The document summarizes the Children's Environmental Health Indicators (CEHI) initiative coordinated by the World Health Organization. It discusses key findings from CEHI projects in multiple regions that identified priority environmental health risks to children like respiratory diseases from air pollution and diarrheal diseases from inadequate water and sanitation. The initiative took a flexible approach, allowing countries and regions to select indicators and collect data suited to their needs while working towards a common set where possible. An assessment of the different experiences provides important lessons for developing and implementing children's environmental health indicators globally.
The Maternal and Child Survival Program (MCSP) is USAID's flagship maternal and child health program, launched in 2014 with $500 million in funding over 5 years. MCSP works in 24 priority countries and additional countries to increase coverage of reproductive, maternal, newborn and child health interventions through strengthening health systems, focusing on innovation, and improving measurement and learning across households, communities, and health facilities to accelerate reductions in maternal and child mortality.
Nigeria national iccm implementation frameworktomowo George
The Nigeria's National ICCM implementation Framework is a 'one national iCCM Implementation Model' describing the activities expected to be carried out at the different levels of government, with clear programme boundaries, roles and responsibilities of individuals, organizations and other players. This framework also shows the pattern of information flow for iCCM in the country.
An Interrupted Time Series Multivariate Regression Analysis Evaluation of Sta...Whitney Bowman-Zatzkin
An Interrupted Time Series Multivariate Regression Analysis Evaluation of State Children's Health Insurance Programs (SCHIP) by Whitney Bowman-Zatzkin, MPA, MSR
As health insurance premiums continue to rise, the ability of many families to provide the critical health coverage to their children (both preventative and emergency) becomes an even greater challenge. In a study released in February 2005 in the Journal of Health Affairs, researchers found that half of those surveyed listed medical bills as the reason for their bankruptcy filings, with 75.7 percent of that half citing issues with health insurance during the illness resulting in the grandiose bills (Himmelstein, 2005). Figures released in 1997 from the Census Bureau reported a minimum of 10.7 million non-insured children within the United States (U.S. Bureau of the Census, 1997). The State Children’s Health Insurance Program (SCHIP) was developed to address these concerns.
SCHIP has been implemented as a supplemental Medicaid program for eligible children based on financial need. The original focus of SCHIP was to provide healthcare coverage to all children from birth to six years of age and having family incomes up to 133 percent of the Federal poverty level (FPL) while also covering children age six and over with family incomes at or above 100 percent of FPL. The goal was to have all children living below established poverty levels and under the age of 19 eligible for coverage by September 2002.
States could choose from the following implementation options.
1. Use SCHIP funding and expand their established Medicaid program to accommodate a larger percentage of children (Expansion Program).
2. Create a program for a new bracket of uninsured children, separate from Medicaid (New Program).
3. Combine the established Medicaid program with a new program offering separate enrollment options (Combination).
States are permitted to divert funds from other resources to provide healthcare to children under very loosely defined parameters. At the time, there was no children’s healthcare program with the strength and financial backing of SCHIP.
This paper evaluates the success of the SCHIP program and whether the choice of implementation design influences its success. SCHIP is currently under consideration for reauthorization making such an evaluation very timely. This paper proceeds as follows. First, I provide background about the SCHIP program. Next, I describe my research design and methods. Then I discuss my findings. Finally, I conclude with a discussion of my results.
This document discusses a study on supporting children's adherence to anti-retroviral (ART) therapy in Malawi. The study followed 47 HIV-positive children on ART over 6 months to a year. 72% of children never missed a dose according to caregiver reports. Clinic attendance was also good, with over 80% of visits either on time or within a week of the scheduled date. Focus groups and interviews with caregivers provided insights into challenges of supporting children's adherence, such as costs of medication and transport as well as caregiver responsibilities, but also motivations like seeing children's health improve. The findings highlight the need for more affordable and less complex ART regimes as well as tools to help caregivers support children's adherence
Overview of the Integrated Community Case Management (iCCM) of Childhood Illn...JSI
The document provides an overview of the Integrated Community Case Management (iCCM) of Childhood Illness Task Force. The Task Force is a global association working to promote integrated community-level management of childhood illness. It includes multilateral agencies, bilateral agencies, NGOs, and academic institutions. The Task Force operates through a steering committee and secretariat to advocate for iCCM adoption, ensure access to best practices and tools, and provide a forum for experience sharing. It maintains a resource center, CCMCentral.com, which centralizes iCCM implementation tools and examples. The conclusion encourages joining the Task Force to access standards and resources, disseminate evidence, and network to shape the future of iCCM programs.
The document discusses the Child Status Index (CSI), an approach developed to monitor and evaluate orphans and vulnerable children. The CSI was created as a tool to assess how children are faring in key areas of wellbeing, determine what services they receive and still need, and evaluate how well programs are achieving their objectives. It evaluates domains like food, shelter, health, education, and psychosocial support. The CSI was developed through participatory methods with stakeholders in Kenya and Tanzania, considers existing frameworks, and has been validated and applied in multiple countries. Future work involves disseminating the tool, conducting trainings, and adapting it for program monitoring and low literacy users.
OneHealth is a tool for medium-term strategic health planning at the national level in countries. It incorporates epidemiology impact models to demonstrate achievable health gains from integrated disease program and health systems planning. OneHealth was developed to enable integrated planning across partners, link disease programs to health systems strengthening, and incorporate costing into the planning process from the beginning. It brings together various stakeholders and allows for scenario analysis of alternative intervention packages, targets, and activities.
This document provides information about the Sierra Club - John Muir Chapter in Wisconsin. It discusses the founding and mission of the Sierra Club, details about the John Muir Chapter including its leadership, priorities, and accomplishments. Key points include that the Sierra Club was founded in 1892 by John Muir and is the oldest and largest grassroots environmental organization in the US, the John Muir Chapter has over 15,000 members and focuses on issues like clean water, clean energy, and preventing destructive mining.
The Maternal and Child Survival Program (MCSP) is USAID's flagship maternal and child health program, launched in 2014 with $500 million in funding over 5 years. MCSP works in 24 priority countries and additional countries to increase coverage of reproductive, maternal, newborn and child health interventions through strengthening health systems, focusing on innovation, and improving measurement and learning across households, communities, and health facilities to accelerate reductions in maternal and child mortality.
Nigeria national iccm implementation frameworktomowo George
The Nigeria's National ICCM implementation Framework is a 'one national iCCM Implementation Model' describing the activities expected to be carried out at the different levels of government, with clear programme boundaries, roles and responsibilities of individuals, organizations and other players. This framework also shows the pattern of information flow for iCCM in the country.
An Interrupted Time Series Multivariate Regression Analysis Evaluation of Sta...Whitney Bowman-Zatzkin
An Interrupted Time Series Multivariate Regression Analysis Evaluation of State Children's Health Insurance Programs (SCHIP) by Whitney Bowman-Zatzkin, MPA, MSR
As health insurance premiums continue to rise, the ability of many families to provide the critical health coverage to their children (both preventative and emergency) becomes an even greater challenge. In a study released in February 2005 in the Journal of Health Affairs, researchers found that half of those surveyed listed medical bills as the reason for their bankruptcy filings, with 75.7 percent of that half citing issues with health insurance during the illness resulting in the grandiose bills (Himmelstein, 2005). Figures released in 1997 from the Census Bureau reported a minimum of 10.7 million non-insured children within the United States (U.S. Bureau of the Census, 1997). The State Children’s Health Insurance Program (SCHIP) was developed to address these concerns.
SCHIP has been implemented as a supplemental Medicaid program for eligible children based on financial need. The original focus of SCHIP was to provide healthcare coverage to all children from birth to six years of age and having family incomes up to 133 percent of the Federal poverty level (FPL) while also covering children age six and over with family incomes at or above 100 percent of FPL. The goal was to have all children living below established poverty levels and under the age of 19 eligible for coverage by September 2002.
States could choose from the following implementation options.
1. Use SCHIP funding and expand their established Medicaid program to accommodate a larger percentage of children (Expansion Program).
2. Create a program for a new bracket of uninsured children, separate from Medicaid (New Program).
3. Combine the established Medicaid program with a new program offering separate enrollment options (Combination).
States are permitted to divert funds from other resources to provide healthcare to children under very loosely defined parameters. At the time, there was no children’s healthcare program with the strength and financial backing of SCHIP.
This paper evaluates the success of the SCHIP program and whether the choice of implementation design influences its success. SCHIP is currently under consideration for reauthorization making such an evaluation very timely. This paper proceeds as follows. First, I provide background about the SCHIP program. Next, I describe my research design and methods. Then I discuss my findings. Finally, I conclude with a discussion of my results.
This document discusses a study on supporting children's adherence to anti-retroviral (ART) therapy in Malawi. The study followed 47 HIV-positive children on ART over 6 months to a year. 72% of children never missed a dose according to caregiver reports. Clinic attendance was also good, with over 80% of visits either on time or within a week of the scheduled date. Focus groups and interviews with caregivers provided insights into challenges of supporting children's adherence, such as costs of medication and transport as well as caregiver responsibilities, but also motivations like seeing children's health improve. The findings highlight the need for more affordable and less complex ART regimes as well as tools to help caregivers support children's adherence
Overview of the Integrated Community Case Management (iCCM) of Childhood Illn...JSI
The document provides an overview of the Integrated Community Case Management (iCCM) of Childhood Illness Task Force. The Task Force is a global association working to promote integrated community-level management of childhood illness. It includes multilateral agencies, bilateral agencies, NGOs, and academic institutions. The Task Force operates through a steering committee and secretariat to advocate for iCCM adoption, ensure access to best practices and tools, and provide a forum for experience sharing. It maintains a resource center, CCMCentral.com, which centralizes iCCM implementation tools and examples. The conclusion encourages joining the Task Force to access standards and resources, disseminate evidence, and network to shape the future of iCCM programs.
