Globalization and Health最新文献

{"title":"Trends and cross-country inequalities of alcohol use disorders: findings from the global burden of disease study 2021.","authors":"Zhaoyang Xie, Gangliang Zhong, Cheng Xu, Tianzhen Chen, Zheyi Du, Yicheng Wei, Min Zhao, Jiang Du","doi":"10.1186/s12992-025-01124-5","DOIUrl":"10.1186/s12992-025-01124-5","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) imposes a significant burden on individuals and society. With globalization, transnational alcohol corporations influence policy enforcement and consumer behavior, hindering cost-effective and evidence-based interventions such as reducing alcohol availability and restricting alcohol advertising, as recommended in the World Health Organization (WHO) Best Buys for the prevention and control of noncommunicable diseases (NCDs).This study utilizes the Global Burden of Disease Study 2021 dataset to examine global and regional disparities, offering key insights into the global trends of AUD and addressing critical research gaps.</p><p><strong>Results: </strong>The global age-standardised prevalence of alcohol use disorders among individuals aged 15 years and older decreased from 1,698 per 100,000 in 1990 to 1,335 per 100,000 in 2021, with an average annual percent change of -0.78%. Similarly, the average annual percent change for mortality and disability-adjusted life years were - 0.82% and - 0.83%, respectively. Importantly, the age-standardised decline in alcohol use disorders was more pronounced in females compared to males (prevalence: -0.82% versus - 0.75%; mortality: -1.22% versus - 0.73%; disability-adjusted life years: -0.95% versus - 0.79%). The age-standardised prevalence of alcohol use disorders may remain higher among males until the year 2040. For the older adult groups aged 55 to 74, there was no statistically significant decline in alcohol use disorders mortality rates (Ps ≥ 0.17). Furthermore, countries characterized by a high sociodemographic index did not exhibit a significant reduction in mortality (average annual percent change: 0.02%). Between 1990 and 2021, high levels of alcohol consumption and experiences of childhood sexual abuse were identified as major risk factors for alcohol use disorders.</p><p><strong>Conclusion: </strong>Understanding the trends of AUD in the context of globalization is crucial. Given that certain populations continue to experience persistent alcohol-related issues, protecting these groups from the influence of transnational alcohol corporations through effective policy measures such as strengthening regulations on alcohol advertising targeting older adults, and establishing independent regulatory agencies may be a key strategy for reducing the global health burden of AUD.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"30"},"PeriodicalIF":5.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Favoring those who contributed to their political campaigns\": an analysis of the incentives received by the food industry in Colombia in the period of 2018-2020.","authors":"María Alejandra Niño Duque, Emanuel Orozco Núñez, Eliana María Pérez Tamayo, Mélissa Mialon, Eric Crosbie, Christian Paul Torres de la Rosa","doi":"10.1186/s12992-025-01123-6","DOIUrl":"10.1186/s12992-025-01123-6","url":null,"abstract":"<p><p>The food industry is a very influential actor in public health policies in Colombia. In particular, industry incentives, such as financial donations and other gifts to political parties, can help develop future alliances and initiate an exchange of favors. The objective of this study was to analyze the incentives granted by the food industry to policymakers in Colombia from 2018-2020 and to understand how these incentives could affect public health policy in the country. An analysis of interest groups was carried out via qualitative methods, which was carried out in six stages: i) a documentary review of information and a content analysis of digital social networks; ii) the identification and characterization of actors in the food industry and decision makers; iii) twenty semi-structured interviews with key actors identified in previous stage); iv) characterization of the types and mechanisms through which incentives are provided; v) a mapping of actors; and vi) the reporting of results. Food industry actors, mainly at the national level, were identified as incentive providers to Colombia's government officials in the executive and legislative branches. We identified six types of incentives: financing electoral campaigns, financial donations, in-kind support, gifts, entertainment, and travel. Our analysis shows that the incentives of the food industry in Colombia can help influence the processes of formulation and implementation of food and nutritional public policies.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"29"},"PeriodicalIF":5.