Globalization and Health最新文献

Background: Marketing of commercial milk formula (CMF) is well resourced and has influenced societal beliefs and practices that have undermined breastfeeding. This has occurred despite legislation in many countries largely reflecting the provisions of the International Code of Marketing of Breast-milk Substitutes.

Methods: A cross-sectional survey was conducted in seven countries: Bangladesh, Mexico, Morocco, Nigeria, South Africa, United Kingdom and Viet Nam to explore the scope and nature of CMF marketing among pregnant women and mothers. A marketing-research methodology was adopted using convenience sampling of women stratified according to infant feeding practices and the infant's age. Participants were identified in hospitals and clinics, as well as in the street, markets and shopping malls. In each country the sample size comprised 300 pregnant women, 150 mothers of children aged > 18 months who were breastfeeding without giving CMF and 600 women feeding their children with CMF. Data were collected using a questionnaire administered on tablets by trained field workers.

Results: Interviews were conducted with 8528 women between October 2019 and March 2021. Overall, 3095/7480 (41.3%) of women reported exposure to CMF marketing ranging from 3% in Morocco to 92% in Viet Nam. The commonest marketing site in all countries was television, but advertising in-store and in magazines and newspapers was also common. In most countries, CMF advertising on social media, websites and YouTube was less compared to traditional media. Reports of receiving free CMF samples varied from 3.1% in Nigeria to 34.6% in Viet Nam. Health professionals were the most common source of advice to mothers about starting CMF and which CMF brand to use.

Conclusions: The study provides quantitative data about CMF marketing and insights on how marketing companies develop effective messages, helping to explain how individual vulnerabilities or aspirations are integrated into marketing strategies. The findings reaffirm the need for action across political and health domains to counter actions of CMF companies. This will require effective national legislation fully reflecting the Code and action by professional bodies to protect health professionals from targeting by CMF marketing. Marketing-research methods could be employed to develop messaging in support of breastfeeding and breastfeeding-friendly policies.

Background: The World Health Organization certified China malaria-free in 2021. Consequently, preventing the risk of malaria re-introduction caused by imported malaria has now become a major challenge. This study aims to characterize the dynamics and predict the risk of malaria importation in Jiangsu Province, where the number of imported malaria cases ranks among the highest in China.

Methods: The annual number of cases with imported malaria in Jiangsu Province, the annual number of travelers from sub-Saharan Africa (SSA) to Jiangsu Province (both Chinese and international travelers), and the annual number of Chinese migrant workers from Jiangsu Province who stayed abroad between 2013 and 2020 were assessed. The spatio-temporal dynamics of malaria importation was characterized with ArcGIS 10.8. A negative binomial model was applied to model malaria importation to Jiangsu Province, China.

Results: A total of 2,221 of imported malaria cases were reported from January 1, 2013, until December 31, 2020. Imported malaria cases into China were mainly from SSA (98%) and P. falciparum (78%), the most common species. A seasonal pattern was observed, with the most cases occurring from December to February. The negative binomial model, which incorporates the number of Chinese migrant workers from Jiangsu Province who stayed abroad as an independent variable, demonstrated better performance (AIC: 96.495, BIC: 94.230) compared to the model based solely on travelers from SSA to Jiangsu Province. The model indicated an estimated 139% increase in imported cases for a 10% increase in Chinese migrant workers from Jiangsu Province who stayed abroad.

Conclusion: In conclusion, our study underscores the importance of incorporating data on Chinese migrant workers who have stayed abroad when predicting malaria importation risks. By integrating both international travel patterns and migrant worker data, our findings offer a more robust framework for assessing and managing malaria risk in Jiangsu Province. This approach provides valuable insights for public health officials, enabling more effective resource allocation and targeted interventions to prevent the re-introduction of malaria and improve overall disease management.

