Level of health data quality and information use, and contributing factors in the Benishangul Gumuze Region, west Ethiopia: using social ecological framework

Background: Creating responsibility for quality healthcare data and utilization are among the basic functions of leadership. While the benefits of data quality and use are well known, the evidence around the role of healthcare information systems leadership and governance in sustaining data demand and use is limited. Therefore, this study aimed to investigate the level and contributing factors of health data quality and information use in Assosa district, Benishangule Gumuze Region. Methods: A mixed approach design, using qualitative exploration and a facility-based quantitative cross-sectional approach was used. Seventeen departments from two health facilities were enrolled for the quantitative component, while 28 in-depth interviews were conducted to complete the qualitative part of the study. A phenomenological approach was used to explore factors influencing the quality and use of health data. Quantitative data was analyzed descriptively using tables and graphs, whereas qualitative data was analyzed using content analysis guided by the framework for the social ecological model. Results: The average levels of information use and report accuracy were 38.6 and 119.33, respectively. Three themes emerged, explaining the main factors that influence quality data generation: individual characteristics, facility and environmental factors, and leadership and governance characteristics. Individual characteristics were motivation, capacity building, commitment, and digital literacy, while facility and environmental factors included infrastructure, healthcare information system resources and supportive supervision. Furthermore, among the leadership and governance related factors, healthcare data, assigning the right person, and system regulation were some of the factors which were identified. Conclusions: The level of health data quality and its utilization was low during the Asossa city adminstration. The unfriendly physical and organizational working environments and high staff turnover which negatively affected the leadership and governance of the health system are some of the reasons which were sighted with regards to the poor quality of data and information use. Therefore, interventions that have multifaceted effects on data quality and use, such as improving leadership and governance practices and behavior should be implemented. [Ethiop. J. Health Dev. 2022;36 (SI-1)]

Polo Científico Productivo de Matanzas: mecanismo de integración de la ciencia y la producción / Productive Scientific Pole of Matanzas: mechanism for integrating science and production

RESUMEN La Unidad de Ciencia, Tecnología e Innovación de la Delegación Territorial del Ministerio de Ciencia, Tecnología y Medio Ambiente en Matanzas, promueve desde el 19 de enero de 2018 la revitalización del Polo Científico Productivo, como forma de procurar un mejor uso a la ciencia matancera e integrar los esfuerzos de los centros de investigación y empresas en pos del desarrollo socioeconómico del territorio. Actualmente, la provincia se encuentra envuelta en un esfuerzo por lograr que cada organismo se responsabilice con la puesta en marcha del Polo Científico Productivo, con la Delegación Territorial del Ministerio de Ciencia, Tecnología y Medio Ambiente como entidad coordinadora. El presente trabajo valora la significación del Polo Científico Productivo en la elevación del impacto de la ciencia y la técnica en la solución de los problemas productivos del territorio matancero (AU).

ABSTRACT The Unit of Science, Technology and Innovation of the Territorial Delegation of the Ministry of Science, Technology and Environment in Matanzas promotes, since January 19 2018, the revival of the Productive Scientific Pole as a form of giving a better use to science done in Matanzas province and integrating the research centers and enterprises efforts in pursuit of the socioeconomic development of the territory. Currently, the province is involved in an effort for ensuring that every organization assumes its responsibility in setting in motion the Productive Scientific Pole with the delegation of the Ministry of Sciences, Technology and Environment as the coordinating entity. This paper is written with the aim of assessing the importance of the Productive Scientific Pole in increasing the impact of science and technique in solving the productive problems of the Matanzas territory. The current paper assesses the importance of the Productive Scientific Pole in increasing the impact of science and technique in solving the productive problems of the Matanzas territory (AU).

Analysis of CSR and the impact of the supply chain on sustainable performance practices: a case study of a mexican exporting company / Análisis de la rse y el impacto de la cadena de suministro en las prácticas de desempeño sustentable: un estudio de caso en una empresa exportadora mexicana

RESUMEN El estudio de caso de la empresa investigada busca comprender la responsabilidad social empresarial (RSE), analizando su cadena de valor desde el Modelo de las 31 prácticas de las cadenas de suministro que el World Economic Forum (2015) propone, desde la perspectiva de la triple ventaja: rentabilidad, medio ambiente y desarrollo de las economías locales. Es una investigación de tipo cualitativa con enfoque de estudio de caso descriptivo. El objetivo del trabajo es observar el impacto de las operaciones de logística internacional en una pyme exportadora mexicana, y analizar si su trascendencia económica ha tenido un desarrollo sustentable en lo social, económico y ambiental. Los resultados indican una ventaja competitiva en la diferenciación del producto a partir del concepto de valor compartido de Porter y Kramer (2002). De acuerdo con el Modelo del WEF, el arquetipo es Liberal humanista, puesto que enfatiza el valor del negocio en 65% y pondera aspectos socio ambientales en un 35 %. No obstante, los impactos en la cadena de suministro deberán mitigarse si se espera que se identifique a la organización como una empresa socialmente responsable.

ABSTRACT The case study presented, seeks to understand the corporate social responsibility (CSR), analyzing its value chain from the Model of the 31 practices of the supply chain that the World Economic Forum (2015). It is a qualitative research, with a descriptive case study approach. The objective of the work is to observe the impact of international logistics operations in a Mexican exporting SME and to analyze whether its economic significance has had a sustainable social, economic and environmental development. The results indicate a competitive advantage in product differentiation based on Porter and Kramer's (2002) concept of shared value. According to the WEF Model, the archetype is: Liberal humanist, since it emphasizes business value by 65% and weights socio-environmental aspects by 35%. However, impacts on the supply chain must be mitigated if the organization is to be identified as a socially responsible company.

Media briefing on COVID-19 and climate change with Dr Tedros and Greta Thunberg - 19/04/2021

