Global health

全球卫生
  • 文章类型: Journal Article
    UNASSIGNED: The Global Financing Facility (GFF) supports national reproductive, maternal, newborn, child, adolescent health, and nutrition needs. Previous analysis examined how adolescent sexual and reproductive health was represented in GFF national planning documents for 11 GFF partner countries.
    UNASSIGNED: This paper furthers that analysis for 16 GFF partner countries as part of a Special Series.
    UNASSIGNED: Content analysis was conducted on publicly available GFF planning documents for Afghanistan, Burkina Faso, Cambodia, CAR, Côte d\'Ivoire, Guinea, Haiti, Indonesia, Madagascar, Malawi, Mali, Rwanda, Senegal, Sierra Leone, Tajikistan, Vietnam. Analysis considered adolescent health content (mindset), indicators (measure) and funding (money) relative to adolescent sexual and reproductive health needs, using a tracer indicator.
    UNASSIGNED:  Countries with higher rates of adolescent pregnancy had more content relating to adolescent reproductive health, with exceptions in fragile contexts. Investment cases had more adolescent content than project appraisal documents. Content gradually weakened from mindset to measures to money. Related conditions, such as fistula, abortion, and mental health, were insufficiently addressed. Documents from Burkina Faso and Malawi demonstrated it is possible to include adolescent programming even within a context of shifting or selective priorities.
    UNASSIGNED: Tracing prioritisation and translation of commitments into plans provides a foundation for discussing global funding for adolescents. We highlight positive aspects of programming and areas for strengthening and suggest broadening the perspective of adolescent health beyond the reproductive health to encompass issues, such as mental health. This paper forms part of a growing body of accountability literature, supporting advocacy work for adolescent programming and funding.
    Main findings: Adolescent health content is inconsistently included in the Global Financing Facility country documents, and despite strong or positive examples, the content is stronger in investment cases than project appraisal documents, and diminishes when comparing content, indicators and financing.Added knowledge: Although adolescent health content is generally strongest in countries with the highest proportion of births before age 18, there are exceptions in fragile contexts and gaps in addressing important issues related to adolescent health.Global health impact for policy and action: Adolescent health programming supported by the Global Financing Facility should build on examples of strong country plans, be more consistent in addressing adolescent health, and be accompanied by public transparency to facilitate accountability work such as this.
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  • 文章类型: Journal Article
    Early childhood is foundational for optimal and inclusive lifelong learning, health and well-being. Young children with disabilities face substantial risks of sub-optimal early childhood development (ECD), requiring targeted support to ensure equitable access to lifelong learning opportunities, especially in low- and middle-income countries. Although the Sustainable Development Goals, 2015-2030 (SDGs) emphasise inclusive education for children under 5 years with disabilities, there is no global strategy for achieving this goal since the launch of the SDGs. This paper explores a global ECD framework for children with disabilities based on a review of national ECD programmes from different world regions and relevant global ECD reports published since 2015. Available evidence suggests that any ECD strategy for young children with disabilities should consists of a twin-track approach, strong legislative support, guidelines for early intervention, family involvement, designated coordinating agencies, performance indicators, workforce recruitment and training, as well as explicit funding mechanisms and monitoring systems. This approach reinforces parental rights and liberty to choose appropriate support pathway for their children. We conclude that without a global disability-focussed ECD strategy that incorporates these key features under a dedicated global leadership, the SDGs vision and commitment for the world\'s children with disabilities are unlikely to be realised.
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  • 文章类型: Journal Article
    UNASSIGNED: Approximately 15 million children are born each year prematurely, representing more than 10 percent of all childbirths worldwide. Prematurity is an acute event and the leading cause of death among newborns and children under five. Sixty percent of these premature deaths occur in Sub-Saharan Africa and Southeast Asia.
    UNASSIGNED: The current study aimed to explore and understand women\'s experiences and perceptions regarding giving birth prematurely at the National Hospital of Muhimbili in Dar es Salaam, Tanzania.
