disparities in important health and social outcomes. Improving the coverage and quality of interventions and services in this community is essential. Other vulnerable populations in Peru should also be identified and targeted so that they can benefit from, and ultimately contribute to, progress in achieving the MDGs.

Data Resource Profile: United Nations Children’s Fund (UNICEF)

PubMed Central

Murray, Colleen; Newby, Holly

2012-01-01

The United Nations Children’s Fund (UNICEF) plays a leading role in the collection, compilation, analysis and dissemination of data to inform sound policies, legislation and programmes for promoting children’s rights and well-being, and for global monitoring of progress towards the Millennium Development Goals. UNICEF maintains a set of global databases representing nearly 200 countries and covering the areas of child mortality, child health, maternal health, nutrition, immunization, water and sanitation, HIV/AIDS, education and child protection. These databases consist of internationally comparable and statistically sound data, and are updated annually through a process that draws on a wealth of data provided by UNICEF’s wide network of >150 field offices. The databases are composed primarily of estimates from household surveys, with data from censuses, administrative records, vital registration systems and statistical models contributing to some key indicators as well. The data are assessed for quality based on a set of objective criteria to ensure that only the most reliable nationally representative information is included. For most indicators, data are available at the global, regional and national levels, plus sub-national disaggregation by sex, urban/rural residence and household wealth. The global databases are featured in UNICEF’s flagship publications, inter-agency reports, including the Secretary General’s Millennium Development Goals Report and Countdown to 2015, sector-specific reports and statistical country profiles. They are also publicly available on www.childinfo.org, together with trend data and equity analyses. PMID:23211414

Engaging with complexity to improve the health of indigenous people: a call for the use of systems thinking to tackle health inequity.

PubMed

Hernández, Alison; Ruano, Ana Lorena; Marchal, Bruno; San Sebastián, Miguel; Flores, Walter

2017-02-21

The 400 million indigenous people worldwide represent a wealth of linguistic and cultural diversity, as well as traditional knowledge and sustainable practices that are invaluable resources for human development. However, indigenous people remain on the margins of society in high, middle and low-income countries, and they bear a disproportionate burden of poverty, disease, and mortality compared to the general population. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators in relation to the 15-year push to meet the Millennium Development Goals. As we enter the Sustainable Development Goals (SDGs) era, there is growing consensus that efforts to achieve Universal Health Coverage (UHC) and promote sustainable development should be guided by the moral imperative to improve equity. To achieve this, we need to move beyond the reductionist tendency to frame indigenous health as a problem of poor health indicators to be solved through targeted service delivery tactics and move towards holistic, integrated approaches that address the causes of inequalities both inside and outside the health sector. To meet the challenge of engaging with the conditions underlying inequalities and promoting transformational change, equity-oriented research and practice in the field of indigenous health requires: engaging power, context-adapted strategies to improve service delivery, and mobilizing networks of collective action. The application of systems thinking approaches offers a pathway for the evolution of equity-oriented research and practice in collaborative, politically informed and mutually enhancing efforts to understand and transform the systems that generate and reproduce inequities in indigenous health. These approaches hold the potential to strengthen practice through the development of more nuanced, context-sensitive strategies for redressing power imbalances, reshaping the service delivery environment and fostering the dynamics of collective action for political reform.

Coherence between health policy and human resource strategy: lessons from maternal health in Vietnam, India and China.

PubMed

Martineau, Tim; Mirzoev, Tolib; Pearson, Stephen; Ha, Bui Thi Thu; Xu, Qian; Ramani, K V; Liu, Xiaoyun

2015-02-01

The failure to meet health goals such as the Millennium Development Goals (MDG) is partly due to the lack of appropriate resources for the effective implementation of health policies. The lack of coherence between the health policies and human resource (HR) strategy is one of the major causes. This article explores the relationship and the degree of coherence between health policy--in this case maternal health policy--processes and HR strategy in Vietnam, China and India in the period 2005-09. Four maternal health policy case studies were explored [skilled birth attendance (SBA), adolescent and sexual reproductive health, domestic violence and medical termination of pregnancy] across three countries through interviews with key respondents, document analysis and stakeholder meetings. Analysis for coherence between health policy and HR strategy was informed by a typology covering 'separation', 'fit' and 'dialogue'. Regarding coherence we found examples of complete separation between health policy and HR strategy, a good fit with the SBA policy though modified through 'dialogue' in Vietnam, and in one case a good fit between policy and strategy was developed through successive evaluations. Three key influences on coherence between health policy and HR strategy emerge from our findings: (1) health as the lead sector, (2) the nature of the policy instrument and (3) the presence of 'HR champions'. Finally, we present a simple algorithm to ensure that appropriate HR related actors are involved; HR is considered at the policy development stage with the option of modifying the policy if it cannot be adequately supported by the available health workforce; and ensuring that HR strategies are monitored to ensure continued coherence with the health policy. This approach will ensure that the health workforce contributes more effectively to meeting the MDGs and future health goals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Taking ICPD beyond 2015: negotiating sexual and reproductive rights in the next development agenda.

PubMed

Girard, Françoise

2014-01-01

On the twentieth anniversary of the International Conference on Population and Development (ICPD), activists, governments and diplomats engaged in the fight for sexual and reproductive health and rights (SRHR) are anxious to ensure that these issues are fully reflected in the development agenda to succeed the Millennium Development Goals after 2015. In inter-governmental negotiations since 1994 and particularly in the period 2012-2014, governments have shown that they have significantly expanded their understanding of a number of so-called 'controversial' issues in the ICPD agenda, whether safe abortion, adolescent sexual and reproductive health services, comprehensive sexuality education or sexual rights. As in the past and in spite of an increasingly complex and difficult multilateral environment, countering the highly organised conservative opposition to SRHR has required a well-planned and determined mobilisation by progressive forces from North and South.

Reinforcing marginality? Maternal health interventions in rural Nicaragua.

PubMed

Kvernflaten, Birgit

2017-06-23

To achieve Millennium Development Goal 5 on maternal health, many countries have focused on marginalized women who lack access to care. Promoting facility-based deliveries to ensure skilled birth attendance and emergency obstetric care has become a main measure for preventing maternal deaths, so women who opt for home births are often considered 'marginal' and in need of targeted intervention. Drawing upon ethnographic data from Nicaragua, this paper critically examines the concept of marginality in the context of official efforts to increase institutional delivery amongst the rural poor, and discusses lack of access to health services among women living in peripheral areas as a process of marginalization. The promotion of facility birth as the new norm, in turn, generates a process of 're-marginalization', whereby public health officials morally disapprove of women who give birth at home, viewing them as non-compliers and a problem to the system. In rural Nicaragua, there is a discrepancy between the public health norm and women's own preferences and desires for home birth. These women live at the margins also in spatial and societal terms, and must relate to a health system they find incapable of providing good, appropriate care. Strong public pressure for institutional delivery makes them feel distressed and pressured. Paradoxically then, the aim of including marginal groups in maternal health programmes engenders resistance to facility birth.

Convention on the rights of the child: promoting human rights in Islamic day schools in Indonesia.

PubMed

Rivin, Beth E

2011-09-01

In recent years, rights-based approaches to health are changing the perspective and work of actors in the development sector. This article describes an NGO program that translates theory into practice by integrating human rights education and human rights principles into primary school health programs in Jakarta, Indonesia. Uplift International, an NGO affiliated with the University of Washington School of Law, aims to improve the rights of urban, poor children through teacher and parent training, uniquely designed for the madrasah (Islamic religious day schools) community. The school program links child rights and child health through human rights education and human rights-based methodologies. The Uplift International program is in its fourth year and plans to expand in scope. Positive outcomes include significant notice by Indonesian Government Ministries. Moreover, there is support from the new Indonesian Special Envoy to the UN for Millennium Development Goals (MDGs).

Socio-economic determinants of life expectancy in Nigeria (1980 - 2011).

PubMed

Sede, Peter I; Ohemeng, Williams

2015-01-01

Attainment of 70 years life expectancy by 2020 is one of the millennium development goals in Nigeria. This study examined the socio-economic determinants of life expectancy in Nigeria using data from 1980-2011. Judging from the endogeneity feature of the variables, A VAR and VECM frameworks were employed. Socio-economic features were proxy by secondary school enrolment, government expenditure on health, per capita income, unemployment rate and the Naira foreign exchange rate. It was found that, the conventional socio-economic variables such as per capita income, education and government expenditure on health considered to be highly effective in determining life expectancy of developing countries are not significant in the case of Nigeria. The study however suggests that, life expectancy in Nigeria could be improved if attention is given to quality of government health expenditure, unemployment and measures to halt the depreciation of the Nigerian Naira against major foreign currency.

The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study.

PubMed

Pearce, Anna; Lewis, Hannah; Law, Catherine

2013-02-01

Despite rises in reconstituted and lone-parent families, relatively little is known about how the health of children in different family types varies, and the extent to which any differences might be explained by poverty. The authors examined this using cross-sectional data on 13 681 seven-year-olds from the Millennium Cohort Study. The authors estimated RRs and 95% CIs for having poor physical (general health, long-standing illness, injury, overweight, asthma, fits) and mental health (using strengths and difficulties scores) according to family structure using Poisson regression. The authors adjusted for confounders (aRR) and then investigated the role of poverty as a mediator by entering a poverty score (based on income, receipt of benefits, subjective poverty and material deprivation) into the main model. Children living in reconstituted and lone-parent families were at a slight increased risk of poor health compared with those living with two natural parents. Adjusting for poverty tended to remove the elevated risk of poor physical health in children living in lone-parent and reconstituted families. However, for the mental health outcomes, poverty tended to remove the elevated risk for lone parents but not for reconstituted families. For example, the aRR for borderline-abnormal total difficulties fell from 1.45 (1.22 to 1.72) to 1.34 (1.13 to 1.59) in children living in reconstituted families and from 1.29 (1.14 to 1.45) to 1.05 (0.92 to 1.19) in those living with lone parents. Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction may help to reduce these differences, especially for children living with lone parents; however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.

Coronary artery disease in Bangladesh: A review

PubMed Central

Islam, A.K.M. Monwarul; Majumder, A.A.S.

2013-01-01

Coronary artery disease (CAD) is an increasingly important medical and public health problem, and is the leading cause of mortality in Bangladesh. Like other South Asians, Bangladeshis are unduly prone to develop CAD, which is often premature in onset, follows a rapidly progressive course and angiographically more severe. The underlying pathophysiology is poorly understood. Genetic predisposition, high prevalence of metabolic syndrome and conventional risk factors play important role. Lifestyle related factors, including poor dietary habits, excess saturated and trans fat, high salt intake, and low-level physical activity may be important as well. Some novel risk factors, including hypovitaminosis D, arsenic contamination in water and food-stuff, particulate matter air pollution may play unique role. At the advent of the new millennium, we know little about our real situation. Largescale epidemiological, genetic and clinical researches are needed to explore the different aspects of CAD in Bangladesh. PMID:23993003

Association between health worker motivation and healthcare quality efforts in Ghana.

PubMed

Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

2013-08-14

Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic's effort towards quality improvement and patient safety (P <0.05). As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.

Reproductive health, and child health and nutrition in India: meeting the challenge

PubMed Central

Paul, Vinod Kumar; Sachdev, Harshpal Singh; Mavalankar, Dileep; Ramachandran, Prema; Sankar, Mari Jeeva; Bhandari, Nita; Sreenivas, Vishnubhatla; Sundararaman, Thiagarajan; Govil, Dipti; Osrin, David; Kirkwood, Betty

2012-01-01

India, with a population of more than 1 billion people, has many challenges in improving the health and nutrition of its citizens. Steady declines have been noted in fertility, maternal, infant and child mortalities, and the prevalence of severe manifestations of nutritional deficiencies, but the pace has been slow and falls short of national and Millennium Development Goal targets. The likely explanations include social inequities, disparities in health systems between and within states, and consequences of urbanisation and demographic transition. In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum. Substantial unmet need for contraception remains, adolescent pregnancies are common, and access to safe abortion is inadequate. Increases in the numbers of deliveries in institutions have not been matched by improvements in the quality of intrapartum and neonatal care. Infants and young children do not get the health care they need; access to effective treatment for neonatal illness, diarrhoea, and pneumonia shows little improvement; and the coverage of nutrition programmes is inadequate. Absence of well functioning health systems is indicated by the inadequacies related to planning, financing, human resources, infrastructure, supply systems, governance, information, and monitoring. We provide a case for transformation of health systems through effective stewardship, decentralised planning in districts, a reasoned approach to financing that affects demand for health care, a campaign to create awareness and change health and nutrition behaviour, and revision of programmes for child nutrition on the basis of evidence. This agenda needs political commitment of the highest order and the development of a people’s movement. PMID:21227494

Reproductive health, and child health and nutrition in India: meeting the challenge.