0:00:34 CL Hello, good day and welcome to... wherever you are listening to us today from [sic]. It's Monday 19th April 2021. My name is Christian Lindmeier and I'm welcoming you to today's global COVID-19 press conference. The press conference today is on COVID updates with a special focus on the linkages between the climate and the COVID-19 crisis and the role of youth in the response ahead of Earth Day, which is 22nd April, and the first Global Youth Summit organised as part of the global youth mobilisation, which is 23rd to 25th April. Today's press conference will include three special guests and I'm happy to welcome Greta Thunberg, Climate and Environmental Activist, Elahi Rawshan from Bangladesh, volunteer in the International Federation of the Red Cross and Red Crescent Society, supporting young people in Bangladesh, and Daisy Moran from the USA, Global Youth Mobilisation Youth Board Member and World YMCA Representative. Welcome to the three of you. We will have simultaneous interpretation as usual provided in the six official UN languages, Arabic, Chinese, French, English, Spanish and Russian, plus Portuguese and Hindi. Now let me introduce the participants here in the room. Present in the room are Dr Tedros Adhanom Ghebreyesus, WHO Director-General, Dr Maria Van Kerkhove, Technical Lead on COVID-19, Dr Bruce Aylward, Special Advisor to the Director-General and the Lead on the ACT Accelerator. We have Mr Anil Suni, Chief Executive Officer from the WHO Foundation and we have Dr Maria Nera, Director for Health and Environment. We also have joining us remotely today Dr Mike Ryan, Executive Director for the Health Emergencies Programme of WHO, and Dr Mariangela Simao, Assistant Director-General for Access to Medicines and Health Products. With this let me hand over to the Director-General for the introductory remarks. Dr Tedros, the floor is yours. Thank you. Thank you, Christian. Good morning, good afternoon and good evening. Last week new cases of COVID-19 increased for the eighth week in a row with more than 5.2 million cases reported, the most in a single week so far. Deaths rose for the fifth straight week and more than three million deaths have now been reported to WHO. It took nine months to reach one million deaths, four months to reach two million and three months to reach three million deaths. Big numbers can make us numb but each one of these deaths is a tragedy for families, communities and nations. Infections and hospitalisations among people aged 25 to 59 are increasing at an alarming rate, possibly as a result of highly transmissible variants and increased social mixing among younger adults. 00:04:28 Today the emergency committee gave me its advice on vaccines, variants, international travel and other issues. Its full statement is available on our website. We have the tools to bring this pandemic under control in a matter of months if we apply them consistently and equitably. On Friday WHO issued an expression of interest for establishing a COVID-19 technology transfer hub for MRNA vaccines to increase production of those vaccines in low and middle-income countries. We're calling for the original manufacturers of MRNA vaccines to contribute their technology and know-how and for manufacturers in low and middle-income countries to express interest in receiving that technology. We have seen incredible innovation in science. Now we need innovation to ensure as many people as possible benefit from that science. The pandemic will recede but we will still be left with all the other challenges that we had before including the climate crisis. 00:05:58 This week marks Earth Day on 22nd April, a reminder that human health depends on the health of the planet that sustains us. COVID-19 has now killed more than three million people. Air pollution kills more than double that number, seven million people every single year. Despite temporary improvements in air quality last year as a result of so-called lock-downs by September air pollution had returned to pre-pandemic levels. Globally CO2 emissions only decreased by less than 6% last year but by December they had rebounded to their previous levels. The health argument for climate action is crystal-clear. The same unsustainable choices that are killing our planet are killing people. There is no vaccine for climate change but we do have solutions. Last year WHO published our manifesto for a healthy and green recovery, calling on all governments to protect nature, support clean energy sources, develop sustainable food systems and healthier cities and reduce polluting activities. 00:07:36 Together the six prescriptions of the WHO manifesto can not only restore resilient economies; they are a linchpin and essential prerequisite for healthy societies. At the COP26 climate conference in Glasgow this year WHO will deliver a special report with recommendations on how to maximise the health benefits of tackling climate change while avoiding the worst health impacts of the climate crisis. WHO is also spearheading an initiative on promoting climate-resistant health systems in collaboration with the Government of the United Kingdom. Today it's my honour to welcome someone who needs no introduction. Over the past few years Greta Thunberg has become the powerful voice of a young generation demanding climate action. Greta's mobilisation of communities, particularly young people, has been truly inspirational and has brought into sharp focus the impact of the climate crisis on people's lives and the urgent need for transformative action. The awareness she has raised on the links between climate, the environment and health has supported WHO's agenda in these areas, demonstrated the threats all of us face and the role young people can play in building a more sustainable, safer, healthier world. 00:09:33 More recently she has become a powerful advocate for vaccine equity. Tack så mycket, Greta. Today Greta has announced a donation of €100,000 from the Greta Thunberg Foundation to the WHO Foundation in support of COVAX to provide vaccines to people in need. Greta, thank you, tack så mycket for your superb advocacy for climate action and now for vaccine equity. Your contribution makes you the youngest person to contribute to COVAX. Welcome and you have the floor. GT Thank you so much for having me. It is an honour to participate in this event and I will talk briefly now. Science shows that in the future we will most likely experience more frequent and more devastating pandemics unless we drastically change our ways and the way we treat nature. Today up to 75% of all emerging diseases come from animals and as we are cutting down forests and destroying habitats we are creating the ideal conditions for diseases to spill over from one animal to another and then to us. 00:11:08 We can no longer separate the health crisis from the ecological crisis and we cannot separate the ecological crisis from the climate crisis. It's all interlinked in many ways. During this pandemic we have seen what we can achieve when we put resources into science. Vaccines were developed in record time but so far on average one in four people in high-income countries have received a coronavirus vaccine compared with just one in over 500 in low and middle-income countries. The international community, governments and vaccine developers must step up their game and address the tragedy that is vaccine inequity. We have the tools we need to correct this great imbalance that exists around the world today in the fight against COVID-19. Just as with the climate crisis those who are the most vulnerable need to be prioritised and global problems require global solutions. It is completely unethical that high-income countries are now vaccinating young and healthy people if that happens at the expense of people in risk groups and on the front lines in low and middle-income countries. This is a moral test. We talk today about showing solidarity and yet vaccine nationalism is what's running the vaccine distribution. It is only when it really comes down to it that we show our true face and that is why I and many others are supporting WHO, GAVI and all involved in the COVAX initiative, which I believe offers the best path forward to ensure a more equitable global vaccine distribution and a way out of this pandemic. Thank you. 00:13:04 TAG Thank you. Thank you so much, Greta, and thank you for your generosity in donating to the WHO Foundation in support of COVAX. These funds will help us save lives. Around the world young people have been affected by the pandemic in many ways from disruptions in education, loss of employment opportunities, mental health challenges and increased domestic and gender-based violence. WHO is committed to ensuring that the global recovery from COVID-19 includes the voices, energy and ideas of young people. To do that we have partnered with an alliance of the six largest youth development organisations in the world to form the Global Youth Mobilisation, to empower young people to respond to the challenges created by the pandemic in their local communities. 00:14:08 The Global Youth Mobilisation has established a grant mechanism with funds from the Solidarity Response Fund to support innovative local solutions to address the impact of the COVID-19 pandemic. From today young people around the world will be able to apply for grants of between 500 and US$5,000 through the Global Youth Mobilisation. These local solutions will be judged and decided on by young people for young people. To mark the starting point for young people to get involved in the Global Youth Mobilisation a Global Youth Summit will be held virtually from this Friday to Sunday, 23rd to 25th April. Over three days thousands of young people, leaders, policymakers and change-makers will come together in one space to discuss the issues facing young people across the world. On behalf of the Big Six youth organisations, the United Nations Foundation and WHO I invite everyone to join us at the Global Youth Summit. Today I'm delighted to be joined by representatives from two of the Big Six organisations. First it's my honour to welcome Elahi Rawshan, a volunteer with the International Federation of the Red Cross and Red Crescent Societies in Bangladesh. Elahi, thank you for joining us today. You have the floor. 00:16:05 ER Thank you, Dr Tedros, for inviting me here today. I'm really honoured to be here. My name is Elahi Rawshan. I'm a Red Cross/Red Crescent youth volunteer living in Bangladesh. There are about three million young people around the world how have been taking action to respond to the COVID-19 pandemic, driving the response efforts and supporting their local communities. I'd like to share with you my story to help explain why recognising, championing and investing in young people through the Global Youth Mobilisation is important. I led the very first disinfection team of Bangladesh Red Crescent Society in different hospitals for two consecutive months. At the beginning of the pandemic here the hospitals needed more supporting hands and we wanted to make sure the hospital environment was safe for everyone and we did to a great extent. One day when the very first COVID patient died in a hospital and everyone was so frightened to go near him, even his own son was reluctant to take his father's body. We went in, we disinfected the room and made sure the body was safe for carrying. 00:17:31 Another day I carried a critical COVID patient on a wheelchair and put an oxygen mask on her when there was no-one around for the support of that person. But I was not the only one; there are thousands of young people in Bangladesh fighting this battle in many different forms. About 4,500 young volunteers of the Red Crescent Society are supporting the vaccination programme every day in Bangladesh. It's mostly the young people here who are making a difference and again it's the young people here who are mostly infected by the pandemic. Many of my friends, colleagues from the different youth organisations and networks have lost their jobs. Almost everyone here is suffering from mental health issues. The data shows that from March 2020 to February 2021 more than 14,000 have committed suicide, which is 45% higher than the previous year and the majority of them are young people. 