The reported impact of non-communicable disease investment cases in 13 countries.

Non-communicable diseases (NCDs) are a leading health and development challenge worldwide. Since 2015, WHO and the United Nations Development Programme have provided support to governments to develop national NCD investment cases to describe the socioeconomic dimensions of NCDs. To assess the impact of the investment cases, semistructured interviews and a structured process for gathering written feedback were conducted between July and October 2022 with key informants in 13 countries who had developed a national NCD investment case between 2015 and 2020. Investment cases describe: (1) the social and economic costs of NCDs, including their distribution and projections over time; (2) priority areas for scaled up action; (3) the cost and returns from investing in WHO-recommended measures to prevent and manage NCDs; and (4) the political dimensions of NCD responses. While no country had implemented all the recommendations set out in their investment case reports, actions and policy changes attributable to the investment cases were identified, across (1) governance; (2) financing; and (3) health service access and delivery. The pathways of these changes included: (1) stronger collaboration across government ministries and partners; (2) advocacy for NCD prevention and control; (3) grounding efforts in nationally owned data and evidence; (4) developing mutually embraced 'language' across health and finance; and (5) elevating the priority accorded to NCDs, by framing action as an investment rather than a cost. The assessment also identified barriers to progress on the investment case implementation, including the influence of some private sector entities on sectors other than health, the impact of the COVID-19 pandemic, and changes in senior political and technical government officials. The results suggest that national NCD investment cases can significantly contribute to catalysing the prevention and control of NCDs through strengthening governance, financing, and health service access and delivery.

The impact of health insurance on maternal and reproductive health service utilization and financial protection in low- and lower middle-income countries: a systematic review of the evidence.

BACKGROUND: Low- and middle-income countries have committed to achieving universal health coverage (UHC) as a means to enhance access to services and improve financial protection. One of the key health financing reforms to achieve UHC is the introduction or expansion of health insurance to enhance access to basic health services, including maternal and reproductive health care. However, there is a paucity of evidence of the extent to which these reforms have had impact on the main policy objectives of enhancing service utilization and financial protection. The aim of this systematic review is to assess the existing evidence on the causal impact of health insurance on maternal and reproductive health service utilization and financial protection in low- and lower middle-income countries. METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search included six databases: Medline, Embase, Web of Science, Cochrane, CINAHL, and Scopus as of 23rd May 2023. The keywords included health insurance, impact, utilisation, financial protection, and maternal and reproductive health. The search was followed by independent title and abstract screening and full text review by two reviewers using the Covidence software. Studies published in English since 2010, which reported on the impact of health insurance on maternal and reproductive health utilisation and or financial protection were included in the review. The ROBINS-I tool was used to assess the quality of the included studies. RESULTS: A total of 17 studies fulfilled the inclusion criteria. The majority of the studies (82.4%, n = 14) were nationally representative. Most studies found that health insurance had a significant positive impact on having at least four antenatal care (ANC) visits, delivery at a health facility and having a delivery assisted by a skilled attendant with average treatment effects ranging from 0.02 to 0.11, 0.03 to 0.34 and 0.03 to 0.23 respectively. There was no evidence that health insurance had increased postnatal care, access to contraception and financial protection for maternal and reproductive health services. Various maternal and reproductive health indicators were reported in studies. ANC had the greatest number of reported indicators (n = 10), followed by financial protection (n = 6), postnatal care (n = 5), and delivery care (n = 4). The overall quality of the evidence was moderate based on the risk of bias assessment. CONCLUSION: The introduction or expansion of various types of health insurance can be a useful intervention to improve ANC (receiving at least four ANC visits) and delivery care (delivery at health facility and delivery assisted by skilled birth attendant) service utilization in low- and lower-middle-income countries. Implementation of health insurance could enable countries' progress towards UHC and reduce maternal mortality. However, more research using rigorous impact evaluation methods is needed to investigate the causal impact of health insurance coverage on postnatal care utilization, contraceptive use and financial protection both in the general population and by socioeconomic status. TRIAL REGISTRATION: This study was registered with Prospero (CRD42021285776).

Female labour participation and infant mortality in Nigeria: implication for the sustainable development goal 3.