PubMed

Paul, Vinod Kumar; Sachdev, Harshpal Singh; Mavalankar, Dileep; Ramachandran, Prema; Sankar, Mari Jeeva; Bhandari, Nita; Sreenivas, Vishnubhatla; Sundararaman, Thiagarajan; Govil, Dipti; Osrin, David; Kirkwood, Betty

2011-01-22

India, with a population of more than 1 billion people, has many challenges in improving the health and nutrition of its citizens. Steady declines have been noted in fertility, maternal, infant and child mortalities, and the prevalence of severe manifestations of nutritional deficiencies, but the pace has been slow and falls short of national and Millennium Development Goal targets. The likely explanations include social inequities, disparities in health systems between and within states, and consequences of urbanisation and demographic transition. In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum. Substantial unmet need for contraception remains, adolescent pregnancies are common, and access to safe abortion is inadequate. Increases in the numbers of deliveries in institutions have not been matched by improvements in the quality of intrapartum and neonatal care. Infants and young children do not get the health care they need; access to effective treatment for neonatal illness, diarrhoea, and pneumonia shows little improvement; and the coverage of nutrition programmes is inadequate. Absence of well functioning health systems is indicated by the inadequacies related to planning, financing, human resources, infrastructure, supply systems, governance, information, and monitoring. We provide a case for transformation of health systems through effective stewardship, decentralised planning in districts, a reasoned approach to financing that affects demand for health care, a campaign to create awareness and change health and nutrition behaviour, and revision of programmes for child nutrition on the basis of evidence. This agenda needs political commitment of the highest order and the development of a people's movement. Copyright © 2011 Elsevier Ltd. All rights reserved.

Macroeconomics, (Adult) Education, and Poverty Eradication in Southern Africa

ERIC Educational Resources Information Center

Nhamo, Senia; Nhamo, Godwell

2006-01-01

The Millennium Summit held in New York in September 2000 outlined the Millennium Development Goals (MDGs). The first of these involves the eradication of extreme poverty and hunger, setting two targets: halving by 2015 the percentage of the world's populace in 1990 with income less than US-$1 a day (i.e., cutting this percentage from 27.9 to 14%);…

Squashing the Millennium Bug: A Year 2000 Compliance Guide for Elementary/Secondary Schools and School Districts.

ERIC Educational Resources Information Center

Root, Mark; Carlson, Robert; Dexter, David; Karinch, Samantha; Kaplan, Heather

This guide was developed to assist the nation's elementary and secondary schools and school districts address their Year 2000 (Y2K) problem. The guide is divided into three sections: Squashing the Millennium Bug Step-by-Step; Remediating Specific Types of Systems; and Appendix. The first chapter presents the following steps for tackling the Year…

Analysis Of The Health Care System Of Pakistan: Lessons Learnt And Way Forward.

PubMed

Kurji, Zohra; Premani, Zahra Shaheen; Mithani, Yasmin

2016-01-01

Pakistani health care system is in progress and since last year, Pakistan has tried to make much improvement in its health care delivery system and has brought out many reforms. A systematic search of national and international literature was looked from peerreviewed databases form MEDLINE, CINAHL, and PubMed. There is little strength in health care delivery system in Pakistan like making health policies, participating in Millennium Development Goals program, initiating vertical programs and introducing Public Private Partnership, improving human resource development and infrastructure by making Basic Health Unit and Rural Health Centres. However, these all programs are very limited in its scope and that is the reason that Pakistan's healthcare system is still not very efficient. There are numerous weaknesses like poor governance, lack of access and unequal resources, poor quality of Health Information Management System, corruption in health system, lack of monitoring in health policy and health planning and lack of trained staff. Pakistan is improving very slowly in the health sector for the last five decades as is evident by its health indicators and above mentioned strengths and weaknesses. Therefore, the Government needs to take strong initiatives to change the current health care system.

Essential interventions: implementation strategies and proposed packages of care

PubMed Central

2014-01-01

In an effort to accelerate progress towards achieving Millennium Development Goal (MDG) 4 and 5, provision of essential reproductive, maternal, newborn and child health (RMNCH) interventions is being considered. Not only should a state-of-the-art approach be taken for services delivered to the mother, neonate and to the child, but services must also be deployed across the household to hospital continuum of care approach and in the form of packages. The paper proposed several packages for improved maternal, newborn and child health that can be delivered across RMNCH continuum of care. These packages include: supportive care package for women to promote awareness related to healthy pre-pregnancy and pregnancy interventions; nutritional support package for mother to improve supplementation of essential nutrients and micronutrients; antenatal care package to detect, treat and manage infectious and noninfectious diseases and promote immunization; high risk care package to manage preeclampsia and eclampsia in pregnancy; childbirth package to promote support during labor and importance of skilled birth attendance during labor; essential newborn care package to support healthy newborn care practices; and child health care package to prevent and manage infections. This paper further discussed the implementation strategies for employing these interventions at scale. PMID:25178110

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

PubMed Central

Li, Zhihui; Li, Mingqiang; Subramanian, S. V.; Lu, Chunling

2017-01-01

ABSTRACT Background: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. Objective: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. Methods: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. Results: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries’ progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [−3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. Conclusions: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings. PMID:29228888

Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic.

PubMed

Budy, Fidel C T

2015-01-01

Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia.

Globalisation and global health governance: implications for public health.

PubMed

Kruk, Margaret E

2012-01-01

Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

MEDICAL BRIGADES, GLOBAL HEALTH AND THE UNITED NATIONS: MILLENNIUM DEVELOPMENT GOALS AND DEVELOPING NATIONS.

PubMed

Portman, Mark T; Martin, Edward J

2015-01-01

Recently, recommendations have been made that global health initiatives change their focus from disease specific intervention to bolstering health systems and general health care. The aim of this is to ultimately increase access to primary care, clean water, education, hygiene, and prevent malnutrition, among other goals. While many major global health initiatives have followed this trend, so have many smaller scale programs including short-term medical brigades. Despite a trending increase in the number of privately run short-term medical brigades, until recently, little research has been done on the potential positive and negative effects that can arise from such programs. Now, guidelines have been initiated to create well-structured programs. When followed, these smaller scale initiatives can be successful in helping increase access to healthcare, sustainably strengthening communities in terms of general health. While recent legislation in the United States has addressed domestic policy in the Patient Protection Affordable Care Act of 2010 (ACA), the ACA should also consider some of the basic "sustainable" policies being implemented by international health care providers.

Preserving idealism in global health promotion.

PubMed

Franco-Paredes, Carlos; Zeuli, Julia; Hernández-Ramos, Isabel; Santos-Preciado, Jose I

2010-12-01

If the field of global health is to evolve in the second decade of the new millennium, we need to revive the idealistic spirit and by using the lens of health equity work toward improved health status around the world. Morality and empathy are considered by-products of our evolutionary history as a human species. Idealism may be a trait that we may choose to preserve in our modern evolutionary history.

The effect of a transition into poverty on child and maternal mental health: a longitudinal analysis of the UK Millennium Cohort Study.

PubMed

Wickham, Sophie; Whitehead, Margaret; Taylor-Robinson, David; Barr, Ben

2017-03-01

Whether or not relative measures of income poverty effectively reflect children's life chances has been the focus of policy debates in the UK. Although poverty is associated with poor child and maternal mental health, few studies have assessed the effect of moving into poverty on mental health. To inform policy, we explore the association between transitions into poverty and subsequent mental health among children and their mothers. In this longtitudinal analysis, we used data from the UK Millennium Cohort Study, a large nationally representative cohort of children born in the UK between Sept 1, 2000, and Jan 11, 2002, who participated in five survey waves as they progressed from 9 months of age to 11 years of age. Our analysis included all children and mothers who were free from mental health problems and not in poverty when the children were aged 3 years. We only included singletons (ie, not twins or other multiple pregnancies) and children for whom the mother was the main respondent to the study. The main outcomes were child socioemotional behavioural problems (Strengths and Difficulties Questionnaire) at ages 5 years, 7 years, and 11 years and maternal psychological distress (Kessler 6 scale). Using discrete time-hazard models, we followed up families without mental health problems at baseline and estimated odds ratios for subsequent onset of maternal and child mental health problems associated with first transition into poverty, while adjusting for confounders, including employment transitions. We further assessed whether or not change in maternal mental health explained any effect on child mental health. Of the 6063 families in the UK Millennium Cohort study at 3 years who met our inclusion criteria, 844 (14%) had a new transition into poverty compared with 5219 (86%) who remained out of poverty. After adjustment for confounders, transition into poverty increased the odds of socioemotional behavioural problems in children (odds ratio 1·41 [95% CI 1·02-1·93]; p=0·04) and maternal psychological distress (1·44 [1·21-1·71]; p<0·0001). Controlling for maternal psychological distress reduced the effect of transition into poverty on socioemotional behavioural problems in children (1·30 [0·94-1·79]; p=0·11). In a contemporary UK cohort, first transition into income poverty during early childhood was associated with an increase in the risk of child and maternal mental health problems. These effects were independent of changes in employment status. Transitions to income poverty do appear to affect children's life chances and actions that directly reduce income poverty of children are likely to improve child and maternal mental health. The Wellcome Trust and The Farr Institute for Health Informatics Research (Medical Research Council). Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

No hospital is an island when it comes to Y2K bug

PubMed Central

Silversides, A

1999-01-01

If a recent meeting on the millennium bug is any indication, Canada's health care facilities have plenty to worry about as the year 2,000 approaches. Topics discussed included the state of readiness within the health care sector and potential legal issues that may arise. PMID:9951449

Environment Quality: Impact From Traffic, Power Plant and Land Morphology, a Case Study of Prishtina

NASA Astrophysics Data System (ADS)

Bajcinovci, Bujar

2017-05-01

Environmental air pollution is a global health concern, a complex phenomenon which is directly reflected on public health, economic and human development. Environmental air pollution has been drastically multiplied, followed by the beginning of the new Millennia in Prishtina, the capital city of the Kosovo. The new millennium began as a crucial activity for the city of Prishtina in terms of demographic, human geography, social and economic phenomena. The presented study aims to determine prevalent traffic and land morphology composition attributes, which have influenced and continue to have environmental impact in the city of Prishtina. According to the conceptual findings from the empirical observations, the heavy city traffic and the land morphology structure, determine the urban air pollution level. Prishtina is generally polluted due to its geomorphic position in relation to the power plants Kosovo A, and Kosova B. The impact of the above cited factors, is even bigger when the dominant winds prevail through valley, which encompasses the city. The findings from this paper propose the necessity of careful driven urban solutions.

Vouchers for health: A demand side output-based aid approach to reproductive health services in Kenya.

PubMed

Janisch, C P; Albrecht, M; Wolfschuetz, A; Kundu, F; Klein, S

2010-01-01

Reaching the United Nation's Millennium Development Goals has been a focus for many countries and development partners. In Kenya, as in many other countries with low levels of development, access to and equity of basic quality health services is limited, especially for the very poor. Among poor populations, maternal mortality is high as access to medical care and financial means are lacking. In 2005, the Governments of Kenya and Germany in cooperation with KfW Banking Group made funds available for the Reproductive Health OBA Voucher Programme offering vouchers for Safe Motherhood, Family Planning and Gender Violence Recovery Services. This programme, herein referred to as Vouchers for Health, was launched in June of 2006 in five Kenyan districts with the aim of providing health services for safe deliveries, long-term family planning methods and victims of gender violence. The way that the programme is being implemented in Kenya demonstrates that the voucher-based approach comprises a variety of key structural elements of a national health insurance scheme: accreditation; quality assurance; reimbursement system; claims processing; integrating the private sector; client choice; provider competition; and access to and equity of services provided.

Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002-2012.

PubMed

Reveiz, Ludovic; Elias, Vanessa; Terry, Robert F; Alger, Jackeline; Becerra-Posada, Francisco

2013-07-01

To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG). Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

Monitoring Sustainable Development Goal 3: how ready are the health information systems in low-income and middle-income countries?

PubMed

Nabyonga-Orem, Juliet

2017-01-01

Sustainable Development Goals (SDGs) present a broader scope and take a holistic multisectoral approach to development as opposed to the Millennium Development Goals (MDGs). While keeping the health MDG agenda, SDG3 embraces the growing challenge of non-communicable diseases and their risk factors. The broader scope of the SDG agenda, the need for a multisectoral approach and the emphasis on equity present monitoring challenges to health information systems of low-income and middle-income countries. The narrow scope and weaknesses in existing information systems, a multiplicity of data collection systems designed along disease programme and the lack of capacity for data analysis are among the limitations to be addressed. On the other hand, strong leadership and a comprehensive and longer-term approach to strengthening a unified health information system are beneficial. Strengthening country capacity to monitor SDGs will involve several actions: domestication of the SDG agenda through country-level planning and monitoring frameworks, prioritisation of interventions, indicators and setting country-specific targets. Equity stratifiers should be country specific in addressing policy concerns. The scope of existing information systems should be broadened in line with the SDG agenda monitoring requirements and strengthened to produce reliable data in a timely manner and capacity for data analysis and use of data built. Harnessing all available opportunities, emphasis should be on strengthening health sector as opposed to SDG3 monitoring. In this regard, information systems in related sectors and the private sector should be strengthened and data sharing institutionalised. Data are primarily needed to inform planning and decision-making beyond SGD3 reporting requirements.

Monitoring Sustainable Development Goal 3: how ready are the health information systems in low-income and middle-income countries?

PubMed Central

Nabyonga-Orem, Juliet

2017-01-01

Sustainable Development Goals (SDGs) present a broader scope and take a holistic multisectoral approach to development as opposed to the Millennium Development Goals (MDGs). While keeping the health MDG agenda, SDG3 embraces the growing challenge of non-communicable diseases and their risk factors. The broader scope of the SDG agenda, the need for a multisectoral approach and the emphasis on equity present monitoring challenges to health information systems of low-income and middle-income countries. The narrow scope and weaknesses in existing information systems, a multiplicity of data collection systems designed along disease programme and the lack of capacity for data analysis are among the limitations to be addressed. On the other hand, strong leadership and a comprehensive and longer-term approach to strengthening a unified health information system are beneficial. Strengthening country capacity to monitor SDGs will involve several actions: domestication of the SDG agenda through country-level planning and monitoring frameworks, prioritisation of interventions, indicators and setting country-specific targets. Equity stratifiers should be country specific in addressing policy concerns. The scope of existing information systems should be broadened in line with the SDG agenda monitoring requirements and strengthened to produce reliable data in a timely manner and capacity for data analysis and use of data built. Harnessing all available opportunities, emphasis should be on strengthening health sector as opposed to SDG3 monitoring. In this regard, information systems in related sectors and the private sector should be strengthened and data sharing institutionalised. Data are primarily needed to inform planning and decision-making beyond SGD3 reporting requirements. PMID:29104767

Future-proofing global health: Governance of priorities.

PubMed

Bennett, Belinda; Cohen, I Glenn; Davies, Sara E; Gostin, Lawrence O; Hill, Peter S; Mankad, Aditi; Phelan, Alexandra L

2018-05-01

The year 2015 was a significant anniversary for global health: 15 years since the adoption of the Millennium Development Goals and the creation of the Global Alliance for Vaccines and Immunization, followed two years later by the Global Fund to Fight AIDS, TB and Malaria. 2015 was also the 10-year anniversary of the adoption of the International Health Regulations (May 2005) and the formal entering into force of the Framework Convention on the Tobacco Control (February 2005). The anniversary of these frameworks and institutions illustrates the growth and contribution of 'global' health diplomacy. Each initiative has also revealed on-going issues with compliance, sustainable funding and equitable attention in global health governance. In this paper, we present four thematic challenges that will continue to challenge prioritisation within global health governance into the future unless addressed: framing and prioritising within global health governance; identifying stakeholders of the global health community; understanding the relationship between health and behaviour; and the role of governance and regulation in supporting global health.

How political epidemiology research can address why the millennium development goals have not been achieved: developing a research agenda.

PubMed

Gil-González, D; Ruiz-Cantero, M T; Alvarez-Dardet, C

2009-04-01

The Millennium Development Goals (MDG) progress targets have not been met. Nevertheless, the United Nations (UN) has not yet undertaken in-depth review in order to discover the reasons behind this lack of progress in achieving the MDG. From a political epidemiology perspective, the intention here is to identify the political elements affecting the social factors impeding MDG fulfilment and, at the same time, to suggest future public policies and appropriate proposals that are both more coherent and supported by broader, empirical knowledge of the relevant issues.

Innovative financing for health: what is truly innovative?

PubMed

Atun, Rifat; Knaul, Felicia Marie; Akachi, Yoko; Frenk, Julio

2012-12-08

Development assistance for health has increased every year between 2000 and 2010, particularly for HIV/AIDS, tuberculosis, and malaria, to reach US$26·66 billion in 2010. The continued global economic crisis means that increased external financing from traditional donors is unlikely in the near term. Hence, new funding has to be sought from innovative financing sources to sustain the gains made in global health, to achieve the health Millennium Development Goals, and to address the emerging burden from non-communicable diseases. We use the value chain approach to conceptualise innovative financing. With this framework, we identify three integrated innovative financing mechanisms-GAVI, Global Fund, and UNITAID-that have reached a global scale. These three financing mechanisms have innovated along each step of the innovative finance value chain-namely resource mobilisation, pooling, channelling, resource allocation, and implementation-and integrated these steps to channel large amounts of funding rapidly to low-income and middle-income countries to address HIV/AIDS, malaria, tuberculosis, and vaccine-preventable diseases. However, resources mobilised from international innovative financing sources are relatively modest compared with donor assistance from traditional sources. Instead, the real innovation has been establishment of new organisational forms as integrated financing mechanisms that link elements of the financing value chain to more effectively and efficiently mobilise, pool, allocate, and channel financial resources to low-income and middle-income countries and to create incentives to improve implementation and performance of national programmes. These mechanisms provide platforms for health funding in the future, especially as efforts to grow innovative financing have faltered. The lessons learnt from these mechanisms can be used to develop and expand innovative financing from international sources to address health needs in low-income and middle-income countries. Copyright © 2012 Elsevier Ltd. All rights reserved.

From social integration to health: Durkheim in the new millennium.

PubMed

Berkman, L F; Glass, T; Brissette, I; Seeman, T E

2000-09-01

It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.

Remembering the forgotten non-communicable diseases.

PubMed

Lopez, Alan D; Williams, Thomas N; Levin, Adeera; Tonelli, Marcello; Singh, Jasvinder A; Burney, Peter G J; Rehm, Jürgen; Volkow, Nora D; Koob, George; Ferri, Cleusa P

2014-10-22

The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low- and middle-income countries will have to contend with a dual burden of infectious and non-communicable diseases (NCDs). Some of these NCDs, such as neoplasms, COPD, cardiovascular diseases and diabetes, cause much health loss worldwide and are already widely recognised as doing so. However, 55% of the global NCD burden arises from other NCDs, which tend to be ignored in terms of premature mortality and quality of life reduction. Here, experts in some of these 'forgotten NCDs' review the clinical impact of these diseases along with the consequences of their ignoring their medical importance, and discuss ways in which they can be given higher global health priority in order to decrease the growing burden of disease and disability.

Public health, GIS, and the internet.

PubMed

Croner, Charles M

2003-01-01

Internet access and use of georeferenced public health information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in public health decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled public health GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Public health will become a responsive and integral part of the National Spatial Data Infrastructure.

A concept paper: using the outcomes of common surgical conditions as quality metrics to benchmark district surgical services in South Africa as part of a systematic quality improvement programme.

PubMed

Clarke, Damian L; Kong, Victor Y; Handley, Jonathan; Aldous, Colleen

2013-07-31

The fourth, fifth and sixth Millennium Development Goals relate directly to improving global healthcare and health outcomes. The focus is to improve global health outcomes by reducing maternal and childhood mortality and the burden of infectious diseases such as HIV/AIDS, tuberculosis and malaria. Specific targets and time frames have been set for these diseases. There is, however, no specific mention of surgically treated diseases in these goals, reflecting a bias that is slowly changing with emerging consensus that surgical care is an integral part of primary healthcare systems in the developing world. The disparities between the developed and developing world in terms of wealth and social indicators are reflected in disparities in access to surgical care. Health administrators must develop plans and strategies to reduce these disparities. However, any strategic plan that addresses deficits in healthcare must have a system of metrics, which benchmark the current quality of care so that specific improvement targets may be set.This concept paper outlines the role of surgical services in a primary healthcare system, highlights the ongoing disparities in access to surgical care and outcomes of surgical care, discusses the importance of a systems-based approach to healthcare and quality improvement, and reviews the current state of surgical care at district hospitals in South Africa. Finally, it proposes that the results from a recently published study on acute appendicitis, as well as data from a number of other common surgical conditions, can provide measurable outcomes across a healthcare system and so act as an indicator for judging improvements in surgical care. This would provide a framework for the introduction of collection of these outcomes as a routine epidemiological health policy tool.

Designing an Elderly Assistance Program Based-on Home Care

NASA Astrophysics Data System (ADS)

Umusya'adah, L.; Juwaedah, A.; Jubaedah, Y.; Ratnasusanti, H.; Puspita, R. H.

2018-02-01

PKH (Program Keluarga Harapan) is a program of Indonesia’s Government through the ministry of social directorate to accelerate the poverty reduction and the achievement of Millennium Development Goals (MDGs) target as well as the policies development in social protection and social welfare domain or commonly referred to as Indonesian Conditional Cash Transfer (CCT) Program. This research is motivated that existing participants of the family expectation program (PKH) that already exist in Sumedang, Indoensia, especially in the South Sumedang on the social welfare components is only limited to the health checking, while for assisting the elderly based Home Care program there has been no structured and systematic, where as the elderly still need assistance, especially from the family and community environment. This study uses a method of Research and Development with Model Addie which include analysis, design, development, implementation and evaluation. Participants in this study using purposive sampling, where selected families of PKH who provide active assistance to the elderly with 82 participants. The program is designed consists of program components: objectives, goals, forms of assistance, organizing institutions and implementing the program, besides, program modules include assisting the elderly. Form of assistance the elderly cover physical, social, mental and spiritual. Recommended for families and companions PKH, the program can be implemented to meet the various needs of the elderly. For the elderly should introspect, especially in the health and follow the advice recommended by related parties

Bringing evidence to policy to achieve health-related MDGs for all: justification and design of the EPI-4 project in China, India, Indonesia, and Vietnam

PubMed Central

Thomsen, Sarah; Ng, Nawi; Biao, Xu; Bondjers, Göran; Kusnanto, Hari; Liem, Nguyen Tanh; Mavalankar, Dileep; Målqvist, Mats; Diwan, Vinod

2013-01-01

Background The Millennium Development Goals (MDGs) are monitored using national-level statistics, which have shown substantial improvements in many countries. These statistics may be misleading, however, and may divert resources from disadvantaged populations within the same countries that are showing progress. The purpose of this article is to set out the relevance and design of the “Evidence for Policy and Implementation project (EPI-4)”. EPI-4 aims to contribute to the reduction of inequities in the achievement of health-related MDGs in China, India, Indonesia and Vietnam through the promotion of research-informed policymaking. Methods Using a framework provided by the Commission on the Social Determinants of Health (CSDH), we compare national-level MDG targets and results, as well as their social and structural determinants, in China, India, Indonesia and Vietnam. Results To understand country-level MDG achievements it is useful to analyze their social and structural determinants. This analysis is not sufficient, however, to understand within-country inequities. Specialized analyses are required for this purpose, as is discussion and debate of the results with policymakers, which is the aim of the EPI-4 project. Conclusion Reducing health inequities requires sophisticated analyses to identify disadvantaged populations within and between countries, and to determine evidence-based solutions that will make a difference. The EPI-4 project hopes to contribute to this goal. PMID:23490302

78 FR 63969 - Defense Health Board; Notice of Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... DHB will receive briefings from the Department to include concussive care in theater, DoD's suicide prevention efforts, DoD Pharmaceutical Operations, and the Millennium Cohort Study with an overview of its...

