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Combating obesity in Southeast Asia countries: current status and the way forward 东南亚国家防治肥胖症:现状与未来之路
Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.006
E Siong Tee, Siok Hui Voon
Obesity is gaining prominence as a serious public health challenge in the Southeast Asia (SEA) region, with an alarming rate of increase in its prevalence. Countries in the region have shown commitment to curbing the rise of obesity by establishing policies, strategies, and action plans. This paper summarises the current situation and strategies undertaken to combat obesity and related chronic diseases. Although a range of policies and strategies have been developed, including national nutrition action plans, community intervention programmes, fiscal measures, nutrition labelling to promote healthier choices, countries in the region are struggling to make significant progress toward halting the scourge of obesity. It is imperative to strengthen existing health systems with a paradigm shift from a focus on “sick care” to and enhancing nutrition initiatives to support obesity prevention. A comprehensive and coordinated approach is essential, one that emphasises high-level coordination across all levels of government and multiple sectors, and a unified plan rather than fragmented initiatives. For strategies to be effective and sustainable, they must address the fundamental environmental determinants of poor dietary choices and nutritional inequalities. A more holistic approach is clearly needed to improve the entire food environment, which in SEA countries must include the multitude of eating places where large segments of the population “eat out” everyday to meet their energy and nutrient needs. There is a recognised need for more comprehensive measures to promote healthy eating among school children and ensure a supportive environment for lifelong healthy habits. This paper calls for a whole-of-government, whole-of-society approach that combines changes to the fundamental food environment and accompanied by systematic monitoring and surveillance systems to achieve long-lasting health outcomes.
在东南亚地区,肥胖症作为一项严重的公共卫生挑战日益突出,其发病率以惊人的速度增长。该地区各国已承诺通过制定政策、战略和行动计划来遏制肥胖症的上升。本文概述了当前的形势以及为防治肥胖症和相关慢性疾病而采取的战略。尽管已经制定了一系列政策和战略,包括国家营养行动计划、社区干预计划、财政措施、营养标签以促进更健康的选择,但该地区各国仍在努力争取在遏制肥胖症祸害方面取得重大进展。当务之急是加强现有的卫生系统,转变工作模式,从注重 "疾病护理 "转向加强营养措施,以支持预防肥胖。必须采取全面、协调的方法,强调各级政府和多个部门之间的高层协调,以及统一的计划而不是零散的举措。要使战略有效且可持续,就必须解决造成不良饮食选择和营养不平等的基本环境决定因素。显然,需要采取更加全面的方法来改善整个食品环境,在东南亚和非洲国家,这必须包括众多的饮食场所,因为大部分人口每天都在这些场所 "就餐",以满足他们对能量和营养的需求。人们认识到,有必要采取更全面的措施来促进学龄儿童的健康饮食,并确保为他们养成终身健康习惯创造有利环境。本文呼吁采取一种全政府、全社会的方法,将改变基本饮食环境与系统的监测和监督系统相结合,以实现长期的健康成果。
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引用次数: 0
Plain language in the healthcare of Japan: a systematic review of “plain Japanese” 日本医疗保健中的通俗语言:"通俗日语 "系统回顾
Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.007
Hatsune Kido , Soichiro Saeki , Mayu Hiraiwa , Masashi Yasunaga , Rie Tomizawa , Chika Honda , Toshio Fukuoka , Kaori Minamitani

Objective

Despite the decrease in the number of foreign visitors and residents in Japan due to the coronavirus disease 2019, a resurgence is remarkable from 2022. However, Japan’s medical support system for foreign patients, especially residents, is inadequate, with language barriers potentially causing health disparities. Comprehensive interpretation and translation services are challenging, but “plain Japanese” may be a viable alternative for foreign patients with basic Japanese language skills. This study explores the application and obstacles of plain Japanese in the medical sector.

Methods

A literature review was performed across these databases: Web of Science, PubMed, Google Scholar, Scopus, CINAHL Plus, Springer Link and Ichushi-Web (Japanese medical literature). The search covered themes related to healthcare, care for foreign patients, and scholarly articles, and was conducted in July 2023.

Results

The study incorporated five papers. Each paper emphasized the language barriers foreign residents in Japan face when accessing healthcare, highlighting the critical role and necessity of plain Japanese in medical environments. Most of the reports focused on the challenges of delivering medical care to foreign patients and the training of healthcare professionals in using plain Japanese for communication.