The document discusses the Child Status Index (CSI), an approach developed to monitor and evaluate orphans and vulnerable children. The CSI was created as a tool to assess how children are faring in key areas of wellbeing, determine what services they receive and still need, and evaluate how well programs are achieving their objectives. It evaluates domains like food, shelter, health, education, and psychosocial support. The CSI was developed through participatory methods with stakeholders in Kenya and Tanzania, considers existing frameworks, and has been validated and applied in multiple countries. Future work involves disseminating the tool, conducting trainings, and adapting it for program monitoring and low literacy users.
OneHealth is a tool for medium-term strategic health planning at the national level in countries. It incorporates epidemiology impact models to demonstrate achievable health gains from integrated disease program and health systems planning. OneHealth was developed to enable integrated planning across partners, link disease programs to health systems strengthening, and incorporate costing into the planning process from the beginning. It brings together various stakeholders and allows for scenario analysis of alternative intervention packages, targets, and activities.
This document provides information about the Sierra Club - John Muir Chapter in Wisconsin. It discusses the founding and mission of the Sierra Club, details about the John Muir Chapter including its leadership, priorities, and accomplishments. Key points include that the Sierra Club was founded in 1892 by John Muir and is the oldest and largest grassroots environmental organization in the US, the John Muir Chapter has over 15,000 members and focuses on issues like clean water, clean energy, and preventing destructive mining.
Este documento describe los volcanes, incluyendo su definición, partes, materiales que arrojan, tipos, localización y algunos de los más importantes del mundo. También explica su relación con la tectónica de placas.
1) Home equity loans, also known as second mortgages, allow homeowners to borrow against the equity in their home. There are two main types - fixed-rate loans which provide a lump sum payment that is repaid over a fixed period at a set interest rate, and home equity lines of credit (HELOCs) which function like credit cards with a pre-approved spending limit.
2) While home equity loans offer lower interest rates than other types of consumer loans, the document cautions that they should only be used judiciously as relying on them for daily expenses could lead to overspending and debt issues.
3) The document provides a brief overview of government health care spending in the US
This document discusses the impacts of carbon dioxide (CO2) emissions from power plants. It notes that while power plants are important sources of energy, their CO2 emissions can negatively impact the environment if not properly managed. The summary discusses strategies to reduce CO2 emissions from power plants, including improving energy efficiency, transitioning to cleaner sources of energy, and offsetting remaining emissions through forestation and carbon sequestration programs. Communities near power plants could benefit from job creation through such emission reduction programs.
Un evento educativo al aire libre se llevará a cabo el 16 de junio en el Palacio de Cristal del Retiro en Madrid. El evento incluirá cuentacuentos, clases universitarias, talleres de inteligencia emocional, fotografía, para bebés, mayores y comida. El objetivo es promover la educación pública.
El documento describe los terremotos, explicando que son movimientos bruscos de la corteza terrestre causados por la liberación repentina de energía acumulada entre las placas tectónicas. Define los conceptos de hipocentro, el punto donde se libera la energía, y epicentro, el punto en la superficie sobre el hipocentro. También describe dos escalas para medir la intensidad de los terremotos: la escala de Richter, basada en registros sísmicos, y la escala de Mercalli, basada en los daños observados.
CONCYTEC en la revista de la Sociedad Nacional de IndustriasConcytec Perú
El Consejo Nacional de Ciencia, Tecnología e
Innovación Tecnológica (Concytec), por intermedio
de Cienciactiva, está impulsando el desarrollo de la
investigación y de la innovación científica hacia las
necesidades del sector empresarial, satisfaciendo
así una antigua demanda de la industria.
The WHO just released a report that looked at how well countries are preparing for the health effects of climate change, and found that few are making progress. Analyzing data from 101 countries, the report says that half have strategies in place, and many of the countries cited finances as being the major challenge to implementing national plans. Only 12 countries reported having a national curriculum to train its health force on the effects of climate change, while 27 countries have plans in development. At the same time, only a quarter of the countries assessed looked at how their countries would be affected by vector-borne, water-, or food-borne diseases as a result of climate change.
This document provides guidance for developing national school policies to promote healthy diets and physical activity as part of implementing the WHO Global Strategy on Diet, Physical Activity and Health (DPAS). It outlines a process for setting up a coordinating team, conducting a situation analysis, developing a workplan and monitoring system, and setting goals and objectives. It provides options for policy elements related to school recognition programs, curriculum, food services, physical environment, health promotion for staff, and school health services. It emphasizes stakeholder involvement including government agencies, teachers, students, parents, and the community. It concludes with recommendations for monitoring and evaluation of policy implementation and development of national indicators.
This document was developed with inputs from many institutions and experts. Several individuals deserve special mention. Mary Arimond, Kathryn Dewey and Marie Ruel developed the analytical framework and provided technical oversight throughout the project. Eunyong Chung and Anne Swindale provided technical support. Nita Bhandari, Roberta Cohen, Hilary Creed de Kanashiro, Christine Hotz, Mourad Moursi, Helena Pachon and Cecilia C. Santos-Acuin conducted analysis of data sets. Chessa Lutter coordinated a working group to update the breastfeeding indicators. Mary Arimond and Megan Deitchler coordinated the working group that developed the Operational Guide on measurement issues which is a companion to this document. Bernadette Daelmans and José Martines coordinated the project throughout its phases. Participants in the consensus meetings held in Geneva 3–4 October 2006 and in Washington, DC 6–8 November 2007 provided invaluable inputs to formulate the recommendations put forward in this document.
Early child development: Report on case studiesDRIVERS
Case study produced as part of the DRIVERS project. The objective of case studies in areas that are key drivers of health inequities is to identify services, policies or practices that are already in place that have the potential to reduce inequalities in health and its social determinants.
Relatório apresenta uma análise do estado atual da BFHI - Baby-Friendly Hospital Initiative (No Brasil, IHAC – Iniciativa Hospital Amigo da Criança) em países ao redor do mundo.
Com base na 2 ª revisão da política global de nutrição, implementado pela OMS em 2016-2017, o documento apresenta a implementação da iniciativa, 25 anos após o seu lançamento.
O relatório descreve a cobertura do programa, o atual processo de designação, razões para rescisão em locais onde o programa foi descontinuado, integração dos dez passos para outras normas e políticas globais, e lições aprendidas. Além disso, o relatório fornece informação qualitativa em alguns dos países que enfrentaram desafios na implementação da BFHI.
Excelente publicação – o Brasil é citado várias vezes.
Number of pages: 60
Publication date: 2017
Languages: English
ISBN: 978 92 4 151238 1
Sps160 chapter 6 health promotion for target groupZul Fadli
The document discusses health promotion programs at schools. It describes the WHO's Global School Health Initiative launched in 1995 to improve student, staff, family and community health through schools. The goal is to increase the number of "Health-Promoting Schools". Strategies discussed include research, advocacy, strengthening national capacities, and creating networks to develop health-promoting schools. Key areas of focus for these schools are listed. Assessment tools are also described, including the Global School-based Student Health Survey.
UNDP final report + case reports carbon foot printingGraeme Esau
This document summarizes the objectives and key findings of a study measuring the carbon footprint of UNDP-administered Global Fund grants for HIV/AIDS, tuberculosis, and malaria programs in Zimbabwe. The study aimed to apply the carbon footprint methodology developed in an earlier study at a larger scale in Africa. It found that the methodology could be applied to measure emissions from the new grants and inform program development. It also identified five priority areas - including waste management, product carbon factors, and fleet vehicles - for further action to reduce emissions in health programs.
Early childhood caries (ECC) affects teeth of children aged under six years. According to the Global Burden of Disease Study in 2017, more than 530 million children globally have dental caries of the primary teeth. However, as primary teeth are exfoliated due to growth of the child, #ECC has previously not been considered important.
Dental caries can lead to abscesses and cause toothache, which may compromise ability to eat and sleep and restrict life activity of children.
Prevalence of ECC is increasing rapidly in low and middle-income countries, and dental caries is particularly frequent or severe among children living in deprived communities. In many countries, access to dental care is not equitable, leaving poor children and families underserved.
Publicação da WHO decreta o fim da desconfiança que a amamentação pode causar cáries no lactente.
A OMS recomenda que os bebês sejam amamentados exclusivamente até seis meses de idade, após o qual a amamentação deve continuar de forma complementar até dois anos de idade ou mais por causa dos muitos benefícios à saúde para mãe e bebê, incluindo saúde bucal.
...
Uma nova revisão sistemática incluindo dados mais recentes mostrou que bebês amamentados com 2 anos de idade não têm maior risco de cárie infantil do que aqueles que foram amamentados até um 1 de idade."
Fonte: World Health Organization. (2019). Ending childhood dental caries: WHO implementation manual. World Health Organization. ISBN 9789240000056 English
Global foundations for reducing nutrient enrichment and oxygen depletion from...Iwl Pcu
This document outlines a project aimed at establishing global foundations for reducing nutrient pollution from land into coastal waters. The project will:
1) Develop quantitative models to map nutrient sources and their effects on coastal areas.
