Multidisciplinary and participatory workshops with stakeholders in a community of extreme poverty in the Peruvian Amazon: Development of priority concerns and potential health, nutrition and education interventions

<p>Abstract</p> <p>Background</p> <p>Communities of extreme poverty suffer disproportionately from a wide range of adverse outcomes, but are often neglected or underserved by organized services and research attention. In order to target the first Millennium Development Goal of eradicating extreme poverty, thereby reducing health inequalities, participatory research in these communities is needed. Therefore, the purpose of this study was to determine the priority problems and respective potential cost-effective interventions in Belen, a community of extreme poverty in the Peruvian Amazon, using a multidisciplinary and participatory focus.</p> <p>Methods</p> <p>Two multidisciplinary and participatory workshops were conducted with important stakeholders from government, non-government and community organizations, national institutes and academic institutions. In Workshop 1, participants prioritized the main health and health-related problems in the community of Belen. Problem trees were developed to show perceived causes and effects for the top six problems. In Workshop 2, following presentations describing data from recently completed field research in school and household populations of Belen, participants listed potential interventions for the priority problems, including associated barriers, enabling factors, costs and benefits.</p> <p>Results</p> <p>The top ten priority problems in Belen were identified as: 1) infant malnutrition; 2) adolescent pregnancy; 3) diarrhoea; 4) anaemia; 5) parasites; 6) lack of basic sanitation; 7) low level of education; 8) sexually transmitted diseases; 9) domestic violence; and 10) delayed school entry. Causes and effects for the top six problems, proposed interventions, and factors relating to the implementation of interventions were multidisciplinary in nature and included health, nutrition, education, social and environmental issues.</p> <p>Conclusion</p> <p>The two workshops provided valuable insight into the main health and health-related problems facing the community of Belen. The participatory focus of the workshops ensured the active involvement of important stakeholders from Belen. Based on the results of the workshops, effective and essential interventions are now being planned which will contribute to reducing health inequalities in the community.</p

Population policies, programmes and the environment

Human consumption is depleting the Earth's natural resources and impairing the capacity of life-supporting ecosystems. Humans have changed ecosystems more rapidly and extensively over the past 50 years than during any other period, primarily to meet increasing demands for food, fresh water, timber, fibre and fuel. Such consumption, together with world population increasing from 2.6 billion in 1950 to 6.8 billion in 2009, are major contributors to environmental damage. Strengthening family-planning services is crucial to slowing population growth, now 78 million annually, and limiting population size to 9.2 billion by 2050. Otherwise, birth rates could remain unchanged, and world population would grow to 11 billion. Of particular concern are the 80 million annual pregnancies (38% of all pregnancies) that are unintended. More than 200 million women in developing countries prefer to delay their pregnancy, or stop bearing children altogether, but rely on traditional, less-effective methods of contraception or use no method because they lack access or face other barriers to using contraception. Family-planning programmes have a successful track record of reducing unintended pregnancies, thereby slowing population growth. An estimated $15 billion per year is needed for family-planning programmes in developing countries and donors should provide at least$5 billion of the total, however, current donor assistance is less than a quarter of this funding target

Following the footsteps: Urbanisation of Wa Municipality and its synergism in risk accumulation, uncertainties and complexities in urban Ghana.

Global demographic characteristics have witnessed a significant shift with more than half of the world's population crossing the rural-urban threshold in 2008. In Ghana, the 2010 census report revealed 50.9% urban population. While the many benefits of organised and efficient cities are well understood, it must be recognised that rapid, often unplanned urbanisation brings risk of profound social instability, risk to critical infrastructure, potential water crises and the potential for devastating spread of disease. These risks can only be further exacerbated as this unprecedented transition from rural to urban areas continues. This also means stakes are high for public and private interventions to ensure that urbanisation reinforces rather than retards prosperity. In spite of these past experiences, urban governance policies in emerging smaller cities are frequently ambivalent and piecemeal, exhibiting similar negative tendencies, a development that has received less academic attention. This study adopted multiple research techniques and the data were generated through a structured questionnaire survey, personal interviews and discussions. Based on our conviction that the development trajectory of any city hinges on the quality of its physical foundation, we seek to fill the knowledge gap using the Wa Municipality, the least urbanised but one of the fastest urbanising cities in Ghana today, as a case study. The results reveal emerging tendencies that indicate that Wa appears to be following in the footsteps of its predecessors - experiencing an inefficient potable water supply system and chronic sanitation situation, making diarrhoea one of many challenges for residents. It is ultimately suggested that a collaborative partnership with all key stakeholders is a better option to reap the potential for urbanisation to strengthen economic growth and development

Global public health security: inequality, vulnerability and public health system capabilities

Assessment of: The World Health Report 2007: A Safer Future: Global Public Health Security in the 21st Century. Geneva: World Health Organization, 2007. 72 pp