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding health in bilateral investment treaties: the Uruguayan experience.","authors":"Gastón Ares, Gerónimo Brunet, Dori Patay, Anne-Marie Thow","doi":"10.1186/s12992-025-01110-x","DOIUrl":"https://doi.org/10.1186/s12992-025-01110-x","url":null,"abstract":"<p><strong>Background: </strong>The proliferation of International Investment Agreements (IIAs), as the result of globalization, has been identified as one of the factors contributing to policy inertia or chill on meaningful public health policy action. Health safeguards, i.e., specific clauses to protect the State's right to regulate, have been increasingly included in IIAs to protect health policy. However, an in-depth understanding of the processes involved in the diffusion of health safeguards in IIAs globally and the factors acting as barriers and facilitators for their uptake is still lacking. In this context, the present study intends to fill this research gap by analysing the uptake of health safeguards in the context of Uruguay, a developing Latin American country. The objectives were to: (i) examine the evolution of the inclusion of health safeguards in the Bilateral Investment Treaties (BITs) signed by Uruguay until 2024, (ii) analyse how Uruguay has approached BITs after the Philip Morris ISDS case, (iii) explore Uruguayan stakeholders' perspectives on the inclusion of health safeguards in BITs, (iv) identify barriers and facilitators for the uptake of health safeguards in the BITs.</p><p><strong>Results: </strong>Documentary analysis of the BITs signed by Uruguay showed an ascending trend in the inclusion of health safeguards, reaching 100% since 2010. Interviews with key stakeholders suggested that health safeguards diffused from abroad through transnational transfer networks. While Uruguay has not faced challenges in including health safeguards in recent BITs, the renegotiation of old generation BIT agreements with developed countries has proven to be difficult. A wide range of factors that act as facilitators and barriers for the inclusion for health safeguards in the BITs were identified, which were related to both the national and intergovernmental levels.</p><p><strong>Conclusions: </strong>Results contribute to the understanding of the factors that influence the evolution of the interface between investment agreements and public health policy by analysing the adoption of health safeguards in BITs. Strong recommendations from international organizations to renegotiate old generation BITs may contribute to overcoming the existing power dynamics and support developing countries in the protection of their regulatory space.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"28"},"PeriodicalIF":5.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Stop, don't touch, run away!\": reconceptualizing firearm industry-funded youth education programs as corporate political activity.","authors":"May C I van Schalkwyk, Benjamin Hawkins, Nason Maani, Mark Petticrew","doi":"10.1186/s12992-025-01106-7","DOIUrl":"https://doi.org/10.1186/s12992-025-01106-7","url":null,"abstract":"<p><strong>Background: </strong>Injuries represent a major threat to child health globally. In the US, firearm injuries are the leading cause of death among children and adolescents. Despite limited evidence of their effectiveness industry-funded bodies promote the delivery of their youth education programs while lobbying against firearm control policies. This article analyzes how the National Rifle Association (NRA) frames issues of gun ownership, safety and the role of the Eddie Eagle GunSafe^® program as an effective firearm safety intervention and examines how the design, promotion and delivery of the program serves the corporate political interests of the firearm industry at the expense of public health.</p><p><strong>Methods: </strong>We conducted an analysis of Eddie Eagle Gunsafe^® program-related materials and the NRA's practices to promote the program's legitimacy and effectiveness, by applying published taxonomies of corporate framing and action strategies. Data were collected from the program-specific websites and other NRA outlets to capture the breadth of strategies used by the NRA.</p><p><strong>Results: </strong>The NRA's education-related practices support the firearm industry's political agenda. The NRA adopts framing and action strategies that present the presence of firearms in homes and communities as inevitable and normal, and the education of children through the delivery of their \"lifesaving\" program as the common-sense and effective way of keeping children safe from firearm injuries. They make misleading claims about the effectiveness of the Eddie Eagle Gunsafe^® program while undermining the credibility of those who advocate for child safety, including mothers and public health actors.</p><p><strong>Conclusion: </strong>The delivery of the Eddie Eagle GunSafe^® program needs critical scrutiny as is increasingly applied to other industry-funded initiatives. Policies based on a recognition that children and adolescents are safest when their homes and communities are free of firearms are needed. Findings from this analysis are relevant beyond the US and can be used to inform the governance of child safety and injury prevention globally. Analysis of the firearm industry extends the literature on the commercial determinants of health to an important new sector with significant impacts on global health.