Conclusion

The knowledge and application of plain Japanese among healthcare professionals are inadequate, and literature also remains scarce. With the increasing number of foreign residents in Japan, the establishment of a healthcare system that effectively uses plain Japanese is essential. However, plain Japanese may not be the optimal linguistic assistance in certain situations, thus it is imperative to encourage more research and reports on healthcare services using plain Japanese.
目标尽管由于 2019 年冠状病毒疾病,在日本的外国游客和居民人数有所减少,但从 2022 年开始,这一现象又显著回升。然而,日本对外国患者(尤其是居民)的医疗支持系统并不完善,语言障碍可能会造成健康差异。全面的口译和笔译服务具有挑战性,但 "普通日语 "可能是具备基本日语能力的外国患者的一个可行选择。本研究探讨了 "简易日语 "在医疗领域的应用和障碍:在以下数据库中进行了文献综述:Web of Science、PubMed、Google Scholar、Scopus、CINAHL Plus、Springer Link 和 Ichushi-Web (日本医学文献)。搜索涵盖了与医疗保健、外国患者护理和学术文章相关的主题,搜索时间为 2023 年 7 月。每篇论文都强调了在日本的外国居民在获得医疗保健服务时所面临的语言障碍,突出了在医疗环境中普通日语的关键作用和必要性。大多数报告都集中在为外国患者提供医疗服务时所面临的挑战,以及培训医疗专业人员使用普通日语进行交流方面。随着居住在日本的外国人越来越多,建立一个能有效使用普通日语的医疗保健系统至关重要。然而,在某些情况下,普通日语可能并不是最佳的语言辅助工具,因此必须鼓励对使用普通日语的医疗保健服务进行更多的研究和报道。
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引用次数: 0
Shared decision making in rural general practices: a qualitative exploration of older rural South Australians’ perceived involvement in clinical consultations with doctors 农村全科诊所的共同决策:对南澳大利亚农村老年人参与医生临床咨询的看法的定性探索
Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.003
Mohammad Hamiduzzaman , Noore Siddiquee , Harry James Gaffney , Frances Barraclough , Aziz Rahman , Jennene Greenhill , Vicki Flood

Background

Shared decision-making (SDM) implementation is a priority for Australian health systems, including general practices but it remains complex for specific groups like older rural Australians. We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.

Methods

We conducted a patient-oriented research, partnering with older rural Australians, families, and health service providers in research design. Participants who visited general practices were purposively sampled from five small rural towns in South Australia. A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.

Results

Telephone interviews were held with 27 participants. Four themes were identified around older rural adults’ involvement in SDM: (1) Understanding of “patient involvement”; (2) Positive and negative outcomes; (3) Barriers to SDM; and (4) Facilitators to SDM. Understanding of patient involvement in SDM considerably varied among participants, with some reporting their involvement was contingent on the “opportunity to ask questions” and the “treatment choices” offered to them. Alongside the opportunity for involvement, barriers such as avoidance of cultural care and a lack of continuity of care are new findings. Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices. Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers.

Conclusion

Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia. Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians’ involvement in general.
背景共同决策(SDM)的实施是澳大利亚医疗系统(包括全科诊所)的首要任务,但对于像澳大利亚农村老年人这样的特殊群体来说,实施起来仍然很复杂。我们发起了一项针对澳大利亚农村老年人的定性研究,以探索在当地普通诊所实施 SDM 的障碍和促进因素。方法我们开展了一项以患者为导向的研究,与澳大利亚农村老年人、家庭和医疗服务提供者合作进行研究设计。我们从南澳大利亚州的五个乡村小镇有目的地抽取了前往普通诊所就诊的参与者。访谈采用了半结构化访谈指南,并进行了反思性主题编码。围绕农村老年人参与 SDM 确定了四个主题:(1)对 "患者参与 "的理解;(2)积极和消极的结果;(3)SDM 的障碍;以及(4)SDM 的促进因素。与会者对患者参与 SDM 的理解存在很大差异,一些人表示他们的参与取决于 "提问的机会 "和为他们提供的 "治疗选择"。除了参与的机会之外,诸如避免文化护理和缺乏护理连续性等障碍也是新发现的问题。在实施 SDM 过程中遇到的挑战还包括全科医生的资源限制和时间限制。结论在南澳大利亚州的乡村全科诊所实施 SDM 时,应同时提供充足的资源和明确的流程指南。全科医生在促进健康知识普及和文化适应性沟通方法方面的创新策略可以提高澳大利亚农村老年人对全科医生的参与度。
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引用次数: 0
Workplace harassment faced by female Nepalese migrants working aboard 在国外工作的尼泊尔女性移民面临的工作场所骚扰问题
Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.001
Padam P Simkhada , Edwin van Teijlingen , Manju Gurung , Samjhana Bhujel , Kalpana Gyawali , Sharada P Wasti

