Tracing the emergence of drowning prevention on the global health and development agenda: a policy analysis.

Drowning has been a neglected health issue, largely absent from the global health and development discourse, until the UN General Assembly adopted its first resolution on global drowning prevention in 2021. This policy analysis examines the role of issue characteristics, actor power, ideas, and political contexts in the emergence of drowning prevention, and it also identifies opportunities for future actions. We identified three factors crucial to enhancing prioritisation: (1) methodological advancements in population-representative data and evidence for effective interventions; (2) reframing drowning prevention in health and sustainable development terms with an elevated focus on high burdens in low-income and middle-income contexts; and (3) political advocacy by a small coalition. Ensuring that the UN resolution on global drowning prevention is a catalyst for action requires positioning of drowning prevention within global health and sustainable development agendas; strengthening of capacity for multisectoral action; expansion of research measuring burden and identifying solutions in diverse contexts; and incorporation of inclusive global governance, commitments, and mechanisms that hold stakeholders to account.

Drowning prevention: turning the tide on a leading killer.

Drowning is a leading killer, particularly of children and young adults, yet has been greatly neglected. Despite accounting for a higher number of deaths than many other substantial public health issues, drowning has not benefitted from the targeted attention it requires, which is particularly tragic because low cost and effective drowning prevention interventions exist. Therefore, the recent UN General Assembly's adoption of a resolution on global drowning prevention is a historic first, and offers an exciting opportunity by providing a comprehensive framework and a practical roadmap that a range of actors and sectors, including governments, can follow to address the challenge of drowning prevention.

Exposure to physical and sexual violence and adverse health behaviours in African children: results from the Global School-based Student Health Survey.

OBJECTIVE: To examine associations between exposure to physical violence (PV) or sexual violence (SV) and adverse health behaviours among a sample of children in five African countries. METHODS: In a cross-sectional analysis of data from Namibia, Swaziland, Uganda, Zambia and Zimbabwe - countries that participated in the Global School-based Student Health Survey in 2003 or 2004 - we compared the relative frequency of several adverse health behaviours among children (primarily students 13-15 years of age) who did and who did not report exposure to PV or SV. We estimated odds ratios (ORs) for such behaviours and their 95% confidence intervals (CIs) after adjusting for age and sex. FINDINGS: Exposure to PV during the 12 months preceding the survey was reported by 27-50% (average: 42%) of the children studied in the five countries, and lifetime exposure to SV was reported by 9-33% (average: 23%). Moderate to strong associations were observed between exposure to PV or SV and measures of mental health, suicidal ideation, current cigarette use, current alcohol use, lifetime drug use, multiple sex partners and a history of sexually transmitted infection (P < 0.05 for all associations). For example, the odds of being a current cigarette smoker were higher in children involved in one fight (OR: 2.20; 95% CI: 1.77-2.75), 2-5 fights (OR: 3.43; 95% CI: 2.54-4.63), or 6 fights or more (OR: 5.95; 95% CI: 4.37-8.11) (P for trend < 0.001) during the 12 months preceding the survey than in children unexposed to PV. CONCLUSION: Childhood exposure to PV and SV is common among African children in some countries and is associated with multiple adverse health behaviours. In developing countries, increased awareness of the frequency of exposure to violence among children and its potential health consequences may lead to heightened attention to the need for health promotion and preventive programmes that address the problem.

World Health Organization's TEACH-VIP: contributing to capacity building for youth violence prevention.

Youth violence is a major public health problem in every region of the world, yet it is especially prevalent in specific settings. Youth homicide rates exceeding 10.0/100,000 occur most often in countries that are low or middle income, or which are experiencing rapid economic or social change. Particularly in low- and middle-income countries, the capacity to develop and implement the comprehensive, multisectoral strategies to prevent youth violence is only just emerging. The prevention of youth violence requires multidisciplinary approaches and a variety of trained professionals. A public health approach to training in the area of injury prevention focuses on providing professionals and paraprofessionals a common understanding of essential skills and knowledge. One important benefit of this is that it addresses a major gap in current public health training that until recently has devoted relatively little attention to injury prevention. Another benefit is that it allows professionals from a variety of backgrounds to work together more effectively to reduce injury. This article will provide a broad overview of youth violence in low- and middle-income countries and will discuss the existing level of capacity within healthcare and public health sectors for responding to these problems. It concludes with a discussion of next steps for increasing capacity and a profile of the World Health Organization (WHO) training curriculum on injury and violence prevention called TEACH-VIP, an acronym for Training, Education, and Advancing Collaboration in Health on Violence and Injury Prevention, as one important effort undertaken by WHO and global injury partners to build capacity.

The value of credible data from under-resourced areas.

Data collection requires a substantial investment in human resources and infrastructure, but it is essential that it is accurate to ensure the credibility of its use. These issues are explored in the light of data from injuries in 'disorganized' settings based on the experiences of field hospitals staffed by the International Committee of the Red Cross. Such data was influential in the campaign to ban landmines and can be used in the legitimate questioning of states' foreign policies. It is important to distinguish between combatant and non-combatant weapons injuries. A significant proportion of civilian weapons injuries in combat zones, particularly post-conflict, occur in a domestic context; some widely quoted figures for civilian war-related injuries are too high, though the correct figures are still far too high. While reducing the supply of arms, the importance of other social factors such as education, poverty and the provision of health care is stressed-provision of health care is affected in combat zones.

Depleted uranium in Kosovo: an assessment of potential exposure for aid workers.

BACKGROUND: During the Kosovo conflict approximately 11 tons of depleted uranium munitions were used against armored targets, predominantly in the west. Potential exposure to uranium amongst employees of the International Red Cross and Red Crescent Movement in western Kosovo was assessed. METHODS: Individuals (n = 31) who had resided at least 3 mo in western Kosovo provided 24-h urine collections and completed an administered questionnaire. Specimens were analyzed for creatinine concentration, and uranium concentration was determined using inductively coupled mass spectrometry. FINDINGS: Subjects ranged in age from 22 to 45 y, and 77% were male. Mean duration of residency was 11 mo, and 14 individuals were in western Kosovo throughout the hostilities. Almost three quarters of subjects reported seeing destroyed tanks or vehicles, predominantly while passing by within a vehicle. Two individuals spent time within 50 m of a destroyed tank or vehicle while outside of a vehicle. Urinary uranium concentrations ranged from 3.5 to 26.9 ng of uranium per liter of urine (median 8.9 ng L(-)). Creatinine normalized values ranged from 2.9 to 21.1 ng of uranium per gram of creatinine (median 7.4 ng g(-1) creatinine). These results fall toward the lower end of urinary uranium determinations made amongst non-exposed populations drawn from a literature review. INTERPRETATION: These results do not indicate an increased exposure to uranium amongst adults living and working in western Kosovo who do not spend time in proximity to destroyed vehicles. Environmental sampling and replication of these results amongst a sample including children and individuals reporting intensive exposure to destroyed vehicles would further develop the exposure assessment.