Globalization and Health最新文献

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Financing pandemic prevention, preparedness and response: lessons learned and perspectives for future. 资助大流行病的预防、准备和应对:经验教训和未来展望。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-21 DOI: 10.1186/s12992-024-01066-4
Nicaise Ndembi, Nebiyu Dereje, Justice Nonvignon, Merawi Aragaw, Tajudeen Raji, Mosoka Papa Fallah, Mohammed Abdulaziz, Benjamin Djoudalbaye, Aggrey Aluso, Yap Boum Ii, Gwen Mwaba, Olive Shisana, Ngashi Ngongo, Jean Kaseya
{"title":"Financing pandemic prevention, preparedness and response: lessons learned and perspectives for future.","authors":"Nicaise Ndembi, Nebiyu Dereje, Justice Nonvignon, Merawi Aragaw, Tajudeen Raji, Mosoka Papa Fallah, Mohammed Abdulaziz, Benjamin Djoudalbaye, Aggrey Aluso, Yap Boum Ii, Gwen Mwaba, Olive Shisana, Ngashi Ngongo, Jean Kaseya","doi":"10.1186/s12992-024-01066-4","DOIUrl":"10.1186/s12992-024-01066-4","url":null,"abstract":"<p><strong>Background: </strong>The attainment of global health security goals and universal health coverage will remain a mirage unless African health systems are adequately funded to improve resilience to public health emergencies. The COVID-19 pandemic exposed the global inequity in accessing medical countermeasures, leaving African countries far behind. As we anticipate the next pandemic, improving investments in health systems to adequately finance pandemic prevention, preparedness, and response (PPPR) promptly, ensuring equity and access to medical countermeasures, is crucial. In this article, we analyze the African and global pandemic financing initiatives and put ways forward for policymakers and the global health community to consider.</p><p><strong>Methods: </strong>This article is based on a rapid literature review and desk review of various PPPR financing mechanisms in Africa and globally. Consultation of leaders and experts in the area and scrutinization of various related meeting reports and decisions have been carried out.</p><p><strong>Main text: </strong>The African Union (AU) has demonstrated various innovative financing mechanisms to mitigate the impacts of public health emergencies in the continent. To improve equal access to the COVID-19 medical countermeasures, the AU launched Africa Medical Supplies Platform (AMSP) and Africa Vaccine Acquisition Trust (AVAT). These financing initiatives were instrumental in mitigating the impacts of COVID-19 and their lessons can be capitalized as we make efforts for PPPR. The COVID-19 Response Fund, subsequently converted into the African Epidemics Fund (AEF), is another innovative financing mechanism to ensure sustainable and self-reliant PPPR efforts. The global initiatives for financing PPPR include the Pandemic Emergency Financing Facility (PEF) and the Pandemic Fund. The PEF was criticized for its inadequacy in building resilient health systems, primarily because the fund ignored the prevention and preparedness items. The Pandemic Fund is also being criticized for its suboptimal emphasis on the response aspect of the pandemic and non-inclusive governance structure.</p><p><strong>Conclusions: </strong>To ensure optimal financing for PPPR, we call upon the global health community and decision-makers to focus on the harmonization of financing efforts for PPPR, make regional financing mechanisms central to global PPPR financing efforts, and ensure the inclusivity of international finance governance systems.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"65"},"PeriodicalIF":5.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016943","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}
引用次数: 0
Discursive framework for a multi-disease digital health passport in Africa: a perspective. 非洲多种疾病数字健康护照的话语框架:一个视角。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-20 DOI: 10.1186/s12992-024-01067-3
Gideon Towett, R Sterling Snead, Julia Marczika, Isaac Prada
{"title":"Discursive framework for a multi-disease digital health passport in Africa: a perspective.","authors":"Gideon Towett, R Sterling Snead, Julia Marczika, Isaac Prada","doi":"10.1186/s12992-024-01067-3","DOIUrl":"10.1186/s12992-024-01067-3","url":null,"abstract":"<p><p>Africa's dual burden of rising incidence of infectious diseases and increasing prevalence of non-communicable diseases (NCDs), such as cardiovascular diseases and diabetes, demands innovative approaches to disease surveillance, response, and cross-border health management in response to growing economic integration and global connectivity. In this context, we propose a discursive framework for the development and implementation of a multi-disease digital health passport (MDDHP) in Africa. The MDDHP would serve as a secure platform for storing and sharing individual health data, offering a comprehensive solution to track and respond to infectious diseases, facilitate the management of NCDs, and improve healthcare access across borders. Empowering individuals to proactively manage their health and improve overall outcomes is a key aspect of the MDDHP. In the paper, we examine the key elements necessary to effectively implement MDDHP, focusing on minimizing risks, maintaining efficacy, and driving its adoption while also taking into consideration the unique contexts of the continent. The paper is intended to provide an understanding of the key principles involved and contribute to the discussion on the development and successful implementation of MDDHP in Africa.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"64"},"PeriodicalIF":5.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008670","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}