Background

Nepal has a long history of labour migration over the years. Migrants can experience a range of problems in their destination countries, and women are more at risk than men. This paper is the first to explore the problems faced by Nepalese women migrants while working abroad.

Methods

This study was conducted among 1,889 women who were registered as migrant returnees at an organisation called Pourakhi Nepal. The study extracted and analysed data from a non-governmental organisation that supports returning female migrant workers in Nepal.

Results

Around half (43.1%) of the women were 35 or older, 30.9% were illiterate, and 63.6% were in their first overseas job. More than one-third (38.5%) had self-reported workplace harassment. Physical violence was the most prevalent (68%), followed by verbal abuse (37.5%), mental stress (29.7%), and sexual abuse (14.1%).Women who were illiterate (adjusted odds ratio [AOR]1.25, 95% confidence interval [CI]: 1.01 to 1.55), unmarried (AOR 1.27, 95% CI: 1.05 to 1.56), worked abroad twice or more (AOR 1.35, 95% CI: 1.10 to 1.66), changed their place of work (AOR 2.38, 95% CI: 1.42 to 4.01), lived without documents (AOR 1.24, 95% CI: 1.03 to 1.50), worked as domestics (AOR 3.56, 95% CI: 2.03 to 6.23), worked in other than Gulf Cooperation Council countries (AOR 1.45, 95% CI: 1.06 to 1.99), women who did not have a fixed salary (AOR 1.64, 95% CI: 1.28 to 2.10) and did not receive salary (AOR 3.71, 95% CI: 2.88 to 4.77) were more likely to be harassed at work.

Conclusion

Our findings suggest that the host governments should introduce and enforce policies protecting women in the workplace. Migrant women should be provided with better information about health risks and hazards as well as how to improve preventive measures in destination countries to reduce workplace harassment.
背景尼泊尔的劳动力迁移历史悠久。移民在目的地国可能会遇到一系列问题,而女性比男性面临的风险更大。本文首次探讨了尼泊尔女性移民在国外工作时所面临的问题。 研究方法本研究的对象是在一个名为 Pourakhi Nepal 的组织中登记为移民回国者的 1,889 名女性。结果大约一半(43.1%)的女性年龄在 35 岁或 35 岁以上,30.9% 是文盲,63.6% 是第一次出国工作。超过三分之一(38.5%)的妇女曾自述在工作场所受到骚扰。文盲(调整后的几率比 [AOR]:1.25,95% 置信区间 [CI]:1.01 至 1.55)、未婚(调整后的几率比 [AOR]:1.25,95% 置信区间 [CI]:1.01 至 1.55)、有工作经验(调整后的几率比 [AOR]:1.25,95% 置信区间 [CI]:1.01 至 1.55)的女性在工作场所受到骚扰。文盲妇女(调整后的几率比 [AOR]:1.25,95% 置信区间 [CI]:1.01 至 1.55)、未婚妇女(AOR:1.27,95% 置信区间:1.05 至 1.56)、在国外工作两次或两次以上的妇女(AOR:1.35,95% 置信区间:1.10 至 1.66)、更换工作地点的妇女(AOR:2.38,95% 置信区间:1.42 至 4.01)、没有证件的妇女(AOR:1.24,95% 置信区间:1.03 至 1.50)、从事家政工作的妇女(AOR:1.27,95% 置信区间:1.05 至 1.56)。50)、从事家政工作(AOR 3.56,95% CI:2.03 至 6.23)、在海湾合作委员会以外的国家工作(AOR 1.45,95% CI:1.06 至 1.99)、没有固定工资的妇女(AOR 1.64,95% CI:1.28 至 2.结论我们的研究结果表明,东道国政府应引入并执行保护工作场所妇女的政策。应向移民妇女提供有关健康风险和危害的更多信息,以及如何改进目的地国的预防措施以减少工作场所的骚扰。
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引用次数: 0
Epidemiology and control of monkeypox outbreak in Houston, Texas 得克萨斯州休斯敦猴痘疫情的流行病学和控制措施
Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.008
Abisola M. Oladimeji, Abayomi Joseph Afe, Louis Carillo, Courtney Hundley, Yufang Zhang, Stephen Long, Kirstin Short, Roger Sealy, Janeana White, David Persse