2) Create a "policy toolbox" with tools and approaches for developing nutrient reduction strategies.
3) Conduct pilot projects in Manila Bay and Chilka Lake to develop stakeholder-led nutrient reduction strategies.
4) Establish a global partnership on nutrient management to stimulate replication of outcomes.
Improving health equity through action across the life course: Summary of evi...DRIVERS
Economic growth, democratisation and improved living conditions have contributed to improved health and longevity in Europe, but profound and systematic differences in health persist. These differences form a gradient that runs from the top to the bottom of society, and this pattern holds true for all European countries.
These health inequalities have existed for centuries and much is now known about their causes – many of which are potentially avoidable.
The main aim of the DRIVERS project is to deepen understanding of the relationships that exist in a European context between some of the key influences on health over the course of a person’s life - early childhood, employment, and income and social protection - and to find solutions to improve health and reduce health inequalities.
This document begins by providing an overview of DRIVERS and its most significant findings. It then describes headline principles and recommendations to help reduce health inequalities across Europe.
The goal of the DRIVERS project is to leave a lasting legacy, by providing evidence that informs the implementation of policies and programmes across different sectors that are effective in reducing health inequalities, improving social justice and contributing to societal and economic progress for all.
This document provides a progress report on implementing recommendations from the Commission on Information and Accountability for Women's and Children's Health. It summarizes that 63 of 75 priority countries have developed Country Accountability Frameworks to strengthen monitoring, review, and action on women's and children's health. Progress includes more countries tracking vital statistics and maternal deaths, monitoring Commission indicators, and conducting health sector reviews. However, more work remains to fully realize the accountability goals.
This document provides biographical and professional information about Jean-Marie Nyambe Wandji. It details his education history including degrees in medicine and public health. It lists his professional experience working for organizations like MSF and Save the Children in various African countries on public health programs related to malaria, nutrition, HIV/AIDS and emergency response. His current role is as an international health humanitarian advisor with Save the Children in the Central African Republic and Niger.
Este documento describe los volcanes, incluyendo su definición, partes, materiales que arrojan, tipos, localización y algunos de los más importantes del mundo. También explica su relación con la tectónica de placas.
1) Home equity loans, also known as second mortgages, allow homeowners to borrow against the equity in their home. There are two main types - fixed-rate loans which provide a lump sum payment that is repaid over a fixed period at a set interest rate, and home equity lines of credit (HELOCs) which function like credit cards with a pre-approved spending limit.
2) While home equity loans offer lower interest rates than other types of consumer loans, the document cautions that they should only be used judiciously as relying on them for daily expenses could lead to overspending and debt issues.
3) The document provides a brief overview of government health care spending in the US
This document discusses the impacts of carbon dioxide (CO2) emissions from power plants. It notes that while power plants are important sources of energy, their CO2 emissions can negatively impact the environment if not properly managed. The summary discusses strategies to reduce CO2 emissions from power plants, including improving energy efficiency, transitioning to cleaner sources of energy, and offsetting remaining emissions through forestation and carbon sequestration programs. Communities near power plants could benefit from job creation through such emission reduction programs.
Un evento educativo al aire libre se llevará a cabo el 16 de junio en el Palacio de Cristal del Retiro en Madrid. El evento incluirá cuentacuentos, clases universitarias, talleres de inteligencia emocional, fotografía, para bebés, mayores y comida. El objetivo es promover la educación pública.
El documento describe los terremotos, explicando que son movimientos bruscos de la corteza terrestre causados por la liberación repentina de energía acumulada entre las placas tectónicas. Define los conceptos de hipocentro, el punto donde se libera la energía, y epicentro, el punto en la superficie sobre el hipocentro. También describe dos escalas para medir la intensidad de los terremotos: la escala de Richter, basada en registros sísmicos, y la escala de Mercalli, basada en los daños observados.
CONCYTEC en la revista de la Sociedad Nacional de IndustriasConcytec Perú
El Consejo Nacional de Ciencia, Tecnología e
Innovación Tecnológica (Concytec), por intermedio
de Cienciactiva, está impulsando el desarrollo de la
investigación y de la innovación científica hacia las
necesidades del sector empresarial, satisfaciendo
así una antigua demanda de la industria.
The WHO just released a report that looked at how well countries are preparing for the health effects of climate change, and found that few are making progress. Analyzing data from 101 countries, the report says that half have strategies in place, and many of the countries cited finances as being the major challenge to implementing national plans. Only 12 countries reported having a national curriculum to train its health force on the effects of climate change, while 27 countries have plans in development. At the same time, only a quarter of the countries assessed looked at how their countries would be affected by vector-borne, water-, or food-borne diseases as a result of climate change.
This document provides guidance for developing national school policies to promote healthy diets and physical activity as part of implementing the WHO Global Strategy on Diet, Physical Activity and Health (DPAS). It outlines a process for setting up a coordinating team, conducting a situation analysis, developing a workplan and monitoring system, and setting goals and objectives. It provides options for policy elements related to school recognition programs, curriculum, food services, physical environment, health promotion for staff, and school health services. It emphasizes stakeholder involvement including government agencies, teachers, students, parents, and the community. It concludes with recommendations for monitoring and evaluation of policy implementation and development of national indicators.
This document was developed with inputs from many institutions and experts. Several individuals deserve special mention. Mary Arimond, Kathryn Dewey and Marie Ruel developed the analytical framework and provided technical oversight throughout the project. Eunyong Chung and Anne Swindale provided technical support. Nita Bhandari, Roberta Cohen, Hilary Creed de Kanashiro, Christine Hotz, Mourad Moursi, Helena Pachon and Cecilia C. Santos-Acuin conducted analysis of data sets. Chessa Lutter coordinated a working group to update the breastfeeding indicators. Mary Arimond and Megan Deitchler coordinated the working group that developed the Operational Guide on measurement issues which is a companion to this document. Bernadette Daelmans and José Martines coordinated the project throughout its phases. Participants in the consensus meetings held in Geneva 3–4 October 2006 and in Washington, DC 6–8 November 2007 provided invaluable inputs to formulate the recommendations put forward in this document.
Early child development: Report on case studiesDRIVERS
Case study produced as part of the DRIVERS project. The objective of case studies in areas that are key drivers of health inequities is to identify services, policies or practices that are already in place that have the potential to reduce inequalities in health and its social determinants.
Relatório apresenta uma análise do estado atual da BFHI - Baby-Friendly Hospital Initiative (No Brasil, IHAC – Iniciativa Hospital Amigo da Criança) em países ao redor do mundo.
Com base na 2 ª revisão da política global de nutrição, implementado pela OMS em 2016-2017, o documento apresenta a implementação da iniciativa, 25 anos após o seu lançamento.
O relatório descreve a cobertura do programa, o atual processo de designação, razões para rescisão em locais onde o programa foi descontinuado, integração dos dez passos para outras normas e políticas globais, e lições aprendidas. Além disso, o relatório fornece informação qualitativa em alguns dos países que enfrentaram desafios na implementação da BFHI.
Excelente publicação – o Brasil é citado várias vezes.
Number of pages: 60
Publication date: 2017
Languages: English
ISBN: 978 92 4 151238 1
Sps160 chapter 6 health promotion for target groupZul Fadli
The document discusses health promotion programs at schools. It describes the WHO's Global School Health Initiative launched in 1995 to improve student, staff, family and community health through schools. The goal is to increase the number of "Health-Promoting Schools". Strategies discussed include research, advocacy, strengthening national capacities, and creating networks to develop health-promoting schools. Key areas of focus for these schools are listed. Assessment tools are also described, including the Global School-based Student Health Survey.
UNDP final report + case reports carbon foot printingGraeme Esau
This document summarizes the objectives and key findings of a study measuring the carbon footprint of UNDP-administered Global Fund grants for HIV/AIDS, tuberculosis, and malaria programs in Zimbabwe. The study aimed to apply the carbon footprint methodology developed in an earlier study at a larger scale in Africa. It found that the methodology could be applied to measure emissions from the new grants and inform program development. It also identified five priority areas - including waste management, product carbon factors, and fleet vehicles - for further action to reduce emissions in health programs.
Early childhood caries (ECC) affects teeth of children aged under six years. According to the Global Burden of Disease Study in 2017, more than 530 million children globally have dental caries of the primary teeth. However, as primary teeth are exfoliated due to growth of the child, #ECC has previously not been considered important.
Dental caries can lead to abscesses and cause toothache, which may compromise ability to eat and sleep and restrict life activity of children.
Prevalence of ECC is increasing rapidly in low and middle-income countries, and dental caries is particularly frequent or severe among children living in deprived communities. In many countries, access to dental care is not equitable, leaving poor children and families underserved.
Publicação da WHO decreta o fim da desconfiança que a amamentação pode causar cáries no lactente.
A OMS recomenda que os bebês sejam amamentados exclusivamente até seis meses de idade, após o qual a amamentação deve continuar de forma complementar até dois anos de idade ou mais por causa dos muitos benefícios à saúde para mãe e bebê, incluindo saúde bucal.
...
Uma nova revisão sistemática incluindo dados mais recentes mostrou que bebês amamentados com 2 anos de idade não têm maior risco de cárie infantil do que aqueles que foram amamentados até um 1 de idade."