Over the time, link between female labour participation and infant mortality has become a subject of debate among scholars and policymakers in developing countries. This subject becomes more critical for a country like Nigeria where there is a persistent challenge to attain minimal global infant mortality rates by 2030, and where over 47% of female working population is unemployed. Against this background, this study utilizes fully modified ordinary least squares to estimate the relationship between female labour participation and infant mortality in Nigeria. The results show that at least 98 children per 1,000 births died in Nigeria between 1990 and 2020. Similarly, over 47% of female working population is currently unemployed in Nigeria. Female labour participation and infant mortality possess a significant negative relationship. Consequently, participation of women in the labour market has a significant effect in reducing infant mortality in Nigeria. In the same vein, female employment contributed to the reduction of infant mortality, though not substantial in nature. As such, the Nigerian policymakers should create a conducive environment that will facilitate participation of more women in the Nigerian labour market so that there will be further reduction of infant mortality in order to achieve the SDG 3.

Au fil du temps, le lien entre la participation des femmes au travail et la mortalité infantile est devenu un sujet de débat parmi les universitaires et les décideurs politiques des pays en développement. Ce sujet devient plus critique pour un pays comme le Nigeria, où il est toujours difficile d'atteindre des taux de mortalité infantile mondiaux minimaux d'ici 2030 et où plus de 47 % de la population active féminine est au chômage. Dans ce contexte, cette étude utilise les moindres carrés ordinaires entièrement modifiés pour estimer la relation entre la participation des femmes au travail et la mortalité infantile au Nigéria. Les résultats montrent qu'au moins 98 enfants pour 1 000 naissances sont morts au Nigeria entre 1990 et 2020. De même, plus de 47 % de la population active féminine est actuellement au chômage au Nigeria. La participation des femmes au travail et la mortalité infantile entretiennent une relation négative significative. Par conséquent, la participation des femmes au marché du travail a un effet significatif sur la réduction de la mortalité infantile au Nigéria. Dans le même ordre d'idées, l'emploi des femmes a contribué à la réduction de la mortalité infantile, même si elle n'est pas substantielle. En tant que tel, les décideurs politiques nigérians devraient créer un environnement propice qui facilitera la participation d'un plus grand nombre de femmes au marché du travail nigérian afin de réduire davantage la mortalité infantile afin d'atteindre l'ODD 3.

Traditional japanese diet score and the sustainable development goals by a global comparative ecological study.

BACKGROUND: Reducing the environmental impact of the food supply is important for achieving Sustainable Development Goals (SDGs) worldwide. Previously, we developed the Traditional Japanese Diet Score (TJDS) and reported in a global ecological study that the Japanese diet is associated with reducing obesity and extending healthy life expectancy etc. We then examined the relationship between the TJDS and environmental indicators. METHODS: The average food (g/day/capita) and energy supplies (kcal/day/capita) by country were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database. The TJDS was calculated from eight food groups (beneficial food components in the Japanese diet: rice, fish, soybeans, vegetables, and eggs; food components that are relatively unused in the traditional Japanese diet: wheat, milk, and red meat) by country using tertiles, and calculated the total score from - 8 to 8, with higher scores meaning greater adherence to the TJDS. We used Land Use (m2), Greenhouse gas (GHG) emissions 2007/2013 (kg CO2eq), Acidifying emissions (g SO2eq), Eutrophying emissions (g PO43- eq), Freshwater (L), and water use (L) per food weight by Poore et al. as the environmental indicators and multiplied these indicators by each country's average food supply. We evaluated the cross-sectional and longitudinal associations between the TJDS and environmental indicators from 2010 to 2020. This study included 151 countries with populations ≥ 1 million. RESULTS: Land use (ß ± standard error; -0.623 ± 0.161, p < 0.001), GHG 2007 (-0.149 ± 0.057, p < 0.05), GHG 2013 (-0.183 ± 0.066, p < 0.01), Acidifying (-1.111 ± 0.369, p < 0.01), and Water use (-405.903 ± 101.416, p < 0.001) were negatively associated with TJDS, and Freshwater (45.116 ± 7.866, p < 0.001) was positively associated with TJDS after controlling for energy supply and latitude in 2010. In the longitudinal analysis, Land Use (ß ± standard error; -0.116 ± 0.027, p < 0.001), GHG 2007 (-0.040 ± 0.010, p < 0.001), GHG 2013 (-0.048 ± 0.011, p < 0.001), Acidifying (-0.280 ± 0.064, p < 0.001), Eutrophying (-0.132 ± 0.062, p < 0.05), and Water use (-118.246 ± 22.826, p < 0.001) were negatively associated with TJDS after controlling for confounders. CONCLUSIONS: This ecological study suggests that the traditional Japanese dietary pattern might improve SDGs except Fresh water.