Background

In the 2022–2023 global outbreak, the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox (Mpox) cases respectively as of November 2023. This study aims to investigate the demographic characteristics and risk factors of Mpox outbreak in Houston and document the epidemiologic control measures implemented with their outcomes.

Methods

Houston Health Department received reports of suspected Mpox cases via electronic case reports and laboratory reports from healthcare providers within Houston. These were then investigated and reclassified as either positive or negative using DNA polymerase chain reaction tests. All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods. Descriptive statistics using frequency distribution was used to analyze the sociodemographic, clinical features and travel history of the cases. A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P < 0.05. Other infection control measures such as community engagement, health education, tracking and contact tracing, vaccination, referrals and laboratory sample logistics support were implemented by the health department.

Results

Out of the total of 1,625 suspected persons investigated for Mpox, 724 (44.6%) tested positive. Among the 724 confirmed cases, male was 700 (96.7%), females 20 (2.8%), transgender male 1 (0.1%), transgender female 3 (0.4%). Age groups 30–39 years constituted 43.6%, 18–29 years 27.4%, 40–49 years 18.2%, 50–59 years was 8%. Race distribution of positive cases was Whites 43.4%, African American 38.7%, Asian 1.4%. Risk factors with P < 0.05 included male gender, age groups 30–39 years and 40–49 years, travel history to Mpox endemic areas, recent sexual contact with known or suspected Mpox cases, human immunodeficiency virus seropositivity. Identifying as gay and bisexual were also statistically significant risk factors for Mpox infection.

Conclusion

The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.
背景在2022-2023年全球猴痘疫情爆发期间,截至2023年11月,美国和德克萨斯州分别记录了31277例和3085例确诊猴痘病例。本研究旨在调查休斯顿猴痘疫情的人口特征和风险因素,并记录所实施的流行病学控制措施及其结果。方法休斯顿卫生局通过电子病例报告和实验室报告接收休斯顿医疗机构的猴痘疑似病例报告。然后,通过 DNA 聚合酶链反应测试对这些病例进行调查并重新分类为阳性或阴性。本研究采用方便的抽样方法,将 2022 年 5 月至 2023 年 1 月期间收到的所有报告病例纳入研究范围。研究采用频数分布描述性统计来分析病例的社会人口学、临床特征和旅行史。采用双侧卡方检验确定 Mpox 检测结果与风险因素之间的关联,显著性水平设定为 P < 0.05。卫生部门还采取了其他感染控制措施,如社区参与、健康教育、追踪和接触者追踪、疫苗接种、转诊和实验室样本物流支持等。在724例确诊病例中,男性700例(96.7%),女性20例(2.8%),变性男性1例(0.1%),变性女性3例(0.4%)。年龄组中,30-39 岁占 43.6%,18-29 岁占 27.4%,40-49 岁占 18.2%,50-59 岁占 8%。阳性病例的种族分布为白人 43.4%、非裔美国人 38.7%、亚裔 1.4%。P < 0.05 的风险因素包括男性、30-39 岁和 40-49 岁年龄组、曾到麻风腮流行区旅行、最近与已知或疑似麻风腮病例有性接触、人类免疫缺陷病毒血清阳性。结论针对高危人群及时实施一级和二级预防措施,能有效遏制麻风腮病毒在休斯顿市的传播。
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引用次数: 0
Mobile health interventions for improving maternal and child health outcomes in South Africa: a systematic review 为改善南非孕产妇和儿童健康成果而采取的移动医疗干预措施:系统性审查
Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.002
Elliot Mbunge , Maureen Nokuthula Sibiya

Background

Maternal and child health (MCH) remains a significant public health concern globally despite previous efforts made to improve MCH services. Initiatives such as antenatal care, postnatal care services exclusive breastfeeding, child vaccination and supplements have been rolled out to improve MCH outcomes. However, inadequate maternal healthcare, socioeconomic factors, obstetric haemorrhaging, complications of hypertension during pregnancy, lack of maternal information, poor universal health coverage and uptake of MCH services exacerbate maternal mortality and child mortality rates, especially in resource-constrained areas in many sub-Saharan African countries including South Africa.

