101-120 of 178 Results


Managing the Paradox of Conflictual Policy and Strategy Regarding Health of Irregular Migrants: Perspective From Europe and Africa  

Ursula Trummer, Michela Martini, and Sabelo Mbokazi

Irregular migrants belong to the most vulnerable migrant groups. Health threats associated with an irregular status are high, and access to health services is severely restricted globally. Concerning migration aspects, a common public narrative for Europe and Africa is that Africa is sending thousands of migrants to embark on an irregular life-threatening journey of migration to Europe every year. Although this is a well documented reality, it is by far not the most important migration pattern in terms of numbers and health threats when looking at Africa. It can be argued that, on the contrary, Africa is mainly characterized by south-to-south migration both for economic and humanitarian reasons, with African nation-states like Uganda being among the top three nations worldwide hosting refugees. In addition, main migration routes from Africa do not target Europe but rather other regions like the Gulf countries. Existing dialogue between Europe and Africa has great potential to fast track and develop joint policies and strategies for meaningful, affordable legal migration patterns and access to the human right to health for irregular migrants. First, a change of the rhetoric around irregular migration from Africa mainly directed toward Europe is needed. Second, existing policies and strategies regarding the health of irregular migrants need to be examined and evaluated. Within all the huge differences concerning public health systems and capacities in Europe and Africa, a common strategy to discourage irregular migration seems to be restricting the access of irregular migrants to their human right to health through national regulations. This has paradoxically created a simultaneous inclusion on grounds of human rights regulations and exclusion on grounds of national restrictions, with “functional ignorance” (health care organizations and personnel ignore the lack of residence permits and its legal implications) and “structural compensation” (facilities run by nongovernmental organizations take over public health responsibilities and health care provision) as key features. Such strategies put a lot of strain on health care providers and irregular migrants and should not be considered as a sustainable solution. Instead, action should be taken to overcome the paradox of contradictory migration and health policies by means of firewalls and structural mechanisms. An important step in this direction can be to rethink cooperation between Europe and Africa in this domain, starting with the development of a joint evidence base relevant for Europe and Africa in an interdisciplinary approach and with European and African scholars that can support proactive policy and strategy development to safeguard the human right to health for irregular migrants together with good migration governance.


Mass Shootings as a Global Phenomenon  

Jason R. Silva

There has been extensive media coverage, public concern, and calls for action surrounding mass shootings in the United States at the turn of the 21st century. To address this concern, there is a growing body of research aimed at understanding and remedying this problem in America. However, recent attacks around the world—like the Kerch Polytechnic College shooting in Ukraine, the Christchurch Mosque shooting in New Zealand, and the Suzano School shooting in Brazil—illustrate that mass shootings are a global phenomenon. To this end, it is critical for research to shed light on this troubling and complex issue and contribute to a more informed public and scholarly discourse on mass shootings and their impact around the world. To understand the global problem, it is necessary to evaluate the prevalence of incidents across countries, mass shooter backgrounds and profiles, and common locations targeted during these attacks. To address this phenomenon, it is important to consider strategies for prevention and harm mitigation, including instituting responsible gun legislation, addressing warning signs and leakage, implementing situational crime prevention measures, and advancing law enforcement responses.


Maternal Health and Well-Being  

Samuel Akombeng Ojong, Bridgette Wamakima, Cheryl A. Moyer, and Marleen Temmerman