How can the Sendai framework be implemented for disaster risk reduction and sustainable development? A qualitative study in Iran.

BACKGROUND: The Sendai Framework is the United Nations' most significant approach to reducing the risk of disasters from 2015 to 2030. This framework designed for all communities. However, communities should create operational and remedial strategies based on their unique circumstances. Considering the gaps in the implementation of Sendai framework strategies in Iran, as a developing country, the present study was designed. METHOD: This study was conducted by using a qualitative direct content analysis method to find out the expert's opinions on the implementation of the Sendai framework in Iran from 2021 to 2023. 35 experts in the focus group discussion and 9 experts in the interview were the participants of the study. RESULTS: Study findings were merged and reported as one main theme entitled Executive actions for implementing the Sendai Framework, four categories, and 37 codes. Eleven codes for the strategy of understanding disaster risk, 11 codes for the strategy of strengthening disaster risk governance to manage disaster risk, eight codes for the strategy of Investing in disaster risk reduction for resilience, and finally, seven codes for the strategy of enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation, and reconstruction were identified as implementation solutions. CONCLUSION: The Sendai Framework has not provided any detailed implementation solutions because the countries' economic, social, level of development, etc., are different. The study's findings can be used as a guide for other developing countries.

Linkages between the Sustainable Development Goals and health in Somalia.

BACKGROUND: The Sustainable Development Goals (SDGs) adopted in 2015 compromises 17 universal and indivisible goals for sustainable development, however the interactions between the SDGs in Somalia is not known which is vital for understanding potential synergies and trad-offs between the SDGs. Hence, this study aims to identify and classify the linkages between the SDGs with a focus on health and well-being (SDG 3) in Somalia. METHODS: Following the SDG Synergies approach, 35 leading experts from the public and private sectors as well as academia and civil society gathered for a 2-day workshop in Mogadishu and scored the interactions between the individual SDGs on a seven point-scale from - 3 to + 3. From this, a cross-impact matrix was created, and network models were used to showcase the direct and indirect interactions between the SDGs with a focus on SDG 3 (good health and well-being). RESULTS: Many promoting and a few restricting interactions between the different SDGs were found. Overall, SDG 16 (peace, justice, and strong institutions) influenced the other SDGs the most. When second-order interactions were considered, progress on SDG 16 (peace, justice, and strong institutions) showed the largest positive impact on SDG 3 (good health and well-being). SDG 3 (good health and well-being) was heavily influenced by progress on other SDGs in Somalia and making progress on SDG 3 (good health and well-being) positively influenced progress on all other SDGs. CONCLUSION: The findings revealed that in Somalia, the interactions between the SDGs are mostly synergistic and that SDG 16 (peace, justice, and strong institutions) has a strong influence on progress on other SDGs as well as progress on SDG 3 (good health and well-being). This study highlights the need for a multisectoral strategy to accelerate progress on the SDGs in Somalia in general, and particularly SDG 3 (good health and well-being).

Trends in household out-of-pocket health expenditures and their underlying determinants: explaining variations within African regional economic communities from countries panel data.