    UNASSIGNED: A qualitative method, using Interpretive Phenomenological Analysis approach was chosen to understand and describe the women\'s experiences. A semi-structured guide was used during the interviews. All interviews were audio-recorded and transcribed verbatim.
    UNASSIGNED: Eight in-depth interviews were conducted. The analysis revealed three superordinate themes: (a) Emotional turmoil: unmet expectations shattering maternal identity, emotional distress, and loss of hope; (b) Adapting to preterm birth and challenges: the unexpected situation, lack of proper care, strenuous breastfeeding routines, and socioeconomic challenges; (c) Significance of proper care and emotional support: good maternal care, mother-to-mother and family support.
    UNASSIGNED: This study provided a deeper understanding of women\'s experiences and perceptions of premature childbirth. The current study indicated the importance of caregivers\' awareness of the women\'s emotional distress, their need to adapt to a sudden unexpected situation, and the necessity of emotional support.
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  • 文章类型: Journal Article
    In this paper, as Black scholars, we address ways that interventions designed to promote equity in health can create pathways for coupling decolonization with antiracism by drawing on the intersection of the health of Africans and African Americans. To frame this intersection, we offer the Public Health Critical Race Praxis (PHCRP) and the PEN-3 Cultural Model as antiracism and decolonization tools that can jointly advance research on colonization and racism globally. We argue that racism is a global reality; PHCRP, an antiracism framework, and PEN-3, a decolonizing framework, can guide interventions to promote equity for Africans and African Americans.
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  • 文章类型: Journal Article
    Ensuring democracy in establishing Global Health (GH) requires including health perspectives and actions of what is conventionally called \"local\". Edging closer to the references of the Meeting of Knowledges to those of Coloniality, we address the implementation of Solidary Greengrocers by the initiative of small-scale fishermen in the South of Bahia, Brazil, in facing socioeconomic and health issues related to the COVID-19 pandemic. The triangulation of methods characterized the fieldwork based on ethnography, action research, and partnership with local stakeholders in analyzing the material. The search for simultaneous health, socioeconomic, environmental, and educational effects allowed for overcoming the risks in GH actions such as humanitarianism, controlism, neoliberalism, and colonialism. The initiative was managed by the political organization of the residents of the reserve, who raised and managed State and civil society resources with autonomy and solidarity, combining traditional knowledge with institutional and technological knowledge of the territory. So-called local experiences contain a complete vision of the world that should not be submitted to a totalizing category. Global Health can benefit from considering the several worlds underlying its object.