Maternal health and well-being refers to the physical, psychological, and emotional well-being of women during pregnancy, childbirth, and the postnatal period, as well as the absence of any morbidities or death either due to pregnancy or its management. Despite making a comparatively late appearance on the international global policy agenda, maternal health and well-being has progressively become a global health policy priority following Deborah Maine’s revolutionary article on maternal mortality. Consequently, key international policy events from Alma Ata to the International Conference on Population and Development events, through the Millennium Development Goals to the Sustainable Development Goals (SDGs) in the last decade have consecrated women’s inalienable right to safe and respectful health services. Also, the growing focus on rights-based care against the backdrop of the need to ensure equity in all communities worldwide has led to an evolution in policy focus, calling on health systems to not only protect women and girls from preventable deaths but to also empower them to thrive, all while recognizing their unique role is ensuring the positive transformation of the communities in which they live. This increasing policy attention has contributed to a disproportionate yet marked reduction in global maternal mortality and morbidity statistics over the last 30 years. However, if the world is to achieve its 2030 SDGs women’s health and gender equality agendas, it is important to recognize that the broad concept of women’s health cannot be limited to the rather narrow window of pregnancy, childbirth, and the postpartum period. While there are huge gaps in all resource-type settings in promoting and protecting women’s agency and autonomy, the fact remains that in addition to ensuring the availability of and access to high-quality maternal health services, women’s health outcomes are inextricably linked to their decision-making power on key issues such as when to become sexually active, the use of contraception, whether or not they want to achieve pregnancy and childbirth, and access to safe abortion care services. Additionally, the growing burden of noncommunicable diseases and the increasing occurrence of worldwide pandemics are providing novel challenges to the health and well-being of the world’s most vulnerable women and girls, thus creating the need to ensure resilient health systems that are considerate of the rights and wishes of the world’s women and girls.


Measuring Mortality Crises: A Tool for Studying Global Health  

Stefano Mazzuco

Measuring the impact of a public health crisis in terms of mortality might seem a straightforward method to quantify its effect on the population because deaths are much more easily registered compared to other health outcomes. However, despite the intuitive appeal of this path, it is far from obvious how to best operationalize it, and all the most used methods have drawbacks that should be kept in mind. Especially during the COVID-19 pandemic, the major routes that have been considered are cause-specific death counts (and related measures such as case fatality rates), excess deaths estimates, and life expectancy decline. All the considered approaches have limitations: Cause-specific deaths are often subject to undercount or overcount issues with significant differences both between and within countries, excess deaths estimates may strongly depend on the baseline (there are several methods to estimate it), and life expectancy drop estimates (or estimates of years of life lost) also depend on the reference level used, which can vary substantially across countries. More generally, the issues of available data quality and standardization of age structure should be taken into proper account. Thus, the choice of which approach is worth using depends on the characteristics of the crisis that need to be evaluated and the type and quality of data available. Interestingly, the three approaches can also be combined so that some of their limitations can be mitigated.


Membrane Filtration  

Maryna Peter

Membrane systems provide a physical barrier to various contaminants in water and therefore are attractive for different applications. Depending on the type of the membrane and its pore size, membranes might remove microbial contaminants, organic chemicals, or salts. The membrane-based systems for drinking water purification exist at different scales. The costs have decreased considerably since the 1990s, increasing the attractiveness for various needs and affordability levels. Household tabletop filters and filters installed under a sink can be used when public water supply quality is unreliable or in emergencies with locally available buckets or jerry cans. Gravity or solar-driven systems exist for off-grid applications in schools, health care facilities, or small communities. Skid-mounted and container-based desalination units are deployed in emergencies when brackish or saline water sources are the only option. Large-scale membrane-based drinking water treatment plants operate worldwide for municipal drinking water treatment. The modular design and flexibility around the capacity, target contaminants, and available energy sources offer opportunities for membrane-based drinking water treatment in various contexts. Further research and development should focus on mitigating membrane fouling, and reducing energy consumption, costs, and the overall technical complexity of the systems.



Funmilola M. OlaOlorun and Wen Shen

Menopause is the natural senescence of ovarian hormonal production, and it eventually occurs in every woman. The age at which menopause occurs varies between cultures and ethnicities. Menopause can also be the result of medical or surgical interventions, in which case it can occur at a much younger age. Primary symptoms, as well as attitudes toward menopause, also vary between cultures. Presently, the gold standard for treatment of menopause symptoms is hormone therapy; however, many other options have also been shown to be efficacious, and active research is ongoing to develop better and safer treatments. In a high-resource setting, the sequelae/physiologic changes associated with menopause can impact a woman’s physical and mental health for the rest of her life. In addition to “hot flashes,” other less well-known conditions include heart disease, osteoporosis, metabolic syndrome, depression, and cognitive decline. In the United States, cardiac disease is the leading cause of mortality in women over the age of 65. The growing understanding of the physiology of menopause is beginning to inform strategies either to prevent or to attenuate these common health conditions. As the baby boomers age, the distribution of age cohorts will increase the burden of disease toward post-reproductive women. In addition to providing appropriate medical care, public health efforts must focus on this population due to the financial impact of this age cohort of women.


