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2.
Acta Trop ; 201: 105219, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31614120

RESUMO

As the only specialized institution for research and control of parasitic diseases at the national level in China for almost 70 years, the National Institute of Parasitic Diseases (NIPD) at the Chinese Center for Disease Control and Prevention (China CDC) has been instrumental in supporting the remarkable progress from high prevalence to transmission interruption or low endemicity of several diseases, lymphatic filariasis, malaria and schistosomiasis in particular. This has taken place through technical guidance, emergency response and scientific research as well as providing technical service, education, training, health promotion and international cooperation. With China's increasing involvement in international cooperation and the increased risk for (re)emerging tropical diseases in mind, the Chinese Government designated in 2017 a new Chinese Center for Tropical Disease Research to NIPD. Responding to the expanded responsibilities, the institute is scaling up its activities in several ways: from parasitic diseases to the wider area of tropical diseases; from disease control to disease elimination; from biological research to policy evidences accumulation; and from public health to global health. Based on this new vision and China's previous accomplishments in the areas mentioned, the institute is in a position to move forward with respect to global health and equitable development according to the central principles of the United Nations' Sustainable Development Goals.


Assuntos
/organização & administração , Doenças Transmissíveis/epidemiologia , Saúde Global/normas , Cooperação Internacional , Doenças Parasitárias/epidemiologia , Saúde Pública/normas , Medicina Tropical/normas , Academias e Institutos , Animais , China/epidemiologia , Humanos , Objetivos Organizacionais , Estados Unidos
3.
Presse Med ; 48(12): 1536-1550, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31784255

RESUMO

Africa along side with south-east Asia are the epicentres of emerging and epidemic prone-infectious diseases and megacity biosecurity threat scenarios. Massive mobility and reluctance in the populations exposed to epidemic and emerging prone-infectious diseases coupled by a weak health system made disease alert and control measures difficult to implement. The investigation of virus detection and persistence in semen across a range of emerging viruses is useful for clinical and public health reasons, in particular for viruses that lead to high mortality or morbidity rates or to epidemics. Innovating built facility to safely treat patients with highly pathogenic infectious diseases is urgently need, not only to prevent the spread of infection from patients to healthcare workers but also to offer provision of relatively invasive organ support, whenever considered appropriate, without posing additional risk to staff. Despite multiple challenges, the need to conduct research during epidemics is inevitable, and candidate products must continue undergoing rigorous trials. Preparedness including management of complex humanitarian crises with community distrust is a cornerstone in response to high consequence emerging infectious disease outbreaks and imposes strengthening of the public health response infrastructure and emergency outbreak systems in high-risk regions.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Epidemias , Controle de Infecções , Doenças Transmissíveis Emergentes/prevenção & controle , Surtos de Doenças/prevenção & controle , Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Saúde Global/normas , Saúde Global/tendências , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/tendências , Saúde Pública/normas , Saúde Pública/tendências , Administração em Saúde Pública/métodos , Administração em Saúde Pública/tendências
4.
Lancet Haematol ; 6(12): e606-e615, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31631023

RESUMO

BACKGROUND: Blood transfusions are an important resource of every health-care system, with often limited supply in low-income and middle-income countries; however, the degree of unmet need for blood transfusions is often unknown. We therefore aimed to estimate the blood transfusion need and supply at national level to determine gaps in transfusion services globally. METHODS: We did a modelling study involving 195 countries and territories. We used blood component preparation data from 2011-13 to estimate blood availability for 180 (92%) of 195 countries from the WHO Global Status Report on Blood Safety and Availability. We calculated disease-specific transfusion needs per prevalent case for 20 causes in the USA using the National (Nationwide) Inpatient Sample dataset between the years 2000 and 2014, and the State Inpatient Databases between 2003 and 2007 from the Healthcare Cost and Utilization Project. Using prevalence estimates for the USA from the Global Burden of Disease (GBD) 2017 study, we estimated the ideal disease specific-transfusion rate as the lowest rate from the years 2000 to 2014. We applied this rate to GBD prevalence results for 195 countries to estimate transfusion needs. Unmet need was the difference between the estimated supply and need. FINDINGS: In 2017, the global blood need was 304 711 244 (95% uncertainty interval [UI] 293 064 637-314 049 479) and the global blood supply was 272 270 243 (268 002 639-276 698 494) blood product units, with a need-to-supply ratio of 1·12 (95% UI 1·07-1·16). Of the 195 countries, 119 (61%) did not have sufficient blood supply to meet their need. Across these 119 countries, the unmet need totalled 102 359 632 (95% UI 93 381 710-111 360 725) blood product units, equal to 1849 (1687-2011) units per 100 000 population globally. Every country in central, eastern, and western sub-Saharan Africa, Oceania, and south Asia had insufficient blood to meet their needs. INTERPRETATION: Our data suggest that the gap between need and supply is large in many low-income and middle-income countries, and reinforce that the WHO target of 10-20 donations per 1000 population is an underestimate for many countries. A continuous expansion and optimisation of national transfusion services and implementation of evidence-based strategies for blood availability is needed globally, as is more government support, financially, structurally, and through establishment of a regulatory oversight to ensure supply, quality, and safety in low-income and middle-income countries. FUNDING: National Institutes of Health.