00:18:44 My dear friends, I have seen localised action making a positive impact on people's lives during this pandemic. I have been trying to collaborate with the Red Crescent Society with my workplace [unclear] who have been offering an online skills programme for the young people. Now as both parties have agreed the Red Crescent youth volunteers will receive a three-month online skills training on different trades like graphics designing, web development, etc. I believe drives like this will help young people individually and at the same time will contribute to the national economy. There are plenty of organisations and individuals out there who are making many more new initiatives to combat this COVID crisis and I would like to invite them all to collaborate with the Global Youth Mobilisation and it will support, promote and invest in your initiatives for improving more lives and communities. Thank you. TAG Thank you. Thank you so much, Elahi. Next it's my pleasure to introduce Daisy Moran, a representative of the World YMCA and a board member of the Global Youth Mobilisation. Daisy, thank you for joining us and you have the floor. 00:20:16 DM Thank you for giving me this opportunity, Dr Tedros, and greetings to you all. I'm Daisy Moran, proud to be with the YMCA in Illinois, USA and proud to be one of the six youth board representatives of the Global Youth Mobilisation. Here's what youth mobilisation has meant for me as the COVID pandemic has significantly increased the inequities in all of our societies. As a young leader I saw a need in my community to offer relief to essential workers who are undocumented immigrants. Through collaboration with fellow young change-makers and organisations we were able to disburse almost $17,000 in relief funds for 38 families. This is just one of thousands of stories that illustrate the simple and powerful fact; when given access and opportunities young people can make a significant difference. In the YMCA and right across the Big Six youth organisations young people have stepped up during the pandemic by delivering supplies to vulnerable people, looking after each other's mental health, making masks, helping share vital public information and now actively facilitating the COVID vaccine campaign. 00:21:35 As the global pandemic enters the recovery and relief period it is crystal-clear that young people are disproportionately impacted by the immediate and long-term implications of disruption in education, employment opportunities, physical and mental health/well-being, to name a few. These two reasons - young people bearing the brunt of the impact of COVID and young people offering so many of the solutions - are what has inspired the Big Six organisations, the World Health Organization and the United Nations Foundation to support young people around the would in delivering and developing youth-led community solutions through the Global Youth mobilisation. I am so excited and I want young people all over the world to be excited and get involved. They can start by attending the Global Youth Summit, which will be held virtually from 23rd to 25th April. At the summit they will hear about the role of young people in the immediate and long-term COVID recovery. It's a great forum where we can share our thoughts, passions, ideas that will influence policies and decisions that impact all of our lives. 00:22:47 This is a critical time for my generation, for our generation to bring policymakers, change-makers, advocate together to address the major challenges confronting young people by solutions and put them into action in our communities. No matter how big or how small I encourage you to have the confidence to apply for funding. If you have an idea to a challenge created by the pandemic you can apply for funding from $500 to $5,000. It is young people like you and me who will evaluate and agree who gets support for these local solutions. So please visit our website, www.globalyouthmobilisation.org We are the movement by youth, for youth and young people really are the answer. We are not the challenge. We are truly being the change that we want to see in the world. Thank you. TAG Thank you. Thank you so much, Daisy - by youth, for youth - and thank you to both of you for your leadership and vision. I look forward to joining both of you at the World Youth Summit and I look forward to seeing what ideas we can help take forward through the Global Youth Mobilisation. This is a reminder that although we're all living through a dark time there are also many reasons for hope and optimism about the future. Christian, back to you. 00:24:24 CL Thank you very much, all, and thank you very much, Dr Tedros. We will start the round of questions and answers. To remind you, if you want to get into the queue for questions please press the raise your hand icon on your screen. We'll start with the first question from Carlos from El Mundo. Carlos, please unmute yourself. CA Hi. CL Go ahead, please. CA It's a question specifically for Greta. Isn't there a risk that the COP26 will lose its momentum? What should we change in the next three months for example to turn the tide and to put the two goals of climate change and vaccination equality on the same level? CL Thank you very much, Carlos. Yes, Greta Thunberg, please. 00:25:27 GT Of course there's a risk that COP will lose momentum but the most important thing is that everyone is safe and of course safety and health come first in these kinds of situations. Of course there's not just one thing that needs to change in order to break this trend that we are seeing now, there's not just one single thing that we can do to - so-called - solve the climate crisis and the vaccine inequity crisis. Of course it's a bit more complicated than that and I think I may not be the best person to answer that. I think there are lots of experts who are more suited for that question but we do need to change our mindsets, we do need to think globally and not only think about ourselves. That's what these crises come down to, that we only think about ourselves, that we don't think about others. They come down to the way we treat others, the way we treat other human beings, the way we treat other animals and nature itself so we need to change our mindsets, if you want one single thing; it's more complicated than but just one thing. CL Thank you very much, Greta. I'll ask Dr Maria Neira from WHO to add, possibly. 00:26:56 MN Thank you, Christian, and thank you very much, Greta. It's really a pleasure to have you with us. You are an inspiration. You have been driving an incredible movement and many people are behind so certainly the COP26 has to be something very successful. In response to your question, Carlos - hola - I think what will change the mindset and what might have an incredible impact is what the Director-General was saying at the beginning, the health argument of climate change. If we are able to explain to people that climate change is about our health, it is affecting our health and if we stop burning fossil fuels the benefits will be enormous in terms of reducing the process of climate change but as well on reducing air pollution. Air pollution, as mentioned again by the Director-General, is responsible for more than seven million premature deaths every year due to exposure to air pollution and in addition to that it creates an environment that makes our health more vulnerable and creates the perfect conditions for more emerging infectious diseases to occur. 00:28:12 So I think we have a perfect case here for creating more action at the COP26, giving the health benefits that can be obtained in an incredible way. If we tackle the causes of air pollution, if we tackle the causes of climate change that will be an enormous health agenda and talking about health is what can make this change that we all need in terms of ambition to go for more at [?] the COP and in convincing people. If we tell people that this is connected to human health I think this will be the final argument that will create much more motivation and engagement and probably a stronger movement to put political pressure on those who will take decisions and hopefully going for much more. Thank you. CL Thank you very much. This was Dr Maria Neira, Director for Environment, Climate Change and Health. The next question goes to Shoko Koyama from NHK. Shoko, please unmute yourself. SH Hello. Can you hear me? CL Go ahead, please. SH Thank you for taking my question. Regarding COVAX, UNICEF is trying to buy one billion syringes by the end of this year in order to distribute to countries together with vaccines. 00:29:37 One billion syringes in addition to the six to 800 million syringes they procure annually seems to be a large quantity. Is COVAX able to procure this huge number of syringes by the end of this year and what challenges are there regarding the procurement of syringes? Thank you. CL Thank you very much, Shoko. I'll give it to Dr Bruce Aylward. BA Thank you very much, Shoko, for the question and thanks for highlighting that it takes more to get the world vaccinated than simply to make and procure the vaccines because there are all the additional pieces that have to go into this including additional supplies like not just syringes, which you mentioned, but also the vaccination cold chains and other supplies that are necessary to keep them in the right conditions before we get them to the actual people who need to be vaccinated. 00:30:38 In terms of the syringes, just like the cold chain equipment the COVAX facility began working with countries way back in October or even earlier last year to look at what numbers of syringes would be required and to start working with manufactures to ensure that pipeline would be there. You might remember some months ago the Director-General invited Henrietta Fore, who is the Executive Director of UNICEF, to join one of these press conferences and at that time she explained what they were already doing to try and make sure that the necessary syringes would be in place. This will continue to be a challenge, just like all of the supplies necessary to get the world vaccinated, these extraordinary numbers but for the moment the pipelines are there and the producers are doing their part. But it all comes back again also to the COVAX facility having the resources it needs so that it can put the contracts in place up-front to make sure the supplies are there, not just the supplies in terms of the vaccines but, exactly as you highlight, the syringes and the other supplies including, as I mentioned, the cold chain equipment and sometimes very specialised cold chain equipment to get these products to people. 00:31:57 CL Thank you very much, Dr Aylward. We'll move on to Robin Mia from AFP. Robin, please unmute yourself. RO Thank you. A question for Greta, if I may. If vaccine inequity carries on and young people start being offered a vaccine in wealthy countries whilst at the same time elderly and wealthy people remain completely unprotected in poor countries, would you advocate a vaccine strike amongst younger people in rich countries until their governments start sharing more vaccines? Thank you. CL Thank you very much, Robin. Of course, Greta, the floor is yours. GT We must not forget that this is not a problem that is caused by individuals. This is a problem that needs to be addressed by the international community, governments and the vaccine developers. It is wrong; if we should start focusing on individuals and urging individuals not to take the vaccine that would send a very wrong message. 00:33:00 Of course everyone who is offered a vaccine should take it but we need to see the bigger picture here and be able to focus on several things at once. So no, I would not advocate for people not to take the vaccine. CL Thank you so much for that. We'll move to Jamil Chad from O Estado de Sao Paulo. Jamil, please unmute yourself. Jamil, do you hear us? Please unmute yourself. JA Can you hear me, Christian? CL Please go ahead. JA Can you hear me? CL Yes. JA Thank you. This is Jamil Chad, a journalist from Brazil. Ms Greta Thunberg, my question is about vaccines but also on climate change. What is your message to President Bolsonaro at this time when both the pandemic is hitting Brazil hard but also climate change is an issue? You'll note very well what is the position of President Bolsonaro. What is the message you can send him today? Thank you. CL Thank you so much, Jamil. Over to Greta. 00:34:24 GT Of course I don't think we should be focusing on talking about individuals since this is a much larger problem but of course Jair Bolsonaro has a huge responsibility both when it comes to the climate, environment and of course we can see the response that Brazil has had during the corona pandemic. I can only speak for myself but I can safely say that he has failed to take the responsibility that is necessary in order to safeguard present and future living conditions for humanity. CL Thank you very much, Greta. We'll move on to Navas Shah from Xinhua. Navas, please unmute yourself. Navas Shah, do you hear us? Please unmute yourself. It looks as if we're not getting to you so we will continue with Gunila Van Hal from Svenska Dagbladet. Gunila, please unmute yourself. GU Can you hear me? CL Wonderful. Go ahead. GU Thanks for taking my question. It is to Greta Thunberg and I'd like to know your view on the proposal from WHO and many governments, among those your own, the Swedish Government, that richer countries should donate remaining vaccine doses to poorer countries once their own risk groups have been vaccinated and before they vaccinate the rest of the population. 