Objective

This study aimed to review mobile health (mHealth) interventions deployed to improve maternal and child health outcomes.

Methods

The study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to search and retrieve relevant literature from reputable, prominent electronic databases (Google Scholar, Scopus, PubMed, Embase, CINAHL, Web of Science, etc.). A total of 26 papers were selected and analyzed.

Results

The findings revealed several mHealth interventions such as MomConnect, Mobile Alliance for Maternal Action, NurseConnect, ChildConnect, CommCare, Road to Health Application and Philani Mobile Video Intervention for Exclusive Breastfeeding have been utilized by healthcare workers and women to improve access to MCH services. However, inadequate digital infrastructure, digital divide, resistance to change, inadequate funding, language barriers, short message service and data costs, lack of digital skills and support, compatibility, scalability and interoperability issues, legislative and policy compliance, lack of mHealth awareness, data security and privacy concerns hinder uptake and utilisation of mHealth interventions. There is a need to scale up and sustain mHealth interventions and update existing regulatory framework, policies and strategies.

Conclusion

mHealth interventions offer unprecedented opportunities to improve access to maternal information and substantially improve maternal and child health services. Stakeholder engagement and the development of sustainable funding strategies are important for successfully implementing and scaling mHealth projects while addressing existing and emerging key issues.
背景母婴健康(MCH)仍然是全球关注的一个重大公共卫生问题,尽管此前已为改善母婴健康服务做出了努力。为了改善母婴健康的成果,已经推出了产前护理、产后护理服务、纯母乳喂养、儿童疫苗接种和补充剂等措施。然而,孕产妇保健不足、社会经济因素、产科出血、妊娠期高血压并发症、孕产妇信息匮乏、全民医保覆盖率低以及对母婴保健服务的接受度低等因素加剧了孕产妇死亡率和儿童死亡率,尤其是在包括南非在内的许多撒哈拉以南非洲国家的资源有限地区。本研究旨在审查为改善妇幼保健成果而部署的移动医疗(mHealth)干预措施。研究采用系统综述和元分析首选报告项目模式,从著名的电子数据库(Google Scholar、Scopus、PubMed、Embase、CINAHL、Web of Science 等)中搜索和检索相关文献。结果研究结果表明,医护人员和妇女利用了多项移动医疗干预措施,如 MomConnect、产妇行动移动联盟、NurseConnect、ChildConnect、CommCare、健康之路应用程序和 Philani 全母乳喂养移动视频干预,以改善获得妇幼保健服务的机会。然而,数字基础设施不足、数字鸿沟、变革阻力、资金不足、语言障碍、短信服务和数据成本、缺乏数字技能和支持、兼容性、可扩展性和互操作性问题、立法和政策合规性、缺乏移动保健意识、数据安全和隐私问题等,都阻碍了移动保健干预措施的吸收和利用。有必要扩大和维持移动保健干预措施,并更新现有的监管框架、政策和战略。利益相关者的参与和可持续供资战略的制定对于成功实施和推广移动保健项目,同时解决现有和新出现的关键问题非常重要。
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引用次数: 0
Time trends and disparities of obesity and related national policies and programs in Nepal: a systematic review 尼泊尔肥胖症的时间趋势和差异以及相关的国家政策和计划:系统综述
Pub Date : 2024-06-01 DOI: 10.1016/j.glohj.2024.05.006
Junxiang Wei , Peng Nie , Liwang Gao , Yang Mi , Youfa Wang

Objective

Overweight and obesity prevalence has increased in low-income countries. This study systematically reviewed the obesity trend, disparities, and prevention and control efforts in Nepal.

Methods

We searched PubMed and Google Scholar for articles and reports published between January 1, 2004 and December 31, 2022. Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts. Overweight and obesity were defined using the World Health Organization body mass index cut points. Thirty-two studies and reports were included.