Fonte: World Health Organization. (2019). Ending childhood dental caries: WHO implementation manual. World Health Organization. ISBN 9789240000056 English
Global foundations for reducing nutrient enrichment and oxygen depletion from...Iwl Pcu
This document outlines a project aimed at establishing global foundations for reducing nutrient pollution from land into coastal waters. The project will:
1) Develop quantitative models to map nutrient sources and their effects on coastal areas.
2) Create a "policy toolbox" with tools and approaches for developing nutrient reduction strategies.
3) Conduct pilot projects in Manila Bay and Chilka Lake to develop stakeholder-led nutrient reduction strategies.
4) Establish a global partnership on nutrient management to stimulate replication of outcomes.
Improving health equity through action across the life course: Summary of evi...DRIVERS
Economic growth, democratisation and improved living conditions have contributed to improved health and longevity in Europe, but profound and systematic differences in health persist. These differences form a gradient that runs from the top to the bottom of society, and this pattern holds true for all European countries.
These health inequalities have existed for centuries and much is now known about their causes – many of which are potentially avoidable.
The main aim of the DRIVERS project is to deepen understanding of the relationships that exist in a European context between some of the key influences on health over the course of a person’s life - early childhood, employment, and income and social protection - and to find solutions to improve health and reduce health inequalities.
This document begins by providing an overview of DRIVERS and its most significant findings. It then describes headline principles and recommendations to help reduce health inequalities across Europe.
The goal of the DRIVERS project is to leave a lasting legacy, by providing evidence that informs the implementation of policies and programmes across different sectors that are effective in reducing health inequalities, improving social justice and contributing to societal and economic progress for all.
This document provides a progress report on implementing recommendations from the Commission on Information and Accountability for Women's and Children's Health. It summarizes that 63 of 75 priority countries have developed Country Accountability Frameworks to strengthen monitoring, review, and action on women's and children's health. Progress includes more countries tracking vital statistics and maternal deaths, monitoring Commission indicators, and conducting health sector reviews. However, more work remains to fully realize the accountability goals.
This document provides biographical and professional information about Jean-Marie Nyambe Wandji. It details his education history including degrees in medicine and public health. It lists his professional experience working for organizations like MSF and Save the Children in various African countries on public health programs related to malaria, nutrition, HIV/AIDS and emergency response. His current role is as an international health humanitarian advisor with Save the Children in the Central African Republic and Niger.
This document provides an introduction to a planning workbook aimed at guiding discussions on scaling up the use of information and communication technologies (ICTs) to improve reproductive, maternal, newborn and child health (RMNCH). It notes that while ICTs and mobile health tools show promise, efforts have been fragmented and the RMNCH and ICT communities have not collaborated effectively. The workbook seeks to address this by creating a platform for inclusive, multi-stakeholder dialogue on obstacles and potential solutions. It was developed through collaboration between key partners and is intended to support evidence-based decision making.
Universal, quality early childhood programmes that are responsive to need pro...DRIVERS
Policy brief produced by the DRIVERS project, aimed at practitioners and policy makers. Provides information about how early childhood is important for health and health inequalities, solutions to improve health equity, and opportunities to advocate at the national and European levels.
Three million newborns die each year from preventable causes like preterm birth, infections, and complications during childbirth. The Saving Newborn Lives program works with governments and partners in multiple countries to increase access to and quality of newborn healthcare, in order to reduce newborn mortality at scale. Evidence shows that their approach of strengthening health systems and promoting improved home practices has helped lower newborn death rates in focus countries.
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This document summarizes the findings of a strategic review of the Integrated Management of Childhood Illness (IMNCI) approach. Some key findings include:
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The review provides 5 recommendations to address these problems, including consolidating global leadership, developing innovative strategies to reach marginalized populations, establishing mechanisms for shared learning and evidence use, tailoring strategies to country contexts, and strengthening monitoring and accountability. The overall
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In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
4. Contents
Co
ent
Summary – Children’s dre
Environmental Health Indicators (CEHI):
EHI):
HI):
Presenting Regional Successes, Learning for the Future 2
A F Framework for Children’s Environmental Health In
Indicators 5
Key Findings Across the CEHI Projects 6
Comparing Different Experiences in Implementing CEHI 7
Linking Indicators to Existing Mechanisms 9
Moving Forward 12
Conclusion 14
Acknowledgements 15
National and Regional Information on Children’s Environmental Health Indicator Development 18
5. 2 Children’s Environmental Health Indicators (CEHI)
Summary –
Children’s Environmental Health Indicators (CEHI):
Presenting Regional Successes
Learning for the Future
Children’s environmental health indicators are aimed at improving the assessment
of children’s environmental health, monitoring the effects of interventions to improve
children’s health in relation to the environment and reporting on the state of children’s
environmental health.
The World Health
Organization (WHO)
has been coordinating
the development and
implementation of this
initiative with funding support from
the Office of Children’s Health
Protection at the United States
Environmental Protection Agency
(USEPA), thereby enabling pilot
projects in Africa, North America,
Latin America, the Caribbean and
the Middle East (Box 1). The initiative
builds on existing international,
regional and national work on child
health and environmental indicators.
Several countries have chosen to
collect new data as part of the
implementation of the CEHI initiative
(e.g. Tunisia, Oman and Cameroon).
In addition, several countries are
contributing to the objectives of
the initiative independently through
the development and reporting of
children’s environmental health with
their own sources of funding, while
sharing results and experiences
along the way (e.g. The Commission
for Environmental Cooperation (CEC)
of North America and the WHO
European Region Environment and
Health Information System (ENHIS)
project).
Many countries came forward to be
part of the initial phase to develop
children’s environmental health
indicators. Their experience proved
very benefi cial for other countries
that joined later. It is hoped that even
more countries will engage actively
in future efforts.
The initiative took a fl exible approach
to the implementation of projects,
focusing on what was feasible in the
short-term while working towards
a common set of indicators in the
medium- and long-term where
possible. Each regional or country
project chose the path most suited
to its specifi c circumstances (e.g.
burden of disease, availability of
resources).
The objectives of the
initiative are to:
• Develop and promote use of children’s
environmental health indicators;
• Improve assessment of children’s
environmental health and monitor the
success or failure of interventions;
• Provide data to inform policy-makers
and to allow measurement
of the effectiveness of policies
and programmes to improve
environmental conditions for children.
6. In order to provide a solid basis for
indicator development and collection,
WHO proposed a set of core indicators
at the global level, which countries
adapted to suit their specifi c needs.
Subsequently, they defi ned and collected
indicators at the national level and integrated them at
the regional level where feasible.
Throughout the CEHI initiative the aim has been to
ensure equal relevance of the indicators for the health
and environment sectors so that both can monitor
their efforts towards realizing healthy environments
for healthy children. The initiative aims to assess best
practices and lessons learned among the different
indicator development projects.
Box 1. Countries and projects contributing to children’s environmental health
indicator development:
THE AFRICAN REGION:
• Cameroon, Kenya, Zimbabwe
THE AMERICAS:
• Canada, Mexico, the United States, United States-Mexico Border, Argentina
THE EASTERN MEDITERRANEAN REGION:
• Oman, Tunisia
THE EUROPEAN REGION:
• (1) Austria, Bulgaria, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Lithuania, Netherlands, Poland,
Portugal, Romania, Slovakia, Slovenia, Spain
• (2) Sweden and the United Kingdom2
• (3) Albania, Armenia, Belarus, Belgium, Croatia, Georgia, Kyrgyzstan, Malta, Serbia, the former Yugoslav Republic of Macedonia,
Uzbekistan3
(1) Formal partners
(2) Volunteering partners
(3) Partners who provided data and information (case studies) input
Presenting Regional Successes, Learning for the Future – Summary 3
7. Figure 1. Countries and projects contributing to the development of children’s
environmental health indicators
Indicators provide a basis for
assessing environmental risks
to children’s health, prioritizing
policy, and ultimately reducing
environmental risks for children.
Children’s environmental health
indicators are important not merely
in emphasizing the links between
environment and health, but in drawing
attention to an often neglected
issue. Special attention should be
devoted to children because they
are generally more vulnerable than
adults to environmental hazards.
They breathe more air and consume
more food and water relative to
their size than adults, their bodies
are still developing and they have
little control over their environment.
The findings of the participating
projects clearly demonstrate that
some priority issues are relevant
to children everywhere on this
planet.
An assessment of all these
efforts provides important
information and lessons
on developing and
implementing children’s
environmental health
indicators and will help
guide future efforts.
4 Children’s Environmental Health Indicators (CEHI)
8. Presenting Regional Successes, Learning for the Future – Summary 5
A Framework for Children’s Environmental Health
Indicators
Children’s environmental
health indicators measure
the multiple links between
exposure to environmental risks
and health outcomes. The Multiple
Exposures Multiple Effects (MEME)
model is a conceptual model for the
defi nition, collection and reporting
of children’s environmental health
indicators on the basis of the
Driving forces – Pressures – State
– Exposure – Effects – Actions
(DPSEEA) framework (Figure 2).
Although several frameworks are
available, embedding indicators for
children’s health and the environment
within the MEME model has several
advantages. It helps to:
o Demonstrate the many links
between environmental exposures,
larger social contexts and health
outcomes;
o Illustrate a spectrum of exposures
and the many locations where
they may occur. These exposures
often work in concert, resulting in
compounded reactions and health
outcomes that may range from
morbidity to mortality;
o Acknowledge that effects of
environmental exposures may be
modifi ed by social, economic and
demographic conditions;
o Show that interventions can
be implemented either in a
preventive manner – at the root of
environmental degradation / at the
site of exposure - or in a remedial
fashion, through the treatment of
negative health outcomes.
