2.Health technology assessment in China: challenges and opportunities
Lizheng SHI ; Yiwei MAO ; Meng TANG ; Wenbin LIU ; Zude GUO ; Luyang HE ; Yingyao CHEN
Global Health Journal 2017;1(1):11-20
Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established to conduct HTA related work.This study reviewed the current status of HTA in China and analysed the challenges of HTA development in the context of health reform under"new normal"economy.Methods:Literature review and webpage searches were used to document the development of HTA in China.An institutional survey has also been conducted to collect information on the HTA research institutions in China.Results:The number of articles and research projects on HTA were rising and are continuing to rise.HTA development has made substantial progress in China in terms of growing number of research institutions and qualified HTA workforce.However,HTA has notable weaknesses such as low capacity for conducting HTA research,limited experience in HTA researchers,and lack of knowledge translation.Conclusion:Currently,the translation of HTA findings to policy-making is limited and the integration of HTA in the policy-making processes is still in its infancy.The HTA development in China has had opportunities due to demands of health care,health insurance,and health technology as a result of health reform.Capacity building and institutionalization of HTA are urgently needed for further development of HTA in China.
3.China's contribution to the millennium development goals: achieving tuberculosis control targets ahead of deadline
Lixia WANG ; Yanni SUN ; Yu WANG
Global Health Journal 2017;1(1):21-25
The millennium development goals (MDGs) were eight international development targets for the year 2015 that were established following the adoption of the United Nations Millennium Declaration in 2000.The MDGs are aimed at reducing extreme poverty and set a series of time-bound goals,particularly in health,gender equality,and environmental sustainability [1].The target set for tuberculosis (TB) was to reduce TB prevalence and mortality rates by half by 2015 compared to the 1990 baseline rates [2].China has in fact achieved the TB targets five years ahead of the scheduled timeline [3].From 1990 through 2010,TB case detections had decreased by 65%,from 170 to 59 cases per 100000 population and the mortality rates by almost 80% [4].
4.Epidemiology of HIV/AIDS in China: recent trends
Yan CUI ; Cynthia X.SHI ; Zunyou WU
Global Health Journal 2017;1(1):26-32
We used nationally reported cases (NCAIDS/China CDC,2016) and published literature to summarize up-to the end of 2015 epidemiologic trends in the HIV/AIDS epidemic in China.HIV-positive cases are distributed unevenly with most infections found in southwest China and the most affected population being men who have sex with men.Transmission mode of HIV infection has shifted from drug injection to sexual contact,which accounts for 95% of total reported cases.Two thirds of cases are from heterosexual transmission.Transmission pattern varies greatly throughout China.Some provinces in China reported heterosexual transmission accounted for over 90% of cases while other provinces reported homosexual transmission accounted for over 80% of cases.Patterns of heterosexually acquired HIV also vary widely,with 80% of cases attributed to commercial sex in some provinces,while in other provinces non-commercial extramarital sex accounted for over 70% of cases.Significant increase in HIV infection was observed among young students aged 15-24.China has successfully controlled blood transfusion-and injecting drug-related transmissions of HIV.Homosexual and non-commercial extramarital heterosexual transmissions have become new challenges for China's HIV/AIDS program.Urgent adoption of the UNAIDS/WHO 90-90-90 target will help overcome these new challenges.