Mental Health of Migrant Children  

Saida M. Abdi

The psychosocial well-being of migrant children has become an urgent issue facing many Western countries as the number of migrant children in the population increases rapidly and health-care systems struggle to support them. Often, these children arrive with extensive exposure to trauma and loss before facing additional stressors in the host country. Yet, these children do not access mental health support even when available due to multiple barriers. These barriers include cultural and linguistic barriers, the primacy of resettlement needs, and the stigma attached to mental health illness. In order to improve mental health services for migrant children, there is a need to move away from focusing on trauma and mental health symptoms and to look instead at migrant children’s well-being across multiple domains, including activities that can promote or diminish psychological well-being. Trauma Systems Therapy for Refugees (TST-R) is an example of an approach that has succeeded in overcoming these barriers by adopting a culturally relevant and comprehensive approach to mental health care.


Mental Health of Refugees  

Jutta Lindert

People who are forcibly displaced are forced to flee by serious threats to fundamental human rights, caused by factors such as persecution, armed conflict, and indiscriminate violence. Contemporary drivers of forced displacement are increasingly complex and interrelated. They include population growth, food insecurity, and water scarcity, at times compounded and multiplied by the effects of climate change. A refugee is someone who fled his or her home and country owing to “a well-founded fear of persecution because of his/her race, religion, nationality, membership in a particular social group, or political opinion,” according to the United Nations 1951 Refugee Convention. Internally displaced persons (IDPs) are people who have not crossed an international border but were forced to move to a different region than the one they call home within their own country. People who cannot return home without serious risk to their human rights have specific needs. Forced displacement, both within a country and to other countries, is a major life event that abruptly changes environmental living conditions, such as social networks, language, and cultural environment of the displaced populations. The changes in environmental living conditions and disruptions in life challenge both the individual and the families of the displaced persons. Both types of forced displacement challenge adaptational mechanisms of individuals and families. Accordingly, the challenges can contribute to changes in mental health and mental disorders. However, estimates of mental health, mental disorders, and mental health determinants vary across and between forcibly displaced persons. This heterogeneity in estimates is associated with differences between refugee groups and with methodological difficulties in assessing refugees’ mental health. Instruments to assess mental health need to be culture-grounded and gender-sensitive to capture the scope and extent of refugees’ mental health and mental disorders. Based on reliable and valid instrument needs for assessing mental health and mental disorders, determinants can be identified and intervention can be developed and evaluated.


Migrant Health in Refugee Camps: A Neglected Public Health Issue  

Manuela Valenti

There are 1 billion migrants in the world today, which means that one in seven of the world’s population are migrants. Of these, 272 million are international migrants and 763 million are internal migrants. It is estimated that around 70 million of the world’s migrants, both internal and international, have been forcibly displaced. Many things force people to leave their homes in search of a better future: war, poverty, persecution, climate change, desertification, urbanization, globalization, inequality, and lack of job prospects. Migrants remain among the most vulnerable members of society even when their living conditions improve after migration. Migrant women and children are a particularly vulnerable group and have a great need for basic and preventive health care. Many refugees and migrants are young and in good health, but hard living conditions and difficulty accessing basic health care can affect their state of health. Many of them face inhuman journeys during migration and live in refugee camps with very low standards of hygiene; when they find a job, they are often exploited. All these things can also affect their mental health. Migrants struggle with similar challenges as other marginalized groups when it comes to access to health care, but they face the additional barriers of mobility, language barriers, cultural differences, lack of familiarity with local health care services, and limited eligibility for publicly and privately funded health care. Governments should provide affordable preventive and basic health care to refugees and migrants not only because it is a human right but also because in the long term it can lower the costs of the whole health care system.