Ensuring the inclusion of sexual and reproductive health and rights under a sustainable development goal on health in the post-2015 human rights framework for development.

PubMed

Haslegrave, Marianne

2013-11-01

Since the 1994 International Conference on Population and Development (ICPD) in Cairo placed reproductive health and rights firmly on the international agenda, civil society and other advocates have worked ceaselessly to ensure that they remain central to women's empowerment and have taken all opportunities to expand the framework to include sexual health and rights. When the development process changed with the introduction of the Millennium Development Goals (MDGs) in 2000, sexual and reproductive health and rights were excluded, and only in 2007 was universal access to reproductive health added back in. In 2014 and 2015, the future of ICPD Beyond 2014, the MDGs and the post-2015 development framework will be decided, following consultations and meetings across the globe. This paper takes stock of the key influences on efforts to achieve the ICPD agenda and summarises the past, current and planned future events, reports and processes between 1994 and 2014, leading up to the determination of the post-2015 development framework and sustainable development goals. It concludes that the one thing we cannot afford to allow is what happened with the MDGs in 2000. We must not leave the room empty-handed, but must instead ensure the inclusion of sexual and reproductive health and rights as a priority under a new health goal. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Health Care Providers' Perceptions of Maternal Health Concerns in the Solomon Islands.

PubMed

Yang, Yung-Mei; Hsiao, Shih-Huai; Chou, Fan-Hao; Hou, Levi; Lee, Shu-Li; Lin, Yu-Hua

2016-01-01

The objective of this study was to explore the maternal health risk factors and sentinel events among women in the Solomon Islands, from the viewpoints of health care providers in the Solomon Islands. Three focus group interviews were conducted in July and August 2011 at a secondary referral hospital in an urban area. The study consisted of 10 registered nurses and 11 skilled birth assistants. Thematic analysis was used for this qualitative data analysis. Six major themes were emerged from the data: (a) environmental hazard: malaria, (b) malnutrition: iron deficiency anemia, (c) adolescent pregnancy, (d) betel nut chewing, (e) cultural beliefs influencing women's health, and (f) difficulty accessing health care services. The results of this study provide a useful first step toward identifying specific maternal health risks among women in the Solomon Islands. The findings may assist the health sector and midwives/antenatal educators to better understand the health risks and reduce the disease burden among pregnant women in South Pacific countries. The results may also contribute to the development of policies to improve maternal health and to accelerate progress toward the fifth target goal of UNICEF's Millennium Development Goals. © The Author(s) 2014.

Contributions of national and global health estimates to monitoring health-related sustainable development goals.

PubMed

Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

2016-01-01

The millennium development goals triggered an increased demand for data on child and maternal mortalities for monitoring progress. With the advent of the sustainable development goals and growing evidence of an epidemiological transition toward non-communicable diseases, policymakers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper discusses lessons learned from Thailand's burden of disease (BOD) study on capacity development on NHEs and discusses the contributions and limitations of GHEs in informing policies at the country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and subnational levels. Initially, the quality of cause-of-death reporting in death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This method helped to improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the Global Burden of Disease 2010 study estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and an effective interface between researchers and decision-makers contribute to enhanced country policy responses, whereas subnational data are intended to be used by various subnational partners. Although GHEs contribute to benchmarking country achievement compared with global health commitments, they may hamper development of NHE capacities. GHEs should encourage and support countries to improve their data systems and develop a data infrastructure that supports the production of empirical data needed to underpin estimation efforts.

Contributions of national and global health estimates to monitoring health-related Sustainable Development Goals in Thailand.

PubMed

Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

2017-01-01

The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper draws lessons learned from Thailand's burden of disease study (BOD) on capacity development for NHEs, and discusses the contributions and limitation of GHEs in informing policies at country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and sub-national levels. Initially, the quality of cause of death reporting in the death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This helped improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the 2010 Global Burden of Diseases (GBD) estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and effective interfaces between researchers and decision makers contribute to enhanced country policy responses, while sub-national data are intended to be used by various sub-national-level partners. Though GHEs contribute to benchmarking country achievement compared with global health commitments, they may hamper development of NHE capacities. GHEs should encourage and support countries to improve their data systems and develop a data infrastructure that supports the production of empirical data needed to underpin estimation efforts.

[Use of satellites for public health purposes in tropical areas].

PubMed

Meynard, J B; Orlandi, E; Rogier, C; Sbai Idrissi, K; Deparis, X; Peyreffite, C; Lightburn, E; Malosse, D; Migliani, R; Spiegel, A; Boutin, J P

2003-01-01

The epidemiological hallmark of the new millennium has been the emergence or recrudescence of transmissible diseases with high epidemic potential. Disease tracking is becoming an increasingly global task requiring implementation of more and more sophisticated control strategies and facilities for sustainable development. A promising initiative involves the use of satellite technology to monitor and forecast the spread of disease. The Health Early Warning System (HEWS) was designed based on successful application of satellite data in food programs as well as in other areas (e.g. weather, farming and fishing). The HEWS integrates data from communications, remote-sensing and positioning satellites. The purpose of this review is to present the main studies containing satellite data on public health in tropical areas. Satellite data has allowed development of more reactive epidemiological tracking networks better suited to increasing population mobility, correlation of environmental factors (vegetation index, rainfall and ocean surface color) with human, animal and insect factors in epidemiological studies and assessment of the role of such factors in the development or reappearance of disease. Satellite technology holds great promise for more efficient management of public health problems in tropical areas.

Anaesthesia and global health initiatives for children in a low-resource environment.

PubMed

Hodges, Sarah C

2016-06-01

As the United Nations moves from Millennium Development Goals to Sustainable Development Goals, we find ourselves with the opportunity to influence the priority of global health initiatives. Previously, the global health community has failed to recognise the importance of access to safe, affordable surgery and developing the necessary specialities that support it as most of the funding focus had been on primary healthcare and infectious diseases. Now the WHO is publishing guidelines to safe surgery and the Lancet Commission on Global Surgery has been launched. However, this is only the start; anaesthesia remains a forgotten speciality within the world of public and global health and there are still challenges in escalating surgery in low and middle-income countries to an acceptable level that is affordable and timely. Although there is increased world interest in safe surgery and anaesthesia this has not yet been translated into a mandate that will compel countries to invest in improving levels of infrastructure, accessibility, manpower, and safety. A general anaesthetic remains a dangerous event in a child's life in resource-limited countries.

Holding a country countdown to 2015 conference on Millennium Development Goals (MDGs) - the Zambian experience.

PubMed

Mukonka, Victor M; Malumo, Sarai; Kalesha, Penelope; Nambao, Mary; Mwale, Rodgers; Mwinga, Kasonde; Katepa-Bwalya, Mary; Babaniyi, Olusegan; Mason, Elizabeth; Phiri, Caroline; Wamulume, Pauline K

2014-01-21

Initiatives such as the Country Countdown to 2015 Conference on Millennium Development Goals (MDGs) have provided countries with high maternal and child deaths like Zambia a platform to assess progress, discuss challenges and share lessons learnt as a conduit for national commitment to reaching and attaining the MDGs four and five. This paper discusses and highlights the process of holding a successful country countdown conference and shares Zambia's experience with other countries planning to organise country countdown to 2015 Conferences on MDGs.

Social sector expenditure and child mortality in India: a state-level analysis from 1997 to 2009.

PubMed

Makela, Susanna M; Dandona, Rakhi; Dilip, T R; Dandona, Lalit

2013-01-01

India is unlikely to meet the Millennium Development Goal for child mortality. As public policy impacts child mortality, we assessed the association of social sector expenditure with child mortality in India. Mixed-effects regression models were used to assess the relationship of state-level overall social sector expenditure and its major components (health, health-related, education, and other) with mortality by sex among infants and children aged 1-4 years from 1997 to 2009, adjusting for potential confounders. Counterfactual models were constructed to estimate deaths averted due to overall social sector increases since 1997. Increases in per capita overall social sector expenditure were slightly higher in less developed than in more developed states from 1997 to 2009 (2.4-fold versus 2-fold), but the level of expenditure remained 36% lower in the former in 2009. Increase in public expenditure on health was not significantly associated with mortality reduction in infants or at ages 1-4 years, but a 10% increase in health-related public expenditure was associated with a 3.6% mortality reduction (95% confidence interval 0.2-6.9%) in 1-4 years old boys. A 10% increase in overall social sector expenditure was associated with a mortality reduction in both boys (6.8%, 3.5-10.0%) and girls (4.1%, 0.8-7.5%) aged 1-4 years. We estimated 119,807 (95% uncertainty interval 53,409-214,662) averted deaths in boys aged 1-4 years and 94,037 (14,725-206,684) in girls in India in 2009 that could be attributed to increases in overall social sector expenditure since 1997. Further reduction in child mortality in India would be facilitated if policymakers give high priority to the social sector as a whole for resource allocation in the country's 5-year plan for 2012-2017, as public expenditure on health alone has not had major impact on reducing child mortality.

Strengthening Indonesia's health workforce through partnerships.

PubMed

Kurniati, A; Rosskam, E; Afzal, M M; Suryowinoto, T B; Mukti, A G

2015-09-01

Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met. Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis. Consistent with Indonesia's decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development. Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country's work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve results. Indonesia's experience indicates that irrespective of geographical or economic status, countries can benefit from multi-stakeholder coordination and engagement to increase access to health workers, strengthen health systems, as well as achieve and sustain UHC. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Strategies to sustain a quality improvement initiative in neonatal resuscitation

PubMed Central

van Heerden, Carlien; Janse van Rensburg, Elsie S.

2016-01-01

Background Many neonatal deaths can be prevented globally through effective resuscitation. South Africa (SA) committed towards attaining the Millennium Development Goal 4 (MDG4) set by the World Health Organization (WHO). However, SA’s district hospitals have the highest early neonatal mortality rates. Modifiable and avoidable causes associated with patient-related, administrative and health care provider factors contribute to neonatal mortality. A quality improvement initiative in neonatal resuscitation could contribute towards decreasing neonatal mortality, thereby contributing towards the attainment of the MDG4. Aim The aim of this study was, (1) to explore and describe the existing situation regarding neonatal resuscitation in a district hospital, (2) to develop strategies to sustain a neonatal resuscitation quality improvement initiative and (3) to decrease neonatal mortality. Changes that occurred and the sustainability of strategies were evaluated. Setting A maternity section of a district hospital in South Africa. Methods The National Health Service (NHS) Sustainability Model formed the theoretical framework for the study. The Problem Resolving Action Research model was applied and the study was conducted in three cycles. Purposive sampling was used for the quantitative and qualitative aspects of data collection. Data was analysed accordingly. Results The findings indicated that the strategies formulated and implemented to address factors related to neonatal resuscitation (training, equipment and stock, staff shortages, staff attitude, neonatal transport and protocols) had probable sustainability and contributed towards a reduction in neonatal mortality in the setting. Conclusion These strategies had the probability of sustainability and could potentially improve neonatal outcomes and reduce neonatal mortality to contribute toward South Africa’s’ drive to attain the MDG4. PMID:27380840

Implementing a Virtual Exchange Project for student nurses in Queensland and Nottingham.