5.The value of China-Africa health development initiatives in strengthening "One Health" strategy
Ernest TAMBO ; Shenglan TANG ; Lin AI ; Xiao-Nong ZHOU
Global Health Journal 2017;1(1):33-46
Implementing national to community-based "One Health" strategy for human,animal and environmental challenges and migrating-led consequences offer great opportunities,and its value of sustained development and wellbeing is an imperative."One Health" strategy in policy commitment,partnership and financial investment are much needed in advocacy,contextual health human-animal and environmental development.Therefore,appropriate and evidence-based handling and management strategies in moving forward universal health coverage and sustainable development goals (SDGs) are essential components to the China-Africa health development initiatives.It is necessary to understand how to strengthen robust and sustainable "One Health" approach implementation in national and regional public health and disaster risk reduction programs.Understanding the foundation of"One Health" strategy in China-Africa public health cooperation is crucial in fostering health systems preparedness and smart response against emerging and re-emerging threats and epidemics.Building the value of China-Africa "One Health" strategy partnerships,frameworks and capacity development and implementation through leveraging on current and innovative China-Africa health initiatives,but also,mobilizing efforts on climatic changes and disasters mitigation and lifestyle adaptations strategies against emerging and current infectious diseases threats are essential to establish epidemic surveillance-response system under the concept of global collaborative coordination and lasting financing mechanisms.Further strengthen local infrastructure and workforce capacity,participatory accountability and transparency on "One Health" approach will benefit to set up infectious diseases of poverty projects,and effective monitoring and evaluation systems in achieving African Union 2063 Agenda and SDGs targets both in Africa and China.
6.Heavy metal pollution and health risk in China
Rian YU ; Lingfei HE ; Ridong CAI ; Biyun LI ; Zhipeng LI ; Kedi YANG
Global Health Journal 2017;1(1):47-55
Following rapid social and economic development over the past several decades,pollution by heavy metals has been both serious and widespread in many areas of the world,including China.The situations of heavy metal pollution in China were reviewed,and the health risk and control policy of such pollution were also analyzed and discussed in present paper.
7.Universal health coverage and public-private participation: towards a new balance?
Global Health Journal 2017;1(2):3-11
This commentary discusses the emergence of a new paradigm to address the health policy issues through Public-Private Participation (PPP).The discussion provides a detailed literature review of PPPs by presenting an initial overview of the ideological shift from state to market intervention,then identifying arguments in support of or against public-private approaches and finally exploring the emergence of this new paradigm of PPP or its hybrid forms.It then discusses the contextual realities of Public-Private Participation in health care,and whether an optimal balance is possible with better government stewardship and private provision.Conceptually,the premise of stewardship in governance is that it is possible to create not only efficient but also effective systems.These ideas may find a receptive audience in many countries,especially in the emerging economies with improving standards.In East Asian societies,the concept of stewardship bears a strong resemblance to Confucian ideals of morality in government,with social expectations of those who govern to be principled and virtuous.Increasingly,a pragmatic theory of development seems to apply in public-private,similarly,through it is expected,that public-private participation in the healthcare system should also achieve the goal of Universal Health Coverage through good governance.
8.Knowledge and practice of care-givers who have under-five diarrhoeal children:a quantitative cross-sectional study in Mataniko settlements in Honiara, Solomon Islands, 2016
Gali AMBROSE ; N.Krishna KESHWA ; Khan SABIHA ; Lowry JOHN ; Mangum TAMARA ; Mohammadnezhad MASOUD
Global Health Journal 2017;1(2):12-22
Introduction:Diarrhoea remains the second most serious health problem among children below five years old in Solomon Islands and is one of the leading causes of infant mortality,which caused about one in every ten children dying before the age of five years.Globally,around 6 million children (<5 years) suffer from diarrhoea each year.Because of lack of previous studies,this study aims to assess the predictors of knowledge and practice of caregivers towards diarrhoea among under-five children in Mataniko informal settlements in Honiara,Solomon Islands,2016.Methods:This quantitative study was conducted at three randomly selected settlements in Honiara,Solomon Islands from June to July 2016.This study was conducted among both male and female caregivers who had children under five years of age,were aged 18 and over,live in Solomon Islands and were willing to participate in the study.A validated structured questionnaire was used to collect the data based on a 2-week recall of diarrhoea episodes.To avoid double-counting,each surveyed household was geo-referenced using global positioning system (GPS).The collected data were entered and analysed using SPSS (version 23.0) and descriptive and analytical statistics.P<0.05 was considered as statistically significant.This study was approved by relevant ethical committees.Results:A total of 205 caregivers with at least one child under-five years participated in the study.The mean ages of caregivers and the under-five children were (30.7+8.2) years and (2.6+1.5) years,respectively.Among 205 caregivers,94 of them had reported that their children (<5 years) had suffered with at least one episode of diarrhoea within the last 2 weeks prior to the survey.This gave a prevalence rate of 45.9%.The caregiver's knowledge about the causes (99.0%) and prevention (98.0%) of under-five diarrhoea was extremely high.Nevertheless,less than half had regularly practiced essential hygiene habits.The factors which appeared to be significantly associated with under-five diarrhoea were irregular hand washing (odds ratio [OR] 2.07,95% confidence interval [CI]:1.12-3.81,P=0.020),inappropriate methods of disposing of children's fecal waste (OR 1.88,95% CIL 1.06-3.33,P=0.030),and using the river for bathing (OR 1.83,95% CI:1.04-3.23,P=0.036),and laundry (OR 2.17,95% CI:1.23-3.84,P=0.008).Conclusion:Diarrhoea is a major public health problem among children below five years in Mataniko informal settlements.To address these exposures,relevant programs and projects should be designed,especially in areas like family planning,household economic allocation and political commitment.Awareness and advocacy programs on birth spacing,food hygiene and potential health risks about the river should be ongoing at the community level.