引用次数: 0
Publisher Correction: Examining aid fragmentation and collaboration opportunities in Cambodia's health sector. 出版商更正:研究柬埔寨卫生部门的援助分散与合作机会。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-19 DOI: 10.1186/s12992-024-01068-2
Suyeon Lee, Eunice Y Park
{"title":"Publisher Correction: Examining aid fragmentation and collaboration opportunities in Cambodia's health sector.","authors":"Suyeon Lee, Eunice Y Park","doi":"10.1186/s12992-024-01068-2","DOIUrl":"10.1186/s12992-024-01068-2","url":null,"abstract":"","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"63"},"PeriodicalIF":5.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004067","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}
引用次数: 0
Faster and farther towards the abyss: global health accelerators instead of tangible changes. 更快、更远地走向深渊:全球健康加速器,而不是切实的变革。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-02 DOI: 10.1186/s12992-024-01050-y
Jens Holst
{"title":"Faster and farther towards the abyss: global health accelerators instead of tangible changes.","authors":"Jens Holst","doi":"10.1186/s12992-024-01050-y","DOIUrl":"10.1186/s12992-024-01050-y","url":null,"abstract":"<p><p>Global health accelerators have become the leading expression of global health engagement and policy. While accelerators seem to be the strategy of the moment, the term is meaningless and devoid of any statement of content. Moreover, acceleration can make social processes too fast to be subject to rational control or governance, especially in an era of (un-)social media, which makes the pace of communication and information. Under the dominance of neoliberalism, acceleration and accelerators pose a particular risk because they encounter a situation in which mankind is moving away from solving vital challenges and addressing their root causes. The fashionable emergence of accelerators cannot inspire confidence in the future trends in global health unless they actually result in tangible change and new approaches to tackling systemic challenges.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"61"},"PeriodicalIF":5.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874635","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}
引用次数: 0
Examining aid fragmentation and collaboration opportunities in Cambodia's health sector. 研究柬埔寨卫生部门的援助分散与合作机会。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-02 DOI: 10.1186/s12992-024-01063-7
Suyeon Lee, Eunice Y Park
{"title":"Examining aid fragmentation and collaboration opportunities in Cambodia's health sector.","authors":"Suyeon Lee, Eunice Y Park","doi":"10.1186/s12992-024-01063-7","DOIUrl":"10.1186/s12992-024-01063-7","url":null,"abstract":"<p><strong>Background: </strong>Cambodia's health sector faces significant challenges exacerbated by aid fragmentation, where development aid is dispersed among numerous small, uncoordinated projects. This study examines the distribution of health sector aid among Cambodia's principal donors to identify priorities, overlaps, and potential collaboration opportunities, addressing the urgent need for aid efficiency and alignment with national health priorities.</p><p><strong>Methods: </strong>Utilizing OECD datasets and the Herfindahl-Hirschman Index (HHI) for the years 2010-2021, this study quantifies aid fragmentation within Cambodia's health sector. It analyzes aid allocations from the top five donors-United States, Australia, South Korea, Japan, and Germany-across various health projects and initiatives, evaluating the extent of fragmentation and identifying areas for potential donor collaboration.</p><p><strong>Results: </strong>This study's findings highlight a pervasive issue of aid fragmentation within Cambodia's health sector, evident through the sector's low HHI score. This indicates a widespread distribution of aid across numerous small-scale initiatives, rather than targeted, unified efforts. A notable example includes Japan and Korea, which exhibit lower HHI scores, indicating a more pronounced fragmentation in their aid allocation. These countries' contributions are spread across various sectors without a dominant focus, contrasting with the United States' significant dedication to infectious disease control. However, beyond this specific area, the US's aid distribution across other priority health areas shows signs of fragmentation. This scattered approach to aid allocation, even amidst instances of focused support, illustrates the overarching challenge of aligning donor contributions with the holistic needs of Cambodia's health infrastructure.</p><p><strong>Conclusions: </strong>This investigation highlights the critical need for enhanced collaboration and strategic harmonization among international donors to mitigate aid fragmentation in Cambodia's health sector. It underscores the importance of adopting integrated and priority-aligned aid strategies to improve the efficiency and impact of health aid. By fostering synergistic partnerships and harmonizing donor efforts, there is a potential to create a more cohesive support framework that resonates with Cambodia's comprehensive health requirements and contributes to sustainable health outcomes. Such harmonization not only aligns with Sustainable Development Goal 3 by optimizing health services and outcomes but also strengthens global partnerships under Sustainable Development Goal 17, fostering a unified approach to international development.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"62"},"PeriodicalIF":5.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878565","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}
