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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 physi
...
cal activity occurs may promote physical activity at 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.
more
Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers
...
to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
more
[Updated 2015]
Scoping Question: In adults with acute convulsive seizures in first-level care or in the community (when no IV access is available), which antiepileptic medications produce benefits and/or harm when compared
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to comparator?
more
In May the Sixty-sixth World Health Assembly adopted resolution WHA66.12 (1) on 17 neglected tropical diseases (NTDs). Among other measures, the resolution urges Member States to:
• ensure count
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ry ownership of prevention, control, elimination and eradication programmes;
• expand and implement interventions and advocate for predictable, long-term international financing for activities related to control and capacity strengthening;
• integrate control programmes into primary health-care services and existing programmes;
• ensure optimal programme management and implementation;
• achieve and maintain universal access to interventions and reach the targets of the roadmap.
more
Health innovation is the creation and implementation of novel processes, products, programmes, policies or systems that lead to transformations or improvements in
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health and equity. This is the first instalment of "Innovation for Health," a knowledge product series dedicated to showcasing health innovation in the Western Pacific and the roles governments can play. This case study documents the health innovation aimed at achieving equity in access to cataract surgical services in Malaysia, examines its enablers and barriers for further scaling up, and serves as a reference for Member States seeking new approaches to decentralize and deliver services to the unreached.
more
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of hea
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lth service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
more
Access to responsive, people-centred health systems is essential to ensure appropriate
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health care for refugees and migrants throughout the process of migration and settlement. Focusing on intercultural competence and diversity sensitivity, this course contributes to a broader WHO strategy to develop an evidence-based response to the public health needs of refugees and migrants.
more
High prices, hard-to-access human insulin, few insulin producers, and weak health systems are just some of the barriers that people with diabetes f
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ace a century after insulin was discovered, WHO notes in a new report
more
Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoida
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ble suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, use
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d on its own, is not enough to understand the complexities of sanitation, hygiene, water, and health. It explores pastoralists’ views and perspectives on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.
more
Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arling
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ton, VA: Management Sciences for Health. Submitted to the United Nations Children’s Fund by JSI, Arlington, VA: JSI Research & Training Institute, Inc.
This guide will assist program managers, service providers, and technical experts when conducting a quantification of commodity needs for the 13 reproductive, maternal, newborn, and child health commodities prioritized by the UN Commission on Life-Saving Commodities for Women and Children. This quantification supplement should be used with the main guide—Quantification of Health Commodities: A Guide to Forecasting and Supply Planning for Procurement. * This supplement describes the steps in forecasting consumption of these supplies when consumption and service data are not available; after which, to complete the quantification, the users should refer to the main quantification guide for the supply planning step.
more
Achieving universal access to WASH in health care facilities requires political will and strong leadership at both national and facility levels, bu
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t is highly cost-effective, and would yield substantial health benefits. A global analysis estimated that universal basic WASH services in health care facilities could be achieved in 46 least developed countries (LDCs) by 2030 for less than US$10 billion, which represents additional expenditures of less than US$1 per person per year.
more
Universal health coverage ensures everyone has access to the health services they need without s
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uffering financial hardship as a result. In December 2012, a UN resolution was passed encouraging governments to move towards providing universal access to affordable and quality health care services. As countries move towards it, common challenges are emerging -- challenges to which research can help provide answers.
more
To test for ethnic discrimination in access to outpatient health care services, we carry out
an
...
email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find that patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
more
Lancet Glob Health 2015; 385: e387–95. Open Access
Conclusion: To ensure that people with disabilities can successfully access the necessary health services, the barriers on the demand side (the ind
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ividuals requiring healthcare) as well as the barriers that are part of the healthcare system, should be attended to.
more
How WHO works to prevent drug use, reduce harm and improve safe access to medicines
The Urban Health Initiative (UHI) goes beyond improving access to health care and promoting heal
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thy behaviours, and focuses on how to build cities that enable and encourage good health.
more
In responding to the health crisis in Venezuela, the United States and the international community can consider several options: they can encourage the Venezuelan government
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to fulfill commitments to protect the population's health and access to essential medicines; and they can support civil society organizations and professional groups providing analysis about the health sector. Strengthening the potential of public health professionals within Venezuela, as well as in the diaspora, to develop plans for reforming the health system and addressing current public health challenges should there be a political opening for them to do so will be important, as well.
more
The GLOBAL HEALTH EDUCATION TOOLBOX of MEDOBX offers access to a collection of practical resources and high quality documents
...
to support knowledge and practical skills within Global Health. This Toolbox was designed to support Global Health theory and practice, providing hands-on resources for students, trainers and NGO-practicioners for free.
The GLOBAL HEALTH EDUCATION TOOLBOX provides:
Key resources for Global Health Education; Introduction & advanced education material; Practical resources for Global Health practicioners; Information on going abroad ; Multilingual materials
more
