Estimates of the Quality of Complementary Feeding Amongvietnamese Infants Aged 6-23months Varied by Howcommercial Baby Cereals Were Classified in 24-H Recalls

The World Health Organization\u27s (WHO) standardized questionnaire for assessing infant and young child feeding practices does not include commercial baby cereals (CBC), which are derived from several food groups and are fortified with micronutrients. We examined how different scenarios for classifying CBC affect estimates of the quality of complementary feeding in children ages 6−23 months in Vietnam in 2014 (n = 4811). In addition to the WHO standardized 24‐h recall questionnaire for infant and young child feeding, we asked mothers about the consumption of CBC. The five resulting scenarios were S1 – omitted CBC; S2 – CBC classified as grains; S3 – as grains and dairy; S4 – as grains, dairy and fruit/vegetables; and S5 – as grains, dairy, fruit/vegetables and any others. Including CBC resulted in 4−11 percentage points higher in the prevalence of children who were fed each of the six food groups compared with what was reported in the WHO standardized questionnaire. Minimum dietary diversity (% fed ≥ 4 out of the 7 food groups) was higher in S5 (90%) than in S1 (84%), S2 (84%), S3 (85%) and S4 (86%). Minimum acceptable diet was also higher in scenarios S5 (80%) than in S1 (74%), S2 (75%), S3 (75%) and S4 (77%). Consumption of iron‐rich foods was 94% when CBC was accounted, which was higher than the alternative scenario (89%). In summary, when CBC were included, population‐level estimates of dietary quality were higher than when CBC were omitted. Guidance is required from the WHO about how to account for the consumption of CBC when estimating the quality of complementary feeding

Infant Formula Feeding at Birth Is Common and Inversely Associated With Subsequent Breastfeeding Behavior in Vietnam

BACKGROUND: The association between infant formula feeding at birth and subsequent feeding patterns in a low- or middle-income context is not clear. OBJECTIVE: We examined the association of infant formula feeding during the first 3 d after birth with subsequent infant formula feeding and early breastfeeding cessation in Vietnam. METHODS: In a cross-sectional survey, we interviewed 10,681 mothers with children aged 0-23 mo (mean age: 8.2 mo; 52% boys) about their feeding practices during the first 3 d after birth and on the previous day. We used stratified analysis, multiple logistic regression, propensity score-matching analysis, and structural equation modeling to minimize the limitation of the cross-sectional design and to ensure the consistency of the findings. RESULTS: Infant formula feeding during the first 3 d after birth (50%) was associated with a higher prevalence of subsequent infant formula feeding [stratified analysis: 7-28% higher (nonoverlapping 95% CIs for most comparisons); propensity score-matching analysis: 13% higher (P \u3c 0.001); multiple logistic regression: OR: 1.47 (95% CI: 1.30, 1.67)]. This practice was also associated with a higher prevalence of early breastfeeding cessation (e.g., \u3c 24 mo) [propensity score-matching analysis: 2% (P = 0.08); OR: 1.33 (95% CI: 1.12, 1.59)]. Structural equation modeling showed that infant formula feeding during the first 3 d after birth was associated with a higher prevalence of subsequent infant formula feeding (β : 0.244; P \u3c 0.001), which in turn was linked to early breastfeeding cessation (β : 0.285; P \u3c 0.001). CONCLUSIONS: Infant formula feeding during the first 3 d after birth was associated with increased subsequent infant formula feeding and the early cessation of breastfeeding, which underscores the need to make early, exclusive breastfeeding normative and to create environments that support it

The Manila Declaration on the Drug Problem in the Philippines

When Philippine President Rodrigo R. Duterte assumed office in 2016, his government launched an unprecedented campaign against illegal drugs. The drug problem in the Philippines has primarily been viewed as an issue of law enforcement and criminality, and the government has focused on implementing a policy of criminalization and punishment. The escalation of human rights violations has caught the attention of groups in the Philippines as well as the international community. The Global Health Program of the Association of Pacific Rim Universities (APRU), a non-profit network of 50 universities in the Pacific Rim, held its 2017 annual conference in Manila. A special half-day workshop was held on illicit drug abuse in the Philippines which convened 167 participants from 10 economies and 21 disciplines. The goal of the workshop was to collaboratively develop a policy statement describing the best way to address the drug problem in the Philippines, taking into consideration a public health and human rights approach to the issue. The policy statement is presented here

Establishing Competencies for a Global Health Workforce: Recommendations from the Association of Pacific Rim Universities