引用次数: 0
The place of health in the EU-CELAC interregional cooperation from 2005 to 2023: a historical, empirical and prospective analysis. 2005 至 2023 年卫生在欧盟-拉加共同体地区间合作中的地位:历史、经验和前景分析。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-01 DOI: 10.1186/s12992-024-01059-3
Carolina Salgado
{"title":"The place of health in the EU-CELAC interregional cooperation from 2005 to 2023: a historical, empirical and prospective analysis.","authors":"Carolina Salgado","doi":"10.1186/s12992-024-01059-3","DOIUrl":"10.1186/s12992-024-01059-3","url":null,"abstract":"<p><strong>Background: </strong>Much has been said by actors from different fields and perspectives about the manifold changes in world affairs triggered by the COVID-19 pandemic. In this context, it is to be expected that there will be impacts on long-standing partnerships such as the one between the European Union and the Community of Latin American and Caribbean Countries. However, few studies have demonstrated these impacts, either empirically, by uncovering their specificities or from a historical perspective, to allow for a reasonable methodological comparison of the patterns used to define the partnership and that have changed or have been affected in some way by the pandemic.</p><p><strong>Results: </strong>Through an in-depth qualitative assessment of primary and secondary sources, this article contributes to this research gap. It analyzes the patterns and changes or impacts in light of two strands of behavior that can make sense of EU-CELAC health cooperation-revisionist or reformist. The findings show an economy-driven health agenda as a new pattern of cooperation, which derives from EU reformist behavior after the pandemic.</p><p><strong>Conclusions: </strong>The EU power to enforce its priorities in the context of health cooperation with CELAC is the main factor that will define how (and not just which) competing interests and capacities will be accommodated. The relevance of the study to the fields of global governance for health, interregional health cooperation and EU foreign policy is threefold. It shows us i.how two more international regimes are easily intertwined with health-trade and intellectual property-with the potential to deepen asymmetries and divergences even between long-standing strategic partners; ii.contrary to the idea that reformist behaviors are only adopted by actors who are dissatisfied with the status quo, the study shows us that the reformist actor can also be the one who has more material power and influence and who nevertheless challenges the success of cooperation in the name of new priorities and the means to achieve them; and iii.how the EU will find it difficult to operationalize its new priorities internally, among states and private actors, and with those of CELAC, given the history of intense disputes over health-related economic aspects.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"60"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874637","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}
引用次数: 0
Understanding the secondary outcomes of international travel measures during the covid-19 pandemic: a scoping review of social impact evidence. 了解科维德-19 大流行期间国际旅行措施的次要结果:社会影响证据的范围审查。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-01 DOI: 10.1186/s12992-024-01064-6
Kelley Lee, Salta Zhumatova, Catherine Z Worsnop, Ying Liu Bazak
{"title":"Understanding the secondary outcomes of international travel measures during the covid-19 pandemic: a scoping review of social impact evidence.","authors":"Kelley Lee, Salta Zhumatova, Catherine Z Worsnop, Ying Liu Bazak","doi":"10.1186/s12992-024-01064-6","DOIUrl":"10.1186/s12992-024-01064-6","url":null,"abstract":"<p><strong>Background: </strong>Assessment of the effective use of international travel measures during the COVID-19 pandemic has focused on public health goals, namely limiting virus introduction and onward transmission. However, risk-based approaches includes the weighing of public health goals against potential social, economic and other secondary impacts. Advancing risk-based approaches thus requires fuller understanding of available evidence on such impacts.</p><p><strong>Methods: </strong>We conducted a scoping review of existing studies of the social impacts of international travel measures during the COVID-19 pandemic. Applying a standardized typology of travel measures, and five categories of social impact, we searched 9 databases across multiple disciplines spanning public health and the social sciences. We identified 26 studies for inclusion and reviewed their scope, methods, type of travel measure, and social impacts analysed.