Suchergebnisse

Background: A substantial global burden of health can be attributed to unhealthy lifestyles and an unhealthy living environment. The concept of a Healthy City is continually creating and improving physical and social environments to enable healthy living. The aim of this paper is to investigate how the Healthy City concept would tackle the complexity of health by addressing the socio-economic and political determinants of health in the Western Pacific Region. Methods: The SPIRIT model adopted by the Alliance for Healthy Cities can provide a framework for an integrated and holistic approach to enable policy, environment, social matters, behaviours, and bio-medical interventions to take their rightful place side by side. The performance of cities awarded by the AFHC was analysed under each domain of the SPIRIT model to show the efforts striving to acquire the qualities of a healthy city. Findings: Two cities have incorporated the Healthy City concept in most of their policies outside the health sector, with a high level of commitment from city leaders and citizens, so the Health City activities were recognised as part of the means to advance the cityies' general planning. One city has made use of its strong network of key stakeholders from different sectors and disciplines to establish a "Medical–Social–Community' model. All three cities have collected health information to reflect health status, determinants of health and issues reflecting health promotion to enable the creation of a city health profile and show positive changes in health. The cities have engaged key stakeholders to launch a variety of health-promoting programmes according to the needs of the population. Conclusion: The AFHC can play an important role in linking the cities with strong action in Healthy City activities to support other cities in Healthy City development.

AbstractAfghanistan has made remarkable progress in reducing maternal mortality over the past few decades, and male participation in their pregnant partner's reproductive health care is crucial for further improvement. This study aimed to examine whether male attendance at antenatal care (ANC) with their pregnant partners might be beneficially associated with the degree of utilization of reproductive health care by the pregnant partners. Data for 2660 couples (women aged 16–49 years) were taken from the 2015 Afghanistan Demographic and Health Survey (AfDHS). Bivariate and multivariate logistic regression models were employed to explore the association between male attendance at ANC with their pregnant partners and reproductive health care utilization outcomes, including adequate utilization (four or more visits) of ANC services, ANC visits during the first trimester (up to 12 weeks) of pregnancy, rate of blood and urine testing during pregnancy, rate of institutional delivery and utilization of postnatal check-up services. The results indicated that the rate of male attendance at ANC with their pregnant partners was 69.4%. After controlling for covariates, pregnant partners who were accompanied to ANC by their male partners were more likely to adequately utilize ANC services (AOR=1.42; 95% CI: 1.18–1.71), commence ANC visits even during the first trimester (AOR=1.21; 95% CI: 1.03–1.42), give birth at a health facility (AOR=1.23; 95% CI: 1.03–1.47) and present themselves for postnatal check-ups (AOR=1.24; 95% CI: 1.04–1.47) than those who were not accompanied by them. The study demonstrated that participation of male partners in ANC was positively associated with their pregnant partners' utilization of reproductive health care services in Afghanistan. The findings suggest that, to improve maternal and child health outcomes in the country, it would be worthwhile implementing interventions to encourage male partners to become more engaged in the ANC of their pregnant partners.

Summary.The associations between household demographic variables and mortality of children aged less than five years were investigated using data from the 1998 Demographic and Health Survey (DHS) of the Republic of Côte d'Ivoire, Western Africa. Of the total of 1992 children born to women included in the study population during the 5-year period preceding the survey, 260 (13%) had died and 1732 (87%) were alive at the time of the survey. Logistic regression analyses used to compare biosocial variables between the deceased and living children showed that the sex of the child, birth interval and mother's occupation were associated with child's survival status. After adjusting for their effects, household demographic variables (i.e. number of household members, number of household members under 5 years [HM−5Y], number of household members 5 years or older [HM+5Y], the proportion of HM−5Y among all household members, and the ratio of HM−5Y to HM+5Y) were shown to be associated with the child's survival status. This study provided insight into the effects of intra-household competition among children and availability of care-givers as potential determinants of child survival. The results indicate that improvement of the childcare environment and reproductive intervention are necessary to reduce child mortality in West African countries.

Injury among older adults is a serious health concern, but little information is known about it, particularly in developing countries. This study aimed to determine the prevalence of, and examine the socioeconomic, demographic, and health determinants of, self-reported injuries among older Filipinos. Using a pooled data of 21,316 community-dwelling residents aged 60 years or over from three waves of the Philippine National Demographic and Health Survey, multivariate logistic regression analyses were performed to assess the relationship between participants' characteristics and reports of injuries. The total prevalence of self-reported injuries over a 10-year period was at 1.2%. Older adults with either government or private health insurance were more likely to report experiencing injuries (adjusted odds ratio (AOR) 1.55, 95% confidence interval (CI), 1.14–2.11), regardless of socio-demographic and economic status. In contrast, female older adults were found to be associated with a lower likelihood of self-reported injuries, after adjustment for other variables (AOR 0.69, 95% CI 0.53–0.88). Older adults who attained secondary education or higher also showed a lower likelihood of self-reported injuries (AOR 0.53, 95% CI 0.31–0.92). The proportion of older adults with injuries in the Philippines is still relatively low. However, preventive approaches with a special focus on gender, educational attainment, and health insurance status of older adults are warranted.

Anthropogenic freshwater habitats may provide undervalued prospects for long-term conservation as part of species conservation planning. This fundamental, but overlooked, issue requires attention considering the pace that humans have been altering natural freshwater ecosystems and the accelerated levels of biodiversity decline in recent decades. We compiled 709 records of freshwater mussels (Bivalvia, Unionida) inhabiting a broad variety of anthropogenic habitat types (from small ponds to large reservoirs and canals) and reviewed their importance as refuges for this faunal group. Most records came from Europe and North America, with a clear dominance of canals and reservoirs. The dataset covered 228 species, including 34 threatened species on the IUCN Red List. We discuss the conservation importance and provide guidance on how these anthropogenic habitats could be managed to provide optimal conservation value to freshwater mussels. This review also shows that some of these habitats may function as ecological traps owing to conflicting management practices or because they act as a sink for some populations. Therefore, anthropogenic habitats should not be seen as a panacea to resolve conservation problems. More information is necessary to better understand the trade-offs between human use and the conservation of freshwater mussels (and other biota) within anthropogenic habitats, given the low number of quantitative studies and the strong biogeographic knowledge bias that persists. ; This publication is based upon work from COST Action CA18239, supported by COST (European Cooperation in Science and Technology). A.M.L. was financed by the Institute of Environmental Sciences Jagiellonian University (N18/DBS/000003) and K.N. by the Aragón Government. The authors acknowledge Jarosław Andrzejewski, Bartosz Czader, Anna Fica, Marcin Horbacz, Tomasz Jonderko, Steinar Kålås, Tomasz Kapela, Bjørn Mejdell Larsen, Maciej Pabijan, Katarzyna Pawlik, Ilona Popławska, Joanna Przybylska, Tomasz Przybył, Mateusz Rybak, Kjell ...