Migration and Obesity  

Solveig A. Cunningham and Hadewijch Vandenheede

There are over 230 million international migrants worldwide, and this number continues to grow. Migrants tend to have limited access to and knowledge about resources and preventative care in their communities of reception, but nonetheless they are often in better health by many measures compared with native-born people in their communities of reception and with the people they left behind at their place of origin. With time since arrival, however, immigrants’ health advantages often dissipate and they experience increases in health problems, especially obesity and diabetes, which are chronic diseases that are increasingly prevalent in the overall population as well and are associated with multiple co-morbidities and limitations. It may be that immigrants have specific health endowments leading to these health patterns, or that the processes involved in migration, including exposure to new environments, behavioral change, and stress of migration may also affect risks of obesity and other chronic conditions. Understanding the health patterns of migrants can be useful in identifying their specific health needs, as well as contributing to our understanding of how specific environments, changes in environments, and individual health endowments interplay to shape the long-term health of populations.


Migration, Migrants, and Health in Latin America and the Caribbean  

Deisy Ventura, Jameson Martins da Silva, Leticia Calderón, and Itzel Eguiluz

The World Health Organization has recognized health as a right of migrants and refugees, who are entitled to responsive healthcare policies, due to their particular social determinants of health. Migrants’ and refugees’ health is not only related to transmissible diseases but also to mental health, sexual and reproductive health, and non-communicable diseases, such as diabetes. Historically, however, migration has been linked to the spread of diseases and has often artificially served as a scapegoat to local shortcomings, feeding on the xenophobic rhetoric of extremist groups and political leaders. This approach fosters the criminalization of migrants, which has led to unacceptable violations of human rights, as demonstrated by the massive incarceration and deportation policies in developed countries, for example, the United States under the Trump administration. In Latin America and the Caribbean, in particular, there have been legal developments, such as pioneering national legislation in Argentina in 2004 and Brazil in 2017, which suggest some progress in the direction of human rights, although in practice drawbacks abound in the form of countless barriers for migrants to access and benefit from healthcare services in the context of political turmoil and severe socioeconomic inequality. The COVID-19 pandemic has exposed and enhanced the effects of such inequality in the already frail health conditions of the most disenfranchised, including low-income migrants and refugees; it has both caused governments in Latin America to handle the crisis in a fragmented and unilateral fashion, ignoring opportunities to cooperate and shield the livelihoods of the most vulnerable, and served as a pretext to sharpen the restrictions to cross-border movement and, ultimately, undermine the obligation to protect the dignity of migrants, as the cases of Venezuela and the U.S.-Mexico border illustrate. Still, it could represent an opportunity to integrate the health of migrants to the public health agenda as well as restore cooperation mechanisms building on previous experiences and the existing framework of human rights organizations.


Monitoring and Evaluation of Sexual and Reproductive Health Programs  

Janine Barden-O'Fallon and Erin McCallum

Monitoring and evaluation (M&E) can be defined as the systematic collection, analysis, and use of data to answer questions about program performance and achievements. An M&E system encompasses all the activities related to setting up, collecting, reporting, and using program information. A robust, well-functioning M&E system can provide program stakeholders with the information necessary to carry out a responsive and successful program intervention and is therefore a critical tool for program management. There are many tools and techniques needed for successful M&E of sexual and reproductive health (SRH) programs. These include frameworks to visually depict the organization of the program, its context and goals, and the logic of its M&E system. Essential practices of M&E also include continuous stakeholder engagement, the development of indicators to measure program activities and outcomes, the collection and use of data to calculate the indicators, and the design and implementation of evaluation research to assess the benefits of the program. Over time, language around “M&E” has evolved, and multiple variations of the phrase are in use, including “MEL” (monitoring, evaluation, and learning), “MER” (monitoring, evaluation, and reporting), and “MERL” (monitoring, evaluation, research, and learning), to name but a few. These terms bring to the forefront a particular emphasis of the M&E system, with an apparent trend toward the use of “MEL” to emphasize the importance of organizational learning. Despite this trend, “M&E” continues to be the most widely known and understood phrase and implicitly includes activities such as learning, research, and reporting within a robust system.