Results

Overall, overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited. The combined overweight and obesity (OW/OB) and obesity rates in women aged 15‒49 years increased from 8.5% to 22.2% and from 0.9% to 5.1% between 2006 and 2016, respectively. OW/OB and obesity rates in men were 17.1% and 2.5% based on data from the 2016 Demographic and Health Survey. OW/OB rate in under-five children increased from 0.6% to 2.8% between 2006 and 2016. Obesity rates for school-age (5‒9 years) boys and girls in 2016 were 2.4% and 2.8%, respectively, and were 1.1% and 1.4% for male and female adolescents aged 10‒19 years, respectively. OW/OB prevalence was much higher among women, residents in urban areas and central provinces, and in higher socioeconomic status groups. Projected prevalence of OW/OB and obesity for 2030 in adults aged 15‒49 was 44.7% and 8.3%, respectively, while it was 2.2% for OW/OB in preschool children. Policies and direct interventions that specifically focused on obesity prevention and control are limited.

Conclusions

OW/OB prevalence in Nepal has increased during the past 1.8 decades, disproportionately affecting population groups. Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention. In the future, Nepal needs to develop population-based programs for obesity prevention.

目标在低收入国家,超重和肥胖的发生率有所上升。本研究系统回顾了尼泊尔的肥胖趋势、差异以及预防和控制工作。方法我们检索了 PubMed 和 Google Scholar 上 2004 年 1 月 1 日至 2022 年 12 月 31 日期间发表的文章和报告。此外,我们还从政府网站上检索了与肥胖症预防相关的国家政策和项目信息,并咨询了相关专家。超重和肥胖的定义采用世界卫生组织的体重指数切点。结果尽管具有全国代表性的数据仍然有限,但总体而言,尼泊尔所有群体的超重和肥胖率都有所上升。2006 年至 2016 年间,15-49 岁女性的综合超重和肥胖率(OW/OB)分别从 8.5% 上升至 22.2%,肥胖率从 0.9% 上升至 5.1%。根据 2016 年人口与健康调查的数据,男性的 OW/OB 和肥胖率分别为 17.1%和 2.5%。五岁以下儿童的 OW/OB 率在 2006 至 2016 年间从 0.6% 上升至 2.8%。2016 年学龄(5-9 岁)男童和女童的肥胖率分别为 2.4% 和 2.8%,10-19 岁男性和女性青少年的肥胖率分别为 1.1% 和 1.4%。在女性、城市地区和中部省份居民以及社会经济地位较高的群体中,OW/OB的流行率要高得多。预计到 2030 年,15-49 岁成年人的 OW/OB 和肥胖患病率分别为 44.7% 和 8.3%,而学龄前儿童的 OW/OB 患病率为 2.2%。专门针对肥胖症预防和控制的政策和直接干预措施十分有限。现有的干预措施大多集中在营养不良方面,对预防肥胖有一定的间接影响。未来,尼泊尔需要制定以人口为基础的肥胖预防计划。
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引用次数: 0
Shaping global health promotion: a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences (1986‒2021) 塑造全球健康促进:对 10 届全球健康促进大会(1986-2021 年)的全面分析
Pub Date : 2024-06-01 DOI: 10.1016/j.glohj.2024.05.002
Shiyu Liu , Meichen Sun , Na Zhang , Zhaozhang Sun , Xiangyang Tian , Liming Li , Youfa Wang

Objective

This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion, effectively addressing diverse health challenges that evolved over different periods.

Methods

The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986‒2021. We summarized the themes and key achievements, and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.

Results

The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale. The primary purpose and goal are to promote health from regional to global. Significantly, our findings highlight a transition in the primary actors driving health promotion. It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization, governments, and international bodies, to a more inclusive approach involving non-governmental organizations and the general public. This development implies that health promotion has evolved into a collective global endeavor, demanding the proactive involvement of various stakeholders, and forging new alliances in public health. Meanwhile, the coronavirus disease 2019 (COVID-19) pandemic has further shaped the landscape of health promotion, underscoring the need for intensified focus on areas including disease prevention, health education, and the integration of digital health technologies, and emphasizing the importance of a multidimensional, responsive approach in public health initiatives.

Conclusions

Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally. Countries, together with public and private entities, should intensify cooperation. Multisectoral collaboration among partners such as healthcare, education, social security, and the industry is vital for health promotion and achieving global health goals.

