The World Health Organization (WHO) has launched a campaign to highlight urban planning as a crucial link to building a healthy 21st century. In particular, WHO calls on municipal authorities, concerned residents, advocates for healthy living and others to take a close look at health inequities in cities and take action. Rapid urbanisation has resulted in significant changes in our living standards, lifestyles, social behaviour and health. This article notes that many cities face a triple threat: infectious diseases, which thrive when people are crowded together; chronic, non-communicable diseases including diabetes, cancers and heart disease, which are on the rise with unhealthy lifestyles; and urban health is often further burdened by road traffic accidents, injuries, violence and crime. WHO outlines five actions that could significantly increase the chance people will be able to enjoy better urban living conditions: promote urban planning for healthy behaviours and safety; improve urban living conditions; ensure participatory governance; build inclusive cities that are accessible and age-friendly; and make cities resilient to disasters and emergencies.
Equity in Health
This study used the Millennium Development Goals’ (MDG) database from 2000 to 2006 to investigate the association between globalisation and women’s health in sub-Saharan Africa based on various determinants of heath. Results suggest that developing countries are becoming more integrated with world markets through some lowering of trade barriers. At the same time, women’s occupational roles are changing, which could affect their health status. However, it is difficult to measure the impact of globalisation on women’s health from the MDG database. First, data on trade liberalisation is aggregated at the regional level and does not hold any information on individual countries. Second, too few indicators in the MDG database are disaggregated by sex, making it difficult to separate the effects on women from those on men. The paper concludes that the MDG database is not adequate to assess the effects of globalisation on women’s health in Sub-Saharan Africa. It recommends that researchers aim to address this research question to find other data sources or turn to case studies. Further research on globalisation and health, using reliable sources, is urgently needed.
The child survival and development strategy in Kenya is guided by the National Health Sector Strategic Plan II: 2005–2010 (NHSSP II), the targets anticipated in achieving the Millennium Development Goals (MDGs) and Vision 2030 goals. The health sector has laid down policy and plans to facilitate the implementation of accelerated child survival and development within this strategy. The health sector currently faces several challenges and needs to focus on improving access to health services, as utilisation remains low, with more than 47% of the population travelling more than five kilometres to reach a health facility. Yet several notable achievements have been made in efforts to reduce the causes of childhood morbidity and mortality, especially with regards to malaria, vaccine preventable diseases, diarrhoea and in improving water and sanitation. There still needs to be a significant scaling up of activities related to specific targets both in terms of programme delivery and financing. Despite recent improvements, Kenya still needs to reduce infant mortality from 77 to 26 deaths per 1,000 live births and under five mortality from 115 to 33 deaths per 1,000 live births to achieve MDGs on child survival and development by 2015.
The objective of this study was to determine the leading causes of fatal injury for urban South African children aged 0–14 years, the distribution of those causes and the current potential for safety improvements. Injury surveillance data was obtained from the National Injury Mortality Surveillance System 2001–2003 for six major South African cities varying in size, development and sociodemographic composition. The study identified the leading causes of fatal injury in childhood as road traffic injuries – among vehicle passengers and especially among pedestrians – drowning, burns and, in some cities, firearm injuries. Disparities between cities and between population groups were largest for deaths from pedestrian injuries, while differences between boys and girls were greatest for drowning deaths. The study concluded that, in the face of the high variability observed between cities and population groups in the rates of the most common types of fatal injuries, a safety agenda should combine safety-for-all countermeasures and targeted countermeasures that help reduce the burden for those at greatest risk.
For the first time in decades, researchers are reporting a significant drop worldwide in the number of women dying each year from pregnancy and childbirth, to about 342,900 in 2008 from 526,300 in 1980. The findings, published in the medical journal The Lancet, challenge the prevailing view of maternal mortality as an intractable problem that has defied every effort to solve it. 'The overall message, for the first time in a generation, is one of persistent and welcome progress,' the journal’s editor, Dr Richard Horton, wrote. The study cited a number of reasons for the improvement: lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of 'skilled attendants' – people with some medical training – to help women give birth. Improvements in large countries like India and China helped to drive down the overall death rates.
In this speech, delivered as the Eighth Annual Jeffrey P Koplan Global Leadership in Public Health Lecture in Atlanta, in the United States, Margaret Chan, Director-General of the World Health Organization, has admitted that global governance has failed to embrace equity as an explicit policy objective in the international systems that govern financial markets, economic relations, trade, commerce and foreign affairs. And health has suffered as a result. She criticises the way in which development models have assumed that living conditions and health status would somehow automatically improve as countries modernised, liberalised their trade and experienced rapid economic growth – yet this has not happened. She also points out that international trade agreements will not, by themselves, guarantee food, job or health security, nor access to affordable medicines. Instead, all of these outcomes require deliberate policy decisions. She calls for world leaders to recognise that health concerns can, in some instances, be more important than economic interests and that the net result of all our international policies should be to improve the quality of life for as many of the world’s people as possible. Greater equity in health status should be adopted as an indicator of human progress, she recommends.
There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: 'Africa's chronic disease burden: Local and global perspectives'. The papers offer new empirical evidence and comprehensive reviews on, among others, diabetes in Tanzania, and HIV and AIDS care-giving among children in Kenya. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. The editorial discusses insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. It argues that there is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub-Saharan Africa. The editorial concludes that the economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them.
A new report by Zimbabwe's National AIDS Council (NAC), showing a dramatic rise in sexually transmitted infections (STIs) among people aged 15 to 24 in the capital, Harare, has health experts worried that the country's success so far in reducing HIV could be reversed. STIs heighten vulnerability to HIV infection, and this age group is one of the most affected. According to the NAC report, more than 24,000 people were treated for STIs in 2009, compared to 8,500 cases recorded in 2008. During this time almost 900,000 male condoms and over 155,000 female condoms were distributed in Harare. Itai Rusike, executive director of the Community Working Group on Health (CWGH), a network of civic groups that promote health awareness, blamed the rise in STIs on a too-narrow focus on HIV and AIDS treatment, at the cost of prevention interventions, especially for young people.
This report presents the preliminary findings of a study undertaken in six pilot countries – Uganda, Rwanda, Kenya, Tanzania, Burundi and DR Congo. The objectives of the study were to provide a detailed assessment of food security-related initiatives, plans and strategies and also to describe the status of food security in the six countries. Based on the experiences and lessons learnt thereof, the study proposed ways of enhancing synergies and coherence between the identified food security initiatives of the regional economic communities (RECs), inter-governmental organisations (IGOs) and individual member states within Eastern Africa, to strengthen regional and country-specific partnerships in the development of a regional food security programme for Eastern Africa.
This report, which is issued pursuant to General Assembly resolution 64/184, presents information on progress made in achieving the Millennium Development Goals through a comprehensive review of successes, best practices and lessons learned, obstacles and gaps, and challenges and opportunities, leading to concrete strategies for action. It consists of four main sections. The introduction examines the importance of the Millennium Declaration and how it drives the United Nations development agenda. The second section reviews progress on achieving the Millennium Development Goals, presenting both shortfalls and successes in the global effort and outlines emerging issues. The third section sums up lessons learned to shape new efforts for accelerating progress to meet the Goals and identifies key success factors. The fourth and final section lists specific recommendations for action. The report calls for a new pact to accelerate progress in achieving the Goals in the coming years among all stakeholders, in a commitment towards equitable and sustainable development for all.