COVID-19, poverty and inclusive development.

The COVID-19 epidemic provides yet another reason to prioritize inclusive development. Current response strategies of the global community and countries expose a low level of solidarity with poorer nations and poorer people in all nations. Against this background, this paper addresses the question: What are the development challenges that the COVID-19 pandemic lays bare and what lessons can be learnt for the way recovery processes are designed? Using an inclusive development and DPSIR lens to assess the literature, our study finds that, first, the current response prioritises the 'state' and 'impact' concerns of wealthier classes at the expense of the remainder of the world population. Second, responses have ignored underlying 'drivers' and 'pressures', instead aiming at a quick recovery of the economy. Third, a return to business-as-usual using government funding will lead to a vicious cycle of further ecological degradation, socio-economic inequality and domestic abuse that assist in exacerbating the drivers of the pandemic. We argue instead for an inclusive development approach that leads to a virtuous cycle by emphasizing human health, well-being and ecosystem regeneration. We conclude that the lost years for development did not commence in 2020 with the onset of COVID-19; the downward trend has actually been waxing over the past three decades. From this perspective, COVID-19 may be the shock needed to put the last first and transform vicious into virtuous cycles of inclusive development.

'You have a child who will call you "mama" ': understanding adolescent pregnancy in South Sudan.

BACKGROUND: Pregnancy amongst adolescent girls is common in many parts of the world. The dominant discourse in public health unquestioningly paints this as a problem; it does not pay sufficient attention to girls' views. OBJECTIVES: This paper presents a critical account of adolescent South Sudanese girls' reasons for and explanations of childbearing. It discusses their experiences and views on childbearing and attempts to explain their reproductive choices and actions, in context. METHODS: The study draws upon 24 interviews with adolescent boys, girls and parents from Wau, South Sudan. Data was analysed using the framework analysis approach. RESULTS: Three interacting themes within which adolescent girls framed their views and decisions about childbearing are identified. The local society places high value on motherhood - adolescent girls' desires to become mothers is a reproduction of this social norm. Girls linked having a child to the possibility of making one's 'own home'; in the difficult and uncertain context they lived in, for many girls, having a child (and making a home) appeared as one of the few means to be happy. In making the decision to bear a child, the girls navigated multiple dilemmas and trade-offs between an unpromising present and an uncertain future. Bearing a child and making one's 'own home' was seen as a way to exit into the world of adults, and as a strategy towards achieving security and stability. CONCLUSIONS: Instead of simplistically problematizing adolescent pregnancy in South Sudan, it is important to take into account the experiences and standpoints of adolescent girls, and to recognize that in choosing to become mothers, they are in many ways exercising agency despite being severely constrained by complex, insecure and unfair social circumstances. We argue that such an approach will allow the development of more appropriate, realistic and inclusive health and social policies and programs.

Sustainable development goals for health promotion: a critical frame analysis.

The Sustainable Development Goals (SDGs) lay the foundations for supporting global health and international development work for the next 15 years. Thirty years ago, the Ottawa Charter defined health promotion and outlined key principles for global action on health, including the importance of advocating, enabling and mediating for health equity. Advocacy underscores a human right to health and suggests political action to support its attainment. Enabling speaks to health promotion's focus on the empowerment of people and communities to take control over their health and aspirations. Mediation draws attention to the critical intersectoral partnerships required to address health and social inequities. Underpinned by this approach, the aim of this paper is to consider how key health promotion principles, namely, rights, empowerment and partnership feature (and are framed) within the SDGs and to consider how these framings may shape future directions for health promotion. To that end, a critical frame analysis of the Transforming Our World document was conducted. The analysis interrogated varying uses and meanings of partnerships, empowerment and rights (and their connections) within the SDGs. The analysis here presents three framings from the SDGs: (1) a moral code for global action on (in)equity; (2) a future orientation to address global issues yet devoid of history; and (3) a reductionist framing of health as the absence of disease. These framings raise important questions about the underpinning values of the SDGs and pathways to health equity - offering both challenges and opportunities for defining the nature and scope of health promotion.

Education about HIV/AIDS--theoretical underpinnings for a practical response.

Human immunodeficiency virus (HIV)- and acquired immunodeficiency syndrome (AIDS)-related education is seen by many as central to increasing young people's awareness of, as well as decreasing their vulnerability to, HIV. There is less agreement, however, on the central goals of HIV- and AIDS-related education and the form it might best take. This paper offers a conceptual framework for understanding some of the main approaches to HIV- and AIDS-related education being implemented today, drawing a distinction between approaches which are 'scientifically' informed; those that draw upon notions of 'rights' and those which are overtly 'moralistic' in the sense that they promote conservative moral positions concerning sexuality and sexual acts. In outlining these three approaches, we examine different ways in which the terms 'science', 'rights' and 'moral values' are conceptualized and some of the key assumptions underpinning different forms of HIV- and AIDS-related education. Findings will be useful for those desiring to develop a typology of approaches to HIV- and AIDS-related education and their potential effects.