本研究分析了 10 届全球健康促进大会如何在形成和推动全球健康促进共识和行动方面发挥了重要作用,有效地应对了不同时期的各种健康挑战。方法本研究采用文本分析方法,对 1986-2021 年间召开的 10 届全球健康促进大会的宣言和报告进行了系统的文本编码。我们总结了会议主题和主要成果,并提取和分析了会议宣言中的关键词汇,以构建全球健康促进共识和行动。主要目的和目标是从地区到全球促进健康。重要的是,我们的研究结果突显了推动健康促进工作的主要参与者的转变。它强调了健康促进工作从主要由世界卫生组织、各国政府和国际机构等组织推动,转变为由非政府组织和公众参与的更具包容性的方式。这一发展意味着健康促进已演变成一项全球性的集体工作,需要各利益相关方的积极参与,并在公共卫生领域建立新的联盟。与此同时,2019 年冠状病毒病(COVID-19)大流行进一步改变了健康促进工作的格局,突出了加强对疾病预防、健康教育和数字健康技术整合等领域的关注的必要性,并强调了在公共卫生行动中采取多层面、反应迅速的方法的重要性。各国应与公共和私营实体加强合作。医疗保健、教育、社会保障和行业等合作伙伴之间的多部门合作对于促进健康和实现全球健康目标至关重要。
{"title":"Shaping global health promotion: a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences (1986‒2021)","authors":"Shiyu Liu ,&nbsp;Meichen Sun ,&nbsp;Na Zhang ,&nbsp;Zhaozhang Sun ,&nbsp;Xiangyang Tian ,&nbsp;Liming Li ,&nbsp;Youfa Wang","doi":"10.1016/j.glohj.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.glohj.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><p>This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion, effectively addressing diverse health challenges that evolved over different periods.</p></div><div><h3>Methods</h3><p>The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986‒2021. We summarized the themes and key achievements, and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.</p></div><div><h3>Results</h3><p>The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale. The primary purpose and goal are to promote health from regional to global. Significantly, our findings highlight a transition in the primary actors driving health promotion. It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization, governments, and international bodies, to a more inclusive approach involving non-governmental organizations and the general public. This development implies that health promotion has evolved into a collective global endeavor, demanding the proactive involvement of various stakeholders, and forging new alliances in public health. Meanwhile, the coronavirus disease 2019 (COVID-19) pandemic has further shaped the landscape of health promotion, underscoring the need for intensified focus on areas including disease prevention, health education, and the integration of digital health technologies, and emphasizing the importance of a multidimensional, responsive approach in public health initiatives.</p></div><div><h3>Conclusions</h3><p>Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally. Countries, together with public and private entities, should intensify cooperation. Multisectoral collaboration among partners such as healthcare, education, social security, and the industry is vital for health promotion and achieving global health goals.</p></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 2","pages":"Pages 91-96"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S241464472400023X/pdfft?md5=aacecf9c1ee4c8b6f66367f9a4333cd6&pid=1-s2.0-S241464472400023X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Community-led total sanitation (CLTS) implementation in West Mamprusi Municipal Assembly in Ghana. What do communities think eleven years on? 在加纳西曼普鲁西市议会实施社区主导的全面环境卫生 (CLTS)。十一年过去了,社区怎么看?
Pub Date : 2024-06-01 DOI: 10.1016/j.glohj.2024.05.003
Elijah Adam , Emmanuel Badu

Objective

Access to improved sanitation is a fundamental human right and an important aspect of Public Health. However, an estimated thousands of people in Ghana especially, the West Mamprusi Municipal Assembly (WMMA) still have no access to adequate toilet facilities. This has brought untold health repercussions to the inhabitants, the community, and the environment at large. To address this menace, the community-led total sanitation (CLTS) was implemented. This study aimed to assess communities’ perspectives on the implementation of CLTS and to understand the factors influencing its success and failures.

Methods

A mixed-method approach involving sequential qualitative and quantitative methods was employed in this study. Participants for the quantitative study were randomly selected and surveyed using questionnaires. The qualitative study employed focus group discussion involving purposively sampled participants including assembly members, opinion leaders, and assembly staff.

Results

The CLTS program in WMMA realized an apparent use of construction and proper use of household latrines leading to a reduction of open defecation free (ODF) and two communities achieving sanitized status in the history of the study area, enabling the training of latrine artisans and natural leaders to facilitate the CLTS expansion and sustainability, improved sanitation and hygiene, strengthened the enforcement of community rules and regulations and many others.