Figure 3 shows an adapted example
of the MEME model applied to indoor
air pollution as used in the North
American project led by the CEC
in 2006. As the model suggests,
a number of air contaminants –
individually or in combination – can
produce or be associated with a
number of health outcomes (Briggs,
2003). Conversely, a single health
outcome may be attributable to or
associated with multiple exposures
to multiple substances over time.
Figure 2. Multiple Exposures – Multiple Effects (MEME)
Health outcome
Contexts
Social conditions
Economic conditions
Demographic conditions
Causes
Attributable to
Preventive actions Remedial actions
Figure 3. The MEME model as applied to indoor air
pollution
Contexts
Social conditions
Economic conditions
Demographic conditions
Exposure Health outcome
Source: CEC, 2006.
AGENTS
Environmental
tobacco smoke
Biomass emissions
SOURCES
Smoking
Burning of wood and
charcoal
Causes or is associated with
Attributable to or is
associated with
Preventive actions Remedial actions
Actions
Middle ear infections
Bronchitis
Pneumonia and other acute
respiratory conditions
Development and
exacerbation of asthma
Low birth weight
Sudden infant death
syndrome (SIDS)
Ambient
environment
Community
Home
Distal
Proximal
Exposure
Well-being
Morbidity
Mortality
Less severe
More severe
Actions
9. Key Findings Across the CEHI Projects
Children’s environmental
health risks worldwide are
as diverse as the climatic
conditions, political settings,
social environments, and levels of
economic development they inhabit.
Risks range from the long-standing
and well-known issues (such as
inadequate shelter, lack of clean
water and clean air) to more recent
emerging risks, such as exposure
to chemicals, radiation, and climate
change.
Key fi ndings confi rm that diarrhoeal
diseases from inadequate water
and sanitation and respiratory
diseases from indoor and outdoor air
pollutants threaten children’s health
in Tunisia, the United States, Mexico
and countries in Europe alike. In
low income countries, pollutants
in the air children breathe indoors
commonly come from black carbon
from the use of biomass fuels, and in
other countries, exposure to second
hand smoke. This broad range of
identifi ed risks is highlighted below.
o Cameroon: Inadequate access
to water, sanitation and waste
disposal were identified as the
major contributing factors to the
environmental burden of disease
in children.
o Kenya and Zimbabwe: Rapid
urbanization was singled out as
the source of several clusters
of environmental health risks
ranging from inadequate
infrastructure to unfavourable
social environments.
o Oman: Respiratory diseases and
physical injuries rank at the top of
environmentally related threats to
children’s health. While expanding
water access almost universally
has dramatically reduced mortality
and morbidity due to diarrhoeal
diseases, improving water quality
still remains a national priority.
o Tunisia: A survey of children’s
environmental health issues
and evaluation of existing
environmental and health policies
led to revised national programmes
to reduce indoor air pollution and
to the incorporation of child safety
provisions in urban planning
projects.
o The European Region: Respiratory
diseases and physical injuries
were found to be priority areas
for action. Major contributing
factors are smoking and obesity.
Radiation and exposure to
hazardous chemicals represent
emerging environmental health
risks.
o North America (Canada, Mexico
and the United States): Indicators
were reported under three thematic
areas: asthma and respiratory
disease, effects of exposure to
lead and other toxic substances,
and waterborne diseases. Only
one of the indicators, addressing
asthma in children, was fully
reported by all three countries.
Although the countries were able
to provide relevant information for
most of the selected indicators,
this clearly illustrates the
challenge of obtaining comparable
information on environmental
health issues across sectors and
national borders. Overall, these
data show a rise in reported cases
of childhood asthma across North
America.
o Argentina: Identification and
collection of information on
children’s diseases such as asthma
and diabetes was not complete
while data on long standing and
well known indicators (e.g. water
pollution indicators and diarrhoeal
diseases or malnutrition) were
complete. Gaps were identifi ed in
data relating to many recent and
emerging environmental threats
(e.g. diseases related to chemical
exposure or climate change).
6 Children’s Environmental Health Indicators (CEHI)
10. Presenting Regional Successes, Learning for the Future – Summary 7
Comparing Different Experiences in Implementing
CEHI
O ne of the principal aims was to
adopt a fl exible approach to
the selection of indicators and
collection of data. In order to facilitate
this exercise, a two-tiered evaluation
was conducted in collaboration
with the Johns Hopkins School of
Advanced International Studies
(SAIS) in the United States, at the
project level and at the indicator
level by, for example, trained
interviewers, external consultants,
and stakeholders. Eight evaluation
criteria served as the framework for
the comparison and evaluation of
the different projects (Box 2).
Each project was unique and
contributed to the development and
improvement of the objectives of
CEHI. More specifi cally:
o Cameroon served as an example
of how an initial primary data
collection effort can serve as a
guide for future priority setting in
the implementation of national
programmes;
o Kenya developed a well-designed
and highly sophisticated plan for
data collection;
o Zimbabwe demonstrated its ability
to collect valuable secondary
data from a variety of sources
at the sub-national, national and
international level;
o Oman had an ambitious plan for
the collection of an extensive list
of indicators, demonstrating a
desire to comprehensively assess
children’s environmental burden of
disease;
o Tunisia is taking plans further.
Following primary data collection
for CEHI, the plans are to set up
a national monitoring system for
children’s environmental health;
o The European region project
served as an example to others
of a well-established concerted
effort and demonstrated the
possibilities that can arise from
successful collaboration among
different actors and countries;
o The project in North America
successfully respected national
differences while creating a unifi ed
project among the United States,
Mexico and Canada by allowing
flexibility in the data reported
under each indicator;
o The United States-Mexico
border project demonstrated
the importance of focusing on
the local realities of regions and
of portraying those realities in a
graphic, user-friendly manner.
o Argentina established a multi-sectoral
and participative
workgroup and using the MEME
model, produced an indicator
profi le on children’s environmental
health (Perfi l Sana). This provides
a useful tool for decision-making
on children’s environmental health
policies.
The cross-project evaluation found
several commonalities in the
prioritization of health issues. The
most striking one consists of the fact
Box 2. Evaluation Criteria
I. EVALUATION AT PROJECT LEVEL:
1. Prioritization of children’s environmental health topics
2. Data collection method
3. Inter-sectoral collaboration and capacity building
4. Report format.
II. EVALUATION AT INDICATOR LEVEL:
5. Comprehensiveness of indicators
6. Utility and practicability of the indicators
7. Level of disaggregation (e.g. by gender, socioeconomic status, provision of
time-trend)
8. Policy relevance (e.g. is the indicator child-specifi c? or is the indicator rel-evant
for devising policies?).
11. 8 Children’s Environmental Health Indicators (CEHI)
that three indicator topics – water
and sanitation, indoor/outdoor air
pollution and respiratory illness –
were chosen by almost all efforts
as priorities. Unintentional physical
injuries and exposure to chemical
contaminants are other recurrent
issues across all regions. At the
International Children’s Environmental
Health Indicators (CEHI) workshop
in Hammamet, Tunisia, in 20084, it
was established that the three topics
identifi ed above could serve as the
basis for the development of a set of
core indicators that all participating
members could use and append with
complementary indicators suited
specifi cally to their local needs.
4 http://www.who.int/ceh/cehi_workshop_tunisia2008/en/index.html
Box 3. The Eastern Mediterranean Region – The Tunisian Experience
The Tunisian pilot project prioritized environmental health issues according to the results of a preliminary survey to
identify focus areas.
The survey has three modules: (i) roster of people and health, (ii) housing quality and water, hygiene, and (iii)
sanitation. This assessment tool did not cover environmental health exclusively, and collected information on a
variety of biological, hygienic and behavioural determinants of human, specifi cally child health.
Primary data populated the 46 indicators selected, all newly collected as part of the CEHI pilot project through the
implementation of household surveys. The Tunisian example demonstrates the value of using external (e.g. WHO’s
list of available indicators5 or the MEME model) and local resources effi ciently, while defi ning national priorities.
The fi nal report presents – in a graphic and user-friendly manner – all of the data collected and provides a detailed
discussion of both the lessons learned and the ways in which Tunisia’s initial activities can be carried forward in the
future.
5 http://www.who.int/ceh/indicators/indicators2003/en/index.html
case studies
Box 4. The Americas – The experience of the Council of the North
American Commission for Environmental Cooperation (CEC)
The North American project prioritized environmental health issues according to the recommendations adopted by
the CEC of North America in 2002 in recognition of the shared environmental health threats to children in the three
countries: (i) exposure to lead and toxic substances, (ii) respiratory illnesses, and (iii) waterborne diseases.
Suitable indicators were identifi ed according to data availability, scientifi c soundness and credibility, and indicator
applicability and clarity. Country reports were prepared by each country, providing data and contextual information
to populate the 13 indicators selected, drawing on national and local datasets.
While not all countries presented data for all indicators, missing data were replaced by alternative, yet related
measures. Thus the project acknowledged existing data gaps as well as national differences among the participating
countries.
The fi nal report, based on the country reports6, provides extensive information and illustrations of data sources and
analysis. A discussion of lessons learned regarding both individual indicators and the project as a whole, including
data needs and opportunities for enhanced cooperation, is also included.