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"27"},"PeriodicalIF":5.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Kuznets Curve conjecture assessment in African economies: conditioning effects of urbanization, food, and trade using gender-based regional analysis.","authors":"Wenxin Wang, Isaac Adjei Mensah, Samuel Atingabili, Akoto Yaw Omari-Sasu, Emmanuel Nouwati, Clement Yenube Kunkuaboor, Emma Serwaa Obobisa, Mu Qiao","doi":"10.1186/s12992-025-01121-8","DOIUrl":"10.1186/s12992-025-01121-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Obesity is recognized as a significant health challenge in Africa, contributing to the double burden of malnutrition and elevating the risks of diabetes, heart disease, and hypertension. Existing studies on the Obesity Kuznets Curve (OKC) assessment overlook Africa's unique socio-economic and gender-specific dynamics. In light of the claim that different socioeconomic characteristics significantly influence the prevalence of obesity in different nations, this study examines the nonlinear relationship between economic growth and each of the obesity prevalence in males, females, and both sexes, respectively, while accounting for the effects of urbanization, trade, and food production.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study employs a panel data design to analyse the OKC hypothesis in a multivariate non-linear framework. The study focusses on Africa, with the study units consisting of African countries analysed within the framework of regional groupings and differentiated by obesity prevalence in males, females and both sexes correspondingly. Specifically, the study utilised panel data of 45 African nations sub-panelled into Eastern, Western, Central and Southern regions during the period from 2000 to 2020. The primary outcome variable is obesity prevalence, while the key exposure variable is economic growth. The study also considers trade openness, urbanization and food production as additional covariates influencing obesity prevalence to provide a nuanced analysis. Considering the existence of residual cross-sectional dependence and heterogeneity issue in the panel data, we applied the novel Biased Comment Method of Method estimator using the dynamic fixed-effect model as the main method to ensure robust and reliable estimates. This novel approach allows the study to address unobserved heterogeneity and interdependencies across regional economies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The principal findings demonstrated a distinct pattern of the OKC (non-linear relationship between the country's economic growth and obesity) when analysing prevalence of obesity in both sexes collectively and also when considering obesity prevalence in males and females separately across the geographical panels used. The results further showed that trade openness is positively associated with obesity prevalence in males and females separately together with both sexes collectively across all regional classifications. However, the effect of urbanization, and food production on obesity prevalence in males, obesity prevalence in females and obesity prevalence in both sexes correspondingly varied across the regional classifications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our analysis leads to specific policy recommendations, including the development of robust, regionally tailored health policies aimed at preventing obesity across Africa. These include promoting healthy diets through subsidies on nutritious foods, regulating trade polices to limit","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"26"},"PeriodicalIF":5.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition in care interventions for Refugee, Immigrant and other Migrant (RIM) populations: a health equity-oriented scoping review.","authors":"Amy Liu, Yasaman Yazdani, Manahel Elias, Krisha Patel, Divine Budzi, Ammar Saad, Kevin Pottie","doi":"10.1186/s12992-025-01114-7","DOIUrl":"10.1186/s12992-025-01114-7","url":null,"abstract":"<p><strong>Background: </strong>Transition in care involves the transfer of responsibility for aspects of patient and public health care among providers, institutions, and health and social sectors. Indeed, health systems increasingly require individuals to interact with a number of providers, in a number of health settings, and across multiple points of time. Refugees, immigrants, and migrant (RIM) individuals face several precarious transitions, language and cultural barriers, and unfamiliarity with public health systems, which may result in health inequities. A greater understanding of the interventions that facilitate effective transitions in care for RIM populations is needed to improve health outcomes in this vulnerable group.</p><p><strong>Methods: </strong>This health equity-oriented scoping review aimed to report the characteristics of Transition in Care (TiC) interventions for RIM populations and identify which equity-relevant characteristics of RIM populations were targeted by these interventions. We searched MEDLINE, Embase, and Scopus for eligible studies published in English from the year 2000 onward. Two independent reviewers screened search records and extracted relevant data from included studies. We used a public health and health equity lens to identify the social determinants of health that were addressed by TiC interventions.