Urban agriculture: a global analysis of the space constraint to meet urban vegetable demand

Urban agriculture (UA) has been drawing a lot of attention recently for several reasons: the majority of the world population has shifted from living in rural to urban areas; the environmental impact of agriculture is a matter of rising concern; and food insecurity, especially the accessibility of food, remains a major challenge. UA has often been proposed as a solution to some of these issues, for example by producing food in places where population density is highest, reducing transportation costs, connecting people directly to food systems and using urban areas efficiently. However, to date no study has examined how much food could actually be produced in urban areas at the global scale. Here we use a simple approach, based on different global-scale datasets, to assess to what extent UA is constrained by the existing amount of urban space. Our results suggest that UA would require roughly one third of the total global urban area to meet the global vegetable consumption of urban dwellers. This estimate does not consider how much urban area may actually be suitable and available for UA, which likely varies substantially around the world and according to the type of UA performed. Further, this global average value masks variations of more than two orders of magnitude among individual countries. The variations in the space required across countries derive mostly from variations in urban population density, and much less from variations in yields or per capita consumption. Overall, the space required is regrettably the highest where UA is most needed, i.e., in more food insecure countries. We also show that smaller urban clusters (i.e., <100 km2 each) together represent about two thirds of the global urban extent; thus UA discourse and policies should not focus on large cities exclusively, but should also target smaller urban areas that offer the greatest potential in terms of physical space

Ebola respons-ibility: moving from shared to multiple responsibilities

Combating threats of infectious diseases has been increasingly framed as a global shared responsibility for a multi-actor framework, of states, international organisations and non-governmental actors. However, the outbreak of Ebola Virus Disease (EVD) has shown that this governance framework has not been able to limit the spread of this virus, despite the normative and legislative changes to global disease control. By unbundling the concept of responsibility, this article will assess how global shared responsibility may have failed due to the fact that accountability does not fall on any one state or stakeholder, highlighting an inherent weakness with the global disease governance regime. As such, this paper concludes that a move towards multiple responsibilities may prove a more effective mechanism for ensuring global health security

Factors Influencing the Implementation of Integrated Management of Childhood Illness (IMCI) by Healthcare Workers at Public Health centers & Dispensaries in Mwanza, Tanzania.

\ud Integrated Management of Childhood Illness (IMCI) was developed by the World Health Organization (WHO) and the United Nations International Children's Fund (UNICEF) and aims at reducing childhood morbidity and mortality in resource-limited settings including Tanzania. It was introduced in 1996 and has been scaled up in all districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza, Tanzania since reports indicates that the guidelines are not full adhered to by the healthcare workers. A cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza city were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the 2 facilitators. Data were analyzed using SPSS and presented using figures and tables. Only 51% of healthcare workers interviewed had been trained. 69% of trained Healthcare workers expressed understanding of the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illnesses especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, lack of onsite mentoring and lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through training, onsite mentoring, supportive supervision and strengthening the healthcare system through increasing access to essential medicines, vaccines, strengthening supply chain management, increasing healthcare financing, improving leadership & management were the major interventions that could assist in IMCI implementation. The healthcare workers can implement better IMCI through the collaboration of supervisors, IMCI focal person, Council Health Management Teams (CHMT) and other stakeholders interested in child health. However, significant barriers impede a sustainable IMCI implementation. Recommendations have been made related to supportive supervision and HealthCare system strengthening among others.\u

Module 6

The Essential Services Package is a guidance tool identifying the essential services to be provided to all women and girls who have experienced gender-based violence, including services that should be provided by the health, social services, police and justice sectors. This package also provides guidelines for the coordination of these services. Module 6 is an implementation guide, produced in 2017

Module 1

The Essential Services Package is a guidance tool identifying the essential services to be provided to all women and girls who have experienced gender-based violence, including services that should be provided by the health, social services, police and justice sectors. This package also provides guidelines for the coordination of these services

One Health – an Ecological and Evolutionary Framework for tackling Neglected Zoonotic Diseases

Understanding the complex population biology and transmission ecology of multihost parasites has been declared as one of the major challenges of biomedical sciences for the 21st century and the Neglected Zoonotic Diseases (NZDs) are perhaps the most neglected of all the Neglected Tropical Diseases (NTDs). Here we consider how multihost parasite transmission and evolutionary dynamics may affect the success of human and animal disease control programmes, particularly neglected diseases of the developing world. We review the different types of zoonotic interactions that occur, both ecological and evolutionary, their potential relevance for current human control activities, and make suggestions for the development of an empirical evidence base and theoretical framework to better understand and predict the outcome of such interactions. In particular, we consider whether preventive chemotherapy, the current mainstay of NTD control, can be successful without a One Health approach. Transmission within and between animal reservoirs and humans can have important ecological and evolutionary consequences, driving the evolution and establishment of drug resistance, as well as providing selective pressures for spill‐over, host switching, hybridizations and introgressions between animal and human parasites. Our aim here is to highlight the importance of both elucidating disease ecology, including identifying key hosts and tailoring control effort accordingly, and understanding parasite evolution, such as precisely how infectious agents may respond and adapt to anthropogenic change. Both elements are essential if we are to alleviate disease risks from NZDs in humans, domestic animals and wildlife