Background: The global movement of people in the context of strict immigration laws and policies places significant numbers of people in insecure migration status worldwide. Insecure status leaves people without recourse to legal, governmental or social protection from violence and abuse. This review synthesized qualitative studies that reported how migrants associated physical and physically enforced sexual violence they experienced with their insecure migration status.

Methods: We conducted a qualitative evidence synthesis of 31 studies published between 1 January 2000 and 31 May 2023, with data from Europe, North America, East Asia, South Asia, the Middle East and Africa. Our thematic synthesis produced 14 inductive descriptive codes, four descriptive themes and three analytical themes.

Results: We generated robust qualitative evidence showing that women experienced sexual violence while in transit or without status in a host state, and that they associated that violence with their insecure migration status. This was the case across the various geographic routes and destination countries. We found evidence that women associated intimate partner violence with lacking (legal) access to support because of their insecure migration status. We found evidence that women connected their unwillingness to leave violent circumstances, and therefore their prolonged or repeated exposure to violence, with a fear of immigration removal produced by their insecure migration status.

Conclusion: To protect people in insecure migration status from experiencing violence that they associated with their migration status, it's necessary to ensure that the reporting of violence does not lead to immigration enforcement consequences for the victim.

Background: The Coronavirus disease (COVID-19) pandemic caused significant morbidity and mortality in Africa, in addition to other socio-economic consequences. Across the continent, Schools of Public Health (SPHs) played several roles in supporting national, regional, and global response to the pandemic. Following a published and grey literature search, this paper reviews and analyses the contribution of SPHs in Africa during the COVID-19 pandemic.

Contribution of the schools of public health: SPH faculty in most countries contributed their expertise through COVID-19 task forces and advisory committees where they guided and supported decision-making. Faculty also supported the identification, review, and synthesis of rapidly evolving global and local evidence, adapting it to the local context to guide policy decisions. Through research, SPHs contributed to a better understanding of the disease epidemiology, response interventions, as well as prevention and control measures. SPHs engaged in training field epidemiologists, frontline health workers, and district response teams. SPH staff, students and field epidemiology trainees also supported field activities including surveillance, contact tracing, as well as managing quarantine facilities and points of entry. SPHs engaged in public education and awareness-raising initiatives to share information and dispel misinformation. In partnership with other stakeholders, SPHs also developed important innovations and technologies.

Conclusion: SPHs are a critical pillar for pandemic prevention, preparedness, and response, that support health systems with important functions. To further enhance their capacity, efforts to improve coordination of SPHs, strengthen collaboration among schools, harmonize training and curricula, and enhance capacity for advanced research are needed. There is also a need to bridge the inequities in capacity and resources that exist among SPHs across regions and countries.

Background: Formal evidence regarding the effects of sanctions on population health status and the health system is scarse in Iran. Given the intricate and multifaceted nature of sanctions, a nuanced understanding of their impact is imperative. We aimed to investigate the magnitude and effects of sanctions on population health and healthcare system during the last two decades in Iran.

Design: This is a mixed-methods research. We quantified the impact of sanctions using 28 indicators, i.e. macroeconomic, healthcare resources and health outcomes indicators from 2000 to 2020. The concurrent qualitative study aimed to explore the pathway of the effect by considering perceptions of both patients and health policy makers towards sanctions; Interview data was analyzed using content analysis.

Setting: This study was conducted in Iran at both national and sub-national levels.

Results: Our findings revealed that the trend of 11 indicators (39.2%) had changed after the change point in 2009; four indicators (14.2%) significantly deteriorated after the change point. Further, five indicators revealed significant increases during the sanctions period: Out-of-Pocket payment (OOP), household expenditure on food and mortality rates due to Chronic Obstructive Pulmonary Disease (COPD), thalassemia and hypertension. Our qualitative analysis revealed that patients identified availability, cost and quality of medicines and healthcare services as the most significant challenges that compromised population's health. From the policy makers' perspective, the effect of sanctions on health system functions and infrastructures, i.e. economic, political, social, educational and research had significant repercussions on population health.