</p><p><strong>Results: </strong>Our systematic search identified a total of 42 studies, evaluating the impact of 38 unique interventions or public health programs. The delivery of interventions involved various healthcare sectors and professionals. Additionally, some programs enlisted non-medical personnel to provide health-related education and support. The most promising programs for health outcomes involved health navigation or providing public health education for RIM populations. The most common equity-relevant characteristics considered in these studies were language, cultural background, and education level.</p><p><strong>Conclusion: </strong>This novel scoping review reveals a diverse range of public health interventions that are being implemented to improve national and international transitions in care for RIM populations, with the most promising from healthcare navigation and health education. Future research should target transitions to digital health technologies, public health, hospital-to-home, and pediatric to adult care gaps to ensure smoother transitions in care for equity-deserving populations navigating new healthcare systems.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"25"},"PeriodicalIF":5.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding global health security amidst a scramble for Africa's minerals for the clean energy transition.","authors":"Oluwayemisi Ajumobi","doi":"10.1186/s12992-025-01102-x","DOIUrl":"10.1186/s12992-025-01102-x","url":null,"abstract":"<p><p>The global transition to renewable energy is increasing the demand for critical minerals mining in Africa. Without appropriate safeguards, expansion of mining operations on the continent increases the risk of mining-associated infectious disease outbreaks with epidemic and pandemic potential.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"24"},"PeriodicalIF":5.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Gates Foundation's network diplomacy in European donor countries.","authors":"Antoine de Bengy Puyvallée, Katerini Tagmatarchi Storeng, Simon Rushton","doi":"10.1186/s12992-025-01112-9","DOIUrl":"https://doi.org/10.1186/s12992-025-01112-9","url":null,"abstract":"<p><p>The Gates Foundation is the most influential private philanthropic foundation in global health and development. This article examines how the Foundation has developed an unparalleled capacity to rally other donors to its priorities, which include the development and distribution of technological tools to reduce the burden of infectious disease and child mortality in the world's most impoverished regions. Using publicly available data, the article analyses the Gates Foundation's strategic engagement in Europe, focusing on its bureaucratic presence, government relations, and grant-making in its three European focus countries: the United Kingdom (UK), Germany and France. It highlights that, since 2010, the Gates Foundation has built a bureaucratic infrastructure akin to a diplomatic service, establishing country offices in London and Berlin alongside representation in Paris, Brussels and Stockholm. Through regular engagement with elected officials and bureaucrats in these nations, the Foundation has forged many strategic partnerships, effectively leveraging European states' diplomatic power in wider political forums and alliances. Moreover, the Foundation has disbursed billions in grants to recipients in the UK, Germany, and France to advance research and innovation on its priority health issues, implement programs in poor countries, and develop policy and advocacy related to global health and development. Combined, these efforts have contributed to securing substantial and recurrent government co-investment in Gates-supported initiatives. The article proposes that the Foundation exercises a form of 'network diplomacy' that entails building and maintaining wide networks across European societies with the aim of aligning donor governments' overseas development assistance and policies with the Foundation's strategic objectives in global health and development. The concept of network diplomacy offers a new perspective on how the Gates Foundation has consolidated and expanded its transnational political presence through an approach that is strategic, bureaucratised and institutionalised, rather than simply a product of its financial might. The findings amplify existing concerns regarding the sway of private foundations over public policy, their impact on democratic accountability and governance in donor states, and the resultant implications for the Foundation's intended beneficiaries in low- and middle-income countries.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"22"},"PeriodicalIF":5.