00:36:06 What do you think about this and what do you respond to people questioning this, saying, why should we sacrifice our own populations in order to save the world? Thank you. CL Thank you, Gunila. Over to Greta, please. GT I think that is a very reasonable thing to do. We need to protect and prioritise the most vulnerable people in risk groups and working on the front lines, no matter which countries they come from; at least that's my opinion. Of course I understand that people will be frustrated by that. Of course I also want to return to everyday life and everyone I know wants to do that as well but we need to act in solidarity and we need to use common sense when it comes to these issues. As I said, the only sensible thing to do, the only morally right thing to do is to prioritise the people who are the most vulnerable no matter whether they live in a high-income country or a low-income country. 00:37:23 CL Thank you very much, Ms Thunberg. We'll move ahead to Jamie Keaton from AP. Jamie, please unmute yourself. JM Thank you, Christian. My question is both for Ms Thunberg and Ms Moran. What is your message to young people who have become a major driver of COVID-19 infection? We heard the Director-General, Dr Tedros, just mention that increased social mixing among younger adults is possibly one of the reasons for the increase in infections and hospitalisations among people aged 25 to 59. If I could just sneak in a another question to Ms Thunberg, ahead of President Biden's climate summit what do you hope it will achieve? Thank you. CL No small questions today. Thank you very much, Jamie. Let's move to Greta Thunberg first and then on. Thank you. GT Yes, of course it's absolutely crucial that everyone takes our personal responsibility in this crisis. We young people may be the ones who are in general least affected by the virus in a direct way but of course, as I said, we need to act in solidarity with the people in risk groups. 00:38:57 Of course many young people fail to draw that connection maybe; of course not everyone but of course there will always be some. My message to those is that during crises like these we need to take a few steps back and act for the greater good of society and in order to protect our fellow citizens and of course especially people in risk groups because that is the thing you do during crises; you step up for one another. My hopes for the Biden summit; I hope that we will soon in one way or another start treating this crisis like a crisis - the climate crisis, that is - because if we are to be blunt, we can have as many summits as we want, we can have as many meetings and conferences as we want and make nice speeches and nice pledges like next year or 2050 and so on. But as long as those things contain so many loopholes as they do and as long as we are not actually treating the crisis as a crisis of course we won't be able to achieve any major changes. As I mentioned earlier, we need to change our mindsets and we need to change or view of the world. We cannot try to solve this crisis with the same approach that got us into it in the first place so we need to start treating the crisis like a crisis. 00:40:40 Without an increased level of awareness among people in general of course there will be no pressure on world leaders to actually start making the changes that are necessary to safeguard humanity so my hope is that we will start treating the crisis like a crisis. CL Thank you so much, Greta. Let me first give the floor to Daisy Moran from the global youth organisation [unclear]. Daisy. DM Thank you and thank you for your question. I believe my generation, our generation that we are representing is a generation of allyship because we understand our privilege and how to use our privileges to uplift those in the most vulnerable situations. The Global Youth Summit is a platform and a forum for all of youth and stakeholders and supporters to come together to really listen to what are the policy changes that need to be made so that we can have more equitable societies and systems in place. So I hope that you can join us this weekend while we discuss the important issues and challenges facing our generation and how our youth leaders are in a position to create the most innovative solutions to tackle these big issues. Thank you. 00:41:59 CL Thanks so much, Daisy. Now we'll move to Dr Maria Van Kerkhove. MK Thanks, Christian. Those were excellent answers but I did want to clarify something here with regard to increased transmission. We are seeing increased rates of infection across all age groups. Last week there were 5.2 million cases reported to WHO globally, the largest in a single week since this pandemic began, 16 months into the pandemic. That is the largest increase in a week that we have seen to date. We've seen an increase across all age groups. We need to take the blame away and in the question it was meant to blame and we can't do that. Everyone has a role to play in this pandemic. We all have a role to play in keeping ourselves and our loved ones safe. What we are seeing is a slight age shift in some countries driven by social mixing and social mixing doesn't necessarily mean going out and having a party. It means individuals who have to leave their home to go to work, it means individuals have to feed their families and if you increase social mixing for a variety of reasons, whether this is for work or for religious reasons or indeed socialising itself the virus will take advantage of that. 00:43:18 If you add on top of it these variants of concern, variants that are circulating around the world, particularly the B117 variant which is circulating in a large number of countries across the globe that have increased transmissibility; if you add variants that have increased transmissibility with increased mixing this virus will take off and case numbers will increase. In a number of countries we've seen a very, very steep incline due to this. In addition to that we are seeing some countries not able to implement the public health and social measures that are needed to allow for physical distancing and in many parts of the world physical distancing is really not possible but in other parts of the world it is. So we need to do what we can to avoid those crowded settings, avoid those settings where social mixing - particularly indoor, crowded settings where there's poor ventilation, where the virus really likes to spread efficiently between individuals. 00:44:18 We need governments to enable people to carry out those measures; very easy for us to say stay home if you can but we need governments to support individuals to work from home, to stay home if necessary so that we can reduce the possibility for the virus to spread. All of us really have a role to play. Youth, young people, children, young adults are showing us ways in which to be innovative, to remain socially connected yet physically distant. I think what we are seeing with the youth and this youth mobilisation is really energetic. There's a spirit, there's an energy here that is holding leaders accountable and saying, help us help the situation and I'm really inspired to see that. I was really happy to hear the by youth, for youth as you pointed out and showing us that young people, young adults, children can make a significant difference every day. So please let's stop the blame in terms of who is spreading. All of us have a role to play, all of us need to be supported in taking those individual-level measures as well as measures at the family, at the community, at the sub-national, at the international level. 00:45:30 CL Thanks so much, Dr Van Kerkhove. We have Dr Mike Ryan, WHO Health Emergencies Executive Director, to add. MR Thanks, Christian. I just want to reflect on one thing that Daisy said. She said youths are not the problem, youths are the solution and I fundamentally believe in that and thank you, Daisy, for saying that and the energy from everyone today is fantastic. Reflecting on something that Greta said, she spoke about mindset and mindset is everything and Tedros reminds of that every day, I think; it's one of his most common pronouncements about mindset and it doesn't matter what problem you're trying to solve. There's no amount of announcement, there's no amount of recommendations, there's no amount of anything that changes anything until we change our mindset and that can be the mindset about protecting ourselves and our families from COVID and taking precautions. It can be the mindset on government's response to COVID. It can be the mindset driving climate action and reducing climate change. 00:46:37 So I think really we all need to reflect on that. It is our mindsets that drive our behaviour, both positive and negative and they're having a huge impact on the planet and obviously our behaviour's having a huge impact on the trajectory of this pandemic. Thank you. CL Thank you very much, Dr Ryan. The next question in line comes from Isabel Sacco from EFE. Isabel, please unmute yourself. IS Good afternoon, thank you, Christian. I would like to know if you can give us an overview of the proportion of the people under 40 years old who are in ICUs globally or by region. Connected to that, what do we know about mortality among babies? I saw figures from Brazil that indicate that 1,300 babies have died there from COVID. Thank you. CL Thank you very much, Isabel; very detailed questions. Let me give to Dr Maria Van Kerkhove first. MK Thanks for these very important questions. I cannot give you a specific answer of the proportion of those under 40 in ICU but what I can say is that there is an increasing number of hospitalisations among younger individuals and this is driven by what I answered in the last part of the question. 00:48:01 When you have increased transmissibility across all age groups you will see increased rates of hospitalisation, you will see an increased proportion of ICU and you will see increases in death. We are seeing unfortunately a little bit of a shift in the age structure in terms of the median age of individuals who are infected but that is driven by changes in social mixing patterns. If you remember, last spring, in the northern hemisphere's spring we saw a similar situation where as societies were opening up across Europe for example there was an age shift in the median age; it went from an older age group to a slightly younger age group. Again this is driven by people who are leaving their homes to go back to work and if there is the virus that is spreading, if you have virus variants this is a dangerous combination. We are seeing increases in hospitalisation among younger age groups and increased ICU and increased deaths. 00:48:55 With regard to children I did see that report that you mentioned about Brazil. Overall if we look at infection among children, if we look at severity among children still around the world there is a lower proportion of children that experience disease, that experience severe disease and some children do die. If there is a lot of virus that is circulating, if you have millions of cases being reported - and you know so far we've had 140 million cases reported worldwide - we will see deaths in all age groups. With regard to the youngest children, overall they tend to be more mild but again this is not universal. We do see that children, particularly children with underlying conditions but children in general, have died from COVID. So everyone is at risk from this virus. People are at risk of getting infected, at risk of getting severe disease so we do need to do what we can where we can as much as we can to first and foremost prevent infections but also making sure that we use the systems that are in place to get tested, to be able to carry out the public health actions that do prevent the spread from an adult to a child, from a child to an adult; everything that we can to really prevent that level of infection and care for as many people as we can, getting them early into that clinical care pathway to receive the care based on the symptoms that they have. 00:50:28 CL Thank you so much. The next question goes to Akwazi Sarpong from BBC News Africa. Akwazi, please unmute yourself. Akwazi, do you hear us? Yes, please go ahead. AK [Inaudible]. CL Akwazi, the sound is really bad. Please try one more time. AK Yes, [inaudible] in Ghana so [inaudible]. I have two questions. I would like [sound slip] many young people living with disability, particularly visual impairment, have been affected by this virus in Africa and at the global level. The second question is, what programmes are in place to support families with children and young persons with disability and special needs to help us combat this? Thank you. CL Thank you very much, Akwazi; very important questions. I'll hand to Dr Van Kerkhove for a start. 