BACKGROUND: The persistently high out-of-pocket health spending (OOPHE) in Africa raise significant concern about the prospect of reaching SDG health targets and UHC. The study examines the convergence hypothesis of OOPHE in 40 African countries from 2000 to 2019. METHODS: We exploit the log t , club clustering, and merging methods on a panel of dataset obtained from the World Development Indicators, the World Governance Indicators, and the World Health Organization. Then, we employ the multilevel linear mixed effect model to examine whether countries' macro-level characteristics affect the disparities in OOPHE in the African regional economic communities (RECs). RESULTS: The results show evidence of full panel divergence, indicating persistent disparities in OOPHE over time. However, we found three convergence clubs and a divergent group for the OOPHE per capita and as a share of the total health expenditure. The results also show that convergence does not only occur among countries affiliated with the same regional economic grouping, suggesting disparities within the regional groupings. The findings reveal that countries' improved access to sanitation and quality of governance, increased childhood DPT immunization coverage, increased share of the elderly population, life expectancy at birth, external health expenditure per capita, and ICT (information and communication technology) significantly affect within-regional groupings' disparities in OOPHE per capita. The results also show that an increasing countries' share of elderly and younger populations, access to basic sanitation, ICT, trade GDP per capita, life expectancy at birth, childhood DPT immunization coverage, and antiretroviral therapy coverage have significant impacts on the share of OOPHE to total health expenditure within the regional groupings. CONCLUSION: Therefore, there is a need to develop policies that vary across the convergence clubs. These countries should increase their health services coverage, adopt planned urbanization, and coordinate trade and ICT access policies. Policymakers should consider hidden costs associated with access to childhood immunization services that may lead to catastrophic health spending.

Green R & D investment, ESG reporting, and corporate green innovation performance.

Given the contradictory empirical evidence on the relationship between green R&D expenditure and corporate Green Innovation performance (GIP), The present research study is a distinctive investigation into the moderating impacts of ESG reporting on this relationship. We utilized a data collection of 3,846, firm-year observations of A-share listed firms in China from 2016 to 2022 from CSMAR and Bloomberg databases. The firm's Corporate GIP is assessed and measured by looking at the total quantity of green patents. Lastly, models with multiple regression analyses and fixed effects were employed. The findings show that ESG reporting has a positive and significant impact on the association between corporate GIP and green R&D expenditure, implying its compensating and supportive function in the form of green signals in green outputs. This research could help executives and lawmakers, especially in developing countries to build innovative environmental strategies for business sustainability.

Unveiling spatial disparities in basic medical and health services: insights from China's provincial analysis.

Based on the panel data of 31 provinces (municipalities and autonomous regions) in China from 2012 to 2019, this paper constructs the evaluation index system of basic medical and health services in China from seven dimensions: medical and health facilities, health expenditure, medical services, traditional Chinese medicine hospital services, maternal and child health care, people's health and medical security, disease control and public health. The entropy method was used to measure the level of basic medical and health services in China, and its spatial differences and convergence characteristics were further investigated. In this study, we employ the entropy weight method, σ convergence, and ß convergence as our primary methodologies. The entropy weight method is used to evaluate the variability of each indicator, determine the weights of indicators, and quantify the information content of the data. σ convergence illustrates the process by which the variance of a sample decreases over time. ß convergence refers to the gradual approach of variables within an economic system towards their long-term equilibrium level over time. The results show that: (1) The scores of basic medical and health services in China's four major regions (including Northeast, East, Central and West) remain in a relatively stable state, with small fluctuations and great room for improvement; (2) There are significant regional differences in the level of basic medical and health services in China, and the intra-regional differences are much greater than the inter-regional differences; (3) There is no significant σ convergence observed in China and its four major regions; however, there is a notable presence of ß convergence.

Population mobility : spatial spillover effect of government health expenditure in China.

BACKGROUND: Since the 20th century, pursuing Universal Health Coverage (UHC) has emerged as an important developmental objective in numerous countries and across the global health community. With the intricate ramifications of population mobility (PM), the government faces a mounting imperative to judiciously deploy health expenditure to realise UHC effectively. OBJECTIVE: This study aimed to construct a comprehensive UHC index for China, assess the spatial effects of Government Health Expenditure (GHE) on UHC, and explore the moderating effects of PM on this association. METHOD: A Dynamic Spatial Durbin Model (DSDM) was employed to investigate the influence of the GHE on UHC. Therefore, we tested the moderating effect of PM. RESULTS: In the short-term, the GHE negatively impacted local UHC. However, it enhanced the UHC in neighbouring regions. Over the long term, GHE improved local UHC but decreased UHC in neighbouring regions. In the short-term, when the PM exceeded 1.42, the GHE increased the local UHC. Over the long term, when the PM exceeded 1.107, the GHE impeded local UHC. If the PM exceeded 0.91 in the long term, the GHE promoted UHC in neighbouring regions. The results of this study offer a partial explanation of GHE decisions and behaviours. CONCLUSIONS: To enhance UHC, a viable strategy involves augmenting vertical transfer payments from the central government to local governments. Local governments should institute healthcare systems tailored to the urban scale and developmental stages, with due consideration for PM. Optimising the information disclosure mechanism is also a worthwhile endeavour.