6 Link to fi nal North American report and country reports: http://www.who.int/ceh/publications/northamericanreport/en/index.html
12. Presenting Regional Successes, Learning for the Future – Summary 9
Linking Indicators to Existing Mechanisms
Overall, the biggest challenge
is integrating the indicators
into existing surveys and
reporting tools both at national and
international levels.
The process of implementing
CEHI in countries will need the
participation of multilateral agencies
such as WHO, the United Nations
Environment Programme (UNEP),
the United Nations Development
Programme (UNDP), the United
Nations Children Fund (UNICEF),
the Organisation for Economic
Opportunities include:
o I n c o r p o r a t i n g c h i l d re n ’s
environmental health indicators
into existing national data
collection mechanisms such as:
• censuses
• clinical data
• data collected and monitored at
community level in cooperation
with schools
• routinely collected environmental
data
• routinely collected paediatric
data.
o I n c o r p o r a t i n g c h i l d re n ’s
environmental health questions
and issues into international
surveys and data collection and
reporting mechanisms such as:
• Demographic and Health
Surveys (DHS): Implemented
by Macro International Inc. in
75 countries, the DHS collects
nationally representative
population-based surveys with
large sample sizes (usually
between 5000 and 30 000
households).
• GEO Data Portal: This portal
is the authoritative source
for data sets used by UNEP
and its partners in the Global
Environment Outlook (GEO)
report and other integrated
environment assessments. Its
online database holds more
Cooperation and Development
(OECD) and the World Bank as
well as national governments,
nongovernmental organizations and
other stakeholders.
Incorporati ch ren’s
13. 10 Children’s Environmental Health Indicators (CEHI)
than 450 different variables, as
national, subregional, regional
and global statistics or as
geospatial data sets (maps),
covering themes like freshwater,
population, forests, emissions,
climate, disasters, health and
GDP.
• Living Standards Measurement
Study (LSMS): Implemented
by the World Bank to help
policy makers identify how
policies could be designed and
improved to positively affect
outcomes in health, education,
economic activities, housing
and utilities, etc.
• Joint Monitoring Programme
for Water Supply and Sanitation
(JMP): Implemented by WHO
and UNICEF. The overall aim of
the JMP is to report globally on
the status of the water supply
and sanitation sector, and to
support countries in improving
their monitoring performance
to enable better planning and
management at the country
level.
• Millennium Development Goals
(MDGs): The United Nations
site for the MDG Indicators
presents the official data,
definitions, methodologies
and sources for more than 60
indicators to measure progress
towards the MDGs. The data
and analyses are the product
of the work of the Inter-agency
and Expert Group (IAEG) on
MDG Indicators, coordinated
by the United Nations Statistics
Division.
Box 5. Children’s Environment and Health Action
Plan for Europe (CEHAPE) – Europe’s action
programme
The Fourth Ministerial Conference on Environment and Health (2004) adopted
CEHAPE, an international instrument negotiated with member states to develop
and manage environmental health indicators. The project, established by the
WHO Regional Offi ce for Europe, set four regional priority goals identifying key
themes for action on children’s health in relation to environmental factors:
gastrointestinal health related to safe water and adequate sanitation; healthy
and safe transport, mobility, and home environment to reduce injuries and
enhance physical activity; respiratory health and clean air; and health through
an environment free of hazardous chemical, physical, and biological factors.
The declaration from the Ministerial Conference reaffi rmed that environmental
health indicator systems are essential for policy making relevant to children’s
environmental health. With this in mind, an international project – Implementing
Environment and Health Information System in Europe (ENHIS), co-funded by
the European Commission (EC) and coordinated by the WHO Regional Offi ce
for Europe – developed a prototype of an evidence-based system to support
children’s health and environmental policies in the European Region.
The interdependence between science and policymaking is probably best
exemplifi ed by the interaction between CEHAPE7 and ENHIS8. While indicators
serve as the basis and starting point for CEHAPE, the very same indicators
are also used to benchmark and evaluate the resulting policy actions through
ENHIS.
7 Children’s Environment and Health Action Plan for Europe. More information: http://www.euro.who.int/childhealthenv/
policy/20020724_2
8 European Environment and Health Information System. More information: www.enhis.org
14. • Multiple Indicator Cluster
Surveys (MICS): The MICS
programme developed by
UNICEF assists countries in
fi lling data gaps for monitoring
the situation of children and
women through statistically
sound, inter n a t i o n a l l y
comparable estimates of
socioeconomic and health
indicators. The household
survey programme is the largest
source of statistical information
on children.
Presenting Regional Successes, Learning for the Future – Summary 11
• World Health Statistics:
Implemented by WHO, the
World Health Statistics contains
WHO’s annual compilation of
data from its 193 Member
States, and includes, in the
2009 report, a summary of
progress towards the health-related
MDGs and targets.
This integration of CEHI into existing
international and national data
collection and reporting mechanisms
could translate into a valuable tool.
Although some of the information
readily collected, reported and
available through international and
national surveys or databases could
be used to monitor and evaluate
children’s environmental health, pilot
studies identifi ed large data gaps in
information across countries and
regions.
Good quality information is available
on indicators related to water quality
for example but gaps exist in
indicators related to pesticides, child
labour, nutrition, and unintentional
injuries.
Box 6. Argentina
On the basis of the preparation of the Indicator Profi le for Argentina and the
assessment of children’s environmental health and other on-going efforts in Argentina,
the development and creation of a Working Group on Children Environmental Health at
the Argentinean Society of Paediatrics and the promotion of Children Environmental
Health Units (Unidades Pediatricas Ambientales), were launched at different levels in
the country with strong involvement of paediatricians. The information and evidence
contained in the Indicator Profi le has helped promote an “Atlas of Children in
Argentina” under the National Ombudsman carried out with support from UNDP, UNICEF,
the International Labour Organization (ILO) and the Pan-American Health Organization
(PAHO).
15. 12 Children’s Environmental Health Indicators (CEHI)
MOVING FORWARD
In April 2008, a group of international technical experts and representatives of governments and
partner agencies committed to children’s environmental health indicators convened in Hammamet,
Tunisia to assess the progress made with the project and to discuss future directions. On the basis
of discussions about the challenges faced and the lessons learned from the experience of collecting
indicators, participants developed 10 key ideas to ensure the sustainability of the initiative:
ENGAGE IN A TARGETED ADVOCACY AND COMMUNICATION STRATEGY
The need to draw attention to children’s environmental health issues and more specifi cally towards data collection
and reporting, to involve all stakeholders, including children themselves, as well as recognize, replicate and
disseminate successful experiences was identifi ed. There is a need for a few simple key messages – targeted to
specifi c audiences such as policy-makers, public health offi cials, healthcare providers – detailing the importance of
indicator development. Educational practices and methodologies which build knowledge and understanding while
encouraging participation of children can play a role in decreasing the severity of impacts from environmental
health impacts.
INCORPORATE CHILDREN’S ENVIRONMENTAL HEALTH INTO CLIMATE CHANGE ISSUES
In order to increase the visibility, relevance and usefulness of children’s environmental health, it is important to
incorporate the initiative into the climate change agenda. Children are particularly vulnerable, and are likely to
suffer disproportionately from both direct and indirect adverse health effects of climate change. Recent estimates
suggest that almost 90% of the global burden of disease from climate change is borne by children (WHO 2007c).
There is a need to enhance the understanding of current and potential impacts of climate-related risks, of the
degree of population vulnerability, of characteristics of vulnerable groups (such as children), of the type of
surveillance and alert and emergency management systems, of the most useful indicators for monitoring and
evaluation, and of the criteria for action.
HIGHLIGHT ECONOMIC BENEFITS OF ADDRESSING CHILDREN’S ENVIRONMENTAL HEALTH
The economic benefi ts of preventing environment-related diseases are many and must be quantifi ed and clearly
communicated to policy-makers. This work has begun at the OECD and should be continued. Existing data mainly
refl ect health outcomes and remedial actions, but rarely expose the responsible environmental risk factors.
However, knowledge about these risk factors is essential for countries to strengthen preventive programmes
in addition to responsive medical care. This will help to avert diseases, save children’s lives, improve families’
livelihoods and reduce the burden on a nation’s health care system. Children’s environmental health indicators
can be used to identify specifi c cost-effective interventions targeted towards the improvement of children’s
environmental health.
ENSURE GREATER POLICY RELEVANCE OF INDICATORS
Children’s environmental health indicators provide a way to clarify the linkages kage
between the environment
and health. Indicators may refl ect the effectiveness of past and current rrent pol
policies, and may suggest needs and
opportunities for new interventions to improve children’s health. Policy olicy r
relevance is a key consideration in
selecting and designing indicators.
CREATE A CORE SET OF INDICATORS TO FACILITATE COMPARABILITY
The difference in the approaches taken by the pilot projects makes comparisons very diffi cult. It was suggested
that a limited number of indicators (i.e. a core set) applicable to all regions be agreed upon through a collaborative
expert opinion approach. Subsequently, each region could develop complementary indicators specifi c to its own
circumstances, taking into account traditional as well as emerging threats. In this manner, cross-country/regional
comparisons would be facilitated, as would tailor-made assessments of the local burden of disease related to
environmental health.