00:51:35 MK I can start. In fact we have departments that are working particularly on persons with disabilities to ensure that persons with disabilities, who are disproportionately affected by COVID-19 in a variety of ways, whether this is about getting the right care, receiving information appropriately so that they know how to keep themselves safe, making sure that they have the ability to receive the materials they need, testing, etc. We have some guidance that is coming out, I hope, today - it was approved yesterday - looking specifically at the more than one billion people worldwide who are living with disabilities, making sure that they have access to vaccination for example. We have seen some innovation in terms of personal protective equipment; if you've noticed, some of the masks for example will have a clear panel so that you can see lips moving for people who have a hearing impairment so there are a number of innovations that are coming online to support individuals with disabilities but also families with disabilities as well because even individuals with disabilities; their caretakers have to be able to care for them. So we need to make sure that those caregivers are protected against the virus as well so there're a number of activities that are underway to ensure those living with disabilities as well as those caring for those with disabilities have the appropriate care and information that they need. 00:53:05 CL Thank you very much, Dr Van Kerkhove. The next question goes to Priti Padnaik from Geneva Health Files. Priti, please unmute yourself. No, Priti lowered her hand apparently in the meantime or we don't find you any more. The next question goes to John Zaracostas from The Lancet. John, please unmute yourself. JO Good afternoon. Can you hear me there? CL Very well. Go ahead. JO I was wondering if you could give me up-to-date estimates on how many vaccine facilities worldwide with excess capacity could be enabled to produce vaccines and secondly, if possible, if Dr Tedros could give us his perspective on what's going on in his homeland where right now they're facing an existential threat. CL Thank you very much. We'll take the first question and I guess we'll see if Mariangela Simao is online... or then... SS I could start. CL Dr Swaminathan; exactly. Please go ahead. SS Thank you. Thank you very much, John, for that question. This is exactly the work that we've started now as part of the COVID vaccine manufacturing taskforce with our COVAX partners, CEPI, GAVI, UNICEF as well as the private sector and regional bodies like the African Union but also other regional organisations. The idea really is to take a short-to-medium-term and a longer-term approach. The short-term and the immediate need is to increase vaccine supplies within the next weeks and months and that can be done by unblocking roadblocks and obstacles that have been identified by the manufacturers and by working with suppliers of those critical ingredients and raw materials so that we can link suppliers and manufacturers as well as work with member states to make sure that export bans and things like that don't interfere with the process of vaccine manufacturing. That's our immediate short-term priority which hopefully will be able to put more doses for COVAX in the coming weeks. The second, more medium-term, is to look at fill and finish capacity to link... 00:55:43 We know that there's a lot of unused fill and finish capacity globally and therefore we need manufacturers who have the capacity to make bulk product and link them with these existing fill and finish capacities in facilities around the world. CEPI already has done a mapping of that and it exists. Then the third, more medium to longer-term, is really to develop new facilities that would build on existing facilities, particularly in low and middle-income countries and get technology transfer, encourage companies. As the DG mentioned, the WHO put out a call on Friday both for owners of technology, particularly MRNA technology to begin with, to come forward to work with us to share that technology, share the know-how and experience with recipient companies that will be selected according to a set of criteria that we are developing. 00:56:40 This will ensure not only supplies for this pandemic - though it may take a few months to get up and running if we start with existing facilities with some expertise - but also will help the future regional health security of regions which currently do not have any manufacturing capacity. This obviously can be extended to vaccines for many other infectious diseases. So that's what the taskforce is looking at and over the coming days we will provide much more detail. Thank you. CL Thank you so much, Dr Swaminathan. I'm calling on Dr Mike Ryan to take the other part. MR Thank you, John; important question. The situation in Tigray in Ethiopia remains very, very dire at the moment. The situation is not improving. We have unpredictable access, increasing humanitarian needs, increasing sexual violence. The response has been hindered by armed clashes throughout the region and many areas are still not receiving food or other assistance. We've got 4.5 million people affected by this crisis. 2.5 million of them have no access to services whatsoever. Half a million people have no access to food. We have a million internally displaced people in 178 sites scattered across the region being served by IOM and UNHCR. 00:58:18 We've had over 800 cases of sexual and gender-based violence reported from just five hospitals alone; that many cases. We've over 62,000 refugees who have crossed into Sudan. That safety valve is very, very difficult to manage and very difficult for us to have access from that side and to support people in the affected area. So, as I said, unpredictable access, displacement, tremendous humanitarian needs but we have 20 health partners working with us who are operational on the ground but they're only accessing about half of the... where aid is concerned. When we look at health facilities, we've done a health facilities survey throughout the region in 264 health facilities. As of now only 72 of those facilities are operational and 40 of those are only partially accessible. 19 hospitals have been completely damaged or destroyed; 15 more with major damage. There're inadequate supply chains across the board. 00:59:23 So the situation in Tigray could not be more dire, the people there could not be in more need of support and help. The situation is deteriorating. The situation is very much a massive concern on a purely humanitarian basis here. There is a health crisis on top of a humanitarian crisis. We're very concerned about malnutrition, about malaria, about cholera, measles, COVID-19 - positivity rates have been rising - and other diseases like meningitis and other diseases that will exploit malnutrition, they will exploit stress and they will exploit all of what's happening in that population. We have resumed surveillance activities but only covering about 30% of the population and again severe, acute malnutrition is a major, major issue. It is very hard to overstate the extent of the humanitarian crisis and the health crisis currently unfolding in Tigray and the WHO and the other UN agencies and NGOs are calling for unfettered humanitarian access and for military conflict and those perpetrating the conflict to remove themselves from civilian areas and those who should not be there should not be there. Thank you. CL Thank you very much. This was Dr Mike Ryan, Executive Director for WHO's Health Emergencies Programme and Dr Bruce Aylward wanted to come in too. 01:00:51 BA Thanks, Christian. I just want to come back to the important point you raised, John, about how much capacity is unused around the world right now because there was huge attention last week at the conference of the African Union on the consultation that was called by the World Trade Organization to try to expand vaccine production globally. But we need to remember that the challenge is how we're actually using the doses that are being made because last week while those conferences were taking place 100 million more doses of vaccine were administered around the world. The issue, John, is where they're being administered because 1% of that 100 million went to low-income countries so 99 million doses of vaccine last week went into high, upper-middle-income and some low-middle-income countries but only 1% of that went to the lowest-income countries. 01:01:48 So every time we bring new capacities online, when we bring new deals online, etc, that you're hearing about we need to ask the question of where those doses are going because those doses are not going to the places that have got the least vaccine today. So we need to be careful in thinking that we can simply build additional capacity because that capacity is still going to the wrong places, quite frankly. While we are giving great attention to how we expand capacity it's going to take weeks and months for that to come online and in the meantime we've got to take some urgent and important decisions about how we are going to use the vaccines that exist today because if we have a lot more weeks where 100, 99% of the vaccine goes to a set of countries that already have most of the vaccine we are not going to get out of this crisis as rapidly and efficiently and with the least lives lost possible. CL Thank you very much for all your answers. With this we're coming to the end of our question-and-answer session. I was very glad to have you all online today and our special guests and I will ask our special guests to start the closing round and we'll go in reverse order. We'll start with Daisy Moran, the Global Youth Mobilisation, Youth [Unclear] and Worldwide YMCA representative. Daisy, please go ahead. 01:03:20 DM Thank you for the opportunity once again and as a reminder, please join us this weekend on April 23rd to 25th to have your voice heard. You have the solutions; please come to the table. We want you to be involved in your local communities and we have the funds to support you. With any questions please visit our website at www.youthglobalmobilisation.org Thank you. CL Fantastic. Thanks so much. Now we go to Elahi Rawshan, volunteer from the International Federation of the Red Cross and Red Crescent Societies, supporting young people in Bangladesh. Elahi, please go ahead. ER Thank you. I would like to thank everyone for inviting me here and I would like to echo the last voice; young people are the solution and I would like to invite all the localised solutions to collaborate with the Global Youth Mobilisation, who have been supporting these local actions and promoting them. 01:04:22 So I would also like to invite everyone to join the Global Youth Summit coming up this week from 23rd to 25th. Thank you once again. CL Thank you so much, Elahi, to you. Last but not least we go to Greta Thunberg, Climate and Environmental Activist. Greta, the floor is yours. GT To be honest I don't really have anything more to add. Just take care, everyone. But also while we have media here, I really urge you to really bring awareness to this issue of vaccine inequity because you have the power to raise awareness about this. When we talk about countries like, for example, the UK and the US - just as a few examples - that they are mass-vaccinating large groups of their populations, even healthier young people, we see it from a different perspective, that we don't always see it from our Western, privileged point of view but rather that we think globally and we need to prioritise those most vulnerable first. Thank you. Take care, everyone. CL Thank you so much, Greta, for these words. Yes, there's hardly anything to add; I agree. From my side let me thank everyone and remind you that the sound files of this press briefing will be shared right afterwards today and the transcript will be available as of tomorrow. Dr Tedros. TAG Thank you. Thank you, Christian. I would like to thank our guests today, Greta, Elahi and Daisy. You have been wonderful. Thank you so much indeed. I would also like to join you in inviting everybody to join on the 23rd to 25th the Global Youth Summit, from Friday to Sunday so I look forward to seeing you there. I would also like to thank our media colleagues who have joined and see you in our upcoming presser. That will be on Friday. Thank you so much. 01:06:54

