Global growth is projected to slow significantly amid high inflation, tight monetary policy, and more restrictive credit conditions. The possibility of more widespread bank turmoil and tighter monetary policy could result in even weaker global growth and lead to financial dislocations in the most vu...lnerable emerging market and developing economies (EMDEs). Comprehensive policy action is needed to foster macroeconomic and financial stability. Among many EMDEs, and especially in low-income countries, bolstering fiscal sustainability will require generating higher revenues, making spending more efficient, and improving debt management practices. Continued international cooperation is also necessary to tackle climate change, support populations affected by crises and hunger, and provide debt relief where needed.
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We combine data on Chinese development projects with data from Demographic and Health Surveys to study the impact of Chinese aid on household welfare in sub-Saharan Africa. We use a novel methodology to test the effect of Chinese aid on three important development outcomes: education, health, and nu...trition. For each outcome, we use difference-in-difference estimations to compare household areas near Chinese project sites to control areas located farther away, before and after receiving Chinese aid. This empirical strategy rules out many confounding factors that can bias measuring the impact of Chinese aid on our outcome variables. First, we find that Chinese projects significantly improve education and child mortality in treatment areas, but do not significantly affect nutrition. Second, social sector projects have a larger effect on outcomes than economic projects. Third, we do not find significant effects for projects that ended more than five years before the post-treatment survey wave. Our results are robust to a host of robustness checks.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NE...MLs) of LMICs and potential determinants for selection.
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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Medical devices are used for the prevention, diagnosis and treatment of illness and diseases and for rehabilitation. WHO developed guidance on medical device donation in 2011, which has been now reviewed, with new evidence, new references on considerations for medical device solicitation and provisi...on, risks associated with inappropriate donations, the responsibilities of donors and recipient, and the steps they should follow before, during and after a donation. It includes three sections: description of major problems that may be faced during the donation process, listing of best practices for donors and recipients and addressing situations requiring special attention. It also has three annexes for further reading: the criteria for the acceptability of a donation, literature review on donations of medical devices between 2010 and 2023 and a flyer. This document is intended to improve the quality of medical devices donations, including medical equipment, single-use medical devices and in-vitro diagnostics, to provide maximum benefit to all stakeholders. The considerations can be used to develop institutional or national policies and regulations for medical devices donations. This document is intended for use by any organization, expert or practitioner involved in the donation, procurement, management of medical devices, including health workers, biomedical engineers, health managers, policymakers, donors, nongovernmental organizations and academic institutions.
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interim guidance, 25 November 2024