</p><p><strong>Results: </strong>The studies cover a diverse range of national settings with a strong focus on high-income countries. A broad range of populations are studied, hindered in their outbound or inbound travel. Most studies focus on 2020 when travel restrictions were widely introduced, but limited attention is given to the broader effects of their prolonged use. Studies primarily used qualitative or mixed methods, with adaptations to comply with public health measures. Most studies focused on travel restrictions, as one type of travel measure, often combined with domestic public health measures, making it difficult to determine their specific social impacts. All five categories of social impacts were observed although there was a strong emphasis on negative social impacts including family separation, decreased work opportunities, reduced quality of life, and inability to meet cultural needs. A small number of countries identified positive social impacts such as restored work-life balance and an increase in perceptions of safety and security.</p><p><strong>Conclusions: </strong>While international travel measures were among the most controversial interventions applied during the COVID-19 pandemic, given their prolonged use and widespread impacts on individuals and populations, there remains limited study of their secondary impacts. If risk-based approaches are to be advanced, involving informed choices between public health and other policy goals, there is a need to better understand such impacts, including their differential impacts across diverse populations and settings.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"59"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874638","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}
引用次数: 0
Securing the rights and health of domestic workers: the importance of ratifying the ILO's C189. 保障家庭佣工的权利和健康:批准国际劳工组织 C189 的重要性。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-08-01 DOI: 10.1186/s12992-024-01065-5
Andrian Liem, Sabina Satriyani Puspita, Fajar, Lita Anggraini
{"title":"Securing the rights and health of domestic workers: the importance of ratifying the ILO's C189.","authors":"Andrian Liem, Sabina Satriyani Puspita, Fajar, Lita Anggraini","doi":"10.1186/s12992-024-01065-5","DOIUrl":"10.1186/s12992-024-01065-5","url":null,"abstract":"<p><p>This commentary highlights the critical importance of ratifying the International Labour Organization's (ILO) Domestic Workers Convention No. 189-2011 (C189) to secure the rights and health of domestic workers (DWs) worldwide, particularly in light of the World Health Organization's World Health Day 2024 theme 'My Health, My Right'. The ILO's C189 represents a significant advancement in labour rights, offering protection to a highly feminised sector where women make up 80% of the estimated 50-100 million DWs worldwide. The ILO's C189 aims to address the marginalisation and exploitation that DWs have historically faced by ensuring that they receive the same protections as other workers. This encompasses measures against abuse, harassment and violence, and the establishment of a secure and healthy working environment, as outlined in Article 13. The commentary emphasises the urgent need for the enactment of legal frameworks in countries such as Indonesia, where many of the approximately 10 million DWs encounter shocking abuses both within the country and abroad. The ratification of the C189 and the enactment of national laws, such as Indonesia's Draft Law on the Protection of Domestic Workers (RUU PPRT), are essential for the safeguarding of the rights and health of DWs. The commentary compares Indonesia with the Philippines, as the latter has been a signatory to the C189 since 2012 and has enacted its National Domestic Workers Act in 2013. The ratification of the C189, therefore, is imperative for igniting the protection and advancement of labour rights for DWs globally. This ILO's C189 represents a significant first step in addressing the long-standing and complex issues of marginalisation and exploitation prevalent in this predominantly female sector. It is also essential that the potential obstacles and concerns related to the ratification and implementation of the ILO's C189 are addressed collaboratively by stakeholders and not viewed as justifications for inaction.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"58"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874636","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}
引用次数: 0
Evaluating the effect of health insurance reform on health equity and financial protection for elderly in low- and middle-income countries: evidences from China. 评估医疗保险改革对中低收入国家老年人健康公平和经济保障的影响:来自中国的证据。
IF 5.9 2区 医学
Globalization and Health Pub Date : 2024-07-30 DOI: 10.1186/s12992-024-01062-8
Hongzhi Wang, Xin Xiang
{"title":"Evaluating the effect of health insurance reform on health equity and financial protection for elderly in low- and middle-income countries: evidences from China.","authors":"Hongzhi Wang, Xin Xiang","doi":"10.1186/s12992-024-01062-8","DOIUrl":"10.1186/s12992-024-01062-8","url":null,"abstract":"<p><strong>Background: </strong>To achieve Universal Health Coverage (UHC), China have implemented health system reform to expend health coverage and improve health equity. Scholars have explored the implementing effect of this health reform, but gaps remained in health care received by elderly. This study aims to assess the effect of implementing health insurance payment reform on health care received by elderly, as well as to evaluate its effect on cost sharing to identify whether improve financial protection of elderly under this reform.