Research has shown that if prospective parents lose weight and reduce weight gain during pregnancy, this may lower the risk of their unborn children from developing non-communicable diseases in later life. Interventions have been launched in low- and middle-income countries (LMICs) to get these adults to lose weight, yet they have limited impact. As an alternative, the authors of this paper argue that the most promising strategy to improve prospective parents' body composition and lifestyle is the promotion of health literacy in adolescents. Multiple but integrated forms of community-based interventions that focus on nutrition, physical activity, family planning, breastfeeding and infant feeding practices are needed. They need to address the wider social economic context in which adolescents live and to be linked with existing public health programmes in sexual and reproductive health and maternal and child health initiatives. Addressing the promotion of such health literacy in parents-to-be in LMICs requires a wider social perspective. A range of multisectoral agencies will have to work together and could be linked to issues of women's empowerment, reproductive health, communicable disease prevention and Millennium Development Goals 4 and 5 (maternal and child health).
Equity in Health
This paper offers an overview of calculations of global inequality, recently and over the long-run as well as main controversies and political and philosophical implications of the findings. The author focuses in particular on the winners and losers of the most recent episode of globalisation, from 1988 to 2008. He suggests that the period might have witnessed the first decline in global inequality between world citizens since the Industrial Revolution. The decline however can be sustained only if countries’ mean incomes continue to converge (as they have been doing during the past ten years) and if internal (within-country) inequalities, which are already high, are kept in check. Mean-income convergence would also reduce the huge “citizenship premium” that is enjoyed today by the citizens of rich countries.
In this paper, the authors outline a conceptual and policy approach to bring social concerns more centrally into green economy and sustainable development debates. They first examine a wide range of social problems and other issues associated with the green economy, reasserting that any development transformation must be both green and fair, leading to a green society, not just a green economy. The authors argue in favour of comprehensive or transformative social policy, which goes beyond social protection, human capital formation or green jobs by also focusing on redistribution and social reproduction. Achieving a shift towards such policies will depend crucially on addressing the politics of governance itself, specifically, the ways different actors - particularly social movements and those most disadvantaged - contest ideas and policies, participate in governance, and organise and mobilise to resist and influence change. Such arenas of policy and action are crucial both from the perspective of distributional and procedural justice, as well as for driving deeper structural transformations. The authors conclude by highlighting issues of fragmentation associated with knowledge, institutional arrangements and social agency, and point to the need for "joined-up analysis, policy and action".
In this policy brief, the authors highlight worsening income inequalities between and within countries in recent decades, while noting that gender inequalities are narrowing at a snail’s pace. They argue that increases in inequality are partly due to the neglect of policy instruments to promote equality of outcome in favour of approaches that claim to create equality of opportunity. Current social discontent and distrust of government highlight the urgency of addressing inequality head-on: reducing inequality should be should be high on the post-2015 development agenda and should be seen as a goal in itself. It should also be reflected in other goals. The authors recommend that development targets should be set for within-country inequalities, including inequalities across regions, gender, ethnicity and income status. Proposed targets and indicators could include: inequality expressed in terms of the top and bottom deciles/ventiles; wages vs. profits (functional distribution of income); gender-based wage gaps; other labour market indicators, such as median wage, existence of minimum wage, percentage of labour force with social protection (female, male); and female/male ratio of unpaid work.
In this latest edition of the Atlas of African Health Statistics, the World Health Organisation (WHO) provides the latest available data on Health status and trends for various countries, including Life expectancy, Adult mortality, Child mortality, Maternal mortality, and Age standardised death rates. It also contains data on Africa’s burden of disease and various aspects of the health system, such as health financing, the health workforce, medical products and equipment, health information and health technology. Specific programmes and services run on the continent are also included, such as HIV and AIDS, tuberculosis, malaria, immunisation and vaccines development, child and adolescent health, maternal and newborn health, gender and women's health, neglected tropical diseases, and non-communicable diseases and conditions. The Atlas also considers the key determinants of health, including risk factors for health, food safety and nutrition, demography, resources and infrastructure, poverty and income inequality, environment, science and technology and emergencies and disasters. Progress so far on the Millennium Development Goals is included. All data is presented in visual format, such as graphs and maps, for easier reading.