Conclusion: We could not find compelling evidence to establish significant associations between the imposition of sanctions and the trend of population health. Nevertheless, our qualitative study revealed people's deteriorating life experiences, e.g. increasing catastrophic health expenditure, limited access to necessary medicine, medical equipment, procedures and interventions, imposed by sanctions, with ultimate reducing impact on the overall quality of life. It seems that sanctions have negatively affected financial and physical access to medication and healthcare services. Nonetheless, Iran has demonstrated remarkable resilience against their highly detrimental effects, maybe due to its established economic infrastructure and healthcare system.

Nigeria is witnessing a mass emigration of its active labor force to more advanced economies, just like other developing countries. Approximately half of licensed medical doctors in Nigeria have emigrated, contributing to a widening doctors-to-patients ratio. In response to this concerning trend, in 2023, a legislator introduced a bill to restrain doctors from leaving Nigeria upon completing their studies by withholding their full license for five years. The public, including health professionals, criticized the bill. This study investigates the public discourse on the bill by extracting and analyzing responses published in newspaper articles, blogs, tweets, and LinkedIn posts. The analysis revealed that, while a few politicians supported the bill, the general populace opposed it due to perceived inconsistencies, a lack of focus on the core causes of migration, allegations of political elite's hypocrisy, concerns about human rights violations and unemployment. By conducting this research, this article sheds light on the complexities of public opinion surrounding the proposed legislation, providing valuable insights into the multifaceted challenges associated with addressing the medical brain drain in Nigeria. The article contributes to the ongoing debate on the migratory trends of highly skilled workers from developing countries to advanced economies.

Background: The targeted application of cutting-edge high-throughput molecular data technologies provides an enormous opportunity to address key health, economic and environmental issues in the tropics within the One Health framework. The Earth's tropical regions are projected to contain > 50% of the world's population by 2050 coupled with 80% of its biodiversity however these regions are relatively less developed economically, with agricultural productivity substantially lower than temperate zones, a large percentage of its population having limited health care options and much of its biodiversity understudied and undescribed. The generation of high-throughput molecular data and bespoke bioinformatics capability to address these unique challenges offers an enormous opportunity for people living in the tropics. MAIN: In this review we discuss in depth solutions to challenges to populations living in tropical zones across three critical One Health areas: human health, biodiversity and food production. This review will examine how some of the challenges in the tropics can be addressed through the targeted application of advanced omics and bioinformatics and will discuss how local populations can embrace these technologies through strategic outreach and education ensuring the benefits of the One Health approach is fully realised through local engagement.

Conclusion: Within the context of the One Health framework, we will demonstrate how genomic technologies can be utilised to improve the overall quality of life for half the world's population.

Background: The beverage industry's role in undermining nutrition-related population health is a growing global concern. Industry strategies that affect policy, science, and public opinion are increasingly exposed. However, those used in the retail space-known as market strategies-remain largely unspecified. The purpose of this study was to uncover the market strategies beverage companies use with US retailers to secure their influence and control in the primary setting where the public purchases their products-food retail.

Methods: We conducted a qualitative study based on multiple data sources: 49 interviews with industry insiders, including chain retail managers, independent store owners, and sales representatives and distributors of major food and beverage companies; 15 business files shared by participants, including written beverage marketing agreements and contracts; and 27 purposively sampled, publicly-available industry documents. All data were thematically analyzed.

Results: We identified that beverage agreements, which dictate the products, space, marketing, and prices of company products in retail settings, are universal regardless of the retailer's market size. While ubiquitous, the agreement terms, services, and treatment beverage companies provided varied widely-with large US retail chains receiving superior opportunities, such as financial incentives and additional services, and independent and small chain retailers often experiencing disadvantaged, more expensive, non-negotiable terms. Despite this, companies also used several strategies that diminished concerns of differential treatment and thus effectively managed their reputation among independent and small chain retailers.