    Garantir a democracia na constituição do campo da Saúde Global (SG) requer a inclusão de perspectivas e ações sanitárias do que se convencionou chamar de “local”. Aproximando os referenciais do Encontro de Saberes ao de Colonialidade, abordamos a implementação de Quitandas Solidárias por iniciativa de pescadores artesanais, no sul da Bahia, no enfrentamento de questões socioeconômicas e de saúde ligadas à pandemia de COVID-19. A triangulação de métodos caracterizou os trabalhos de campo, baseados na etnografia, pesquisa-ação e parceria com agentes locais na análise do material. A busca de efeitos simultaneamente sanitários, socioeconômicos, ambientais e educativos possibilitou relativa superação dos riscos presentes nas ações de SG como os de humanitarismo, controlismo, neoliberalismo e colonialismo. A iniciativa foi gerida pela organização política dos moradores da reserva, que captaram e manejaram recursos do Estado e da sociedade civil com autonomia e solidariedade, aliando os saberes tradicionais aos conhecimentos institucionais e tecnológicos do território. As experiências ditas locais contêm uma visão completa de mundo que não devem ser submetidas a uma categoria totalizante. A Saúde Global pode se beneficiar da consideração dos diversos mundos que constituem o seu objeto.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    全球卫生互惠创新强调在高收入国家和低收入国家之间转移技术或干预措施,以解决共同的公共卫生问题。与“发展援助”或“反向创新”的单向模型相反。以证据为基础的干预措施通常会根据其在新环境中开发和应用的环境进行调整,在高收入和低收入环境中提供学习和合作的机会。然而,很少有明确的程序来指导研究人员和实施者如何将公平和以学习为导向的方法纳入跨环境的干预适应。我们整合了教育学的理论,实施科学,以及公共卫生方面的例子,包括在不同环境中适应行为健康干预措施的经验,以制定双向程序,跨高收入和低收入环境的干预适应的公平过程。相互适应能力建设模型(MCB-MA)由七个步骤组成:1)探索:就新环境中拟议的适应和情况评估的范围进行对话;2)制定共同的愿景:就适应的共同目标达成一致;3)正规化:围绕资源和数据共享制定协议;4)共享互补的专业知识:小组发起干预措施,支持适应小组了解干预措施并制定适应措施,同时从适应小组收集新的干预措施实施策略;5)互惠培训:发起和适应小组合作培训将实施适应干预措施的个人;6)相互反馈:发起和适应小组共享有关适应干预措施结果和经验教训的数据和反馈;7)考虑后续步骤:讨论未来的合作。这种有证据的程序可以为研究人员提供具体的行动,以解决经常模棱两可且具有挑战性的建立公平伙伴关系的任务。这些步骤可以与现有的干预适应模型一起使用,指导干预本身的适应。
    Global health reciprocal innovation emphasizes the movement of technologies or interventions between high- and low-income countries to address a shared public health problem, in contrast to unidirectional models of \"development aid\" or \"reverse innovation\". Evidence-based interventions are frequently adapted from the setting in which they were developed and applied in a new setting, presenting an opportunity for learning and partnership across high- and low-income contexts. However, few clear procedures exist to guide researchers and implementers on how to incorporate equitable and learning-oriented approaches into intervention adaptation across settings. We integrated theories from pedagogy, implementation science, and public health with examples from experience adapting behavioral health interventions across diverse settings to develop a procedure for a bidirectional, equitable process of intervention adaptation across high- and low-income contexts. The Mutual capacity building model for adaptation (MCB-MA) is made up of seven steps: 1) Exploring: A dialogue about the scope of the proposed adaptation and situational appraisal in the new setting; 2) Developing a shared vision: Agreeing on common goals for the adaptation; 3) Formalizing: Developing agreements around resource and data sharing; 4) Sharing complementary expertise: Group originating the intervention supporting the adapting group to learn about the intervention and develop adaptations, while gleaning new strategies for intervention implementation from the adapting group; 5) Reciprocal training: Originating and adapting groups collaborate to train the individuals who will be implementing the adapted intervention; 6) Mutual feedback: Originating and adapting groups share data and feedback on the outcomes of the adapted intervention and lessons learned; and 7) Consideration of next steps: Discuss future collaborations. This evidence-informed procedure may provide researchers with specific actions to approach the often ambiguous and challenging task of equitable partnership building. These steps can be used alongside existing intervention adaptation models, which guide the adaptation of the intervention itself.