Empresas con propósito social y ambiental / Companies with social purpose and environmental

El documento contiene un diagnóstico, opciones de política, recomendaciones para la implementación de la política propuesta y una hoja de ruta para el próximo gobierno con horizontes a 100 días, un año y cinco años de gestión. Todo ello se pone a disposición de los partidos políticos, los candidatos a la Presidencia y al Congreso de la República, los medios de comunicación, la sociedad civil y la ciudadanía en general. Finalmente, este esfuerzo no hubiera sido posible sin el apoyo de nuestros cuatro aliados estratégicos y 11 auspiciadores, a quienes agradecemos por su compromiso con la gobernabilidad democrática y el desarrollo sostenible del Perú.

Vendrán virus más peligrosos y solo un ecosistema saludable nos salvará / More dangerous viruses will come and only a healthy ecosystem will save us

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Urban organic community gardening to promote environmental sustainability practices and increase fruit, vegetables and organic food consumption / Prácticas agrícolas ecológicas urbanas para promover la sostenibilidad ambiental y aumentar el consumo de frutas, verduras y alimentos orgánicos

OBJECTIVE: To describe the environmental practices of participants in an urban organic community garden at the beginning of their gardening experience and after a period of six months, and to discover their opinion about how this activity influenced the consumption of vegetables, fruits and organic food. METHOD: Interviews using structured questionnaires were conducted twice with 115 city dwellers: when they started in the vegetable garden and about 6 months later. The questionnaire included questions related to environmental practices. The second evaluation also included questions related to the consumption of organic food, vegetables and fruit. RESULTS: This research showed significant behavioural transformation, including positive outcomes in environmental practices such as recycling and trying to persuade friends or family to recycle, compost leftovers or choose to walk/bike to save petrol. In the opinion of the participants, activities in the organic community garden helped to increase consumption of fruits, vegetables and organic food. CONCLUSIONS: The study results reinforce the hypothesis that an organic community vegetable garden can induce significant, positive behavioural changes among its users. In particular this research suggests horticulture is associated with positive improvements in personal environmental behaviours, awareness of the environment's high social priority and increased consumption of organic food, fruit and vegetables

OBJETIVO: Caracterizar las prácticas ambientales de los participantes de un jardín comunitario orgánico urbano al inicio de su experiencia en prácticas agrícolas y después de 6 meses, así como conocer su opinión sobre cómo esta actividad influyó en el consumo de verduras, frutas y alimentos orgánicos. MÉTODO: Las entrevistas con cuestionarios estructurados se realizaron dos veces a 115 habitantes de la ciudad: cuando comenzaron en la huerta y unos 6 meses después. El cuestionario incluyó preguntas relacionadas con las prácticas ambientales. La segunda evaluación incluyó también preguntas sobre el consumo de alimentos orgánicos, verduras y frutas. RESULTADOS: Se observó una transformación conductual significativa, incluidos resultados positivos en prácticas ambientales como el reciclaje e intentar que amigos o familiares reciclen, la composta de sobras o elegir caminar o ir en bicicleta para ahorrar gasolina. En opinión de los participantes, las prácticas agrícolas de la comunidad orgánica contribuyeron a aumentar el consumo de frutas, verduras y alimentos orgánicos. CONCLUSIÓN: Los resultados del estudio refuerzan la hipótesis de que un huerto comunitario orgánico puede inducir cambios conductuales significativos entre sus usuarios. En particular, esta investigación sugiere que la horticultura se asocia con mejoras positivas en los comportamientos ambientales y la conciencia de la alta prioridad social del medio ambiente y un mayor consumo de alimentos orgánicos, frutas y verduras

Construção de hidrelétricas e populações atingidas no Brasil: uma revisão sistemática / Construction of hydroelectric power plants and affected populations in Brazil: a systematic review

Este estudo possui o objetivo de realizar uma revisão sistemática dos artigos produzidos no Brasil nos últimos dez anos acerca dos grandes empreendimentos hidrelétricos e dos seus impactos às populações atingidas. A busca foi realizada na Biblioteca Virtual em Saúde Psicologia e na Biblioteca Virtual de Saúde. Localizaram-se 329 trabalhos, sendo que 42 deles foram utilizados para o desenvolvimento deste estudo. Os resultados apontaram para uma equidade entre o número de artigos teóricos e empíricos, demonstrando que as revistas com maior número de publicações estão vinculadas a áreas interdisciplinares, envolvendo a geografia, o meio ambiente e a sociologia. Quanto aos principais resultados, identificou-se um declínio geral nas condições de saúde física e mental, a implantação de políticas reparatórias insuficientes e o papel do Movimento dos Atingidos por Barragens como estratégia de resistência social e política.(AU)

This study aims to carry out a systematic review of the articles that have been produced in Brazil in the last ten years about large hydroelectric power plant projects and their impacts on populations directly or indirectly affected. A search for different articles was performed in the Virtual Health Library in Psychology and in the Virtual Health Library. A total of 329 studies were found, and 42 of them were used in this study. The results show evenness between the numbers of theoretical and empirical articles, which demonstrate that journals with the greatest number of publications are linked to interdisciplinary areas, involving geography, environment and sociology. As for the studies' main results, an overall decrease in physical and mental health conditions, the implementation of insufficient reparative policies and the role of the Movement of People Affected by Dams as a strategy of social and political resistance were identified.(AU)

La universidad y su articulación con la sociedad en la búsqueda de entornos saludables en Yaguajay / The university and its coordination with the society in the search of healthy environments

