Need of training for health professionals on National Rural Health Mission

Training plays a key role in health manpower development and management of health care system. Since NRHM is a new concept, due weight-age has to be given to various components of the Mission. For the efficient and effective performance of medical and paramedical workers a certain level of competence in the form of knowledge, skill and attitude are essential. Various aspects of training activities to be included in training programmes have been discussed in the paper.     

Need for dedicated focus on urban health within National Rural Health Mission

National Rural Health Mission represents an important public health initiative to address essential health needs of the country's underserved population. For the Mission to achieve its goals, urban population needs to be included in its scope. Urban poor population constitutes nearly a third of India's urban population and is growing at three times the national population growth rate. Health status and access of reproductive and child health services of slum dwellers are poor and comparable to the rural population. Efforts to improve the conditions of urban poor necessitate strengthening national policy and fiscal mandate, augmenting and strengthening the urban health delivery system, coordinating among multiple stakeholders, involving private sector, strengthening municipal functioning and building community capacities. National Rural Health Mission should be broadened to National Public Health Mission. This paper discusses issues pertaining to health conditions of the urban poor, present status of services, challenges and suggests options for NRHM to bridge the large gap.     

Morocco's National Response to the COVID-19 Pandemic: Public Health Challenges and Lessons Learned

This report aimed to provide an overview of the epidemiological situation of COVID-19 in Morocco and to review the actions carried out as part of the national response to this pandemic. The methodology adopted was based on literature review, interviews with officials and actors in the field, and remote discussion workshops with a multidisciplinary and multisectoral working group. Morocco took advantage of the capacities already strengthened within the framework of the application of the provisions of the International Health Regulations (IHR) of 2005. A SWOT analysis made it possible to note that an unprecedented political commitment enabled all the necessary means to face the pandemic and carry out all the response activities, including a campaign of relentless communication. Nevertheless, and despite the efforts made, the shortage of human resources, especially those qualified in intensive care and resuscitation, has been the main drawback to be addressed. The main lesson learned is a need to further strengthen national capacities to prepare for and respond to possible public health emergencies and to embark on a process overhaul of the health system, including research into innovative tools to ensure the continuity of the various disease prevention and control activities. In addition, response to a health crisis is not only the responsibility of the health sector but also intersectoral collaboration is needed to guarantee an optimal coordinated fight. Community-oriented approaches in public health have to be strengthened through more participation and involvement of nongovernmental organizations (NGOs) and civil society in operational and strategic planning.     

Challenges and Opportunities for Urban Environmental Health and Sustainability: the HEALTHY-POLIS initiative

Cities around the world face many environmental health challenges including contamination of air, water and soil, traffic congestion and noise, and poor housing conditions exacerbated by unsustainable urban development and climate change. Integrated assessment of these risks offers opportunities for holistic, low carbon solutions in the urban environment that can bring multiple benefits for public health. The Healthy-Polis consortium aims to protect and promote urban health through multi-disciplinary, policy-relevant research on urban environmental health and sustainability. We are doing this by promoting improved methods of health risk assessment, facilitating international collaboration, contributing to the training of research scientists and students, and engaging with key stakeholders in government, local authorities, international organisations, industry and academia. A major focus of the consortium is to promote and support international research projects coordinated between two or more countries. The disciplinary areas represented in the consortium are many and varied, including environmental epidemiology, modelling and exposure assessment, system dynamics, health impact assessment, multi-criteria decision analysis, and other quantitative and qualitative approaches. This Healthy-Polis special issue presents a range of case studies and reviews that illustrate the need for a systems-based understanding of the urban environment.     

Social Conditions and Urban Health Inequities: Realities,Challenges and Opportunities to Transform the Urban Landscape through Research and Action

The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a “natural” or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.     

Urban Family Planning in Sub-Saharan Africa: an Illustration of the Cross-sectoral Challenges of Urban Health

The multi-sectoral nature of urban health is a particular challenge, which urban family planning in sub-Saharan Africa illustrates well. Rapid urbanisation, mainly due to natural population increase in cities rather than rural–urban migration, coincides with a large unmet urban need for contraception, especially in informal settlements. These two phenomena mean urban family planning merits more attention. To what extent are the family planning and urban development sectors working together on this? Policy document analysis and stakeholder interviews from both the family planning and urban development sectors, across eight sub-Saharan African countries, show how cross-sectoral barriers can stymie efforts but also identify some points of connection which can be built upon. Differing historical, political, and policy landscapes means that entry points to promote urban family planning have to be tailored to the context. Such entry points can include infant and child health, female education and employment, and urban poverty reduction. Successful cross-sectoral advocacy for urban family planning requires not just solid evidence, but also internal consensus and external advocacy: FP actors must consensually frame the issue per local preoccupations, and then communicate the resulting key messages in concerted and targeted fashion. More broadly, success also requires that the environment be made conducive to cross-sectoral action, for example through clear requirements in the planning processes’ guidelines, structures with focal persons across sectors, and accountability for stakeholders who must make cross-sectoral action a reality.Keyword: Reproductive health, Cross-sectoral, Family planning, sub-Saharan Africa     

A National Call to Action: CDC''s 2001 Urban and Rural Health Chartbook

It remains to be seen if Congress will recognize the CDC report as a national call to action, or whether future CDC reports will simply record the ongoing health disparities of rural America. Regardless of the Congressional outcome in 2002, the CDC report clearly succeeds in moving the national debate on rural concerns beyond the political rhetoric and into a data-driven debate.     

The National Rural Health Mission (NRHM): a critical overview

This paper explores the forces that led to the conceptualisation of the National Rural Health Mission (NRHM) including the role of the Common Minimum Programme and the Structural Adjustment Programme. The paper analyses the key components of the NRHM in terms of the theoretical frameworks of decentralisation, integration of programmes, primary health care, community health workers and standards.     

城市流动人口中青少年对生殖健康的需求调查

在北京经济迅速发展的今天 ,外来人口在建设北京的进程中 ,起着举足轻重的作用。但由于他们受教育程度偏低、缺乏获取生殖健康知识的途径 ,再加上没有专门的组织和机构去关注他们 ,使他们成为生殖健康教育的薄弱人群。为此 ,有必要了解、掌握他们对生殖健康方面的需求 ,更好地为其提供服务。对象与方法1 对象　 2 0 0 2年 3月 ,北京市西城区妇幼保健所在西直门宾馆、国谊宾馆、动物园 3个单位 ,随机抽取外地来京、未婚的服务员、保安人员共 2 70人为调查对象。发放调查问卷2 70张 ,回收 2 6 5张 ,有效问卷 2 56张 ,有效率为 96 6 0 %。2 …     

Population Health Science: Fulfilling the Mission of Public Health

Policy Points

• The historical mission of public health is to ensure the conditions in which people can be healthy, and yet the field of public health has been distracted from this mission by an excessive reliance on randomized‐control trials, a lack of formal theoretical models, and a fear of politics.
• The field of population health science has emerged to rigorously address all of these constraints. It deserves ongoing and formal institutional support.

The united states is failing in population health. life expectancy in the United States is falling for the first time since reliable mortality records have been available, and health equity has been on a downward trend for decades. ¹ Why is the United States, among the richest countries in the world, failing to protect the health of its residents? A dysfunctional medical system that pays for sickness rather than wellness is certainly part of the problem, but so is confusion about the role of public health in the United States.