Bulletin of the World Health Organization最新文献

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.

Food insecurity and malnutrition are rising worldwide due to disruptions in food systems related to interconnected health-, climate- and conflict-related crises. Although governments globally are committed to addressing nutritional challenges, policy responses have increasingly focused on food security and, particularly, on food affordability. However, these short-term measures often overlook the necessity of integrating nutritious foods into the food system to ensure improved long-term nutrition. By drawing on the United Nations Committee on World Food Security's Voluntary guidelines on food systems and nutrition, this article outlines opportunities for policy-makers to integrate nutrition into key elements of the crisis response. Key policy areas where nutrition could be further integrated include social protection, agricultural investment, trade policy and urban planning. Strengthening the focus of nutrition in these measures will be essential to establish long-term incentives that support food systems transformation for improved nutrition. Drawing on theories of the policy process, I propose that stronger governance and cross-sectoral dialogue will be critical to achieve sustained nutritional outcomes. Health policy-makers can play a leadership role in supporting cross-sectoral policy change by carefully framing the policy issues, advocating for institutional structures that promote collaboration across sectors to prioritize nutrition, and strengthening the management of conflicts of interest in food system policy-making.

[This corrects the article on p. 650 in vol. 102, PMID: 39219771.].

Objective: To investigate the relationship between the Responsible Parenthood and Reproductive Health Law in the Philippines and women's unmet needs for contraception.

Methods: The study involved data on women aged 18 to 49 years from the 2013 (n = 14 053), 2017 (n = 21 835) and 2022 (n = 24 253) Philippine Demographic and Health Surveys. The Responsible Parenthood and Reproductive Health Law was enacted in 2012, but not fully implemented until 2017. Survey-weighted logistic regression was used to estimate the association between variables and an unmet need for contraception, and the probability that women in different wealth quintiles would have an unmet need.

Findings: We observed a persistent gap in unmet needs between women in the lowest and highest wealth quintiles in all years. In 2013, the odds of unmet needs for women in the lowest quintile compared with those in the highest were 1.288 (standard error (SE): 0.124); and in 2022, it was 1.287 (SE: 0.113). Nevertheless, the weighted proportion of women with unmet needs declined between 2013 and 2022; in the lowest wealth quintile, it fell from 18.4% to 10.6%. Moreover, the probability of having an unmet need declined across all wealth quintiles between 2013 and 2022; the largest decline was from 0.146 (95% confidence interval, CI: 0.131-0.162) to 0.088 (95% CI: 0.079-0.098) in the lowest quintile.

Conclusion: The unmet needs for contraception declined substantially following implementation of a new reproductive health law. However, there was a persistent gap in unmet needs between the lowest and highest wealth quintiles.

Objective: To identify the barriers preventing manufacturers of similar biotherapeutic human insulin from submitting their products to the World Health Organization (WHO) for prequalification.

Methods: We used a self-administered questionnaire to collect data from companies producing similar biotherapeutic human insulin. We included questions about the insulin products manufactured, knowledge of WHO prequalification requirements, export of the products and compliance with good manufacturing practices. Companies had the possibility to provide additional relevant information. We sent the questionnaire to 20 manufacturers in total. We evaluated responses and organized the data into themes.

Results: We had a response rate of 55% (11/20 companies). Five broad themes emerged: (i) manufacturers and products; (ii) expressions of interest awareness and participation; (iii) need for technical assistance and training; (iv) market and supply chain challenges; and (v) approval for good manufacturing practices. The most important reasons for manufacturers' lack of response to WHO's expression-of-interest invitation were absence of a mechanism to guarantee return on investment, and perceived complexity of prequalification requirements for insulin-similar biotherapeutic products.

Conclusion: To encourage greater participation in the WHO prequalification programme, international procurement agencies associated with the programme should consider establishing a platform to enter into advance purchasing agreements with manufacturers. In addition, WHO's Local Production and Assistance Unit should provide companies with ongoing technical assistance on the development of their human insulin products and improvement of their production facilities to comply with the WHO requirements for good manufacturing practices.