Assuntos
Bancos de Sangue/provisão & distribução , Transfusão de Sangue , Saúde Global , Acesso aos Serviços de Saúde/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Bancos de Sangue/economia , Bancos de Sangue/normas , Bancos de Sangue/estatística & dados numéricos , Segurança do Sangue/normas , Segurança do Sangue/estatística & dados numéricos , Transfusão de Sangue/economia , Transfusão de Sangue/normas , Transfusão de Sangue/estatística & dados numéricos , Geografia , Carga Global da Doença , Saúde Global/economia , Saúde Global/normas , Saúde Global/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Modelos Teóricos , Determinação de Necessidades de Cuidados de Saúde/economia , Determinação de Necessidades de Cuidados de Saúde/organização & administração , Determinação de Necessidades de Cuidados de Saúde/normas , Áreas de Pobreza , Prevalência
5.
Rev Sci Tech ; 38(1): 155-171, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31564733

RESUMO

In order to manage global and transnational health threats at the human- animal-environment interface, a multisectoral One Health approach is required. Threats of this nature that require a One Health approach include, but are not limited to, emerging, endemic and re-emerging zoonotic diseases, food safety, antimicrobial resistance (AMR), vector-borne and neglected infectious diseases, toxicosis and pesticides. Relevant Kenyan authorities formally institutionalised One Health in 2011 through the establishment of the Zoonotic Disease Unit (ZDU) and its advisory group, the Zoonoses Technical Group. At that time, the One Health agenda focused on zoonotic diseases. As the issue of AMR began to gain traction globally, a One Health approach to its management was advocated in Kenya in 2015. This paper summarises a series of interviews (with respondents and key informants) that describe how AMR institutionalisation evolved in Kenya. It also examines how responses to other health threats at the human-animal- environment interface were coordinated and used to identify gaps and make recommendations to improve One Health coordination at the national level in Kenya. Results showed that the road to the institutionalisation of AMR through the National Action Plan on Prevention and Containment of Antimicrobial Resistance, 2017-2022 and a formally launched One Health coordination mechanism, the National Antimicrobial Stewardship Interagency Committee (NASIC), took ten years. Moreover, supplementary actions are still needed to further strengthen AMR coordination. In addition to the ZDU and NASIC, Kenya has established two other formal multisectoral and multidisciplinary coordination structures, one for aflatoxicosis and the other for health threats associated with pesticide use. The country has four distinct and separate One Health coordination mechanisms: for zoonoses, for AMR, for aflatoxicosis and for the health threats associated with pesticide use. The main gap lies in the lack of overall coordination between these topic-specific structures. An overall coordination mechanism for all One Health issues is therefore needed to improve synergy and complementarity. None of the topic-specific mechanisms plays a critical role in the policy development process, institutionalisation or implementation of activities related to the other topic areas. The authors recommend renaming the ZDU as the One Health Office, and expanding it to include AMR and food safety teams, and their associated technical working groups. Through this restructuring, the One Health Office would become an umbrella organisation dealing with all four issues mentioned above. Based on Kenya's experience, the authors recommend that other countries also consider expanding the scope of multisectoral One Health coordination mechanisms to include other shared health threats.