Monitoring Migrants’ Health Risk Factors for Noncommunicable Diseases  

Stefano Campostrini

Noncommunicable diseases (NCDs) have become the first cause of morbidity and mortality around the world. These have been targeted by most governments because they are associated with well-known risk factors and modifiable behaviors. Migrants present, as any population subgroup, peculiarities with regard to NCDs and, more relevantly, need specific information on associated risk factors to appropriately target policies and interventions. The country of origin, assimilation process, and many other migrant health aspects well studied in the literature can be related to migrants’ health risk factors. In most countries, existing sources of information are not sufficient or should be revised, and new sources of data should be found. Existing survey systems can meet organizational difficulties in changing their questionnaires; moreover, the number of changes in the adopted questionnaire should be limited for the sake of brevity to avoid excessive burden on respondents. Nevertheless, a limited number of additional variables can offer a lot of information on migrant health. Migrant status, country of origin, time of arrival should be included in any survey concerned about migrant health. These, along with information on other Social Determinants of Health and access to health services, can offer fundamental information to better understand migrants’ health and its evolution as they live in their host countries. Migrants are often characterized by a better health status, in comparison with the native population, which typically is lost over the years. Public health and health promotion could have a relevant role in modifying, for the better, this evolution, but this action must be supported by timely and reliable information.


Newborn Mortality  

Li Liu, Lucia Hug, Diana Yeung, and Danzhen You

As under-5 mortality declines globally, newborn or neonatal mortality is becoming increasingly important. Depending on measurement and empirical data sources, calculation of the magnitude and trend of all-cause and cause-specific neonatal mortality ranges from direct methods to model-based estimates. From 1990 to 2019, the global neonatal mortality rate decreased by 52%, though wide regional variations persist, with sub-Saharan Africa (SSA) consistently experiencing the highest neonatal mortality rates, followed by Southern Asia, accounting for 79% of the 2.4 million total newborn deaths in 2019. Globally, most deaths in 2019 are due to preterm birth complications (36%), intrapartum-related events (24%), congenital abnormalities (10%), pneumonia (8%), and sepsis (7%). Since 2000, in low- and middle-income regions like Central Asia and South Asia and SSA, most deaths were avoided through declines in intrapartum-related events (3.4% and 1.9% AARR [average annual rate of reduction from 2000 to 2019], respectively) and preterm birth complications (2.9% and 1.9% AARR, respectively); whereas high-income regions like Europe, Northern America, Eastern Asia and South-Eastern Asia were more rapidly able to reduce deaths due to congenital abnormalities (2.8% and 3.2% AARR, respectively). More investment is urgently required to improve data collection and data quality, as well as to leverage supporting empirical data with statistical modeling to improve the validity of neonatal mortality and cause-of-death estimates.


NGO Contributions to Community Health and Primary Health Care: Case Studies on BRAC (Bangladesh) and the Comprehensive Rural Health Project, Jamkhed (India)  