Background: The Association of Pacific Rim Universities Global Health Program facilitates exchange of information, knowledge and experiences in global health education and research among its 50 member universities. Despite the proliferation of global health educational programs worldwide, a lack of consensus exists regarding core competencies in global health training and how these are best taught. Methods: A workshop was convened with 30 faculty, university administrators, students, and NGO workers representing both the Global North and South to gain consensus on core competencies in masters’-level global health training. The co-authors then collaborated to refine the list of competencies, categorize them into domains, and develop a plan for how academic institutions can ensure that these competencies are effectively taught. Findings: Nineteen competencies across five domains were identified: knowledge of trends and determinants of global disease patterns; cultural competency; global health governance, diplomacy and leadership; project management; and ethics and human rights. The plan for how academic institutions can best train students on these competencies outlined five key opportunities: coursework; practicums; research opportunities; mentorship; and evaluation. The plan recommended additional institutional strategies such as maximizing collaborative research opportunities, international partnerships, capacity-building grants, and use of educational technology to support these goals. Conclusions and Recommendations: While further research on the implementation of competency-based training is warranted, this work offers a step forward in advancing competency-based global health masters’ education as identified by a globally diverse group of expert stakeholders and economies. Given the challenges facing the current global health landscape, comparable competency-based training across institutions is critical to ensure the training of competent global health professionals

Navigating Hurdles:A Review of the Obstacles Facing the Development of the Pandemic Treaty

INTRODUCTION: The emergence of the COVID-19 pandemic has served as a call for enhanced global cooperation and a more robust pandemic preparedness and response framework. As a result of this pressing demand, dialogues were initiated to establish a pandemic treaty designed to foster a synchronized global strategy for addressing forthcoming health emergencies. In this review, we discussed the main obstacles to this treaty.RESULTS: Among several challenges facing the pandemic treaty, we highlighted (1) global cooperation and political will, (2) equity in access to resources and treatments, (3) sustainable financing, (4) compliance and enforcement mechanisms, (5) sovereignty concerns, and (6) data sharing and transparency.CONCLUSION: Navigating the hurdles facing the development of the pandemic treaty requires concerted efforts, diplomatic finesse, and a shared commitment to global solidarity. Addressing challenges in global cooperation, equitable access, transparency, compliance, financing, and sovereignty is essential for forging a comprehensive and effective framework for pandemic preparedness and response on the global stage.</p

Social, Economic, and Political Events Affect Gender Equity in China, Nepal, and Nicaragua: A Matched, Interrupted Time-Series Study

: Progress in gender equity can improve health at the individual and country levels.: This study\u27s objective was to analyze recent trends in gender equity and identify historical and contextual factors that contributed to changes in gender equity in three countries: China, Nepal, and Nicaragua.: To assess gender equity trends, we used the Gender Gap Index (GGI) from the World Economic Forum\u27s Global Gender Gap Report (2006-2017). The GGI incorporated data on economic participation, educational attainment, health, and political empowerment for almost 150 countries. We selected China, Nepal, and Nicaragua because of their major changes in GGI and diversity in geographical location and economic status. We reviewed major social, economic, and political events during 2006-2017, and identified key events in each country. We compared countries\u27 GGI with matched controls average using interrupted time-series analysis.: Nepal and Nicaragua both had dramatic increases in GGI (improvement in equity), Nepal (β = 0.029; 95% CI: 0.003, 0.056) and Nicaragua (β = 0.035; 95% CI: 0.005, 0.065). This was strongly influenced by political empowerment, which likely impacted access to education and employment opportunities. Despite major economic growth and new policies to address gender inequities (e.g. the One-Child Policy), China saw a significant decline in GGI between 2010 and 2017 (β = -0.014; 95% CI: -0.024, -0.004), largely resulting from decreased gender equity in educational attainment, economic participation, and health/survival sub-indices.: Key social, economic, and political events helped explain trends in countries\u27 gender equity. Our study suggested that supportive social and political environments would play important roles in empowering women, which would advance human rights and promote health and well-being of individuals, households, communities, and countries

National Nutrition Strategies That Focus on Maternal, Infant, and Young Child Nutrition in Southeast Asia Do Not Consistently Align With Regional and International Recommendations

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy and support at birth in seven; and school feeding, deworming, and treatment of severe acute malnutrition in six. All NNS contained programme monitoring and evaluation plans with measurable indicators and targets. Not all NNS covered wasting, exclusive breastfeeding, low birthweight, and childhood overweight. Strategies for achieving NNS goals and objectives were health system strengthening (nine), social and behaviour change communication (nine), targeting vulnerable groups (eight), and social or community mobilization (four). All addressed involvement, roles and responsibilities, and collaboration mechanisms among sectors and stakeholders. There was a delay in releasing NNS in Indonesia, Myanmar, and the Philippines. In conclusion, although Southeast Asian NNS have similarities in structure and contents, some interventions and indicators vary by country and do not consistently align with regional and international recommendations. A database with regularly updated information on NNS components would facilitate cross-checking completeness within a country, comparison across countries, and knowledge sharing and learning

Disease Burden, Risk Factors, and Trends of Leukaemia: A Global Analysis.