Conclusions: Findings suggest a use of the consolidated power among beverage companies with significant implications for the healthfulness of food retail settings. We conclude by highlighting key policy and legal targets that could be leveraged in the US to address power imbalances in the retailer-beverage company relationship and ultimately shift retail towards promoting public health.

Introduction: The concept of the commercial determinants of health (CDH) is used to study the actions of commercial entities and the political and economic systems, structures, and norms that enable these actions and ultimately influence population health and health inequity. The aim of this study was to develop a typology that describes the diverse set of activities through which commercial entities influence population health and health equity across industries.

Methods: We conducted a scoping review to identify articles using CDH terms (n = 116) published prior to September 13, 2022 that discuss corporate activities that can influence population health and health equity across 16 industries. We used the qualitative constant comparative method to inductively code descriptions and examples of corporate activities within these articles, arrange the activities into descriptive domains, and generate an overarching typology.

Results: The resulting Corporate Influences on Population Health (HEALTH-CORP) typology identifies 70 corporate activities that can influence health across industries, which are categorized into seven domains of corporate influence (i.e., political practices, preference and perception shaping practices, corporate social responsibility practices, economic practices, products & services, employment practices, and environmental practices). We present a model that situates these domains based on their proximity to health outcomes and identify five population groups (i.e., consumers, workers, disadvantaged groups, vulnerable groups, and local communities) to consider when evaluating corporate health impacts.

Discussion: The HEALTH-CORP typology facilitates an understanding of the diverse set of corporate activities that can influence population health and the population groups affected by these activities. We discuss how the HEALTH-CORP model and typology could be used to support the work of policy makers and civil society actors, as well as provide the conceptual infrastructure for future surveillance efforts to monitor corporate practices that affect health across industries. Finally, we discuss two gaps in the CDH literature that we identified based on our findings: the lack of research on environmental and employment practices and a dearth of scholarship dedicated to investigating corporate practices in low- and middle-income countries. We propose potential avenues to address these gaps (e.g., aligning CDH monitoring with other occupational health monitoring initiatives).

Introduction: Primary health care (PHC) is the most common model for providing primary care, and PHC services are the most common points of care that immigrants and refugees attend as a first step. Most immigrants travel to low- and middle-income countries (LMICs), yet only a few studies have examined their health conditions and their access to PHC in these countries. We have attempted to identify the barriers and facilitators that immigrants and refugees encounter when using PHC in these countries.

Methods: We searched PubMed, Scopus, Web of Science, Embase, ProQuest, Google Scholar, Microsoft Academic, and OpenGrey in this scoping review from its inception to the end of October 2023. Moreover, we manually searched key journals, reference lists, and citations from included studies to identify any missed studies. We extracted data from each selected study using a predefined form. Finally, a thematic analysis approach was utilized to synthesize the collected data from the included qualitative studies.

Results: 17 qualitative studies were included in this review, which were from Iran (n = 3), Brazil (n = 3), Kenya (n = 2), Jordan (n = 2), Eastern Sudan (n = 1), Lebanon (n = 1), Bangladesh (n = 1), India (n = 1), Turkey (n = 1), Thailand (n = 1), and Malaysia (n = 1). Among the most common and important reported barriers are language differences, insufficiency of trained carers, unemployment, inability to pay the costs of hospital and medicines, no insurance coverage for immigrants, no clear referral and care system for immigrants, discrimination against women, and improper residence locations. Insurance coverage, awareness programs, and the study of immigrants' needs, along with their social and financial support from family, are among the most essential facilitators.

Conclusion: For LMICs, funding is always a limitation, and increasing PHC utilization is the best choice for improving health. Knowing the challenges and facilitators of PHC utilization from the point of view of each stakeholder is a promising way to decide and make policies that can improve the health of both immigrants and refugees, as well as society as a whole.