PubMed

Todhunter, Fern; Hallawell, Bob; Pittaway, Debbie

2013-09-01

This paper discusses the design and initial progress made with a virtual learning environment to help student nurses develop an understanding of cultural awareness and globalization. Using a Web-based application the Virtual Exchange Project was designed to facilitate study-elsewhere experiences located in the student's own setting. Promotion of the United Nations' Millennium Development goals provided an opportunity for student nurses to explore changes in global health and disease patterns, nursing education and systems of nurse regulation in the United Kingdom and Australia. A pedagogical framework created for this activity acknowledges the social and academic identities that learners often use, when working together in a virtual environment. The architecture of the Virtual Exchange supports local conversations about nurse education and health and social issues across hemispheres. Copyright © 2012 Elsevier Ltd. All rights reserved.

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed Central

Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne

2005-01-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed

Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne

2005-04-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

Agenda setting for maternal survival: the power of global health networks and norms

PubMed Central

Smith, Stephanie L; Rodriguez, Mariela A

2016-01-01

Nearly 300 000 women—almost all poor women in low-income countries—died from pregnancy-related complications in 2010. This represents a decline since the 1980s, when an estimated half million women died each year, but is still far higher than the aims set in the United Nations Millennium Development Goals (MDGs) at the turn of the century. The 1970s, 1980s and 1990s witnessed a shift from near complete neglect of the issue to emergence of a network of individuals and organizations with a shared concern for reducing maternal deaths and growth in the number of organizations and governments with maternal health strategies and programmes. Maternal health experienced a marked change in agenda status in the 2000s, attracting significantly higher level attention (e.g. from world leaders) and greater resource commitments (e.g. as one issue addressed by US$40 billion in pledges to the 2010 Global Strategy for Women’s and Children’s Health) than ever before. Several differences between network and actor features, issue characteristics and the policy environment pre- and post-2000 help to explain the change in agenda status for global maternal mortality reduction. Significantly, a strong poverty reduction norm emerged at the turn of the century; represented by the United Nations MDGs framework, the norm set unusually strong expectations for international development actors to advance included issues. As the norm grew, it drew policy attention to the maternal health goal (MDG 5). Seeking to advance the goals agenda, world leaders launched initiatives addressing maternal and child health. New network governance and framing strategies that closely linked maternal, newborn and child health shaped the initiatives. Diverse network composition—expanding beyond a relatively narrowly focused and technically oriented group to encompass allies and leaders that brought additional resources to bear on the problem—was crucial to maternal health’s rise on the agenda in the 2000s. PMID:26273062

Global health in the 21st century

PubMed Central

Laaser, Ulrich; Brand, Helmut

2014-01-01

Introduction Since the end of the 1990s, globalization has become a common term, facilitated by the social media of today and the growing public awareness of life-threatening problems common to all people, such as global warming, global security and global divides. Review For the main parameters of health like the burden of disease, life expectancy and healthy life expectancy, extreme discrepancies are observed across the world. Infant mortality, malnutrition and high fertility go hand in hand. Civil society, as an indispensable activator of public health development, mainly represented by non-governmental organisations (NGOs), is characterised by a high degree of fragmentation and lack of public accountability. The World Federation of Public Health Associations is used as an example of an NGO with a global mission and fostering regional cooperation as an indispensable intermediate level. The lack of a globally valid terminology of basic public health functions is prohibitive for coordinated global and regional efforts. Attempts to harmonise essential public health functions, services and operations are under way to facilitate communication and mutual understanding. Recommendations 1) Given the limited effects of the Millennium Development Goal agenda, the Post-2015 Development Goals should focus on integrated regional development. 2) A code of conduct for NGOs should be urgently developed for the health sector, and NGOs should be registered and accredited. 3) The harmonisation of the basic terminology for global public health essentials should be enhanced. PMID:24560267

Global health in the 21st century.

PubMed

Laaser, Ulrich; Brand, Helmut

2014-01-01

Since the end of the 1990s, globalization has become a common term, facilitated by the social media of today and the growing public awareness of life-threatening problems common to all people, such as global warming, global security and global divides. For the main parameters of health like the burden of disease, life expectancy and healthy life expectancy, extreme discrepancies are observed across the world. Infant mortality, malnutrition and high fertility go hand in hand. Civil society, as an indispensable activator of public health development, mainly represented by non-governmental organisations (NGOs), is characterised by a high degree of fragmentation and lack of public accountability. The World Federation of Public Health Associations is used as an example of an NGO with a global mission and fostering regional cooperation as an indispensable intermediate level.The lack of a globally valid terminology of basic public health functions is prohibitive for coordinated global and regional efforts. Attempts to harmonise essential public health functions, services and operations are under way to facilitate communication and mutual understanding. 1) Given the limited effects of the Millennium Development Goal agenda, the Post-2015 Development Goals should focus on integrated regional development. 2) A code of conduct for NGOs should be urgently developed for the health sector, and NGOs should be registered and accredited. 3) The harmonisation of the basic terminology for global public health essentials should be enhanced.

Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria.

PubMed

Lawani, Lucky O; Onyebuchi, Azubuike K; Iyoke, Chukwuemeka A; Okeke, Nwabunike E

2014-05-01

To determine the prevalence of female genital mutilation (FGM), the common forms of FGM, reasons for the practice, associated obstetric outcomes, and how these have affected efforts to achieve Millennium Development Goals (MDGs) 3, 4, and 5 in southeast Nigeria. A prospective descriptive study of parturients in southeast Nigeria was conducted from January to December 2012. All primigravid women attending delivery services at 2 health institutions during the study period were recruited, examined, and classified using the 2008 WHO classification for FGM. The mean age of the 516 participants was 27.24±4.80 years and most (66.3%) had undergone FGM. Type II FGM was the most common form, accounting for 59.6% of cases. Most FGM procedures were performed in infancy (97.1%) and for cultural reasons (60.8%). Women who had undergone FGM had significantly higher risk for episiotomy, perineal tear, hemorrhage, cesarean delivery, neonatal resuscitation, fresh stillbirth/early neonatal death, and longer hospitalization, with higher risk ratios associated with higher degrees of FGM. FGM is still a common practice in southeast Nigeria, where its association with adverse reproductive outcomes militates against efforts to achieve MDGs 3, 4, and 5. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Maternal mortality as a Millennium Development Goal of the United Nations: a systematic assessment and analysis of available data in threshold countries using Indonesia as example

PubMed Central

Reinke, Evelyn; Supriyatiningsih; Haier, Jörg

2017-01-01

Background In 2015 the proposed period ended for achieving the Millennium Development Goals (MDG) of the United Nations targeting to lower maternal mortality worldwide by ~ 75%. 99% of these cases appear in developing and threshold countries; but reports mostly rely on incomplete or unrepresentative data. Using Indonesia as example, currently available data sets for maternal mortality were systematically reviewed. Methods Besides analysis of international and national data resources, a systematic review was carried out according to Cochrane methodology to identify all data and assessments regarding maternal mortality. Results Overall, primary data on maternal mortality differed significantly and were hardly comparable. For 1990 results varied between 253/100 000 and 446/100 000. In 2013 data appeared more conclusive (140–199/100 000). An annual reduction rate (ARR) of –2.8% can be calculated. Conclusion Reported data quality of maternal mortality in Indonesia is very limited regarding comprehensive availability and methodology. This limitation appears to be of general importance for the targeted countries of the MDG. Primary data are rare, not uniformly obtained and not evaluated by comparable methods resulting in very limited comparability. Continuous small data set registration should have high priority for analysis of maternal health activities. PMID:28400953

Investing in health systems for universal health coverage in Africa.

PubMed

Sambo, Luis Gomes; Kirigia, Joses Muthuri

2014-10-28

This study focused on the 47 Member States of the World Health Organization (WHO) African Region. The specific objectives were to prepare a synthesis on the situation of health systems' components, to analyse the correlation between the interventions related to the health Millennium Development Goals (MDGs) and some health systems' components and to provide overview of four major thrusts for progress towards universal health coverage (UHC). The WHO health systems framework and the health-related MDGs were the frame of reference. The data for selected indicators were obtained from the WHO World Health Statistics 2014 and the Global Health Observatory. African Region's average densities of physicians, nursing and midwifery personnel, dentistry personnel, pharmaceutical personnel, and psychiatrists of 2.6, 12, 0.5, 0.9 and 0.05 per 10 000 population were about five-fold, two-fold, five-fold, five-fold and six-fold lower than global averages. Fifty-six percent of the reporting countries had fewer than 11 health posts per 100 000 population, 88% had fewer than 11 health centres per 100 000 population, 82% had fewer than one district hospital per 100 000 population, 74% had fewer than 0.2 provincial hospitals per 100 000 population, and 79% had fewer than 0.2 tertiary hospitals per 100 000 population. Some 83% of the countries had less than one MRI per one million people and 95% had fewer than one radiotherapy unit per million population. Forty-six percent of the countries had not adopted the recommendation of the International Taskforce on Innovative Financing to spend at least US$ 44 per person per year on health. Some of these gaps in health system components were found to be correlated to coverage gaps in interventions for maternal health (MDG 5), child health (MDG 4) and HIV/AIDS, TB and malaria (MDG 6). Substantial gaps exist in health systems and access to MDG-related health interventions. It is imperative that countries adopt the 2014 Luanda Commitment on UHC in Africa as their long-term vision and back it with sound policies and plans with clearly engrained road maps for strengthening national health systems and addressing the social determinants of health.

76 FR 12134 - Notice of the March 23, 2011 Millennium Challenge Corporation Board of Directors Meeting...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... MILLENNIUM CHALLENGE CORPORATION [MCC FR 11-02] Notice of the March 23, 2011 Millennium Challenge Corporation Board of Directors Meeting; Sunshine Act Meeting AGENCY: Millennium Challenge Corporation. [[Page 12135

Tobacco control, global health policy and development: towards policy coherence in global governance

PubMed Central

Collin, Jeff

2015-01-01

The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed ‘tobacco exceptionalism’. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference. PMID:22345267

Tobacco control, global health policy and development: towards policy coherence in global governance.

PubMed

Collin, Jeff

2012-03-01

The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed 'tobacco exceptionalism'. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference.

Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015.

PubMed

2016-10-08

In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8-61·8) and varied widely by country, ranging from 85·5 (84·2-86·5) in Iceland to 20·4 (15·4-24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r 2 =0·88) and the MDG index (r 2 =0·92), whereas the non-MDG index had a weaker relation with SDI (r 2 =0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0-10·4), and gains on the MDG index (a median change of 10·0 [6·7-13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1-8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Bill & Melinda Gates Foundation. Copyright © 2016 The Authors(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Can paying for results help to achieve the Millennium Development Goals? A critical review of selected evaluations of results-based financing.

PubMed

Oxman, Andrew D; Fretheim, Atle

2009-08-01

Results-based financing (RBF) refers to the transfer of money or material goods conditional on taking a measurable action or achieving a predetermined performance target. RBF is being promoted for helping to achieve the Millennium Development Goals (MDGs). We undertook a critical appraisal of selected evaluations of RBF schemes in the health sector in low and middle-income countries (LMIC). In addition, key informants were interviewed to identify literature relevant to the use of RBF in the health sector in LMIC, key examples, evaluations, and other key informants. The use of RBF in LMIC has commonly been a part of a package that may include increased funding, technical support, training, changes in management, and new information systems. It is not possible to disentangle the effects of financial incentives as one element of RBF schemes, and there is very limited evidence of RBF per se having an effect. RBF schemes can have unintended effects. When RBF schemes are used, they should be designed carefully, including the level at which they are targeted, the choice of targets and indicators, the type and magnitude of incentives, the proportion of financing that is paid based on results, and the ancillary components of the scheme. For RBF to be effective, it must be part of an appropriate package of interventions, and technical capacity or support must be available. RBF schemes should be monitored for possible unintended effects and evaluated using rigorous study designs. © 2009 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

What role for the home learning environment and parenting in reducing the socioeconomic gradient in child development? Findings from the Millennium Cohort Study.