Leukaemia accounted for approximately 2.5% of all new cancer incidence and 3.1% of cancer-related mortality. The investigation of its risk factors and epidemiologic trends could help describe the geographical distribution and identify high-risk population groups. This study aimed to evaluate the global incidence, mortality, associated risk factors, and temporal trends of leukaemia by sex, age, and country. We extracted incidence and mortality of leukaemia from GLOBOCAN, CI5, WHO mortality database, NORDCAN, and SEER. We searched the WHO Global Health Observatory data repository for the age-standardised prevalence of lifestyle and metabolic risk factors. We tested the trends by calculating Average Annual Percentage Change (AAPC) from Joinpoint regression. The age-standardized rate of incidence and mortality were 5.4 and 3.3 per 100,000 globally. The incidence and mortality of leukaemia were associated with Human Development Index, Gross Domestics Products per capita, prevalence of smoking, physical activity, overweight, obesity, and hypercholesterolaemia at the country level. Overall, more countries were showing decreasing trends than increasing trends in incidence and mortality. However, an increasing trend of leukaemia incidence was found in Germany, Korea, Japan, Canada and the United Kingdom (AAPC, 2.32-0.98) while its mortality increased in the Philippines, Ecuador, Belarus, and Thailand (AAPC, 2.49-1.23). There was a decreasing trend of leukaemia for the past decade while an increase in incidence and mortality was observed in some populations. More intensive lifestyle modifications should be implemented to control the increasing trends of leukaemia in regions with these trends. Future studies may explore the reasons behind these epidemiological transitions

Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis

BACKGROUND: Lung cancer ranks second for cancer incidence and first for cancer mortality. Investigation into its risk factors and epidemiologic trends could help describe geographical distribution and identify high-risk population groups. RESEARCH QUESTION: What is the global incidence, mortality, associated risk factors, and temporal trends of lung cancer by sex, age, and country? STUDY DESIGN AND METHODS: Data on incidence and mortality were retrieved from the Global Cancer Observatory (GLOBOCAN), Cancer Incidence in Five Continents series I-X, World Health Organization (WHO) mortality database, the Nordic Cancer Registries (NORDCAN), and the Surveillance, Epidemiology, and End Results Program (SEER). We searched the WHO Global Health Observatory data repository for age-adjusted prevalence of current smoking. The Average Annual Percentage Change (AAPC) of the trends were obtained by Joinpoint Regression. RESULTS: The age-standardized rate of incidence and mortality were 22.4 and 18.0 per 100,000 globally. The lung cancer incidence and mortality were associated with Human Development Index (HDI), Gross Domestic Products (GDP), and prevalence of smoking. For incidence, more countries had increasing trends in females but decreasing trends in males (AAPC, 1.06 to 6.43 for female; -3.53 to -0.64 for male). A similar pattern was found in those 50 years or older, whereas those aged younger than 50 years had declining incidence trends in both sexes in most countries. For mortality, similar to incidence, 17 of 48 countries showed decreasing trends in males and increasing trends in females (AAPC, -3.28 to -1.32 for male, 0.63 to 3.96 for female). INTERPRETATION: Most countries had increasing trends in females but decreasing trends in males and in lung cancer incidence and mortality. Tobacco related measures and early cancer detection should be implemented to control the increasing trends of lung cancer in females, and in regions identified as having these trends. Future studies may explore the reasons behind these epidemiological transitions

Incidence, mortality, risk factors, and trends for Hodgkin lymphoma: a global data analysis.

Hodgkin lymphoma is a lymphatic malignancy commonly found in cervical lymph nodes. This study evaluated the worldwide incidence, mortality, associated risk factors, and temporal trends of Hodgkin lymphoma by sex, age, and country. Methods: The age-standardised Hodgkin lymphoma incidence and mortality were retrieved from the GLOBOCAN, CI5 volumes I-XI, WHO mortality database, the NORDCAN and SEER Program. The age-standardised prevalence of smoking, alcohol drinking, obesity, and hypertension was also extracted for each country. Trends were tested using Average Annual Percentage Change (AAPC) from Joinpoint regression analysis. Results: The Hodgkin lymphoma incidence and mortality were 0.98 and 0.26 per 100,000 in 2020. A higher incidence was observed in high-income countries, while higher mortality was found in low-income countries. Incidence and mortality were associated with GDP per capita, prevalence of smoking, obesity, and hypertension at the population level. Despite the decreasing mortality trend, there was an increasing incidence, especially among females, younger population, and subjects from Asian countries. Conclusions: There was an increasing trend in Hodgkin lymphoma incidence, especially among subjects who were female, younger population, and from Asian countries. Further studies are needed to investigate the reasons for these epidemiologic trends