Medical insurance, vulnerability to poverty, and wealth inequality.

Background: China has made remarkable achievements in alleviating poverty under its current poverty standards. Despite these immense successes, the challenge of consolidating these achievements remains. In reality, health risks are among the significant factors causing rural households to fall into poverty, and medical insurance is the significant factor mitigating household vulnerability to poverty. Therefore, alleviating or guarding against households falling into poverty is essential. Methods: This paper establishes a multi-equilibrium model that incorporates heterogeneous health risks and medical insurance. Through parameter calibration and value function iteration, numerical solutions are derived. Results: Heterogeneous health risks significantly increase poverty vulnerability and wealth inequality in rural households. Medical insurance, through its investment incentives and loss compensation effects, efficiently mitigates these issues, especially benefiting those in poorer health. Furthermore, the dual-slanted compensation policy efficiently mitigates the adverse effects of "reverse redistribution." Conclusion: Medical insurance effectively mitigates household vulnerability to poverty and wealth inequality. Government departments must establish health records for residents. By recognizing variations in health conditions, these departments can provide households with poorer health conditions with a higher medical expense compensation ratio. In addition, the government should further focus medical expense reimbursements toward households on the cusp of escaping poverty to ensure that they are not plunged back (or further) into poverty due to medical expenses.

How are microbes helping end hunger?

This article explores the potential of microbiology to positively impact all aspects of the food supply chain, improving the quantity, quality, safety, and nutritional value of food products by providing innovative ways of growing, processing, and preserving food and thus contributing to Zero Hunger, one of the Sustainable Development Goals (SDGs) of the United Nations.

Analysis of affordability differences for rare diseases in China: a comparison across disease types and regions.

BACKGROUND: China has implemented policies to make rare diseases more affordable. While previous studies evaluated overall affordability, few have examined affordability differences across regions and disease types. Given the vastness of China and varying medical policies across cities, this study assesses the affordability of rare diseases based on China's First List of Rare Diseases (CFLRD), National Reimbursement Drug List (NRDL), and outpatient chronic and special disease policies in each prefecture. METHOD: Six rare diseases were selected and the average annual treatment cost of all relevant drugs in NRDL was calculated for each disease. Based on the WHO/HAI standardized approach, the study analyzed 289 cities with outpatient chronic and special disease policies, measured the security levels by the actual reimbursement ratio of Basic Medical Insurance (BMI) and affordability by the ratio of individual expenses after reimbursement to the annual disposable income of urban residents in the province. The security levels and affordability differences across disease types and provinces were analyzed using the Mann-Whitney U test and the K-W test. RESULT: The affordability of rare diseases varied significantly on the disease types and annual treatment cost. Diseases with an annual treatment cost below 100 000 yuan are affordable to all prefectures even with low reimbursement rates, while those with a higher treatment cost were not affordable in at least 80% of prefectures even though the reimbursement ratio is high. The affordability of the same disease varies significantly across provinces and municipalities. Outpatient chronic and special diseases insurance and critical illness insurance, and the inconsistencies between them, result in regional differences. CONCLUSION: Although China has made progress in improving the affordability of rare diseases, significant differences persist between cities and diseases. The study suggests the optimization of the BMI system and explores independent funds and innovative insurance models to enhance the affordability of rare diseases, particularly those with extremely high treatment costs.

Households catastrophic health expenditure among older people with noncommunicable diseases: A cross-sectional study from Iran.