Assuntos
Saúde Global , Saúde Única , Animais , Antibacterianos , Farmacorresistência Bacteriana , Saúde Global/normas , Política de Saúde , Humanos , Quênia , Zoonoses/microbiologia , Zoonoses/prevenção & controle
6.
Rev Sci Tech ; 38(1): 145-154, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31564744

RESUMO

The One Health approach supports global health security by improving coordination, collaboration and communication at the human-animal-environment interface to address shared health threats such as zoonotic diseases, antimicrobial resistance, food safety and others. Over the past decade, country after country has implemented the One Health approach and demonstrated recognised benefits. However, in order to build sustainability of One Health in these efforts, One Health champions and implementers need to collect and provide government decision-makers with country-level data on One Health's impact to help justify policy decisions and resource allocations. Due to the broad, often seemingly all encompassing, nature of One Health in promoting synergies of multiple disciplines and sectors, the One Health community has faced difficulties in determining specific One Health impact indicators for formally evaluating One Health successes. In this paper, the author a) briefly reviews the ongoing commentary on the recognised benefits of the implementation of a One Health approach in the global health security context, b) discusses challenges in measuring the impact of One Health, and c) proposes possible solutions for evaluating the impact of One Health on global health security.


Assuntos
Saúde Global , Saúde Única , Desenvolvimento Sustentável , Animais , Saúde Global/normas , Metas , Humanos , Saúde Única/normas , Saúde Única/tendências , Zoonoses/prevenção & controle
9.
Malar J ; 18(1): 267, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31477109

RESUMO

Parasite resistance against anti-malarial drugs is a major threat to the ongoing malaria control and elimination strategies. This is especially true since resistance to the currently recommended artemisinins and partner drugs has been confirmed in South East Asia (SEA) and new anti-malarial compounds are not expected to be available in the near future. Spread from SEA or independent emergence of artemisinin resistance in sub-Saharan Africa (SSA) could reverse the achievements in malaria control that have been attained in the past two decades and derail the ongoing elimination strategies. The current surveillance of clinical efficacy and resistance to anti-malarial drugs is based on efficacy trials to assess the clinical performance of anti-malarials, in vivo/ex vivo assessment of parasite susceptibility to anti-malarials and prevalence of known molecular markers of drug resistance. Whereas clinical efficacy trials are restricted by cost and the complex logistics of patient follow-up, molecular detection of genetic mutations associated with resistance or reduced susceptibility to anti-malarials is by contrast a simple and powerful tool for early detection and monitoring of the prevalence of resistant parasites at population level. This provides needed information before clinical failure emerges, allowing policy makers to anticipate problems and respond. The various methods previously used in detection of molecular markers of drug resistance share some limitations: low-throughput, and high costs per sample and demanding infrastructure. However, recent technological advances including next-generation sequencing (NGS) methodologies promise greatly increased throughput and reduced costs, essentially providing unprecedented potential to address different research and operational questions of relevance for drug policy. This review assesses the potential role of NGS to provide comprehensive information that could guide drug policies in malaria endemic countries and looks at the foreseeable challenges facing the establishment of NGS approaches for routine surveillance of parasite resistance to anti-malarials in SSA.


Assuntos
Antimaláricos/uso terapêutico , Controle de Doenças Transmissíveis/legislação & jurisprudência , Resistência a Medicamentos/genética , Sequenciamento de Nucleotídeos em Larga Escala , Plasmodium falciparum/genética , Formulação de Políticas , África ao Sul do Saara , Controle de Doenças Transmissíveis/métodos , Quimioterapia Combinada , Saúde Global/legislação & jurisprudência , Saúde Global/normas , Legislação de Medicamentos , Malária Falciparum/tratamento farmacológico , Plasmodium falciparum/efeitos dos fármacos
10.
Artigo em Inglês | MEDLINE | ID: mdl-31370229

RESUMO

Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe the transnational restaurant industry structure and eating trends. Secondly, we summarize results from a scoping review of healthy dietary guidelines for restaurants. Thirdly, we describe a systematic review of five electronic databases (2000-2018) to identify studies on nutrient profile and portion size changes made by transnational restaurants over 18 years. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, identified 179 records, and included 50 studies conducted in 30 countries across six regions. The scoping review found a few expert-recommended targets for restaurants to improve offerings, but no internationally accepted standard for portions or serving sizes. The systematic review results showed no standardized assessment methods or metrics to evaluate transnational chain restaurants' practices to improve menu offerings. There was wide variation within and across countries, regions, firms, and chains to reduce energy, saturated and trans fats, sodium, and standardized portions. These results may inform future research and encourage transnational chain restaurants to offer healthy product profiles and standardized portions to reduce obesity and NCD risks worldwide.