</p><p><strong>Methods: </strong>We identified hospitalization of 46,714 elderly with cerebral infarction from 2013 to 2023. To examine the determinant role played by DRGs payment reform in healthcare for elderly and their financial protection, this study employs the OLS linear regression model for analysis. In the robustness checks, we validated the baseline results through several methods, including excluding the data from the initial implementation of the reform (2021), reducing the impact of the pandemic, and exploring the group effects of different demographic characteristics.</p><p><strong>Results: </strong>The findings proposed that implementing DRGs payment reduces drug expenses but increases treatment expense of chronic disease for elderly in China. This exacerbates healthcare costs for elderly patients and seems to be contrary to the original purpose of health care reform. Additionally, the implementation of DRGs payment reduced the spending of medical insurance fund, while increased the out-of-pocket of patients, revealing a shift in health care expenses from health insurance fund to out-of-pocket.</p><p><strong>Conclusions: </strong>This study shares the lessons from China's health reform and provides enlightenment on how to effective implement health reform to improve health equity and achieve UHC in such low- and middle-income countries facing challenges in health financing.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"20 1","pages":"57"},"PeriodicalIF":5.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855283","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}
引用次数: 0
Which government policies to create sustainable food systems have the potential to simultaneously address undernutrition, obesity and environmental sustainability? 哪些创建可持续粮食系统的政府政策有可能同时解决营养不良、肥胖和环境可持续性问题?
IF 10.8 2区 医学
Globalization and Health Pub Date : 2024-07-27 DOI: 10.1186/s12992-024-01060-w
Celia Burgaz, Iris Van-Dam, Kelly Garton, Boyd A. Swinburn, Gary Sacks, Gershim Asiki, Rafael Claro, Adama Diouf, Ana Paula Bartoletto Martins, Stefanie Vandevijvere
{"title":"Which government policies to create sustainable food systems have the potential to simultaneously address undernutrition, obesity and environmental sustainability?","authors":"Celia Burgaz, Iris Van-Dam, Kelly Garton, Boyd A. Swinburn, Gary Sacks, Gershim Asiki, Rafael Claro, Adama Diouf, Ana Paula Bartoletto Martins, Stefanie Vandevijvere","doi":"10.1186/s12992-024-01060-w","DOIUrl":"https://doi.org/10.1186/s12992-024-01060-w","url":null,"abstract":"A transformation of food systems is urgently needed, given their contribution to three ongoing and interlinked global health pandemics: (1) undernutrition and food insecurity, (2) obesity and non-communicable diseases (NCDs), and (3) climate change and biodiversity loss. As policymakers make decisions that shape food systems, this study aimed to identify and prioritise policies with double- or triple-duty potential to achieve healthier and more environmentally sustainable food systems. This study undertook a 4-step methodological approach, including (i) a compilation of international policy recommendations, (ii) an online survey, (iii) four regional workshops with international experts and (iv) a ranking for prioritisation. Policies were identified and prioritised based on their double- or triple-duty potential, synergies and trade-offs. Using participatory and transdisciplinary approaches, policies were identified to have double- or triple-duty potential if they were deemed effective in tackling two or three of the primary outcomes of interest: (1) undernutrition, (2) obesity/NCDs and (3) environmental degradation. The desk review identified 291 recommendations for governments, which were merged and classified into 46 initially proposed policies. Based on the results from the online survey, 61% of those policies were perceived to have double- or triple-duty potential. During the workshops, 4 potential synergies and 31 trade-offs of these policies were identified. The final list of 44 proposed policies for healthier and more environmentally sustainable food systems created was divided into two main policy domains: ‘food supply chains’ and ‘food environments’. The outcome with the most trade-offs identified was ‘undernutrition’, followed by ‘environmental sustainability’, and ‘obesity/NCDs’. Of the top five expert-ranked food supply chain policies, two were perceived to have triple-duty potential: (a) incentives for crop diversification; (b) support for start-ups, and small- and medium-sized enterprises. For food environments, three of the top five ranked policies had perceived triple-duty potential: (a) affordability of healthier and more sustainable diets; (b) subsidies for healthier and more sustainable foods; (c) restrictions on children's exposure to marketing through all media. This study identified and prioritised a comprehensive list of double- and triple-duty government policies for creating healthier and more environmentally sustainable food systems. As some proposed policies may have trade-offs across outcomes, they should be carefully contextualised, designed, implemented and monitored.","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"57 1","pages":""},"PeriodicalIF":10.8,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141775718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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