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  • 文章类型: Journal Article
    目的:研究全球胃癌的历史发病率和死亡率趋势以及到2035年预测的胃癌死亡率。
    方法:发病率数据来自五大洲癌症发病率(CI5)卷I-XI,和死亡率数据来自世界卫生组织(WHO)死亡率数据库的最新更新.我们使用连接点回归分析来检查历史发病率和死亡率趋势,并使用R中的NORDPRED软件包来预测2035年按国家和性别划分的死亡人数和死亡率。
    结果:2020年报告了超过1,089,000例新胃癌病例和769,000例相关死亡。从2003年到2012年,男性人群中胃癌发病率的年均变化百分比(AAPC),韩国,Japan,马耳他,加拿大,塞浦路斯,和瑞士呈增长趋势(P>0.05);女性人口中,加拿大[AAPC,1.2;(95%Cl,0.5-2),P<0.05]呈增加趋势;而韩国,厄瓜多尔,泰国,塞浦路斯呈上升趋势(P>0.05)。AAPC在2006年至2015年男性人群胃癌死亡率中,泰国[3.5(95%cl,1.6-5.4),P<0.05]呈增加趋势;马耳他岛,新西兰,土耳其,瑞士,和塞浦路斯有增加的趋势(P>0.05);在20-44岁的男性人口中,泰国[AAPC,3.4;(95%cl,1.3-5.4),P<0.05;挪威,新西兰,荷兰,斯洛伐克,法国,哥伦比亚,立陶宛,美国呈增加趋势(P>0.05)。据预测,到2035年,斯洛文尼亚和法国的女性死亡率将呈现上升趋势。据预测,以色列男性人口和智利的绝对死亡人数,法国,到2035年,加拿大女性人口将增加。
    结论:在过去的十年中,胃癌的发病率和死亡率呈下降趋势;仍然有一些国家显示出增长的趋势,尤其是在45岁以下的人群中。尽管预计到2035年大多数国家的死亡率将下降,但由于人口增长,胃癌导致的绝对死亡人数可能会进一步增加。
    OBJECTIVE: To study the historical global incidence and mortality trends of gastric cancer and predicted mortality of gastric cancer by 2035.
    METHODS: Incidence data were retrieved from the Cancer Incidence in Five Continents (CI5) volumes I-XI, and mortality data were obtained from the latest update of the World Health Organization (WHO) mortality database. We used join-point regression analysis to examine historical incidence and mortality trends and used the package NORDPRED in R to predict the number of deaths and mortality rates by 2035 by country and sex.
    RESULTS: More than 1,089,000 new cases of gastric cancer and 769,000 related deaths were reported in 2020. The average annual percent change (AAPC) in the incidence of gastric cancer from 2003 to 2012 among the male population, South Korea, Japan, Malta, Canada, Cyprus, and Switzerland showed an increasing trend (P > 0.05); among the female population, Canada [AAPC, 1.2; (95%Cl, 0.5-2), P < 0.05] showed an increasing trend; and South Korea, Ecuador, Thailand, and Cyprus showed an increasing trend (P > 0.05). AAPC in the mortality of gastric cancer from 2006 to 2015 among the male population, Thailand [3.5 (95%cl, 1.6-5.4), P < 0.05] showed an increasing trend; Malta Island, New Zealand, Turkey, Switzerland, and Cyprus had an increasing trend (P > 0.05); among the male population aged 20-44, Thailand [AAPC, 3.4; (95%cl, 1.3-5.4), P < 0.05] showed an increasing trend; Norway, New Zealand, The Netherlands, Slovakia, France, Colombia, Lithuania, and the USA showed an increasing trend (P > 0.05). It is predicted that the mortality rate in Slovenia and France\'s female population will show an increasing trend by 2035. It is predicted that the absolute number of deaths in the Israeli male population and in Chile, France, and Canada female population will increase by 2035.
    CONCLUSIONS: In the past decade, the incidence and mortality of gastric cancer have shown a decreasing trend; however, there are still some countries showing an increasing trend, especially among populations younger than 45 years. Although mortality in most countries is predicted to decline by 2035, the absolute number of deaths due to gastric cancer may further increase due to population growth.