PubMed

Kelly, Y; Sacker, A; Del Bono, E; Francesconi, M; Marmot, M

2011-09-01

Early child health and development (ECD) is important for health in later life. Objectives were to (1) examine the extent of socioeconomic inequality in markers of ECD at ages 3 and 5 years; (2) examine whether the ECD-income gap widens between these ages; (3) assess the contribution of the home learning environment, family routines and psychosocial environment to observed inequalities in ECD. Data on socioemotional difficulties, and tests of cognitive ability in 3-year-old (n=15 382) and 5-year-old (n=15 042) children from the UK Millennium Cohort Study were used. Children in the highest income group were less likely to have socioemotional difficulties compared with those in the lowest income group at 3 and 5 years (2.4% vs 16.4% and 2.0% vs 15.9%, respectively) and had higher mean scores: age 3 'school readiness' 114 versus 99; verbal ability 54 versus 48, and age 5: verbal ability 60 versus 51, non-verbal ability 58 versus 54 and spatial ability 54 versus 48 (all p<0.001). The income gap in verbal ability scores widened between ages 3 and 5 (Wald test, p=0.04). Statistical adjustment for markers of home learning, family routines and psychosocial environments did more to explain the income gap in socioemotional difficulties than in cognitive test scores. Our results suggest that relationships between family income and markers of ECD are amenable to change. The role of home learning, family routines and psychosocial environmental factors are potentially important in closing income gaps in ECD.

Developing capacities of community health workers in sexual and reproductive, maternal, newborn, child, and adolescent health: a mapping and review of training resources.

PubMed

Tran, Nguyen Toan; Portela, Anayda; de Bernis, Luc; Beek, Kristen

2014-01-01

Given country demands for support in the training of community health workers (CHWs) to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH), the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs. A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages) and depth (focused packages), including family planning, antenatal and childbirth care (mainly postpartum haemorrhage), newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems. There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of interventions to be delivered by CHWs. Packages with defined competencies and methods for assessing competencies and supervision are considered best practices but remain a gap.

Developing Capacities of Community Health Workers in Sexual and Reproductive, Maternal, Newborn, Child, and Adolescent Health: A Mapping and Review of Training Resources

PubMed Central

Tran, Nguyen Toan; Portela, Anayda; de Bernis, Luc; Beek, Kristen

2014-01-01

Background Given country demands for support in the training of community health workers (CHWs) to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH), the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs. Methods A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. Results We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages) and depth (focused packages), including family planning, antenatal and childbirth care (mainly postpartum haemorrhage), newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems. Conclusions There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of interventions to be delivered by CHWs. Packages with defined competencies and methods for assessing competencies and supervision are considered best practices but remain a gap. PMID:24736623

Improving Human Resources for Health means Retaining Health-Workers: Application of the WHO-Recommendations for the Retention of Health-Workers in Rural Northern-Nigeria.

PubMed

Afenyadu, Godwin Y; Adegoke, Adetoro A; Findley, Sally

2017-01-01

Nigeria is one of 57 countries with critical shortage of health workers (HWs). Strategies to increase and equitably distribute HWs are critical to the achievement of Health Millennium/Sustainable Development Goals. We describe how three Northern Nigeria states adapted World Health Organisation (WHO)-recommended incentives to attract, recruit, and retain midwives. Secondary analysis of data from two surveys assessing midwife motivation, retention, and attrition in Northern Nigeria; and expert consultations. Midwives highlighted financial and non-financial incentives as key factors in their decisions to renew their contracts. Their perspectives informed the consensus positions of health managers, policymakers and heads of institutions, and led to the adaptation of the WHO recommendations into appropriate state-specific incentive packages. The feedback from midwives combined with an expert consultation approach allowed stakeholders to consider and use available evidence to select appropriate incentive packages that offer the greatest potential for helping to address inadequate numbers of rural midwives.

Health economic perspectives of pediatric malnutrition: determinants of innovative progress.

PubMed

Spieldenner, Jörg

2010-01-01

Despite some improvements in recent years, extreme poverty and malnutrition remain a critical concern for developing countries. Malnutrition, and more specifically pediatric malnutrition, is a reality affecting millions of children, particularly in South Asia and Africa. It causes increased mortality and morbidity, decreased physical and intellectual development, poor productivity and a number of negative economic outcomes. Health economics data clearly demonstrate that interventions are effective and efficient, but more data are needed to measure that efficiency. Initiatives to address microdeficiencies have focused on vitamin A, iodine, zinc, iron and folate. Iodine is often used as a best practice example. Two main institutions lead the efforts to address malnutrition throughout the world: the UN with its UN Millennium Development Goal project, and the Copenhagen Consensus. We consider micronutrient deficiencies, particularly in iodine, corresponding interventions, their effects and health economic data. We discuss how developing public/private partnership could boost the effectiveness of interventions by combining the competencies of both sides: credibility, national and international buy-in, experience of public institutions, commercial competencies, high penetration rate, and product knowledge of private industry. Copyright © 2010 S. Karger AG, Basel.

Developing a National-Level Concept Dictionary for EHR Implementations in Kenya.

PubMed

Keny, Aggrey; Wanyee, Steven; Kwaro, Daniel; Mulwa, Edwin; Were, Martin C

2015-01-01

The increasing adoption of Electronic Health Records (EHR) by developing countries comes with the need to develop common terminology standards to assure semantic interoperability. In Kenya, where the Ministry of Health has rolled out an EHR at 646 sites, several challenges have emerged including variable dictionaries across implementations, inability to easily share data across systems, lack of expertise in dictionary management, lack of central coordination and custody of a terminology service, inadequately defined policies and processes, insufficient infrastructure, among others. A Concept Working Group was constituted to address these challenges. The country settled on a common Kenya data dictionary, initially derived as a subset of the Columbia International eHealth Laboratory (CIEL)/Millennium Villages Project (MVP) dictionary. The initial dictionary scope largely focuses on clinical needs. Processes and policies around dictionary management are being guided by the framework developed by Bakhshi-Raiez et al. Technical and infrastructure-based approaches are also underway to streamline workflow for dictionary management and distribution across implementations. Kenya's approach on comprehensive common dictionary can serve as a model for other countries in similar settings.

Global Health Governance and Global Power: A Critical Commentary on the Lancet-University of Oslo Commission Report.

PubMed

Gill, Stephen; Benatar, Solomon

2016-01-01

The Lancet-University of Oslo Commission Report on Global Governance for Health provides an insightful analysis of the global health inequalities that result from transnational activities consequent on what the authors call contemporary "global social norms." Our critique is that the analysis and suggested reforms to prevailing institutions and practices are confined within the perspective of the dominant-although unsustainable and inequitable-market-oriented, neoliberal development model of global capitalism. Consequently, the report both elides critical discussion of many key forms of material and political power under conditions of neoliberal development and governance that shape the nature and priorities of the global governance for health, and fails to point to the extent of changes required to sustainably improve global health. We propose that an alternative concept of progress-one grounded in history, political economy, and ecologically responsible health ethics-is sorely needed to better address challenges of global health governance in the new millennium. This might be premised on global solidarity and the "development of sustainability." We argue that the prevailing market civilization model that lies at the heart of global capitalism is being, and will further need to be, contested to avoid contradictions and dislocations associated with the commodification and privatization of health. © The Author(s) 2016.

A framework convention on global health: health for all, justice for all.

PubMed

Gostin, Lawrence O

2012-05-16

Health inequalities represent perhaps the most consequential global health challenge and yet they persist despite increased funding and innovative programs. The United Nations is revising the Millennium Development Goals (MDGs) that will shape the world for many years to come. What would a transformative post-MDG framework for global health justice look like? A global coalition of civil society and academics--the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)--has formed an international campaign to advocate for a Framework Convention on Global Health (FCGH). Recently endorsed by the UN Secretary-General, the FCGH would reimagine global governance for health, offering a new post-MDG vision. This Special Communication describes the key modalities of an FCGH to illustrate how it would improve health and reduce inequalities. The modalities would include defining national responsibilities for the population's health; defining international responsibilities for reliable, sustainable funding; setting global health priorities; coordinating fragmented activities; reshaping global governance for health; and providing strong global health leadership through the World Health Organization.

New dialogue for the way forward in maternal health: addressing market inefficiencies.

PubMed

McCarthy, Katharine; Ramarao, Saumya; Taboada, Hannah

2015-06-01

Despite notable progress in Millennium Development Goal (MDG) five, to reduce maternal deaths three-quarters by 2015, deaths due to treatable conditions during pregnancy and childbirth continue to concentrate in the developing world. Expanding access to three effective and low-cost maternal health drugs can reduce preventable maternal deaths, if available to all women. However, current failures in markets for maternal health drugs limit access to lifesaving medicines among those most in need. In effort to stimulate renewed action planning in the post-MDG era, we present three case examples from other global health initiatives to illustrate how market shaping strategies can scale-up access to essential maternal health drugs. Such strategies include: sharing intelligence among suppliers and users to better approximate and address unmet need for maternal health drugs, introducing innovative financial strategies to catalyze otherwise unattractive markets for drug manufacturers, and employing market segmentation to create a viable and sustainable market. By building on lessons learned from other market shaping interventions and capitalizing on opportunities for renewed action planning and partnership, the maternal health field can utilize market dynamics to better ensure sustainable and equitable distribution of essential maternal health drugs to all women, including the most marginalized.

Making basic health care accessible to rural communities: a case study of Kiang West district in rural Gambia.

PubMed

Sanneh, Edward Saja; Hu, Allen H; Njai, Modou; Ceesay, Omar Malleh; Manjang, Buba

2014-01-01

This study focuses on lack of access to basic health care, which is one of the hindrances to the development of the poor, and subjects them to the poverty penalty. It also focuses on contributing to the Bottom of the Pyramid in a general sense, in addition to meeting the health needs of communities where people live on less than $1 a day. Strengthened multistakeholder responses and better-targeted, low-cost prevention, and care strategies within health systems are suggested to address the health burdens of poverty-stricken communities. In this study, a multistakeholder model which includes the government, World Health Organization, United Nations Children Emergency Fund, and the Medical Research Council was created to highlight the collaborative approach in rural Gambia. The result shows infant immunization and antenatal care coverage were greatly improved which contributes to the reduction in mortality. This case study also finds that strategies addressing health problems in rural communities are required to achieve 'Millennium Development Goals'. In particular, actual community visits to satellite villages within a district (area of study) are extremely vital to making health care accessible. © 2013 Wiley Periodicals, Inc.

The "Asian miracle".

PubMed

Sadik, N

1999-12-01

Over the past 30 years, Asia and the Pacific region has stood out to the rest of the world as a model of development. Stunning economic growth accompanied by huge investments in health education significantly contributed to reduced infant, child and maternal deaths, smaller family size, higher living standards, and significant improvement in the status of women. However, financial and economic crisis which spread throughout Asia beginning in mid-1997, has given a grim warning that financial turbulence can wipe out developmental gains owing to reduced social sector investment. The crisis increased poverty and unemployment, decreased educational involvement, and budgetary constraints for social programs, including those concerning population and reproductive health. At the dawn of the new millennium the challenge for Asia and the Pacific will be to respond to the key issues that came out at the International Conference on Population and Development review, and to maintain the momentum of progress which it accomplished in the past 3 decades. Priority should be given on areas of reproductive health, reduction of maternal mortality, reproductive health needs of adolescents, reducing abortion, addressing the health consequences of unsafe abortion, prevention of HIV/AIDS, gender issues, and education.

21st Century Science for Sustainable Development in the Developing World

NASA Astrophysics Data System (ADS)

Sachs, J. D.