Assuntos
/normas , Saúde Global/normas , Doenças não Transmissíveis/prevenção & controle , Política Nutricional , Obesidade/prevenção & controle , Tamanho da Porção/normas , Restaurantes/normas , Qualidade dos Alimentos , Guias como Assunto , Humanos
11.
Glob Health Action ; 12(1): 1651017, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31431145

RESUMO

Background: The current approach to global health has significantly contributed to improving it, as evidenced by the progress made toward the Millennium Development Goals (MDGs). However, the health gains achieved are often highly unequitable, and the current approach is expected to be insufficient to meet the future health equity challenges. There is an urgent need to re-think and expand the scope of research and programmatic strategies. Objective: This paper aims to assess the ideological underpinnings of the currently dominant norms in global health, with the goal of highlighting the research and programmatic areas that are marginalized and warrant greater efforts in order to resolve persistent health inequity and achieve the UN Sustainable Development Goals (SDGs). Methods: We have conducted a critical review of the literature that traces the historical origins of global health to the period between the mid-19th century and the end of the 20th century. Results: Critical review of the historical origins of global health reveals a set of dominant norms in global health that are ideological in character, and profoundly shape the current practice. We identified key manifestations of the ideological underpinnings as 1) Democratic deficit, 2) Depoliticization of the discourse, 3) Marginalization of the scholarship that interrogates the relations of power. Conclusion: Examination of the dominant norms that shape the foundation of our knowledge and action in global health is required to solve persistent health inequity challenges and meet the SDGs. Inversion of the key manifestations of the dominant norms can serve as guiding principles to elaborate alternative frameworks that have the theoretical and programmatic potential for a fundamental rather than an incremental change in the practice of global health.


Assuntos
Saúde Global/história , Saúde Global/normas , Equidade em Saúde/organização & administração , Objetivos Organizacionais , História do Século XIX , História do Século XX , História do Século XXI , Humanos
12.
Nat Microbiol ; 4(9): 1432-1442, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31439928

RESUMO

Several interconnected human, animal and environmental habitats can contribute to the emergence, evolution and spread of antibiotic resistance, and the health of these contiguous habitats (the focus of the One Health approach) may represent a risk to human health. Additionally, the expansion of resistant clones and antibiotic resistance determinants among human-associated, animal-associated and environmental microbiomes have the potential to alter bacterial population genetics at local and global levels, thereby modifying the structure, and eventually the productivity, of microbiomes where antibiotic-resistant bacteria can expand. Conversely, any change in these habitats (including pollution by antibiotics or by antibiotic-resistant organisms) may influence the structures of their associated bacterial populations, which might affect the spread of antibiotic resistance to, and among, the above-mentioned microbiomes. Besides local transmission among connected habitats-the focus of studies under the One Health concept-the transmission of resistant microorganisms might occur on a broader (even worldwide) scale, requiring coordinated Global Health actions. This Review provides updated information on the elements involved in the evolution and spread of antibiotic resistance at local and global levels, and proposes studies to be performed and strategies to be followed that may help reduce the burden of antibiotic resistance as well as its impact on human and planetary health.


Assuntos
Resistência Microbiana a Medicamentos , Saúde Global , Saúde Única , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias/efeitos dos fármacos , Doenças Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/epidemiologia , Microbiologia Ambiental , Saúde Global/legislação & jurisprudência , Saúde Global/normas , Humanos , Microbiota/efeitos dos fármacos , Saúde Única/legislação & jurisprudência , Saúde Única/normas
14.
Global Health ; 15(1): 39, 2019 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196092

