Food environments are usually defined as the settings with all the different types of
food made available and accessible to people as they go about their daily lives.
That is, the range of food in supermarkets, small retail outlets, wet markets
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, street
food stalls, coffee shops, tea houses, school canteens, restaurants, and all the other
venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing,
marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate
quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems
and food environments are challenged in supporting consumer choices that are
consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges.
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The World Health Organization (WHO) has recommended a universal antiretroviral therapy (ART) for all HIVinfected children before the age of two since 2010, but this implies an early identification o
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f these infants. We described the Prevention of Mother-to-Child HIV Transmission (PMTCT) cascade, the staffing and the quality of infrastructures in pediatric HIV care facilities, in Ouagadougou, Burkina Faso.
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Human rights must be at the centre of all prevention, preparedness, containment and treatment efforts from the start, in order to best protect public health and support the groups and people who are most at risk. States have an obligation to protect
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and guarantee everyone the right to the highest attainable standard of health.
All European states have committed to fulfilling the right to health and have signed international and regional human rights treaties to that purpose. In the context of the current pandemic, authorities should engage all available resources to counter the pandemic while fulfilling the right to health.
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Child Friendly Spaces (CFSs) are used by humanitarian agencies as a means to promote protection and psychosocial wellbeing for children in emergency settings. World Vision International together with Columbia University is conducting a series of stu
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dies to investigate the effectiveness of CFSs in various humanitarian contexts in order to document evidence of the positive effects they have in relation to child wellbeing and protection, to identify good practice in their design and implementation and to develop improved monitoring and evaluation approaches for CFSs. The case studies have so far all been focused on refugee settings and while internally displaced populations (IDPs) share many of the circumstances and challenges of refugees it was decided that CFSs operating in IDP settings warrant a particular investigation in order to assess their relevance and effectiveness in promoting child protection and psychosocial wellbeing. This report thus presents the findings from an IDP focused study on CFS effectiveness in three camps near Goma, eastern Democratic Republic of Congo (DRC).
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Investment in all the drivers and facilitators of hand hygiene action in health care to ensure that it occurs at the point of care and other critical moments requires a multidisciplinary, multifaceted approach. WHO describes such an approach as a
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multimodal improvement strategy” (MMIS) which is at the core of its implementation models for hand hygiene and infection prevention and control (IPC) programmes. The focus of this document is on the resource considerations for investing in hand hygiene improvement in health care (primary, secondary and tertiary) using the MMIS approach.
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The Lancet Global Health Volume 9, ISSUE 3, e361-e365, March 01, 2021
The public health community has tried for decades to show, through evidence-based research, that safe water, sanitation, and hygiene (WASH) and clean cooking fuels that reduce ho
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usehold air pollution are essential to safeguard health and save lives in low-income and middle-income countries. In the past 40 decades, there have been many innovations in the development of low-cost and efficacious technologies for WASH and household air pollution, but many of these technologies have been associated with disappointing health outcomes, often because low-income households have either not adopted, or inconsistently adopted, these technologies.
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The household transmission investigation is a case-ascertained prospective study of all identified household contacts of a laboratory confirmed 2019-nCoV infection (see 2.2 Study population). It is intended to provide rapid and early information on
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the clinical, epidemiological and virological characteristics of 2019-nCoV.
There are three primary objectives of this household transmission study:
To better understand the extent of transmission within a household by estimating the secondary infection rate for household contacts at an individual level, and factors associated with any variation in the secondary infection risk.
To characterize secondary cases including the range of clinical presentation, risk factors for infection, and the extent and fraction of asymptomatic infections.
To characterize serologic response following confirmed 2019-nCoV infection (highly encouraged, but optional depending on laboratory capacity and resources)
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One of the many gender inequities in the health and care workforce that COVID-19 has exposed is around the fit and design of Personal Protective Equipment (PPE). The rapid onset and scale of COVID-19 led to shortages of PPE in most countries, causin
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g preventable infection and mortality among healthcare workers and others on the front lines. Even though most health workers are women, manufacturing specifications for medical PPE are usually drawn up based on the male body and there have been many reports of PPE not designed for women's bodies. WGH undertook a global research project to document the challenges women health workers have faced.
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The design of anaesthesia equipment for use in hospitals in the developing world must take intoaccount the local conditions, particularly whether reliable supplies of compressed oxygen andelectricit
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y are available. Designs should ensure that maintenance is feasible locally. Internationalstandards should encourage the design of suitable equipment to ensure safe anaesthesia for patientsworldwide
Anaesthesia, 2007,62(Suppl. 1), pages 54–60
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta
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in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c
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ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Design and Illustration Ioanna Aravani
We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Dis
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ease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based
studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative
study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD:
1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore,
we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).
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The Urban Health Initiative (UHI) goes beyond improving access to health care and promoting healthy behaviours, and focuses on how to build cities that enable and encourage good health.
Part of the MSF "Guideline for cholera control"
All India Disaster Mitigation Institute (AIDMI) has been a signatory to the Climate and Environment Charter since 2021 and has worked extensively in advancing the commitments to the Charter through its programs and operations, as well as an advocacy
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partner within India and regionally.
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MEDBOX has gathered a selection of over 60 African hits from different countries into a play list with the aim of raising awareness on the diverse ways to fight COVID-19 in addition to a COVID-19 Toolbox https://www.covid19box.org with all the up t
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o date information on the pandemic. Feel free to pass it onto your contacts, the poster can be printed and used in different settings such as cultural centers, hospitals and refugee camps. To the COVID-19 African hist playlist visit: https://www.youtube.com/playlist?list=PLQvyjafXneiihYMqxMmrQLD_iwXvi3eiT.
Enjoy empowerment and rhythm! Spread the music, not the virus!
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MEDBOX has gathered a selection of over 60 African hits from different countries into a play list with the aim of raising awareness on the diverse ways to fight COVID-19 in addition to a COVID-19 Toolbox https://www.covid19box.org with all the up t
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o date information on the pandemic. Feel free to pass it onto your contacts, the poster can be printed and used in different settings such as cultural centers, hospitals and refugee camps. To the COVID-19 African hist playlist visit: https://www.youtube.com/playlist?list=PLQvyjafXneiihYMqxMmrQLD_iwXvi3eiT.
Enjoy empowerment and rhythm! Spread the music, not the virus!
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Facing the global nutrition challenges, the World Health Organization (WHO) teamed up with the United Nations Institute for Training and Research (UNITAR) to design, under the guidance of the Depart
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ment of Nutrition for Health and Development (NHD), a Nutrition Knowledge Hub. By building the technical and functional capacities of all relevant staff at WHO through e-learning courses and key nutrition-related training and knowledge materials, the Nutrition Knowledge Hub aims to contribute to the acceleration and increase of the nutrition impact at the country level. The Nutrition Knowledge Hub also offers free and open courses to reach a larger public and raise awareness on the malnutrition problem and WHO’s response.
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