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  • 文章类型: Journal Article
    背景:中年女性对一系列更年期障碍感到困惑,可能会令人痛苦,并对个人产生相当大的影响,社会和工作生活。我们旨在通过系统评价和荟萃分析来估计中年妇女中19种更年期症状的全球患病率。
    方法:从1月开始在多个数据库中进行全面搜索,2000年3月,2023年进行相关研究。采用双反正弦变换的随机效应模型进行数据分析。
    结果:共321项研究,包括482,067名中年妇女,用于进一步分析。我们发现更年期症状的患病率不同,关节和肌肉不适的患病率最高(65.43%,95%CI62.51-68.29)和最低的正式治疗(20.5%,95%CI13.44-28.60)。值得注意的是,南美在某种更年期症状中的患病率极高,包括抑郁症和泌尿生殖道症状。此外,高收入国家(49.72%)的潮热患病率明显低于低收入国家(65.93%),中下层(54.17%),和中上层(54.72%,p<0.01),而个人因素,如更年期,对大多数更年期症状有影响,特别是在阴道干燥。绝经后妇女阴道干燥的患病率(44.81%)比绝经前妇女高2倍(21.16%,p<0.01)。此外,在体重指数(BMI)和睡眠问题的患病率之间观察到显着的区别,抑郁症,焦虑和泌尿问题。
    结论:更年期症状的患病率受社会和个人因素的影响,需要引起公众的关注。
    BACKGROUND: Women at middle age are puzzled by a series of menopausal disturbances, can be distressing and considerably affect the personal, social and work lives. We aim to estimate the global prevalence of nineteen menopausal symptoms among middle-aged women by performing a systematic review and meta-analysis.
    METHODS: Comprehensive search was performed in multiple databases from January, 2000 to March, 2023 for relevant studies. Random-effect model with double-arcsine transformation was used for data analysis.
    RESULTS: A total of 321 studies comprised of 482,067 middle-aged women were included for further analysis. We found varied prevalence of menopausal symptoms, with the highest prevalence of joint and muscular discomfort (65.43%, 95% CI 62.51-68.29) and lowest of formication (20.5%, 95% CI 13.44-28.60). Notably, South America shared dramatically high prevalence in a sort of menopausal symptoms including depression and urogenital symptoms. Besides, countries with high incomes (49.72%) had a significantly lower prevalence of hot flashes than those with low (65.93%), lower-middle (54.17%), and upper-middle (54.72%, p < 0.01), while personal factors, such as menopausal stage, had an influence on most menopausal symptoms, particularly in vaginal dryness. Prevalence of vagina dryness in postmenopausal women (44.81%) was 2-fold higher than in premenopausal women (21.16%, p < 0.01). Furthermore, a remarkable distinction was observed between body mass index (BMI) and prevalence of sleep problems, depression, anxiety and urinary problems.
    CONCLUSIONS: The prevalence of menopausal symptoms affected by both social and personal factors which calls for attention from general public.
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  • 文章类型: Journal Article
    国际上,美国(U.S.)引用了下背痛(LBP)的最高成本负担。成本持续上升,快于通货膨胀率和卫生支出的总体增长。我们对PubMed的同行评审和非同行评审文献进行了全面的文献综述,Scopus,和谷歌学者关于患病率的当代数据,成本,以及预计的未来成本。美国的政策制定者长期以来一直试图通过限制低价值服务和早期成像来解决LBP的高成本负担。尽管做出了这些努力,成本(~400亿美元;~2,000美元/患者/年)随着未指明成像率的增加而继续上升,手术率高,以及随后的翻修手术,没有进行适当的非药物试验,也没有相应地降低LBP患病率。全球范围内,LBP的总体患病率继续上升,主要是由于人口老龄化的增加.成本控制方法应侧重于对患者进行仔细和全面的临床评估,以更好地了解何时需要更多资源密集型干预措施。
    Internationally, the United States (U.S.) cites the highest cost burden of low back pain (LBP). The cost continues to rise, faster than the rate of inflation and overall growth of health expenditures. We performed a comprehensive literature review of peer-reviewed and non- peer-reviewed literature from PubMed, Scopus, and Google Scholar for contemporary data on prevalence, cost, and projected future costs. Policymakers in the U.S. have long attempted to address the high-cost burden of LBP through limiting low-value services and early imaging. Despite these efforts, costs (~$40 billion; ~$2,000/patient/yr) continue to rise with increasing rates of unindicated imaging, high rates of surgery, and subsequent revision surgery without proper trial of non-pharmacologic measures and no corresponding reduction in LBP prevalence. Globally, the overall prevalence of LBP continues to rise largely secondary to a growing aging population. Cost containment methods should focus on careful and comprehensive clinical assessment of patients to better understand when more resource-intensive interventions are indicated.
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