RESUMO

BACKGROUND: Although various organizations working in developed countries established the standards and approaches used in occupational hygiene, occupational hygiene professional interests and needs continue to develop in a global context. There is thus an urgent need for expanded occupational hygiene models. For successful field implementation, these models should be based on several sets of criteria, including those related to international standards, various national requirements, and multidisciplinary approaches. This is particularly important for countries in which no occupational hygiene model has been developed. This study thus examined the consensus on occupational hygiene standards among stakeholders in Turkey regarding the development of a national model. A modified Delphi study was conducted among key occupational health experts in Turkey who could aid in the relevant implementation, policy-making, and educational processes for such a model. Participants were selected from various governmental institutions, non-governmental organizations, trade unions, universities, and occupational health practices. RESULTS: The first-round findings were obtained from open-ended questions. The results revealed several requirements, including the adoption of an international hygiene definition, the official recognition of professional and practical areas in Turkish occupational hygiene, hygienist training methods, priorities, and competent institutions. Second-round findings indicated a consensus rate of over 80% regarding the need for implementation standards, training and education standards, requirements and priorities, and competent institutions for professionals working in the field of occupational hygiene. A third-round and SWOT analysis was also conducted among the group to confirm the consensus issues. CONCLUSIONS: The search for solutions and developmental expectations increases when awareness of internationalization and the need for common global standards increase. This developmental process may provide the basis for an appropriate model in developing countries.


Assuntos
Consenso , Saúde Global/normas , Higiene/normas , Modelos Organizacionais , Saúde do Trabalhador/normas , Técnica Delfos , Humanos , Turquia
15.
Value Health ; 22(6): 627-641, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31198179

RESUMO

BACKGROUND: We have seen significant advancement in a range of health technologies, some with transformative or curative potential. Nevertheless, it is often unclear how global health systems recognize or reward innovation. OBJECTIVES: To consider what is transformative, challenges for transformative therapies, and downstream health ecosystem effects. METHODS: A systematic review of publications in English between 2012 and 2018 was conducted with a focus on value assessment processes and health system effects of a range of breakthrough health technology categories. After screening 9012 records, 222 unique studies were identified. The study also included an analysis of 100 health technology assessments (HTAs) from 5 markets to consider how and in what ways global HTA bodies evaluate transformative therapies. Global sales and technology/procedure utilization data were also evaluated to gain insights into patient access and commercial impact. RESULTS: This article evaluated uncertainties around evidence of efficacy, safety, and duration of effect, as well as underlying study quality and methodological considerations in the target categories. Although many HTA evaluations had similar approaches to assessing parameters such as safety, there were significant differences across technology categories. Technology-driven trends also surfaced where global HTA and payer systems may not yet be prepared to recognize and reward emerging technology impacts, including use of next-generation diagnostic results to guide care, considering novel impacts on therapy sequencing and clinical pathway management, and changes in payment and health delivery models. CONCLUSIONS: Some trends stemming from rapid evolution of breakthrough therapies will prompt reconsideration of our conventional value assessment and reward models, because health system measurement and management processes have not fully anticipated their effects.


Assuntos
Assistência à Saúde/métodos , Economia/tendências , Assistência à Saúde/economia , Assistência à Saúde/tendências , Saúde Global/normas , Saúde Global/tendências , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31213520

RESUMO

BACKGROUND: Global health (GH) offerings by pediatric residency programs have increased significantly, with 1 in 4 programs indicating they offer a GH track. Despite growth of these programs, there is currently no widely accepted definition for what comprises a GH track in residency. METHODS: A panel of 12 pediatric GH education experts was assembled to use the Delphi method to work toward a consensus definition of a GH track and determine essential educational offerings, institutional supports, and outcomes to evaluate. The panelists completed 3 rounds of iterative surveys that were amended after each round on the basis of qualitative results. RESULTS: Each survey round had 100% panelist response. An accepted definition of a GH track was achieved during the second round of surveys. Consensus was achieved that at minimum, GH track educational offerings should include a longitudinal global child health curriculum, a GH rotation with international or domestic underserved experiences, predeparture preparation, preceptorship during GH electives, postreturn debrief, and scholarly output. Institutional supports should include resident salary support; malpractice, evacuation, and health insurance during GH electives; and a dedicated GH track director with protected time and financial and administrative support for program development and establishing partnerships. Key outcomes for evaluation of a GH track were agreed on. CONCLUSIONS: Consensus on the definition of a GH track, along with institutional supports and educational offerings, is instrumental in ensuring consistency in quality GH education among pediatric trainees. Consensus on outcomes for evaluation will help to create quality resident and program assessment tools.