Background and Aims: Noncommunicable diseases are one of the main difficulties faced by older adults in many countries. The study aimed to investigate the households' catastrophic health expenditure (CHE) among older people with noncommunicable diseases. Methods: This cross-sectional study was conducted between October and December 2022 in Semnan, Iran, with the participation of 400 older individuals suffering from diabetes and hypertension. The Content Validity Ratio (which is calculated based on necessity criterion) and Content Validity Index (which calculated based on relevance, transparency, and simplicity criteria) values of 0.94 and 0.89, respectively, confirmed the content validity of the researcher-made questionnaire. The occurrence of CHE was estimated using the World Health Organization's rule of "allocating at least 40% of non-food household costs to healthcare." Due to the qualitative nature of the data, the χ 2 test was utilized to assess the statistical association between demographic and background variables and occurrence of CHE. Results: Older people with diabetes and hypertension had an annual direct medical costs of $821 averagely, which includes 9.7% for diagnosis, 23.9% for doctor visits, and 66.4% for treatment. Direct medical costs account for around 0.26 of nonfood costs, with 12.5% of seniors facing high medical charges. Age, marital status, type of basic health insurance, diabetes, the time elapsed since initial diabetes diagnosis, the severity of diabetes complications, and the development of diabetes-related visual impairments, are associated with CHE (p < 0.05). Conclusion: While the prevalence of CHE among elderly individuals with diabetes and hypertension is reasonably manageable, targeted promotional efforts are still necessary to protect those at high risk.

ABM Position Statement: Paid Maternity Leave-Importance to Society, Breastfeeding, and Sustainable Development.

Background: Paid maternity leave benefits all of society, reducing infant mortality and providing economic gains. It is endorsed by international treaties. Paid maternity leave is important for breastfeeding, bonding, and recovery from childbirth. Not all mothers have access to adequate paid maternity leave. Key Information: Paid leave helps meet several of the 17 United Nations' Sustainable Development Goals (2, 3, 4, 5, 8, and 10), including fostering economic growth. A family's expenses will rise with the arrival of an infant. Paid leave is often granted with partial pay. Many low-wage workers earn barely enough to meet their needs and are unable to take advantage of paid leave. Undocumented immigrants and self-employed persons, including those engaging in informal work, are often omitted from maternity leave programs. Recommendations: Six months of paid leave at 100% pay, or cash equivalent, should be available to mothers regardless of income, employment, or immigration status. At the very minimum, 18 weeks of fully paid leave should be granted. Partial pay for low-wage workers is insufficient. Leave and work arrangements should be flexible whenever possible. Longer flexible leave for parents of sick and preterm infants is essential. Providing adequate paid leave for partners has multiple benefits. Increasing minimum wages can help more families utilize paid leave. Cash benefits per birth can help informal workers and undocumented mothers afford to take leave. Equitable paid maternity leave must be primarily provided by governments and cannot be accomplished by employers alone.

Towards mission-driven investment in new antimicrobials? What role for Chinese strategic industrial financing vehicles in responding to the challenge of antimicrobial resistance?

BACKGROUND: Antimicrobial resistance (AMR) causes high levels of global mortality. There is a global need to develop new antimicrobials to replace those whose efficacy is being eroded, but limited incentive for companies to engage in R&D, and a limited pipeline of new drugs. There is a recognised need for policies in the form of 'push' and 'pull' incentives to support this R&D. This article discusses China, a country with a rapidly emerging pharmaceuticals and biotech (P&B) sector, and a history of using coordinated innovation and industrial policy for strategic and developmental ends. We investigate the extent to which 'government guidance funds' (GGFs), strategic industrial financing vehicles (a 'push' mechanism), support the development of antimicrobials as part of China's 'mission-driven' approach to innovation and industrial policy. GGFs are potentially globally significant, having raised approximately US$ 872 billion to 2020. RESULTS: GGFs have a substantial role in P&B, but almost no role in developing new antimicrobials, despite this being a priority in the country's AMR National Action Plan. There are multiple constraints on GGFs' ability to function as part of a mission-driven approach to innovation at present, linked to their business model and the absence of standard markets for antimicrobials (or other effective 'pull' mechanisms), their unclear 'social' mandate, and limited technical capacity. However, GGFs are highly responsive to changing policy demands and can be used strategically by government in response to changing needs. CONCLUSIONS: Despite the very limited role of GGFs in developing new antimicrobials, their responsiveness to policy means they are likely to play a larger role as P&B becomes an increasingly important component of China's innovation and industrial strategy. However, for GGFs to effectively play that role, there is a need for reforms to their governance model, an increase in technical and managerial capacity, and supporting ('pull') incentives, particularly for pharmaceuticals such as antimicrobials for which there is strong social need, but a limited market. Given GGFs' scale and strategic importance, they deserve further research as China's P&B sector becomes increasingly globally important, and as the Chinese government commits to a larger role in global health.