A. Mushtaque R. Chowdhury and Henry B. Perry

Non-governmental organizations (NGOs) working in developing countries are chiefly a post-World War II phenomenon. Though they have made important contributions to health and development among impoverished people throughout the world, the documentation of these contributions has been limited. Even though BRAC and the Jamkhed Comprehensive Rural Health Project (CRHP) are but two of 9.7 million NGOs registered around the world, they are unique. Established in 1972 in Bangladesh, BRAC is now the largest NGO in the world in terms of population served—now reaching 130 million people in 11 different countries. Its programs are multi-sectoral but focus on empowering women and improving the health of mothers and children. Through its unique scheme of generating income through its own social enterprises, BRAC is able to cover 85% of its $1 billion budget from self-generated funds. This innovative approach to funding has enabled BRAC to grow and to sustain that growth as its social enterprises have also prospered. The Jamkhed CRHP, founded in 1970 and located in the Indian state of Maharashtra, is notable for its remarkable national and global influence. It is one of the world’s early examples of empowering communities to address their health problems and the social determinants of those problems, in part by training illiterate women to serve as community health workers. The Jamkhed CRHP served as a major influence on the vision of primary health care that emerged at the 1978 International Conference on Primary Health Care at Alma-Ata, Kazakhstan. Its Institute for Training and Research in Community Health and Population has provided on-site training in community health for 45,000 people from 100 different countries. The book written by the founders entitled Jamkhed: A Comprehensive Rural Health Project, describing its pioneering approach, has been translated into five languages beyond English and is one of the most widely read books on global health. These two exemplary NGOs provide a glimpse of the breadth and depth of NGO contributions to improving the health and well-being of impoverished people throughout the world.


Nonlinear Pricing with Reference Dependence  

Catarina Roseta-Palma, Miguel Carvalho, and Ricardo Correia

Many utilities, including water, electricity, and gas, use nonlinear pricing schedules which replace a single uniform unit price, with multiple elements such as access charges and consumption blocks with different prices. Whereas consumers are typically assumed to be utility maximizers with nonlinear budget constraints, it is more likely that consumer behavior shows limited-rationality features such as reference dependence. Recent studies of water demand have explored consumer reactions to social comparison nudges, which can moderate consumption and might be a useful tool given low demand-price elasticities. Other authors have noted the difficulties of correct price perception when tariff schedules are complex, and attributed those low elasticities to a lack of information. Nonetheless, it is also possible that consumers form reference prices, relative to which the actual price paid is compared, in a way that affects consumption choices. Faced with a nonlinear price schedule, such as increasing block tariffs, consumers could evaluate their actual marginal price as a loss or a gain relative to a particular reference price that is derived from the schedule. Introducing gain/loss terms into the utility function, in the discrete/continuous model of consumer choice that has been widely used for water demand analysis, leads to consumption decisions that vary when a higher-than-reference price is seen as a loss and a lower-than-reference price as a gain. Utilities might wish to explore these reference-price effects according to their strategic goals. For example, if there are capacity constraints or water scarcity problems, potential water savings can be achieved from highlighting the first-block price as a reference and framing higher-block prices as losses, inducing conservation even without raising overall prices. Furthermore, if higher-block prices are subsequently raised the demand response could be stronger.


Obstetric Fistula  

Chi Chiung Grace Chen and René Génadry

Obstetric fistula (OF) is a condition that remains prevalent in non-industrialized nations, mainly in sub-Saharan Africa and Southeast Asia where proper and timely obstetrical care is inaccessible, unavailable, or inadequate. The reasons for the delay vary from country to country where poverty remains a common thread, and understanding the many factors leading to the development of OF is critical in preventing this scourge that has been all but eliminated in industrialized nations. Preventive measures can be effective when developed in conjunction with local resources and expertise and should include patient education and empowerment in addition to educating and equipping healthcare providers. In the absence of such measures, patients develop an « obstructed labor injury complex » involving the genital, urinary, and gastrointestinal tracts. Many troublesome health consequences arise from this complex, including skin lesions from the caustic effects of urine, endocrine abnormalities such as amenorrhea and infertility, neuropsychological consequences such as depression and suicide, and musculoskeletal impairments such as foot drop and contractures. Globally, evidence-based interventions are needed to address the debilitating and persistent medical, psychological, and social effects of this condition on its sufferers. While surgery offers the amelioration of symptoms, many patients may not have access to such care due to lack of funds, knowledge of surgical options, or availability of surgical facility. Even after successful repair of the fistula, patients may still suffer from persistent incontinence, stigma, and socio-economic hardship requiring special programs for support, rehabilitation, and reintegration. Additionally, the patients who are deemed inoperable require special counseling and care. Consensus is needed on standardizing care and outcome measures to improve the quality of care and to evaluate programs directed toward prevention that will render this condition obsolete.