Assuntos
Currículo/normas , Saúde Global/educação , Internato e Residência/métodos , Pediatria/educação , Técnica Delfos , Avaliação Educacional/normas , Saúde Global/normas , Humanos , Internato e Residência/normas , Pediatria/normas , Estados Unidos
17.
Artigo em Inglês | MEDLINE | ID: mdl-31213038

RESUMO

This study intends to analyse the behaviour of epidemiological variables of workers in anoilindustry of Bahia, Brazil, before and after implementation of interdisciplinary practices in occupational health assessments between 2006 and 2015. This is a retrospective longitudinal study carried out in two time periods. Data were collected from the workers electronic medical record and time trends were analysed before (2006-2010) and after (2011-2015) the implementation of the interdisciplinary practices focusing on health promotion. The data were complementarily compared to a control group from the same industry.A statistically significant reduction for data on the number of smokers, periodontal disease and of days away from work was obtained. A significant increase in the number of physically active subjects wasalso observed. Whilenot statistically significant, a reduction in the number of workers with obesity and overweight, with caries and altered glycemia, was identified. Coronary risk and high blood pressure indicators have shown aggravation. It can be concluded that an interdisciplinary health approach during the annual occupational assessments, with action directed to the population needs, can be associated with the improvement of the health indicators assessed, contributing to increased worker productivity in the oil industry.


Assuntos
Saúde Global/normas , Guias como Assunto , Promoção da Saúde/normas , Saúde do Trabalhador/normas , Indústria de Petróleo e Gás/normas , Adulto , Brasil/epidemiologia , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Health Secur ; 17(3): 174-180, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31206322

RESUMO

Uganda is currently implementing the Global Health Security Agenda (GHSA), aiming at accelerating compliance to the International Health Regulations (IHR) (2005). To assess progress toward compliance, a Joint External Evaluation (JEE) was conducted by the World Health Organization (WHO). Based on this evaluation, we present the process and lessons learned. Uganda's methodological approach to the JEE followed the WHO recommendations, including conducting a whole-of-government in-country self-assessment prior to the final assessment, using the same tool at both assessments, and generating consensus scores during the final assessment. The in-country self-assessment process began on March 24, 2017, with a multisectoral representation of 203 subject matter experts from 81 institutions. The final assessment was conducted between June 26 and 30, 2017, by 15 external evaluators. Discrepancies between the in-country and final scores occurred in 27 of 50 indicators. Prioritized gaps from the JEE formed the basis of the National Action Plan for Health Security. We learned 4 major lessons from this process: subject matter experts should be adequately oriented on the scoring requirements of the JEE tool; whole-of-government representation should be ensured during the entire JEE process; equitable multisectoral implementation of IHR activities must be ensured; and over-reliance on external support is a threat to sustainability of GHSA gains.


Assuntos
Saúde Global/normas , Saúde Pública/métodos , Contenção de Riscos Biológicos , Saúde Global/legislação & jurisprudência , Humanos , Cooperação Internacional , Saúde Pública/normas , Vigilância em Saúde Pública/métodos , Uganda , Organização Mundial da Saúde
20.
Int J Gynaecol Obstet ; 146(1): 126-131, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31058318

RESUMO

After the declaration of the Millennium Development Goals in 2000 by the United Nations, many stakeholders allocated financial resources to "global maternal health." Research to expand care and improve delivery of maternal health services has exponentially increased. The present article highlights an overview, namely 10 of the health system, clinical, and technology-based advancements that have occurred in the past three decades in the field of global maternal health. The list of topics has been selected through the cumulative clinical and public health expertise of the authors and is certainly not exhaustive. Rather, the list is intended to provide a mapping of key topics arranged from broad to specific that span from the global policy level to the level of individual care. The list of health system, clinical, and technology-based advancements include: (10) Millennium Development Goals and Sustainable Development Goals; (9) Development of clinical training programs, including the potential for subspecialty development; (8) Prenatal care expansion and potential; (7) Decentralized health systems, including the use of skilled birth attendants; (6) Antiretroviral therapy for HIV; (5) Essential medicines; (4) Vaccines; (3) mHealth/eHealth; (2) Ultrasonography; and (1) Obstetric hemorrhage management. With the Sustainable Development Goals now underway, the field must build upon past successes to sustain maternal and neonatal well-being in the future global health agenda.


Assuntos
Saúde Global/normas , Saúde Materna/normas , Cuidado Pré-Natal/organização & administração , Feminino , Humanos , Mortalidade Materna , Tocologia/organização & administração , Mortalidade Perinatal , Gravidez , Desenvolvimento Sustentável , Nações Unidas
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