9.Iodized salt consumption and iodine deficiency status in China: a cross-sectional study
Lijun FAN ; Xiaohui SU ; Hongmei SHEN ; Peng LIU ; Fangang MENG ; Jun YAN ; Zhenglong LEI ; Shubin ZHANG ; Yunyou GU ; Shoujun LIU ; Dianjun SUN
Global Health Journal 2017;1(2):23-37
Objective:To monitor iodized salt consumption and evaluate iodine deficiency status in 2014 in China.Materials and Methods:In 2014,a nationwide cross-sectional survey was conducted in 31 provinces (in this study,provinces,autonomous regions and municipalities in Mainland China were named as provinces).Probability proportional to size sampling method was adopted to recruit children ages 8-10 and pregnant women.47,467 children's and 18,994 pregnant women's urine samples were collected and 47,706 children's thyroid volumes were examined.Iodine content in salt was determined with 46,900 edible salt samples from children's households;urinary iodine concentration (UIC) was tested from children and pregnant women's urine samples;thyroid volume of children was assessed by ultrasound.Results:The national coverage rate of iodized salt and consumption rate of qualified iodized salt were 96.3% and 91.5%,respectively.Median iodine content in iodized salt was 25.2 mg/kg.In 22 of 31 provinces,the provincial coverage rates of iodized salt were over 95%.And consumption rates of qualified iodized salt were more than 90% in 21 provinces.In this study,the national median urinary iodine concentration (MUIC) of children in China was 197.9 μg/L.At the provincial level,MUIC of children in 19 provinces was 100-199 μg/L,which in 12 provinces was 200-299 μg/L.The national MUIC of pregnant women in 2014 was 154.6 μg/L,slightly higher than the lower limit of the WHO criteria for adequate (150-249 μg/L).At the provincial level,MUIC of pregnant women in 18 provinces was 100-149 μg/L,which in 13 provinces was 150-249 μg/L.The national prevalence of goiter among children in 2014 was 2.6%,of which only Shandong province (5.6%) exceeded the national standard (5%).Conclusions:In China,iodine deficiency disorders (IDD) has been eliminated since 2005.And in 2014,the IDD-free status still remained.
10.E-cigarettes in ten Southeast Asian countries: a comparison of national regulations
Global Health Journal 2017;1(3):1-9
The market and popularity of e-cigarettes are growing rapidly worldwide.However,the research and regulation of this novel product have lagged behind.In this paper,we review and compare the regulatory mechanisms regarding e-cigarettes among ten Association of Southeast Asian Nations (ASEAN) member states.Our findings demonstrate a continuum of the legal regulations of e-cigarettes in Southeast Asia:on the one end,countries such as Brunei,Cambodia,Thailand,and Singapore have prohibited the importation and sale of e-cigarettes with existing tobacco control laws or specific regulations;on the other end,countries such as Myanmar and Vietnam have almost no legal restrictions on e-cigarettes whatsoever.This overview of national regulations will not only clarify the legal status of e-cigarettes in Southeast Asia but also provide some informing lessons for the tobacco control efforts in this region.