Analizar el papel del centro universitario en la articulación con la universidad médica en la búsqueda de entornos saludables y su contribución al desarrollo local en el municipio Yaguajay, constituye el propósito fundamental del presente trabajo, para el que se realizó una revisión documental de numerosos documentos y entrevistas a los principales líderes y a la población. El fomento de prácticas y estilos de vida sanos, la integración y capacitación de actores sociales, el desarrollo de la ciencia, la innovación tecnológica y del potencial científico productivo, junto a la sostenibilidad ambiental, fueron algunos de los resultados evidenciados. Se constató que la universidad en el territorio trabajó por incentivar una cultura saludable, por unificar esfuerzos, coordinar acciones, involucrar sectores, consolidar alianzas interinstitucionales dentro y fuera de la esfera sanitaria, con lo que se demostró la fortaleza de la promoción de salud dentro de los procesos de desarrollo local(AU)

To analyze the role of the university center in the coordination with the medical university in the search of healthy environments and its contribution to the local development in the municipality Yaguajay, constitutes the fundamental intention of the present work, for which a documentary review of numerous documents was carried out and interviews to the principal leaders and the population. The promotion of practices and healthy life styles, the integration and training of social actors, the development of the science, the technological innovation and of the productive scientific potential, along with the environmental sustainability, were some of the demonstrated results. It was stated that the university at the territory was employed for encouraging a healthy culture, for unifying efforts, coordinating actions, involving sectors, consolidating inter-institutional alliances inside and out of the sanitary sphere, with what there was demonstrated the fortitude of the promotion of health inside the processes of local development(AU)

LA GOBERNANZA AMBIENTAL EN LAS ÁREAS NATURALES PROTEGIDAS MEXICANAS: UNA REFLEXIÓN DESDE EL ENFOQUE DEL CAPITAL SOCIAL ESTRUCTURAL / ENVIRONMENTAL GOVERNANCE IN MEXICAN PROTECTED NATURAL AREAS: A REFLECTION FROM THE APPROACH OF STRUCTURAL SOCIAL CAPITAL

En este trabajo se realizan algunas reflexiones sobre los recursos sociales que facilitan la construcción de estructuras de gobernanza ambiental para la gestión de las áreas naturales protegidas ­ANP­. Ante la presencia dominante del Estado en estos territorios, el objetivo es identificar los mecanismos sociales que pueden facilitar la vinculación de los actores sociales a favor de estructuras sociales descentralizadas. Se enfatiza en el enfoque del capital social estructural como marco de análisis de las redes y los patrones de organización social. Si bien se señala la presencia de comunidades fuertes que gestionan los recursos de las áreas naturales protegidas, se destaca la necesidad de construir estructuras sociales complejas basadas en la vinculación de actores sociales de escalas y territorialidades distintas que faciliten los procesos de gobernanza ambiental. Se presenta una visión positiva y causal en torno al capital social estructural y la gobernanza; no obstante, se identifican algunas limitantes de dicho enfoque como marco de análisis para la comprensión de las relaciones sociales en territorios complejos como las áreas naturales protegidas. Metodológicamente este trabajo responde a un proceso de revisión bibliográfica y a un análisis de tipo inductivo donde el insumo principal es la evidencia empírica obtenida en trabajos previos realizados por las autoras. El análisis del capital social estructural desde el enfoque estructural puede dar cuenta de la morfología de las relaciones, no así de los vínculos entre actores sociales como un conjunto de relaciones de conflicto, tensiones y desacuerdos; de ahí que se proponen otras perspectivas.

Some reflections on social resources that facilitate the construction of environmental governance structures for the management of protected areas (PA) are made in this paper. Given the dominant presence of the State in these territories, the objective is to identify the social mechanisms that can facilitate the linking of social actors in favor of decentralized social structures. Emphasis is placed on the approach of structural social capital as a framework for analyzing networks and patterns of social organization. Although, the presence of strong communities that manage the resources of protected natural areas is highlighted, the need to build complex social structures based on the linking of social actors of different scales and territorialities that facilitate environmental governance processes. A positive and causal vision around social capital and governance is presented. However, some limitations of this approach are identified as an analytical framework for the understanding of social relations in complex territories such as natural protected areas. Methodologically, this work responds to a process of literature review and to an inductive type analysis where the main input is the empirical evidence obtained in previous studies carried out by the authors. The analysis of the structural social capital from the structural approach can account for the morphology of relationships, but not for the links between social actors as a set of conflict relationships, tensions and disagreements, hence other perspective are proposed.

Gold is not always gold: Bahía Málaga, touristification strategies in the Colombian pacific / El oro no siempre es dorado: bahía málaga, estrategias de turistificación en el pacífico colombiano

RESUMEN Este artículo aborda la manera en que las comunidades negras en el Pacífico colombiano apropian los conceptos medio ambiente y desarrollo para implementar proyectos de ecoturismo étnico, que en ocasiones se ven bajo el lente de intereses económicos de políticos, empresarios y miembros de las mismas comunidades. La apuesta metodológica de este trabajo privilegia el lugar de la etnografía y el trabajo de campo como herramientas fundamentales para conocer desde la cotidianidad de las comunidades las realidades sociales que aquí se plantean. Estas concepciones dan cuenta de la disputa actual generada desde el Estado por conservar los recursos medioambientales o apostarle a una idea de desarrollo basada en las políticas neoliberales insertadas en la Constitución colombiana de 1991 y el nuevo orden político nacional. Sin embargo, las comunidades nos muestran que estos debates no son necesariamente excluyentes.

ABSTRACT This article discusses how black communities in the Colombian Pacific appropriated concepts about environment and development, which many a times are under the lens of the economic interests of politicians, businessmen and members of the communities themselves. The methodological approach of this study privileges ethnography and fieldwork, which are two key tools to know about the daily life of the communities' social realities presented here. These concepts serve to account the current debate on the question about conserving environmental resources or betting on an idea of development based on neoliberal policies embedded in the Colombian Constitution of 1991 and the new national political order. Nevertheless, communities show that such debates are not necessarily exclusionary.

Metrópoles, cobertura vegetal, áreas verdes e saúde / Metropolises, vegetation, green areas and health

A falta de planejamento no processo de urbanização das grandes metrópoles tem produzido numerosas externalidades negativas, entre elas a supressão de sua cobertura vegetal e de áreas verdes. Inúmeros benefícios têm sido reportados sobre como a presença da vegetação no meio ambiente urbano favorece fatores ambientais, sociais e econômicos, influenciando na saúde da população. O presente trabalho busca apresentar uma série de estudos com enfoque na associação entre áreas verdes e saúde e também uma sucinta reflexão sobre a importância do assunto no município de São Paulo...

The lack of planning in the urbanization process of big cities worldwide has produced numerous negative externalities, including the suppression of vegetation and green spaces. Multiple benefits have been reported on how urban vegetation promotes and influences environmental, social and economic factors, as well as people’s health. This paper presents a series of studies focusing on the association between urban vegetation and human health, as well as a brief reflection on the importance of this issue in the city of São Paulo...

Impacto del proyecto "Con una botella podemos todos" en instituciones educativas bogotanas / Impact of the project "With a bottle we all can" in educational institutions from Bogota / Impacto do projeto "Com uma garrafa todos podemos" em instituições educativas bogotanas

Objetivo: determinar el impacto, en los ámbitos psico- socio-ambiental, del proyecto Con una botella podemos todos, en dos instituciones educativas distritales de Bogotá. Materiales y Métodos: estudio cualitativo de carácter descriptivo, fenomenológico. La muestra de 126 participantes (108 estudiantes, 1 docente, 17 estudiantes de enfermería) se obtuvo por conveniencia, de tipo no probabilístico. Las variables del estudio se centran en la relacion existente entre lo que piensa, siente y hace la persona o grupo investigado cuando participa y se ve enfrentado en actividades y/o procesos para reciclar y su influencia en el campo ambiental. Para la recolección de la información se utilizó una encuesta de 15 ítems con preguntas abiertas, dirigida a los estudiantes participantes de las dos instituciones, una entrevista de 13 ítems para el docente y los estudiantes de enfermería (grupo focal). Resultados: el plástico es el material de mayor reducción. De 8 a 10 personas reducen el consumo en un 50 %; más del 90 % mostraron una motivación extrínseca que los impulsó a actuar y cuidar el planeta, el medio ambiente y la familia. El 76,85 % del grupo encuestado se sintieron tranquilos, felices y, orgullosos como ciudadanos conscientes. Conclusiones: con los procesos de reciclaje se logra una mejora en la participación colectiva o social, en el entendimiento del otro como persona y en la importancia de realizar acciones individuales con el fin de buscar un bien común.

