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: Editorial
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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: Editorial
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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
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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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