Bulletin of the World Health Organization最新文献

Problem: Comparing health policy measures before elections and identifying potential gaps in the health policy debate can be challenging.

Approach: We explored the use of the Health System Performance Assessment for Universal Health Coverage framework to analyse health policy proposals by classifying health policy measures outlined in political manifestos into four health system functions: governance, financing, resource generation and service delivery. As a case study, we analysed the political manifestos of all Portuguese parties with parliamentary representation ahead of the election in March 2024. We calculated the share of measures per health system function for individual political manifestos and identified potential gaps in the health policy debate. When required, we used additional classification criteria and local expertise on political and institutional knowledge.

Local setting: A snap general election was announced in Portugal in November 2023, following an alleged corruption scandal, and political parties began publishing their manifestos on their websites in January 2024.

Relevant changes: We identified and classified 350 health-related measures across the four functions: governance, 29.7% (104 measures); financing, 16.9% (59 measures); resource generation, 33.4% (117 measures); and service delivery, 20.0% (70 measures). These findings enabled characterization of the priorities of parties, facilitated cross-party comparisons and identified missing topics in the political debate.

Lessons learnt: We show that the framework can be adapted to analyse political manifestos, providing a systematic method for comparing and synthesizing health policy proposals. We further demonstrate the potential for extending the framework's applicability beyond health system performance assessment, opening new avenues for policy analysis.

Hamid Jafari talks to Gary Humphreys about the non-linear nature of progress toward polio eradication and the challenges faced in the last two polio-endemic countries in the world.

Declining total fertility rates in urban areas are causing a re-examination of traditional responses to pro-natal policy. Gary Humphreys reports.

[This corrects the article on p. 765 in vol. 102, PMID: 39318887.].

Objective: To examine changes in red-light running and distracted riding among motorcyclists and cyclists before and after the 2020 implementation of the One Helmet, One Seatbelt campaign in China.

Methods: We obtained 192 hours of film before (2019) and after (2021) implementation of the campaign in eight road intersections in Changsha. We calculated percentages and ratios of red-light running and distracted riding. To assess the associations between these traffic behaviours and the campaign, we used multivariable logistic regression models to calculate adjusted odds ratios (aOR).

Findings: We filmed 5256 motorcyclists and cyclists in 2019 and 6269 in 2021. Red-light running decreased from 45.1% to 41.5% during this period (ratio: 0.92; 95% confidence interval, CI: 0.88-0.96), while distracted riding increased from 3.5% to 5.0% (ratio: 1.42; 95% CI: 1.19-1.69). After adjusting for covariates, male riders were more likely to run a red light compared to female riders (aOR: 1.28; 95% CI: 1.06-1.55). Red-light running was also more likely among electric bicycle riders (aOR: 1.46; 95% CI: 1.10-1.95) and motorcyclists (aOR: 1.47; 95% CI: 1.13-1.90) compared to traditional cyclists. All types of riders were less prone to run a red light during peak hours than off-peak hours (aOR: 0.85; 95% CI: 0.73-0.99). Distracted riding was more common on weekends compared to weekdays (aOR: 3.01; 95% CI: 2.02-4.49).

Conclusion: China's national road safety campaign, which focuses on helmet and seatbelt use, was associated with reduced red-light running. Strict enforcement and targeted modifications could improve the campaign's effectiveness.

Evidence about the impact of mass gatherings during the coronavirus disease 2019 (COVID-19) pandemic on the number of disease cases and on the health-care systems of host countries is limited. Additionally, there have been few publications on the lessons identified from the adaptation of mass gatherings held during the pandemic, including the implementation of comprehensive public health and social measures aimed at reducing viral transmission. This article describes preparations made for the 2020 Union of European Football Associations (UEFA) European Football Championship (UEFA Euro 2020) by the World Health Organization's (WHO) Regional Office for Europe, UEFA and other stakeholders after the championship had been rescheduled because of the COVID-19 pandemic. Technical guidance on preparations for the football tournament and risk assessment tools were provided by WHO. A task force established by the WHO Regional Office for Europe conducted traditional and event-based disease surveillance before and during UEFA Euro 2020, monitored public health and social measures in the 11 host countries, and developed a risk communication and community engagement strategy that involved multimedia campaigns targeting news and social media, fans, athletes, event organizers and other stakeholders. The lessons and good practices identified during UEFA Euro 2020 are described to help guide preparations for future mass gatherings in health emergencies. Sharing data and recommendations on best practice from previous mass gatherings with the organizers and countries involved in planning for a major event is particularly important.

Problem: During the coronavirus disease 2019 (COVID-19) pandemic, medical oxygen therapy was urgently needed for patients with hypoxaemia. Many low- and middle-income countries lacked the medical devices for oxygen therapy and experience in their use.

Approach: In addition to providing medical devices for oxygen therapy for countries in need, the World Health Organization (WHO) and partners developed training videos to help local health workers select, use and maintain this equipment. Diverse health professionals, including engineers and clinicians from resource-constrained countries, collaborated in developing draft videos in their local settings. A production team refined these drafts and delivered the training videos through the platform OpenWHO.

Local setting: OpenWHO is WHO's free open-access platform providing courses for health workers and others. The courses, based on WHO's scientific and operational guidance, can be easily adapted, contextualized and translated.

Relevant changes: The production team refined the drafts into 32 training videos. More than 17 505 health workers participated in the OpenWHO course on COVID-19 respiratory equipment between 28 February 2022 and 30 November 2023. Participants were from 189 countries and 38% (6027/16 047) were from low- and lower-middle-income countries.

Lessons learnt: Involving volunteer biomedical engineers and clinicians from low- and middle-income countries helped provide an appropriate training resource. WHO should continue to develop such training tools and offer them through OpenWHO, especially for emergencies.