Objective: to determine the impact of the project "With a bottle we all can", in the psycho - social - environmental fields, in two public educational institutions in Bogota. Materials and Methods: qualitative study of descriptive, phenomenological character. The sample of 126 participants (108 students, 1 professor, and 17 nursing students) was obtained by convenience, of non-probabilistic type. The study variables are focused on the existing relation between what is thought, felt and done by the individual or group studied, when the individual or group participates and faces activities and/or processes to recycle and its influence in the environmental field. For the collection of information a survey of 15 items with open questions was used, directed to the participant students from the two institutions, one interview of 13 items to the professor and the nursing students (focus group). Results: plastic is the material with the most reduction. 8 to 10 individuals reduce the consumption by 50%; more than 90% showed extrinsic motivation that prompted the individual to take action and care for the planet, the environment and family. 76, 85% of the surveyed group felt relaxed, happy and, proud conscious citizens. Conclusions: with the recycling processes an improvement in the collective or social participation is achieved, with understanding of the other as a person and the importance of individual actions in order to achieve a common good.

Objetivo: determinar o impacto, nos âmbitos psico-sócio-ambiental, do projeto "Com uma garrafa todos podemos", em duas instituições educativas distritais de Bogotá D.C. Materiais e Métodos: estudo qualitativo de carácter descritivo, fenomenológico. A amostra de 126 participantes (108 estudantes, 1 docente e 17 estudantes de enfermagem) se obteve por conveniência, de tipo não probabilístico. As variáveis do estudo se centraram na relação existente entre o que pensa, sente e faz a pessoa ou turma pesquisada, quando participa e se vê enfrentado em atividades e/ou processos para reciclar e sua influência na área ambiental. Para a recolecção da informação se utilizou um inquérito de 15 itens com perguntas abertas, dirigida os estudantes participantes das duas instituições, uma entrevista de 13 itens ao docente e aos estudantes de enfermagem (grupo de foco). Resultados: o plástico é o material de maior redução. De 8 a 10 pessoas reduzem o consumo em um 50%; mais do 90 % mostraram uma motivação extrínseca que os impulsou a atuar e cuidar o planeta, o meio ambiente e a família. O 76,85% da turma pesquisada se sentiram tranquilos, felizes, orgulhosos como cidadãos conscientes. Conclusões: com os processos de reciclagem se consegue uma melhora na participação coletiva ou social, no entendimento do outro como pessoa e da importância de realizar ações individuais com o fim de buscar um bem-estar comum.

La aportación de la hermenéutica a la bioética ambiental ante el dilema biocentrismo versus antropocentrismo en la era de la globalización / A contribuição da hermenêutica para a bioética ambiental diante do dilema biocentrismo versus antropocentrismo na era da globalização / The hermeneutics contribution to environmental bioethics faced with the biocentric versus anthropocentric dilemma in the globalization era

El objetivo de este ensayo es mostrar el aporte de la hermenéutica filosófica a la bioética ambiental ante el dilema biocentrismo versus antropocentrismo. Por el primero se entiende la conservación radical e inalterable de la naturaleza, mientras para el segundo se concibe la explotación y comercialización de la tierra sin más límite que la ganancia. La hermenéutica filosófica es un método para fusionar y autolimitar estos dispares horizontes de valoración y significatividad. Dicho método recoge, a través de la ubicación histórica y conceptual, el origen de cada una de estas concepciones y sus respectivas tesis. Gracias a ello, postula la traslación de significados clave, como "tierra", "suelo", "ecosistema", "medio ambiente", hacia una noción holística de "biósfera". Con ello pretende la disolución del dilema y, a su vez, abrir la vía a investigaciones futuras que puedan abordar los dilemas de la bioética ambiental con la traslación hermenéutica de significados con distinto valor.

The aim of this essay is to show the contribution of hermeneutic philosophy to environmental bioethics faced with the biocentric versus anthropocentric dilemma. Biocentric means the radical unchanging conservation of nature, while anthropocentric means the exploitation and commercialization of earth with profit as the only limit. The hermeneutic philosophy is a method to unite and self-limiting these different horizons of value and meaning. Such method gathers through historic and conceptual location, the origin of each one of these conceptions and their respective thesis. Thanks to this, it applies the inclusion of key meanings, such as "earth", "soil", "ecosystem", "environment" within a holistic notion of "biosphere". With this it pretends to solve the problem and, moreover, to open the way to future research which could tackle the environmental bioethical dilemmas with the hermeneutic change of meanings with different values.

O objetivo deste ensaio é mostrar a contribuição da hermenêutica filosófica para a bioética ambiental diante do dilema biocentrismo versus antropocentrismo. Por primeiro entende-se a conservação radical e inalterável da natureza, enquanto, por segundo, se concebe a exploração e comercialização da terra sem mais limite que a ganância. A hermenêutica filosófica é um método para fundir e autolimitar estes díspares horizontes de valoração e significância. Dito método recolhe, através da localização histórica e conceitual, a origem de cada uma destas concepções e suas respectivas teses. Graças a isso, postula a traslação de significados chave, como "terra", "solo", "ecossistema", "meio ambiente", para uma noção holística de "biosfera". Com isso pretende a dissolução do dilema e, por sua vez, abrir a via para pesquisas futuras que possam abordar os dilemas da bioética ambiental com a traslação hermenêutica de significados com distinto valor.

Análisis observacional del uso de agua durante el lavado quirúrgico de manos: el agua como recurso hospitalario derrochado / Observational analysis of water use for surgical hand scrubbing: water as a wasted hospital resource / Análise observacional do uso de água durante a lavagem cirúrgica de mãos: a água como recurso hospitalar desperdiçado

El objetivo de este estudio descriptivo cuantitativo observacional de corte transversal fue determinar el volumen de agua usada \r\ncomo recurso principal en el lavado quirúrgico de manos de un servicio hospitalario para cuantificar la cantidad total que se \r\nmalgasta, así como proponer vías de actuación y mejoras en el manejo de la situación. Para ello, se registró caudal, volumen, \r\ntiempo total de lavado y tiempo útil del agua. De los 19,44 litros de agua utilizados en promedio en cada lavado, más del 85% es \r\nagua desperdiciada que no entra en contacto con la piel del profesional. Los casi 39.000 litros de agua malgastados por mes no \r\nsolo suponen un gasto inútil e innecesario en términos económicos sino una merma severa en la conciencia ecológica de cual\r\n-\r\nquier entidad.

The objective of this quantitative descriptive observational \r\ncross-sectional study was to determine the volume of water \r\nused as a primary resource in the surgical hand washing of \r\na hospitable service in order to quantify the total amount of \r\nwater that is used unnecessarily, in order to propose courses of \r\naction and improvements in handling the situation. To do this, \r\nwe recorded the flow, volume, total time and useful water use.\r\nOf the 19.44 liters of water used on average in each wash, over \r\n85% is wasted water that never comes into contact with the \r\nskin of the professional. The nearly 39,000 liters of water wasted \r\neach month not only represent useless and unnecessary \r\nspending in economic terms but a severe decline in the \r\nenvironmental awareness of any entity.

A gestão começa pelo conhecimento e descrição da realidade \r\nque nos rodeia, procurando pontos fracos onde atuar e colocar os \r\nmeios necessários para melhorar o nosso trabalho. Objetivo: avaliar \r\no volume de água utilizado como principal recurso na lavagem \r\ncirúrgica de mãos de um serviço hospitalar (bloco operatório), dife\r\n-\r\nrenciando a quantidade total da mesma que é desperdiçada, assim \r\ncomo a proposição de meios de atuação e melhoria da situação. \r\nMaterial e método: estudo descritivo quantitativo observacional \r\nde corte transversal, por meio do registro do fluxo, volume, tempo \r\ntotal de lavagem e tempo de uso útil da água.\r\nResultados: dos 19,44 litros de água utilizados em média em \r\ncada lavagem, mais do 85% é água desperdiçada, que não \r\nentra em contato com a pele do profissional. Conclusões: os \r\nquase 39.000 litros de água desperdiçados por mês não só \r\nrepresentam um gasto inútil e desnecessário em termos econô\r\n-\r\nmicos, mas também uma ferida na consciência ecológica de \r\nqualquer empresa ouentidade.

BVSDE Desarrollo Sostenible

El área de Desarrollo Sostenible y Salud Ambiental (SDE), es un equipo multidisciplinario de OPS que conduce y cataliza un esfuerzo innovador, intersectorial y estratégico para reducir los riesgos a la salud y promover los ambientes sanos donde las personas viven, estudian, trabajan y se divierten, como un elemento sustancial y esencial de la Seguridad Humana y del Desarrollo Sostenible.