Occupational Health Challenges for Immigrant Workers  

Emily Q. Ahonen

Occupational health and safety concerns classically encompass conditions and hazards in workplaces which, with sufficient exposure, can lead to injury, distress, illness, or death. The ways in which work is organized and the arrangements under which people are employed have also been linked to worker health. Migrants are people who cross borders away from their usual place of residence, and about one in seven people worldwide is a migrant. Terms like “immigrant” and “emigrant” refer to the direction of that movement relative to the stance of the speaker. Any person who might be classified as a migrant and who works or seeks to work is an immigrant worker and may face challenges to safety, health, and well-being related to the work he or she does. The economic, legal, and social circumstances of migrant workers can place them into employment and working conditions that endanger their safety, health, or well-being. While action in support of migrant worker health must be based on systematic understanding of these individuals’ needs, full understanding the possible dangers to migrant worker health is limited by conceptual and practical challenges to public health surveillance and research about migrant workers. Furthermore, intervention in support of migrant worker health must balance tensions between high-risk and population-based approaches and need to address the broader, structural circumstances that pattern the health-related experiences of migrant workers. Considering the relationships between work and health that include but go beyond workplace hazards and occupational injury, and engaging with the ways in which structural influences act on health through work, are complex endeavors. Without more critically engaging with these issues, however, there is a risk of undermining the effectiveness of efforts to improve the lot of migrant workers by “othering” the workers or by failing to focus on what is causing the occupational safety and health concern in the first place—the characteristics of the work people do. Action in support of migrant workers should therefore aim to ameliorate structural factors that place migrants into disadvantageous conditions while working to improve conditions for all workers.


“One Health” From Concept to Application in the Global World  

Maria Cristina Schneider, Claudia Munoz-Zanzi, Kyung-duk Min, and Sylvain Aldighieri

The vision that everything is connected in this world is not new. However, to respond to the current challenges that the world is facing, the integrated vision that humans, animals, and the environment are linked is more important than ever. Collaboration among multiple disciplines is crucial, and this approach is fundamental to understanding the One Health concept. A transdisciplinary definition of One Health views animals, humans, and their shared settings or environment as linked and affected by the socioeconomic interest of humans and external pressures. A One Health concept calls for various disciplines to work together to provide new methods and tools for research and implementation of effective services to support the formulation of norms, regulations, and policies to the benefit of humanity, animals, and the environment for current and future generations. This will improve the understanding of health and disease processes as well as prediction, detection, prevention, and control of infectious hazards and other issues affecting health and well-being in the human-animal-ecosystem interface, contributing to sustainable development goals, and to improving equity in the world.


Operationalizing Human Rights in Sexual and Reproductive Health and Rights Programming: An Example from a Global Family Planning Partnership  

Karen Hardee

The International Conference on Population and Development (ICPD), which has guided programming on sexual reproductive health and rights (SRHR) for 25 years, reinforced that governments have a role to play in addressing population issues but in ways that respect human rights and address social and gender inequities. The shift at ICPD was partly in response to excesses that had occurred in some family planning programs, resulting in human rights abuses. The 2012 London Summit on Family Planning refocused attention on family planning as a crucial component of SRHR and, in part due to significant pushback on the announcement of a goal of reaching an additional 120 million women and girls with contraception by 2020 in the world’s poorest countries, ignited work to ensure that programming to achieve this ambitious goal would be grounded in respecting, protecting, and fulfilling human rights. This attention to human rights has been maintained in Family Planning 2030 (FP2030), the follow on to Family Planning 2020 (FP2020). While challenges remain, particularly in light of pushback on reproductive rights, widespread work over the past decade to identify human rights principles and standards related to family planning, integrate them into programming, strengthen accountability, and incorporate rights into monitoring and evaluation has improved family planning programs.