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Framing alcohol harm in the UN context - the importance of language.","authors":"Øystein Bakke, Sally Casswell","doi":"10.1186/s12992-025-01117-4","DOIUrl":"https://doi.org/10.1186/s12992-025-01117-4","url":null,"abstract":"<p><strong>Background: </strong>Alcohol is a global health issue with a high level of controversy. After being absent from World Health Organization (WHO) global governing body discussions for about 20 years, alcohol re-entered the agenda in 2005. The expression 'harmful use of alcohol' became the compromise language after hard negotiations, an example of 'adopted language\" that has remained for almost 20 years. This article analyses the background and use of the expression 'harmful use of alcohol' in the context of WHO governing bodies, current challenges and implications for public health.</p><p><strong>Methods: </strong>The article is based on textual analysis of source documents from the time periods 2004-2010 and 2019-2022 and the authors' experience from involvement in the global alcohol policy scene for more than 20 years: WHO governing body records and other documents were analysed, as well as Member State and Non-State Actors' positions and contributions in consultations and statements in WHO governing body debates.</p><p><strong>Results: </strong>The introduction of the concept 'harmful use of alcohol' in WHO documents from 2005 onwards was a political compromise between approaches focussed either on 'alcohol abuse' or a wider concept of harm from alcohol consumption. It has permeated into national alcohol policy documents, academic literature about alcohol harm and UN documents, and been embraced by the alcohol industry. However, it has not prevented and some would argue that it has enabled development of normative statements from WHO that include recommendations for population wide interventions. The relatively new evidence of harm from alcohol at low levels and questioning of evidence suggesting a beneficial effect of moderate use of alcohol together with industry appropriation of 'harmful use' have led to increasing critique of the framing implied by 'harmful use of alcohol'.</p><p><strong>Conclusions: </strong>The language used in WHO documents holds political power in that it may influence the subsequent course of events. This is accentuated by the normative role of WHO in global health policy and the uptake of negotiated language beyond WHO documents. In the next five years it will be possible and valuable to examine in more detail the extent to which this power was made manifest and the need and possible ways to effect change.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"23"},"PeriodicalIF":5.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental financial costs of strengthening large-scale child nutrition programs in Bangladesh, Ethiopia, and Vietnam: retrospective expenditure analysis.","authors":"Tina G Sanghvi, Rick Homan, Tuan Nguyen, Zeba Mahmud, Tamirat Walissa, Marina Nersesyan, Patricia Preware, Edward A Frongillo, Roger Matheson","doi":"10.1186/s12992-025-01118-3","DOIUrl":"https://doi.org/10.1186/s12992-025-01118-3","url":null,"abstract":"<p><strong>Background: </strong>Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children's physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young children do not receive foods with sufficient nutrition particularly in low-and-middle income countries. Program evaluations have documented the effectiveness of large-scale behavior change interventions to improve children's diets, but the budgetary implications of programs are not known. This paper provides the incremental financial costs of strengthening three large-scale programs based on expenditure records from Bangladesh, Ethiopia, and Vietnam.</p><p><strong>Results: </strong>The programs reached between one and 2.5 million mothers and children annually per country at unit costs of between $0.9 to $1.6 per mother and child reached. An additional 0.7 to 1.6 million people who were influential in supporting mothers and achieving scale were also engaged. The largest cost component was counselling of mothers. Rigorous external impact evaluations showed that over 434,500 children benefited annually from consuming a minimum acceptable diet in all countries combined, at an annual cost per country of $6.3 to $34.7 per child benefited.</p><p><strong>Conclusions: </strong>Large scale programs to improve young children's nutrition can be affordable for low- and middle-income countries. The study provides the incremental costs of selectively strengthening key program components in diverse settings with lessons for future budgeting. The costs of treating a malnourished child are several-fold higher than prevention through improved improving young children's dietary practices. Differences across countries in program models, coverage, costs, and outcomes suggest that countries need a minimum investment of resources for strengthening high-reach service delivery and communication channels and engaging relevant behavioral levers and community support for mothers to achieve impact at scale.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"21"},"PeriodicalIF":5.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}