Conclusion

The CLTS program has received more widespread acceptance in the study area than the previous government policy of constructing public toilets, which was greeted with massive failures due to poor implementation. To ensure that gains achieved through CLTS implementation are sustained longer, it is recommended that chiefs and opinion leaders should be involved in the CLTS programs to ensure checks and enforcement. The entrenchment of bylaws and more education to address enduring myths and misconceptions will sustain the program. Subsidies in the form of sanitation loans for latrine construction materials by the government and supporting non-governmental organizations (NGOs) will be paramount in sustaining ODF.

目标获得更好的卫生条件是一项基本人权,也是公共卫生的一个重要方面。然而,在加纳,尤其是在西曼普鲁西市议会(WMMA),估计仍有数千人无法使用适当的厕所设施。这给居民、社区和整个环境带来了难以言表的健康影响。为了解决这一威胁,实施了社区主导的全面卫生设施 (CLTS)。本研究旨在评估社区对实施 CLTS 的看法,并了解影响其成败的因素。定量研究的参与者是随机抽取的,并使用问卷进行调查。结果在 WMMA 的 CLTS 计划中,家庭厕所的建设和正确使用取得了明显成效,减少了露天排便(ODF)现象,有两个社区达到了研究区历史上的卫生标准,培训了厕所工匠和自然领袖,促进了 CLTS 的扩展和可持续性,改善了环境卫生和个人卫生,加强了社区规章制度的执行力度,等等。结论与之前政府修建公共厕所的政策相比,CLTS 计划在研究地区得到了更广泛的认可。为确保通过实施 CLTS 取得的成果能够维持更长时间,建议让酋长和舆论领袖参与 CLTS 计划,以确保检查和执行。制定细则和开展更多教育以解决长期存在的神话和误解将使该计划得以持续。政府以卫生贷款的形式为厕所建筑材料提供补贴,并支持非政府组织(NGOs),这对维持全民冲厕计划至关重要。
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引用次数: 0
Charting the course: India’s health expenditure projections for 2035 规划未来:印度 2035 年卫生支出预测
Pub Date : 2024-06-01 DOI: 10.1016/j.glohj.2024.05.001
Pragyan Monalisa Sahoo , Himanshu Sekhar Rout

Objectives

Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket (OOP) expenses. The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.

Methods

Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development (OECD) iLibrary and National Health Accounts 2019 databases. Gross domestic product (GDP) data from the World Bank was also utilized. Descriptive statistics analyzed the composition and pattern, while the exponential smoothing model forecasted future health expenditures.

Results

The findings revealed that expenditure made by OOP is the primary health financing source, followed by government and pre-paid private spending. The percentage of GDP allocated to total health expenditure remains stable, while the per capita health expenditure fluctuates. Variations in expenditure among states are observed, with Karnataka relying heavily on pre-paid private coverage. Future projections suggest a decline in per capita and total health expenditure as a share of GDP, with a slight increase in the government’s share. Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.

Conclusion

The study highlights variations in health spending in India, characterized by high OOP spending, limited public coverage, and a need for investments, and reforms to improve healthcare access and equity.

目标 了解医疗支出的过去趋势并预测其未来变化,对于规划和减少对自付费用(OOP)的依赖至关重要。本研究分析了印度的医疗支出模式,并预测了直至 2035 年的未来趋势和模式。方法从经济合作与发展组织(OECD)的 iLibrary 和 2019 年国家健康账户数据库中收集了 2000 年至 2019 年印度的医疗支出数据。此外,还利用了世界银行的国内生产总值(GDP)数据。描述性统计分析了医疗支出的构成和模式,而指数平滑模型则预测了未来的医疗支出。结果研究结果表明,OOP 支出是主要的医疗资金来源,其次是政府支出和私人预付支出。医疗卫生总支出占 GDP 的比例保持稳定,而人均医疗卫生支出则有所波动。各邦的支出存在差异,卡纳塔克邦主要依靠私人预付保险。未来的预测表明,人均医疗支出和总医疗支出占 GDP 的比例将有所下降,而政府所占的比例将略有上升。预计人均预付费私人医疗支出和自费医疗支出占总支出的比例将保持相对稳定,但绝对值仍然很高。 结论:本研究强调了印度医疗支出的变化,其特点是自费医疗支出高、公共覆盖面有限,需要投资和改革以改善医疗服务的可及性和公平性。
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引用次数: 0
期刊
Global health journal (Amsterdam, Netherlands)
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