Spatial difference-in-differences analysis of smart city pilot policy and industrial pollution reduction: the mediating role of S&T fiscal expenditure.

Smart city has become one of the most important tool to achieve digital transformation and intelligent development. However, the impacts of smart city pilots (SCP) on different industrial pollution have yet to be tested, and the mechanisms of SCP affect industrial pollution could be richer. In this paper, we construct a spatial difference-in-difference model for 2004-2019 by mapping SCP policy to Chinese city data to systematically quantify the impact and its potential mechanisms of digital transformation on industrial pollution. Our results show that the SCP policy achieves industrial pollution reduction targets, on average, wastewater and SO2 emissions decreased by 6.4% and 6.5%, respectively. Cities with SCP policy have more industrial pollution compared to cities without SCP policy, implying a beggar-thy-neighbor effect of SCP policy. Furthermore, significant regional disparities come to light; SCP policy in the Pearl River Delta exceeds other regions such as the Yangtze River Delta and Jing-Jin-Ji city cluster in terms of realizing the impact of industrial pollution reduction. Importantly, mechanism analysis indicated that the SCP reduced industrial pollution was partially mediated by government S&T fiscal expenditure.

Interventions targeting social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews.

Globally, mental disorders account for almost 20% of disease burden and there is growing evidence that mental disorders are socially determined. Tackling the United Nations Sustainable Development Goals (UN SDGs), which address social determinants of mental disorders, may be an effective way to reduce the global burden of mental disorders. We conducted a systematic review of reviews to examine the evidence base for interventions that map onto the UN SDGs and seek to improve mental health through targeting known social determinants of mental disorders. We included 101 reviews in the final review, covering demographic, economic, environmental events, neighborhood, and sociocultural domains. This review presents interventions with the strongest evidence base for the prevention of mental disorders and highlights synergies where addressing the UN SDGs can be beneficial for mental health.

Regional differences in health resource allocation: a longitudinal study in the Chengdu-Chongqing economic circle, China.

OBJECTIVE: To analyse regional differences in health resource allocation in the Chengdu-Chongqing economic circle. DESIGN: A longitudinal analysis that collected data on health resource allocation from 2017 to 2021. SETTING: The number of beds, health technicians, licensed (assistant) physicians, registered nurses and financial allocations per 1000 population in the 42 regions of Chengdu-Chongqing economic circle were used for the analysis. METHODS: The entropy weight technique for order preference by similarity to an ideal solution (TOPSIS) method and the rank sum ratio (RSR) method were used to evaluate the health resource allocation. RESULTS: The number of licensed (assistant) physicians per 1000 population in the Chengdu-Chongqing economic circle (3.01) was lower than the average in China (3.04) in 2021. According to the entropy weight-TOPSIS method, Yuzhong in Chongqing had the largest C-value and the highest ranking. Jiangbei in Chongqing and Chengdu and Ya'an in Sichuan Province had higher C-values and were ranked in the top 10. Jiangjin, Hechuan, Tongnan and Zhongxian in Chongqing and Guang'an in Sichuan Province had lower C-values and were all ranked after the 30th place. According to the RSR method, the 42 regions were divided into three grades of good, medium and poor. The health resource allocations of Yuzhong, Jiangbei, Nanchuan, Jiulongpo and Shapingba in Chongqing and Chengdu and Ya'an in Sichuan Province were of good grade, those of Tongnan, Jiangjin, Yubei and Dazu in Chongqing and Guang'an and Dazhou in Sichuan Province were of poor grade, and the rest of the regions were of medium grade. CONCLUSION: The regional differences in health resource allocation in the Chengdu-Chongqing economic circle were more obvious, the health resource allocation in Chongqing was more polarised and the health resource allocation in Sichuan Province was more balanced, but the advantaged regions were not prominent enough.