1
2
3
4
5
16. Presenting Regional Successes, Learning for the Future – Summary 13
INTEGRATE CHILDREN’S ENVIRONMENTAL HEALTH INDICATORS INTO NATIONAL HEALTH INFORMATION
SYSTEMS
In order to ensure continuity of this work, children’s environmental health indicators need to be integrated into
other data collecting and reporting mechanisms in a harmonized manner that allows a regional and global
comparability and monitoring. The WHO/Health Metrics Network Framework and standards for country health
information systems is a potentially useful framework for such integration. This would ensure that child health
indicators can be collected sustainably over time, increase their prominence and avoid duplication. It would
be wise to reduce the number of data items to be collected and focus on a few key ones in order to minimize
the burden on other data collection systems and facilitate inter-country comparisons. Incorporating specifi c
questions or even specifi cally developed environmental health components into nationally implemented surveys
(e.g. DHS, MICS, LSMS), constitute potential areas within which children’s environmental health indicators could
be integrated.
DISAGGREGATE DATA AND PROVIDE STATISTICAL INFORMATION
In order to increase the policy relevance of indicators, they should be highly representative and appealing,
and provide a comprehensive overview of the particular situation in a country/region. Moreover, consistent
geographical, gender, and age disaggregation would be useful, as well as the reporting of confi dence intervals
where applicable.
CREATE AN INTERNET PORTAL AS A REFERENCE FOR PARTICIPATING COUNTRIES
Data collection and reporting efforts would be facilitated by the creation of a dedicated web portal hosted by
WHO. Participants could contribute immediately, subject to agreeing technical issues, by uploading their data on
a regular basis and draw on the portal by being able to consult legislation, surveys, best practices, etc. A web
log or a “Q&A” section on such a website would also be useful for national planners to seek guidance and share
experiences, problems, and resources.
STRENGTHEN INCENTIVES TO REPORT
In order to ensure sustainability of the development and use of indicators for children’s environmental health, it
is recommended to strengthen harmonized reporting requirements, thus reducing the reporting burden.
CONTINUE TO PROVIDE TECHNICAL ASSISTANCE THROUGH THE CEHI NETWORK
One common request was the provision of technical assistance to countries and regions that wish to develop
indicators. Although sustainability is key and data collection tools/mechanisms must be rendered self-sustaining,
continuous technical assistance – particularly in the early phases of indicator development – is
crucial. Countries have requested ongoing technical input and support. More assistance could be provided
to countries for data collection and reporting, presenting, analysing and disseminating data through the
establishment of an international CEHI technical network involving stakeholders at every level (e.g. national,
regional and international). Funding remains an issue for several projects and regions and hinders scale-up
efforts.
These 10 key ideas provide a sense of
how far the CEHI initiative has come
and how much potential it has to grow.
The ideas highlight the need for greater
coordination and harmonization, but at
the same time call for specific, tailor-made
approaches to the collection of data
on children’s environmental health and
fi nancial support.
Translating evidence into policy
Producing a list of relevant indicators and
populating them with data is a necessary
step towards the ultimate goal of improving
children’s health. However, future actions
must strive to close the gap between
theory and practice.
The CEHI initiative explicitly addresses
the need to improve knowledge and
data collection, and invites participation
from private and public partners. Policy
6
7
8
9
10
interventions in the area of children’s
environmental health can range from
school education to waste collection
improvement, emission controls and
improved stoves, food regulation and
fl ood control, housing improvements and
disease eradication programmes. Without
a thorough understanding of the linkages
between multiple exposures and multiple
effects, it is not possible to determine
the costs, benefi ts, and effectiveness of
potential interventions (Box 5 & 6).
17. 14 Children’s Environmental Health Indicators (CEHI)
Conclusion
Establishing and using children’s environmental health indicators that express environment and health linkages
in a meaningful way provides countries with the foundation needed to better understand how children’s
environments and their health are related. In addition it provides the baseline information needed to reassess
policies and to move towards preventing childhood death and disease through healthy environments.
What is now required includes:
o the creation of a sustainable clearing house for children’s environmental health indicators;
o the institutionalization of the harmonized collection and reporting efforts undertaken in the framework of the pilot
projects; and
o the effective translation of the vast and comprehensive fi ndings into policy recommendations tailored to specifi c
target populations and areas.
This involves the development of models and application of other statistical tools to enable linkages within complex
systems to be understood. The CEHI initiative offers for the fi rst time a systematic approach to supply the data
necessary for such a task.
18. Acknowledgements
We would like to thank all partners and contributors for their input, dedication and participation at all stages
of the project, from planning through to implementation, and evaluation of the Global Initiative on Children’s
Environmental Health Indicators. We are particularly grateful to the Offi ce of Children’s Health Protection at
the United States Environmental Protection Agency (USEPA) for their continued fi nancial support.
We wish to particularly highlight the participation and contributions of partners and individuals in the different phases
of the Global Initiative:
PARTNERS OF THE GLOBAL INITIATIVE ON CHILDREN’S ENVIRONMENTAL HEALTH INDICATORS:
Governments:
Canada
Italy
Mexico
South Africa
United States of America
Intergovernmental Organizations:
Commission for Environmental Cooperation of North America
Organisation for Economic Co-operation and Development
United Nations Children’s Fund
United Nations Environment Programme
World Health Organization
Nongovernmental Organizations:
International Network on Children’s Health, Environment and Safety (INCHES)
International Society of Doctors for the Environment (ISDE)
Physicians for Social Responsibility (PSR)
World Summit on Sustainable Development, Johannesburg, South Africa 2002
Presenting Regional Successes, Learning for the Future – Summary 15
19. INTERNATIONAL STEERING COMMITTEE
Axelrad, Daniel (USEPA)
Berger, Martha (USEPA)
Gore, Fiona (WHO)
Mendola, Pauline (CDC, USA)
Regondi, Ilaria (Johns Hopkins University SAIS, USA)
Schratz, Alexander (Johns Hopkins University SAIS, USA)
Solmi, Francesca (Johns Hopkins University SAIS, USA)
Woodruff, Tracey (University of California, San Francisco, USA)
CONTRIBUTORS TO THE AMERICAS PROJECT
Bagchi, Atrish (Intern – PAHO Field Offi ce, El Paso, Texas)
Barraza, Antonio (Ministry of Health, Mexico)
Baulch, Samantha (Delphi Group)
Bérubé, Annie (Health Canada)
Buka, Irena (IJC Health Professionals Task Force)
Chanon, Keith (USEPA)
Córdova Villalobos, José Ángel (Ministry of Health, Mexico)
Corra, Lilian (International Society of Doctors for the Environment,
ISDE)
Corvalán, Carlos (PAHO Country Offi ce Brazil)
de Titto, Ernesto (Ministry of Health, Argentina)
Dudley, Bruce (Delphi Group)
Ecclestone, Andrea (Health Canada)
Ecclestone, Susan (Health Canada)
Escamilla Cejudo, José Antonio (PAHO Country Offi ce, Panama)
Escoto, Luis Roberto (PAHO Country Offi ce Argentina)
Edwards, Sally (PAHO Field Offi ce, El Paso, Texas)
Flores, María Angelica (Ministry of Health, Argentina)
Galvão, Luiz Augusto Cassanha (PAHO)
Gosselin, Pierre (IJC Health Professionals Task Force)
Haines, Doug (Health Canada)
Henao, Samuel (PAHO)
Houston, James (IJC Health Professionals Task Force)
Jenkins, Jorge (PAHO Field Offi ce, El Paso, Texas)
Kinghorn, April (Health Canada)
Korc, Marcello (PAHO Country Offi ce Columbia)
LeGrand, Melissa (Health Canada)
McAllister, Jeffrey (Intern – PAHO Field Offi ce, El Paso, Texas)