The High-Level Taskforce for Women, Girls, Gender Equality and HIV for Eastern and Southern Africa concluded a week-long political advocacy mission to South Africa by calling for renewed commitment and leadership to protect the health and rights of young women and girls in the country. South Africa’s Department of Women, Children and People with Disabilities invited the Taskforce to advocate with the country’s leadership around the critical issues facing women and girls today including teenage pregnancy, gender based-violence, transmission of HIV from mother-to-child, and sex work. In order to address the high rates of maternal mortality in South Africa - 310/100,000 live births - earlier this year, the National Department of Health, spearheaded by the Minister of Health, launched the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) in South Africa. Some of the key elements of CARMMA is to strengthen women’s access to comprehensive sexual and reproductive health services, especially family planning to prevent new HIV infections and unintended pregnancies, strengthen the health system to provide human resources for maternal and child health and to intensify the management of HIV-positive mothers.
In this study, researchers quantified prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking and compared them across wealth and education levels in low- and middle-income countries. The study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Smoking and low fruit and vegetable consumption were found to be significantly higher among lower socioeconomic groups. The highest wealth-related inequality was seen in smoking among men in low- income countries. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries. Mixed patterns were found for heavy drinking.
In this article, the authors describe five children who died of clinical rabies in a three month period (September to November 2011) in the Queen Elizabeth Central Hospital. From previous experience and hospital records, this number of cases is higher than expected. The authors express concerned that difficulty in accessing post-exposure prophylaxis (PEP) rabies vaccine may be partly responsible for this rise. They make three recommendations: prompt course of active immunisation for all patients with significant exposure to proven or suspected rabid animals; the use of an intradermal immunisation regime that requires a smaller quantity of the vaccine than the intramuscular regime and gives a better antibody response; and improved dog rabies control measures.
These two challenge papers were commissioned by DANIDA to address two key questions. First, how has the development challenge changed, and how could it be understood for the future? Second, what are the implications for development agencies and development partnerships? Paper 1 by Andrew Norton, aims to support high-level discussion on the challenges facing global development. He reviews four key challenges: persistent poverty; globalisation and socio-economic transitions; sustainable development in the context of climate change; and human security, violence and conflict. He identifies major potential risks as shocks in the world economy, civil conflict and fragility, long-term resource scarcities and climate change. As a result, policy needs to engage with change, he argues, focusing on the supra-national level to deliver global public goods. Paper 2 by Andrew Rogerson picks up the themes emerging from Paper 1 to address the policy and institutional responses that are needed for inclusive and sustainable development. Like Norton, he calls for collective action within the complex institutional space occupied by many actors, policies and instruments. He further outlines three main options available to development agencies: concentrate on being an efficient disburser of official development assistance (ODA); become brokers and managers of ODA and ODA-like funds; or become deal-makers and brokers across government and internationally.
In Kenya, the Jua Kali (“hot sun,” in Swahili) industry is a major economical component of the urban informal sector, consisting primarily of outdoor manufacturing and repair shops. In August 2005, a cross-sectional survey was conducted in a large Jua Kalii area in Eldoret, Kenya. Most of the interviewees described their working conditions as poor, with about 30% of the subjects without easy access to toilets. They identified the three occupational risks as: breathing difficulties due to exposure to smoke, fumes or gases; work accidents; and eye injuries. In many of the work facilities, tools and practices require major improvements in order to provide appropriate working conditions in compliance with modern scientific knowledge and current legislation in Kenya. Changes in these areas require major financial investments and administrative commitments that are probably not easily achievable, the authors warn. But in such areas as institutional training, safety practices, and prevention, much can be accomplished with limited, affordable resources, including the provision of safe drinking water, accessible clean toilets, changes in working conditions (chairs, tables, lighting), training in safe work practices, the provision of basic protective devices such as goggles, gloves and aprons, improved methods of handling hazardous materials, and assistance in training to update work skills in light of changing technologies in their areas of employment.