scholarly journals Global challenges in tobacco control

10.21149/8076 ◽  
2017 ◽  
Vol 59 ◽  
pp. 5 ◽  
Author(s):  
Kerstin Schotte ◽  
Alison Commar ◽  
Evan Blecher ◽  
Vinayak Prasad

The last decade has seen unprecedented achievements in global tobacco control. These include the entry into force of the WHO Framework Convention on Tobacco Control (WHO FCTC) and 179 states, as well as the European Union, becoming Parties to the Treaty,leading to an increased global cognizance of the negative health and economic impact of tobacco use. Governments around the world continue to adopt and implement effective tobacco control strategies and financial contributions from major philanthropies have increased the levels of financial support for tobacco control efforts in low- and middle-income countries. The UN high-level summit on Noncommunicable Diseases (NCDs) in 2011 and the 2015 adoption of the Sustainable Development Goals (SDGs), in which NCDs and acceleration of implementation of WHO FCTC are included as specific targets, represent an increased global recognition of theneed to address tobacco use prevalence as a key element of NCD interventions...

2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000880 ◽  
Author(s):  
Sara Bennett ◽  
Douglas Glandon ◽  
Kumanan Rasanathan

Multisectoral action is key to addressing many pressing global health challenges and critical for achieving the Sustainable Development Goals, but to-date, understanding about how best to promote and support multisectoral action for health is relatively limited. The challenges to multisectoral action may be more acute in low-income and middle-income countries (LMICs) where institutions are frequently weak, and fragmentation, even within the health sector, can undermine coordination. We apply the lens of governance to understand challenges to multisectoral action. This paper (1) provides a high level overview of possible disciplines, frameworks and theories that could be applied to enrich analyses in this field; (2) summarises the literature that has sought to describe governance of multisectoral action for health in LMICs using a simple political economy framework that identifies interests, institutions and ideas and (3) introduces the papers in the supplement. Our review highlights the diverse, but often political nature of factors influencing the success of multisectoral action. Key factors include the importance of high level political commitment; the incentives for competition versus collaboration between bureaucratic agencies and the extent to which there is common understanding across actors about the problem. The supplement papers seek to promote debate and understanding about research and practice approaches to the governance of multisectoral action and illustrate salient issues through case studies. The papers here are unable to cover all aspects of this topic, but in the final two papers, we seek to develop an agenda for future action. This paper introduces a supplement on the governance of multisectoral action for health. While many case studies exist in this domain, we identify a need for greater theory-based conceptualisation of multisectoral action and more sophisticated empirical investigation of such collaborations.


2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).


2018 ◽  
Vol 7 (11) ◽  
pp. 448 ◽  
Author(s):  
Robert Chew ◽  
Kasey Jones ◽  
Jennifer Unangst ◽  
James Cajka ◽  
Justine Allpress ◽  
...  

While governments, researchers, and NGOs are exploring ways to leverage big data sources for sustainable development, household surveys are still a critical source of information for dozens of the 232 indicators for the Sustainable Development Goals (SDGs) in low- and middle-income countries (LMICs). Though some countries’ statistical agencies maintain databases of persons or households for sampling, conducting household surveys in LMICs is complicated due to incomplete, outdated, or inaccurate sampling frames. As a means to develop or update household listings in LMICs, this paper explores the use of machine learning models to detect and enumerate building structures directly from satellite imagery in the Kaduna state of Nigeria. Specifically, an object detection model was used to identify and locate buildings in satellite images. In the test set, the model attained a mean average precision (mAP) of 0.48 for detecting structures, with relatively higher values in areas with lower building density (mAP = 0.65). Furthermore, when model predictions were compared against recent household listings from fieldwork in Nigeria, the predictions showed high correlation with household coverage (Pearson = 0.70; Spearman = 0.81). With the need to produce comparable, scalable SDG indicators, this case study explores the feasibility and challenges of using object detection models to help develop timely enumerated household lists in LMICs.


Author(s):  
Arief Andriyanto ◽  
Faisal Ibnu ◽  
Rina Nur Hidayati

The Sustainable Development Goals emphasizing an intervention to prioritize solutions to the global challenge of poor child development in low and middle income countries (LMICs). In 2015, about 25% of children under five years of age in low were stunted (Kim & Subramanian, 2017; Perkins et al., 2017; UNICEF, 2015) The WHO conceptual framework for stunting (2013) identified household and family factors, complementary feeding, breastfeeding practices and infections as the most plausible causes of stunting(Stewart, Iannotti, Dewey, Michaelsen, & Onyango, 2013)


2020 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer

Abstract Background: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce unhealthy lifestyles. To effectively target these interventions, it is important to know how unhealthy lifestyles vary with socioeconomic characteristics. This study quantifies prevalence and socioeconomic inequalities in unhealthy lifestyles in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030.Methods: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with different unhealthy lifestyles.Results: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively -0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off.Conclusions: This study emphasizes the importance of unhealthy lifestyles in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in unhealthy lifestyles - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Shahirose S. Premji ◽  
Jennifer Hatfield

The 13 million nurses worldwide constitute most of the global healthcare workforce and are uniquely positioned to engage with others to address disparities in healthcare to achieve the goal of better health for all. A new vision for nurses involves active participation and collaboration with international colleagues across research practice and policy domains. Nursing can embrace new concepts and a new approach—“One World, One Health”—to animate nursing engagement in global health, as it is uniquely positioned to participate in novel ways to improve healthcare for the well-being of the global community. This opinion paper takes a historical and reflective approach to inform and inspire nurses to engage in global health practice, research, and policy to achieve the Sustainable Development Goals. It can be argued that a colonial perspective currently informs scholarship pertaining to nursing global health engagement. The notion of unidirectional relationships where those with resources support training of those less fortunate has dominated the framing of nursing involvement in low- and middle-income countries. This paper suggests moving beyond this conceptualization to a more collaborative and equitable approach that positions nurses as cocreators and brokers of knowledge. We propose two concepts, reverse innovation and two-way learning, to guide global partnerships where nurses are active participants.


Author(s):  
Mike Rayner ◽  
Kremlin Wickramasinghe ◽  
Julianne Williams ◽  
Karen McColl ◽  
Shanthi Mendis

The sociopolitical landscape of non-communicable diseases (NCDs) is presented in two chapters in this book. This is the first chapter which introduces the topic. It shows how the recent demographic shifts have changed the global landscape, creating a fertile ground for the rise in the NCD burden. It describes how changes in disease patterns in low- and middle-income countries and factors such as the ageing population, urbanization, globalization, and cultural and political changes have contributed to the problem. Importantly, this chapter sets the scene to introduce NCDs as a development problem, which requires a global political response as demonstrated with the sustainable development goals (SDGs; SDGs and NCDs are discussed in later chapters). This chapter also considers the ways that competing voices and vested interests impact on NCD prevention activities.


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