2004-12-01

Meeting the Millennium Development Goals and, ultimately, eradicating extreme poverty, engages experts from many academic disciplines and different parts of society- climatologists, earth engineers, ecologists, economists, public health specialists, social activists, and politicians. We are in the midst of exciting technological and scientific breakthroughs that make it realistic to end extreme poverty by 2025. Indeed, the experiences of China and India in recent years have illustrated that technology can accelerate economic development to impressively high rates. India, which boasts growth rates of nearly 8% over the past decade, may end hunger among its population as early as 2007, thanks in large part to the Green Revolution underway there. The work of agronomists and economists are not unrelated - the science behind soil nutrients, water, and germplasm all fuel sustainable development. Science and technology are important ingredients for growth, and they are improving at an ever-increasing rate. When applied for the sake of human benefit, we have a tool of unprecedented strength. But the developing world has also reached a point of unprecedented environmental stress. Biodiversity faces serious threats, as do water supplies, forests, and the atmosphere. Developing and developed nations continue to grapple with the consequences of greenhouse gas emissions. We must maintain our scientific investigations and analysis while ensuring that development policy addresses long-term environmental needs. The energy sector is one obvious example. Several developing countries, China and India included, harbor vast coal deposits. Fueling development with coal will drastically exacerbate the ongoing spiral of man-made climate change. My presentation will focus on the contributions that 21st century science can make-indeed, must make-to ensure that sustainable development occurs and we meet the Millennium Challenge of cutting extreme poverty in half by 2015.

Improving Maternal Health in Pakistan: Toward a Deeper Understanding of the Social Determinants of Poor Women’s Access to Maternal Health Services

PubMed Central

Salway, Sarah; Bhatti, Afshan; Shanner, Laura; Zaman, Shakila; Laing, Lory; Ellison, George T. H.

2014-01-01

Evidence suggests national- and community-level interventions are not reaching women living at the economic and social margins of society in Pakistan. We conducted a 10-month qualitative study (May 2010–February 2011) in a village in Punjab, Pakistan. Data were collected using 94 in-depth interviews, 11 focus group discussions, 134 observational sessions, and 5 maternal death case studies. Despite awareness of birth complications and treatment options, poverty and dependence on richer, higher-caste people for cash transfers or loans prevented women from accessing required care. There is a need to end the invisibility of low-caste groups in Pakistani health care policy. Technical improvements in maternal health care services should be supported to counter social and economic marginalization so progress can be made toward Millennium Development Goal 5 in Pakistan. PMID:24354817

Improving maternal health in Pakistan: toward a deeper understanding of the social determinants of poor women's access to maternal health services.

PubMed

Mumtaz, Zubia; Salway, Sarah; Bhatti, Afshan; Shanner, Laura; Zaman, Shakila; Laing, Lory; Ellison, George T H

2014-02-01

Evidence suggests national- and community-level interventions are not reaching women living at the economic and social margins of society in Pakistan. We conducted a 10-month qualitative study (May 2010-February 2011) in a village in Punjab, Pakistan. Data were collected using 94 in-depth interviews, 11 focus group discussions, 134 observational sessions, and 5 maternal death case studies. Despite awareness of birth complications and treatment options, poverty and dependence on richer, higher-caste people for cash transfers or loans prevented women from accessing required care. There is a need to end the invisibility of low-caste groups in Pakistani health care policy. Technical improvements in maternal health care services should be supported to counter social and economic marginalization so progress can be made toward Millennium Development Goal 5 in Pakistan.

Comparison of simulated and reconstructed variations in East African hydroclimate over the last millennium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klein, Francois; Goosse, Hugues; Graham, Nicholas E.

The multi-decadal to centennial hydroclimate changes in East Africa over the last millennium are studied by comparing the results of forced transient simulations by six general circulation models (GCMs) with published hydroclimate reconstructions from four lakes: Challa and Naivasha in equatorial East Africa, and Masoko and Malawi in southeastern inter-tropical Africa. All GCMs simulate fairly well the unimodal seasonal cycle of precipitation in the Masoko–Malawi region, while the bimodal seasonal cycle characterizing the Challa–Naivasha region is generally less well captured by most models. Model results and lake-based hydroclimate reconstructions display very different temporal patterns over the last millennium. Additionally, theremore » is no common signal among the model time series, at least until 1850. This suggests that simulated hydroclimate fluctuations are mostly driven by internal variability rather than by common external forcing. After 1850, half of the models simulate a relatively clear response to forcing, but this response is different between the models. Overall, the link between precipitation and tropical sea surface temperatures (SSTs) over the pre-industrial portion of the last millennium is stronger and more robust for the Challa–Naivasha region than for the Masoko–Malawi region. At the inter-annual timescale, last-millennium Challa–Naivasha precipitation is positively (negatively) correlated with western (eastern) Indian Ocean SST, while the influence of the Pacific Ocean appears weak and unclear. Although most often not significant, the same pattern of correlations between East African rainfall and the Indian Ocean SST is still visible when using the last-millennium time series smoothed to highlight centennial variability, but only in fixed-forcing simulations. Furthermore, this means that, at the centennial timescale, the effect of (natural) climate forcing can mask the imprint of internal climate variability in large-scale teleconnections.« less

Comparison of simulated and reconstructed variations in East African hydroclimate over the last millennium

DOE PAGES

Klein, Francois; Goosse, Hugues; Graham, Nicholas E.; ...

2016-07-13

The multi-decadal to centennial hydroclimate changes in East Africa over the last millennium are studied by comparing the results of forced transient simulations by six general circulation models (GCMs) with published hydroclimate reconstructions from four lakes: Challa and Naivasha in equatorial East Africa, and Masoko and Malawi in southeastern inter-tropical Africa. All GCMs simulate fairly well the unimodal seasonal cycle of precipitation in the Masoko–Malawi region, while the bimodal seasonal cycle characterizing the Challa–Naivasha region is generally less well captured by most models. Model results and lake-based hydroclimate reconstructions display very different temporal patterns over the last millennium. Additionally, theremore » is no common signal among the model time series, at least until 1850. This suggests that simulated hydroclimate fluctuations are mostly driven by internal variability rather than by common external forcing. After 1850, half of the models simulate a relatively clear response to forcing, but this response is different between the models. Overall, the link between precipitation and tropical sea surface temperatures (SSTs) over the pre-industrial portion of the last millennium is stronger and more robust for the Challa–Naivasha region than for the Masoko–Malawi region. At the inter-annual timescale, last-millennium Challa–Naivasha precipitation is positively (negatively) correlated with western (eastern) Indian Ocean SST, while the influence of the Pacific Ocean appears weak and unclear. Although most often not significant, the same pattern of correlations between East African rainfall and the Indian Ocean SST is still visible when using the last-millennium time series smoothed to highlight centennial variability, but only in fixed-forcing simulations. Furthermore, this means that, at the centennial timescale, the effect of (natural) climate forcing can mask the imprint of internal climate variability in large-scale teleconnections.« less

A Cross-Sectional Analytic Study of Postpartum Health Care Service Utilization in the Philippines

PubMed Central

Yamashita, Tadashi; Suplido, Sherri Ann; Ladines-Llave, Cecilia; Tanaka, Yuko; Senba, Naomi; Matsuo, Hiroya

2014-01-01

Background The maternal mortality ratio in the Philippines remains high; thus, it will be difficult to achieve the Millennium Development Goals 5 by 2015. Approximately two-thirds of all maternal deaths occur during the postpartum period. Therefore, we conducted the present study to examine the current state of postpartum health care service utilization in the Philippines, and identify challenges to accessing postpartum care. Methods A questionnaire and knowledge test were distributed to postpartum women in the Philippines. The questionnaire collected demographical characteristics and information about their utilization of health care services during pregnancy and the postpartum period. The knowledge test consisted of 11 questions regarding 6 topics related to possible physical and mental symptoms after delivery. Sixty-four questionnaires and knowledge tests were analyzed. Results The mean time of first postpartum health care visit was 5.1±5.2 days after delivery. Postpartum utilization of health care services was significantly correlated with delivery location (P<0.01). Women who delivered at home had a lower rate of postpartum health care service utilization than women who delivered at medical facilities. The majority of participants scored low on the knowledge test. Conclusion We found inadequate postpartum health care service utilization, especially for women who delivered at home. Our results also suggest that postpartum women lack knowledge about postpartum health concerns. In the Philippines, Barangay health workers may play a role in educating postpartum women regarding health care service utilization to improve their knowledge of possible concerns and their overall utilization of health care services. PMID:24465626

DMCA Section 104 Report: A Report of the Register of Copyrights Pursuant to [Section] 104 of the Digital Millennium Copyright Act.

ERIC Educational Resources Information Center

Library of Congress, Washington, DC. Copyright Office.

As required under section 104 of Public Law No. 105-304, this Report evaluates the effects of title I of the Digital Millennium Copyright Act (DMCA) of 1998 and the development of electronic commerce and associated technology on the operation of sections 109 and 117 of title 17, U.S.C. It also evaluates the relationship between existing and…

Using immunization delivery strategies to accelerate progress in Africa towards achieving the Millennium Development Goals.

PubMed

Clements, C John; Nshimirimanda, Deo; Gasasira, Alex

2008-04-07

Integration of health services brings together common functions within and between organizations to solve common problems, developing a commitment to a shared vision and goals, and using common technologies and resources to achieve these goals. Integration has been the frustrated rally call of Primary Health Care for 30 years. This paper discusses the process of integrating child survival strategies and other heath services with immunization in Africa. Immunization is arguably the most successful health programme throughout the continent, making it the logical vehicle for add-on services. Strong health systems are the best way of delivering cost-effective child survival interventions in a most sustainable manner. But the reality in many African countries is that health systems have been weak for a number of reasons. Joining additional cost-effective child survival interventions on to immunization services may provide the needed boost. The unacceptably high childhood mortality in parts of Africa makes it the ideal location to undertake this exercise. The urgency to scale-up child survival interventions that have proven cost-effective is especially important if the Millennium Development Goals (MDGs) are to be met by 2015. Africa has more to loose than most in failing to scale up to meet these goals, bearing as it does the highest burden of childhood mortality in the world. But so far, prospects do not look good for achieving MDG-4 for the countries with the highest mortality rates. The timeliness of this initiative towards integration could not be better. In the last five years, countries in Africa have received massive injections of financial resources for polio eradication and measles control as well as additional funding for a range of immunization-strengthening activities and the introduction of new and under-utilized vaccines. While the data to support integration are limited, the information to hand suggests the effectiveness of the strategy. Where immunization performance is strong, immunization contacts may be excellent vehicles for additional interventions such as de-worming or Integrated Management of Childhood Illness (IMCI). But where an immunization service is struggling, adding another child survival intervention on to immunization might be the straw that breaks its back. Health managers have a wide range of options for adding on to immunization services, but the best choice will depend very much on local situations.

AN OCCUPATIONAL REPRODUCTIVE RESEARCH AGENDA FOR THE THIRD MILLENNIUM

EPA Science Inventory

There is a significant public health concern about the potential effects of occupational exposure to toxic substances on reproductive outcomes. Several toxicants with reported reproductive and developmental effects are still in regular commercial or therapeutic use and thus prese...

Equity in maternal health care service utilization: a systematic review for developing countries.

PubMed

Çalışkan, Zafer; Kılıç, Dilek; Öztürk, Selcen; Atılgan, Emre

2015-11-01

The objective was to explore progress of equity in the utilization of maternal health care services in developing countries since maternal care is a crucial factor in reducing maternal mortality, which is targeted by the Millennium Development Goal 5. A systematic review of quantitative studies was done. PubMed Central, Web of Science, and Science Direct databases were searched for peer-reviewed and English-language articles published between 2005 and 2015. Thirty-six articles were included in the review. The results reveal the lack of equity in the utilization of maternal health care in developing countries. Thirty-three out of 36 studies found evidence supporting severe inequities while three studies found evidence of equity or at least improvement in terms of equity. Most of the literature devoted to utilization of maternal health care generally provides information on the level of maternal care used and ignore the equity problem. Research in this area should focus not only on the level of maternal care used but also on the most disadvantaged segments of the population in terms of utilization of maternal care in order to reach the set targets.

Integrating tobacco control into health and development agendas.