Integrating Traditional Healers into the Health Care System:Challenges and Opportunities in Rural Northern Ghana

Traditional medicine is widespread in Ghana, with 80% of Ghanaians relying on its methods for primary health care. This paper argues that integrating traditional and biomedical health systems expands the reach and improves outcomes of community health care. Moving beyond literature, it stresses the importance of trust-relationships between healers and biomedical staff. Insights are based on qualitative research conducted in Ghana’s Northern Region (2013–2014). Five challenges to integration emerged out of the data: a lack of understanding of traditional medicine, discrimination, high turnover of biomedical staff, declining interest in healing as a profession, and equipment scarcity. Besides challenges, opportunities for integration exist, including the extensive infrastructure of traditional medicine, openness to collaboration, and grassroots initiatives. Contemplating challenges and opportunities this paper provides recommendations for integration, including: identify/select healers, promote best practices, institute appropriate forms of appreciation/recognition of healers, provide aid and equipment, use communication campaigns to promote integration and steer attitudinal change towards healers among biomedical staff. Most crucial, we argue successful implementation of these recommendations depends on a concerted investment in relationships between healers and biomedical staff

Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal.

BACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is >0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of ≥10% in 1-9 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 1-9 year-olds falls 1% in all districts. CONCLUSION: With a prevalence <5%, TF does not appear to be a significant public health problem in this region. However, TF monitoring and surveillance at sub-district level will be required to ensure that elimination targets are sustained and that TF does not re-emerge as a public health problem. TT surgery remains the priority for trachoma elimination efforts in the region, with an estimated 1819 TT surgeries to conduct

Global poverty and the new bottom billion: what if three-quarters of the world's poor live in middle-income countries?

This paper argues that the global poverty problem has changed because most of the world’s poor no longer live in low income countries (LICs). Previously, poverty was viewed as an LIC issue predominantly; nowadays such simplistic assumptions/ classifications are misleading because some large countries that graduated into the MIC category still have large numbers of poor people. In 1990, we estimate 93 per cent of the world’s poor lived in LICs; contrastingly in 2007–8 three quarters of the world’s poor approximately 1.3bn lived in middle-income countries (MICs) and about a quarter of the world’s poor, approximately 370mn people live in the remaining 39 low-income countries – largely in sub-Saharan Africa. This startling change over two decades implies a new ‘bottom billion’ who do not live in fragile and conflict-affected states, but in stable, middle-income countries. Such global patterns are evident across monetary, nutritional and multi-dimensional poverty measures. This paper argues the general pattern is robust enough to warrant further investigation and discussion

Overweight and obesity in Brazilian adolescents

OBJECTIVE: This study aimed to describe the prevalence of overweight and obesity (OW+O) among Brazilian adolescents and to identify risks for subpopulations defined according to the five country macro-regions and situation (urban-rural) of the domiciles, income, years of school attendance, age and sex.DESIGN: A nationwide home-based survey representative of the Brazilian civilian noninstitutionalized population, performed in 1989.METHODS: the sampling plans followed a stratified, multistage, probability cluster design in the National Research of Health and Nutrition sample, which collected anthropometric data of 14,455 domiciles. in all, 13,715 adolescents ranging from 10 to 19 y of age were studied. the OW + O was defined from a body mass index (BMI) equal or superior to the 85th percentile of the reference population of the NCHS. the prevalences in the different studied groups were compared using the adjusted odds ratio in logistic regression models.RESULTS: the prevalence of OW + O was of 7.7%, reaching 10.6% within the female group and 4.8% within the male group. A direct relation could be established between the socioeconomic level and OW + O. Adolescents of the most industrialized region of the country presented a risk of OW + O 1.86 (95% Cl 1.51 - 2.30) times higher than that found in the least developed region. Male youngsters who lived in urban areas were more liable (OR = 1.71, 95% Cl 1.30-2.25) to overweight than their counterparts of rural areas. the occurrence of menarche increased two and a half times (OR = 2.58, 95% CI 2.11 - 3.15) the risk of OW + O within the female group of adolescents.CONCLUSIONS: the results demonstrate a low prevalence of OW + O among Brazilian adolescents when compared with adolescents of more industrialized regions. the OW + O is twice as high within the female group, which represents a much greater difference than the one encountered in industrialized countries, probably owing to the muscular work carried out preponderantly by male adolescents of lower socioeconomic levels. Higher prevalences in subpopulations of higher socioeconomic level and of more industrialized regions show the great need for differentiated actions to control overweight and obesity in the country.Univ Fed Pelotas, Fac Nutr, BR-96010900 Pelotas, RS, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Pediat, São Paulo, BrazilWeb of Scienc