PubMed

Reddy, K Srinath; Yadav, Amit; Arora, Monika; Nazar, Gaurang P

2012-03-01

Tobacco use is one of the major risk factors for non-communicable diseases, with a profound impact on resource-poor low-income and middle-income countries such as India, where tobacco use is high and where socioeconomic as well as health inequalities are rampant. Effective implementation of the Framework Convention on Tobacco Control requires multisectoral efforts that can fructify through integration of tobacco control into broader health and development agendas such as food and water security, environment, the right to education and human rights. The global tobacco control community will need to explore innovative partnerships beyond its traditional confines and build a global coalition that supports tobacco control by partnering with others having convergent concerns on common determinants. A firm political commitment and intersectoral coordination between government and non-government agencies is paramount in order to implement effective tobacco control programmes. Integration of tobacco control into other health and development agendas as described in this paper has the potential to contribute to the achievement of all the eight United Nations Millennium Development Goals. This paper explores why the whole of government should accord a high priority to tobacco control, and how this integration could be achieved.

The end of the era of generosity? Global health amid economic crisis

PubMed Central

Schneider, Kammerle; Garrett, Laurie

2009-01-01

In the past decade donor commitments to health have increased by 200 percent. Correspondingly, there has been a swell of new players in the global health landscape. The unprecedented, global response to a single disease, HIV/AIDS, has been responsible for a substantial portion of this boon. Numerous health success have followed this windfall of funding and attention, yet the food, fuel, and economic crises of 2008 have shown the vulnerabilities of health and development initiatives focused on short term wins and reliant on a constant flow of foreign funding. For too long, the international community has responded to global health and development challenges with emergency solutions that often reflect the donor's priorities, values, and political leanings, rather than funding durable health systems that can withstand crises. Progress towards achieving the Millennium Development Goals has stalled in many countries. Disease specific initiatives have weakened health systems and limited efforts to improve maternal and child health. As we enter this era of scarce resources, there is a need to return to the foundations of the Alma Ata Declaration signed thirty years ago with the goal of providing universal access to primary healthcare. The global health community must now objectively evaluate how we can most effectively respond to the crises of 2008 and take advantage of this moment of extraordinary attention for global health and translate it into long term, sustainable health improvements for all. PMID:19134211

The role of health professional associations in the promotion of global women's health.

PubMed

Lalonde, André B; Menendez, Hector; Perron, Liette

2010-11-01

Health professional associations, especially those from countries with the highest maternal death burden, have vital roles to play in improving maternal and newborn health and in achieving the Millennium Development Goals 4 and 5. Possessing the knowledge, skills, and influence to positively impact practice at the service delivery level, they can also advocate for change at the policy level and lobby for higher priority and greater investment in the maternal and newborn health field at the national level. The ability of professional associations to assume this leadership is nevertheless contingent on their institutional capacities to achieve planned goals and objectives in support of their organizational mission and strategic priorities. Since 1998, the Society of Obstetricians and Gynaecologists of Canada (SOGC) has been supporting the capacity development efforts of peer professional associations in low-resource countries. SOGC's work in this specific area has led it to develop and pilot an Organization Capacity Improvement Framework (OCIF) that guides professional associations, incrementally, in successive cycles of capacity development. Building on capacity developed within previous capacity-building cycles, this article summarizes and reports on the recent outcomes of the Asociación de Gynecoloígia y Obstetricia de Guatemala's (AGOG) organizational development efforts and the impact they have had in positioning the association as an important contributor in national efforts to improve maternal and newborn health outcomes in the country.

The Millennium Cohort Study: Answering Long-Term Health Concerns of US Military Service Members by Integrating Longitudinal Survey Data with Military Health System Records. Part 2. Pre-Deployment

DTIC Science & Technology

2013-01-01

chronic bronchitis or emphysema (1% vs. 1 %) and asthma (1% vs. 1 %) among deployers compared to nondeployers. These data suggest that ground-troop...determining if diagnoses of pulmonary diseases are changing over time. Hypertension and diabetes mellitus are major causes of cardiovascular disease

Leaving no one behind: a neglected tropical disease indicator and tracers for the Sustainable Development Goals

PubMed Central

Fitzpatrick, Christopher; Engels, Dirk

2016-01-01

The Sustainable Development Goals (SDGs) have emerged as a global pledge to ‘leave no one behind’. Under SDG 3, ‘Ensure healthy lives and promote wellbeing for all’, target 3.3 extends the Millennium Development Goals (MDGs) beyond HIV, TB and malaria to ‘end the epidemic’ of neglected tropical diseases (NTDs) by 2030. Other targets are also relevant to NTDs, especially 3.8 (Universal Health Coverage), 6.1 (water) and 6.2 (sanitation). This commentary summarises the proposed NTD indicator (3.3) and tracers (3.8 and 6.1/6.2). These will help ensure that the world's poorest and most marginalized people are prioritized at every step on the path towards SDG targets. PMID:26940304

Exploratory factor analysis of self-reported symptoms in a large, population-based military cohort

PubMed Central

2010-01-01

Background US military engagements have consistently raised concern over the array of health outcomes experienced by service members postdeployment. Exploratory factor analysis has been used in studies of 1991 Gulf War-related illnesses, and may increase understanding of symptoms and health outcomes associated with current military conflicts in Iraq and Afghanistan. The objective of this study was to use exploratory factor analysis to describe the correlations among numerous physical and psychological symptoms in terms of a smaller number of unobserved variables or factors. Methods The Millennium Cohort Study collects extensive self-reported health data from a large, population-based military cohort, providing a unique opportunity to investigate the interrelationships of numerous physical and psychological symptoms among US military personnel. This study used data from the Millennium Cohort Study, a large, population-based military cohort. Exploratory factor analysis was used to examine the covariance structure of symptoms reported by approximately 50,000 cohort members during 2004-2006. Analyses incorporated 89 symptoms, including responses to several validated instruments embedded in the questionnaire. Techniques accommodated the categorical and sometimes incomplete nature of the survey data. Results A 14-factor model accounted for 60 percent of the total variance in symptoms data and included factors related to several physical, psychological, and behavioral constructs. A notable finding was that many factors appeared to load in accordance with symptom co-location within the survey instrument, highlighting the difficulty in disassociating the effects of question content, location, and response format on factor structure. Conclusions This study demonstrates the potential strengths and weaknesses of exploratory factor analysis to heighten understanding of the complex associations among symptoms. Further research is needed to investigate the relationship between factor analytic results and survey structure, as well as to assess the relationship between factor scores and key exposure variables. PMID:20950474

KSC-00pp0099

NASA Image and Video Library

2000-01-24

JoAnn Morgan, associate director for Advanced Development and Shuttle Upgrades at KSC, studies posters of space-related news stories in the mobile exhibition called "NewsCapade with Al Neuharth." The exhibit started its cross-country tour in San Francisco in April. It is a traveling version of the Newseum in Arlington, Va. Morgan was among four speakers discussing "Space, the Media and the Millennium" at a reception Jan. 24 kicking off the display at KSC

KSC00pp0099

NASA Image and Video Library

2000-01-24

JoAnn Morgan, associate director for Advanced Development and Shuttle Upgrades at KSC, studies posters of space-related news stories in the mobile exhibition called "NewsCapade with Al Neuharth." The exhibit started its cross-country tour in San Francisco in April. It is a traveling version of the Newseum in Arlington, Va. Morgan was among four speakers discussing "Space, the Media and the Millennium" at a reception Jan. 24 kicking off the display at KSC

The need for geriatric dental education in India: the geriatric health challenges of the millennium.

PubMed

Thomas, Susan

2013-06-01

The rapid growth in the elderly population in a developing country such as India poses social and financial challenges by causing a shift towards non-communicable diseases and increases in chronic diseases. The economic impact of the burden of chronic diseases such as cardiovascular disease, hypertension, diabetes and cancer are high. The link between oral health and general health are particularly pronounced in older populations and impairs their quality of life. This paper reveals that in order to address the increasing health challenges and demands of a growing geriatric population, undergraduates and graduate students in dental schools should be given comprehensive or holistic health assessment training. Cost-effective modern educational strategies and educational tools such as problem-based learning will help to overcome the dearth of trained faculty in geriatric dentistry. Multidisciplinary health-care approaches and extended health-care team work are of vital importance to older patients who could benefit physically and psychologically from more efficient dental treatment. With often more than one chronic disease affecting individuals and use of polypharmacy, there is a need to increase overall knowledge of geriatric pharmacy and geriatric medicine. Measures to help older people remain healthy and active are a necessity in developing countries such as India for effective social and economic development. © 2013 FDI World Dental Federation.

Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development.

PubMed

Groce, N; Bailey, N; Lang, R; Trani, J F; Kett, M

2011-12-01

The critical importance of unrestricted access to clean drinking water and basic sanitation for all is highlighted in Millennium Development Goal 7, which calls for the reduction by half of the proportion of people without such access by 2015. Unfortunately, little attention has been paid to the needs of such access for the one billion people living with a disability worldwide, despite the fact that the right to equal access for all international development initiatives is guaranteed in the new United Nations Convention on the Rights of Persons with Disabilities. In this paper, we review what is currently known about access to water and sanitation for persons with disabilities in low- and middle-income countries from the perspective of both international development and global health, and identify existing gaps in research, practice and policy that are of pressing concern if the water and sanitation needs of this large - and largely overlooked - population are to be addressed.

[Contribution of humanities and social sciences to the training of healthcare professionals in Africa: an experience in the context of the mother and child Priority Solidarity Fund].

PubMed

Cauli, Marie

2013-01-01

The mother-and-child Priority Solidarity Fund is a programme supported by Coopération Française in the fields of health, higher education and new technologies. It aims to achieve the Millennium Development Goals of reducing maternal and infantile mortality. This programme, focused on the training of trainers, is developing two innovative plans: digital resources and the integration of the humanities and social sciences. This second aspect is decisive: by aligning content, skills, and needs, it can place greater emphasis on preventive care and give a real meaning to the work of trainers.

Science and Diplomacy in the 21ST Century

NASA Astrophysics Data System (ADS)

Colglazier, E. William

2014-07-01

It is my pleasure to talk to you today about "global water security" at the Erice International Seminars 46th Session focused on "The Role of Science in the Third Millennium." The growing importance of water security can be framed in two ways. First, water resources should be protected so that, on a reliable basis, there is sufficient, safe water to sustain the health and livelihoods of populations, while also increasing their resilience to water-related hazards such as floods and droughts. Second, the geopolitical dimensions of water security should be addressed by considering how water shortages, poor water quality, or floods might impact the stability or failure of states, increase regional tensions, and pose a risk to global public health and food markets, thus hobbling economic growth.

Human rights, health and the state in Bangladesh

PubMed Central

Rahman, Redwanur M

2006-01-01

Background This paper broadly discusses the role of the State of Bangladesh in the context of the health system and human rights. The interrelation between human rights, health and development are well documented. The recognition of health as a fundamental right by WHO and subsequent approval of health as an instrument of welfare by the Universal Declaration of Human Rights (UDHR) and the International Covenant on Social, Economic and Cultural Rights (ICSECR) further enhances the idea. Moreover, human rights are also recognized as an expedient of human development. The state is entrusted to realize the rights enunciated in the ICSECR. Discussion In exploring the relationship of the human rights and health situation in Bangladesh, it is argued, in this paper, that the constitution and major policy documents of the Bangladesh government have recognized the health rights and development. Bangladesh has ratified most of the international treaties and covenants including ICCPR, ICESCR; and a signatory of international declarations including Alma-Ata, ICPD, Beijing declarations, and Millennium Development Goals. However the implementation of government policies and plans in the development of health institutions, human resources, accessibility and availability, resource distribution, rural-urban disparity, the male-female gap has put the health system in a dismal state. Neither the right to health nor the right to development has been established in the development of health system or in providing health care. Summary The development and service pattern of the health system have negative correlation with human rights and contributed to the underdevelopment of Bangladesh. The government should take comprehensive approach in prioritizing the health rights of the citizens and progressive realization of these rights. PMID:16611360