Mercier, Vincent (Health Canada)
Montalvo, Mara (PAHO Field Offi ce, El Paso, Texas)
Monti, Veronica (Asociación Argentina de Medicos por el Medio
Ambiente, AAAMA)
Oliveira, Mara (PAHO Country Offi ce Brazil)
Orris, Peter (IJC Health Professionals Task Force)
Pages, José Antonio (PAHO Country Offi ce Argentina)
Phipps, Erica (Commission for Environmental Cooperation, USA)
Ramirez, Matiana (Ministry of Health, Mexico)
Sims-Jones, Nicki (Health Canada)
Woodruff, Tracey (USEPA)
CONTRIBUTORS TO THE EUROPEAN PROJECT (ENHIS)
Dalbokova, Dafi na (WHO EURO)
Kim, Rokho (WHO EURO)
Krzyzanowski, Michal (WHO EURO)
Nemer, Leda (WHO EURO)
CONTRIBUTORS TO THE EASTERN MEDITERRANEAN REGION
PROJECTS
Abdel Rahim, Ibrahim Mohamed (WHO Country Offi ce Tunisia)
Al Wahaibi, Salim (Ministry of Health, Oman)
Al-Zadjali, Salah Sumar Ali (Ministry of Health, Oman)
Al-Zubi, Ruba (WHO EMRO CEHA)
Al-Zedjali, Majed Shahoo (Ministry of Health, Oman)
Attia, Thouraya (Ministry of Public Health, Tunisia)
Bakir, Hamed (WHO EMRO CEHA)
Bargaoui, Besma (WHO Country Offi ce Tunisia)
Barhoumi, Tarek (Ministry of Public Health, Tunisia)
Ben Abdelaziz, Ahmed (University Hospital Centre SAHLOUL,
Sousse, Tunisia)
Hamza, Ridha (Medical Imaging Service, Tunisia)
Kamoun, Badii (Ministry of Public Health, Tunisia)
Mazouzi, Raja (Ministry of Public Health, Tunisia)
Nedhif, Mabrouk (Ministry of Public Health, Tunisia)
Ouerghemmi, Samir (Ministry of Public Health, Tunisia)
CONTRIBUTORS FROM THE SOUTH EAST ASIAN REGION
Boonyakarnkal, Theechat (Ministry of Public Health, Thailand)
Hildebrand, Alexander (WHO SEARO)
Malhotra, Sudhansh (WHO SEARO)
Yoosuf, Abdul-Sattar (WHO SEARO)
CONTRIBUTORS TO THE AFRICAN REGION PROJECTS
Andjembe, Christine (Consultants Cameroon)
Chibanda, Mark (WHO Country Offi ce Zimbabwe)
Dete, R. G. (Ministry of Health and Child Welfare Zimbabwe)
Karani, Erastus (Ministry of Health, Kenya)
Kariuki, John (Ministry of Health, Kenya)
Langat, Alfred (Ministry of Health, Kenya)
Manga, Blaise (Ministry of Public Health, Cameroon)
Manga, Lucien (WHO AFRO)
Maphosa, Stephen (WHO Country Offi ce Zimbabwe)
Mawoyo, N. (Ministry of Health and Child Welfare Zimbabwe)
Mbam Mbam, Leonard (WHO Country Offi ce Cameroon)
Ndegwa, Wilfred (WHO Country Offi ce Kenya)
Nissack Onloun, Françoise Marcelle (WHO Country Offi ce
Cameroon)
Nkolo, François (Consultants Cameroon)
Okonji, Franklin (Kenya Medical Training College, Nairobi, Kenya)
Senkoro, Hawa (WHO AFRO)
16 Children’s Environmental Health Indicators (CEHI)
20. CONTRIBUTORS FROM THE WESTERN PACIFIC REGION
Ogawa, Hisashi (WHO WPRO)
CONTRIBUTORS FROM WHO HEADQUARTERS
Abou-Zahr, Carla
Bertollini, Roberto
Bonjour, Sophie
Boschi Pinto, Cynthia
Bruné, Marie-Noël
Campbell-Lendrum, Diarmid
Dora, Carlos
Gavidia, Tania (Intern)
Gordon, Bruce
Gore, Fiona
Hossain, Rifat
Ivicek, Kristy (Intern)
Jones, Malia (Intern)
Joseph, Véronique
Mulholland, Catherine
Neira, Maria
Pronczuk, Jenny
Prüss-Üstün, Annette
Rehfuess, Eva
Ryan, Erin (Intern)
Sims, Jacqueline
Wilburn, Susan
Younes, Maged
ATTENDEES AT THE TUNISIA WORKSHOP
Abdel Rahim, Ibrahim Mohamed (WHO Country Offi ce, Tunisia)
Al-Zadjali, Salah Sumar Ali (Ministry of Health, Oman)
Axelrad, Daniel (USEPA)
Bargaoui, Besma (WHO Country Offi ce, Tunisia)
Barhoumi, Tarek (Ministry of Public Health, Tunisia)
Ben Abdelaziz, Ahmed (University Hospital Centre SAHLOUL,
Sousse, Tunisia)
Berger, Martha (USEPA)
Bliss, Katherine (United States Department of State)
Boschi Pinto, Cynthia (WHO)
Corra, Lilian (ISDE, INCHES)
Dalbokova, Dafi na (WHO EURO)
Goodman, Donna (Earthchild Insitute, formerly UNICEF)
Gore, Fiona (WHO)
Hamza, Ridha (Medical Imaging Service, Tunis, Tunisia)
Johri, Amir (WHO EMRO)
Presenting Regional Successes, Learning for the Future – Summary 17
Kamaluddin, Muhammad Amir (Ministry of Health, Malaysia)
Kamoun, Badii (Ministry of Public Health, Tunisia)
Kyle, Amy (University of California, Berkeley, USA)
LeGrand, Melissa (Health Canada)
Lobdell, Danelle (USEPA)
Mazouzi, Raja (Ministry of Public Health, Tunisia)
Mendola, Pauline (CDC, USA)
Musa, Riyad (WHO EMRO)
Nedhif, Mabrouk (Ministry of Public Health, Tunisia)
Oliveira, Thierry (UNEP)
Ouerghemmi, Samir (Ministry of Public Health, Tunisia)
Paris Mancilla, Enrique (Ministry of Health, Chile)
Regondi, Ilaria (Johns Hopkins University SAIS, USA)
Rehfuess, Eva (WHO)
Schratz, Alexander (Johns Hopkins University SAIS, USA)
Senkoro, Hawa (WHO AFRO)
Solmi, Francesca (Johns Hopkins University SAIS, USA)
Thouraya, Attia (ANCSEP)
Von Hildebrand, Alexander (WHO SEARO)
Woodruff, Tracey (University of California, San Francisco, USA)
OTHER INTERNATIONAL INPUT
Briggs, David (Imperial College, London, United Kingdom)
Castano, Juanita (UNEP)
Feldbaum, Harley (Johns Hopkins University SAIS, USA)
Jansen, Maaike (UNEP)
MacDevette, Monika (UNEP)
Mendola, Pauline (CDC, USA)
Metternicht, Graciela (UNEP)
Nagatani, Kakuko (UNEP
Oliveira, Thierry (UNEP)
Tobin, Vanessa (UNICEF)
Quiblier, Pierre (UNEP)
Parker, David (UNICEF)
Simpson, David (Johns Hopkins University SAIS, USA)
Sanchez, Ricardo (UNEP)
Sinisi, Luciana (APAT, Italy)
Van Den Hazel, Peter (INCHES)
van Woerden, Jaap (UNEP)
EDITORIAL AND ADMINISTRATIVE TEAM:
Gouader, Imen (WHO Country Offi ce Tunisia)
Lameyre, Anne-Laure (WHO HQ)
Pond, Katherine (University of Surrey, UK)
Sanchez-Santana, Judy (WHO HQ)
21. 18 Children’s Environmental Health Indicators (CEHI)
National and Regional Information on Children’s
Environmental Health Indicator Development
THE AFRICAN REGION
WHO African Region: www.afro.who.int/des/phe/index.html
THE AMERICAS
Canada, Mexico, United States: Led by the Commission for Environmental Co-operation - CEC, Montreal. http://www.cec.org/programs_
projects/pollutants_health/children/index.cfm?varlan=english
United States: USEPA – Offi ce of Children’s Health Protection. http://yosemite.epa.gov/ochp/ochpweb.nsf/content/homepage.htm
United States: America’s Children and the Environment. http://www.epa.gov/envirohealth/children
United States: CDC – Environmental Public Health Tracking. http://www.cdc.gov/nceh/tracking/
Canada: Health Canada – Report of the Steering Committee to the Federal/Provincial/Territorial Committee on Health and Environment,
May 2, 2006. Recommended Indicators of Children’s Environmental Health In Canada.
Canada: Institute of Child Health (in collaboration with AAAMA/ISDE). http://www.cich.ca/project_safeenvironment.html
Pan-American Health Organization (PAHO): http://www.fep.paho.org/english/env/
Argentina: Ministry of Health. http://www.ambiente.gov.ar/?idseccion=69
Profi le of Children’s Environmental Health in Argentina. http://www.aamma.org/archivos/SANA/intro-ENG.pdf
http://www.aamma.org/archivos/SANA/intro.pdf
THE EUROPEAN REGION
WHO European Centre for Environment and Health, Bonn, Germany: http://www.euro.who.int/EHindicators
Environment and Health Information System for Europe: http://www.enhis.org
THE EASTERN MEDITERRANEAN REGION
WHO Centre for Environment and Health, Amman, Jordan: http://www.emro.who.int/ceha/
Tunisia: Ministry of Public Health – Environmental Health. http://www.santetunisie.rns.tn/msp/msp.html
THE SOUTH-EAST ASIA REGION
WHO South-East Asia Region: http://www.searo.who.int/en/Section23.htm
THE WESTERN PACIFIC REGION
WHO Western Pacifi c Region: http://www.wpro.who.int/environmental_health/
22. Presenting Regional Successes, Learning for the Future – Summary 19
OTHER USEFUL WEBSITES
Asociación Argentina de Médicos por el Medio Ambiente – AAMMA: http://www.aamma.org
Demographic and Health Surveys: http://www.measuredhs.com/
European Environment Agency: http://www.eea.europa.eu/themes/human/indicators
International Society of Doctors for the Environment, ISDE: http://www.isde.org
International Network on Children’s Health Environment and Safety, INCHES: http://www.inchesnetwork.org
Organisation for Economic Co-operation and Development (OECD): http://www.oecd.org/topic/0,2686,en_2649_34283_1_1_1_1_37
465,00.html
Physicians for Social Responsibility – PSR: http://www.psr.org/
United Nations Children’s Fund (UNICEF):
– Statistical data access by indicator or country: http://www.unicef.org/statistics/index.html
– Monitoring the situation of children and women (MICS): http://www.childinfo.org/
– Progress of nations 1997 statistical profi les: http://www.unicef.org/pon97/stat2.htm
United Nations Environment Programme (UNEP):
– Global Environmental Outlook (GEO) data portal: http://geodata.grid.unep.ch/
United Nations Statistics Division (UN):
– Statistical databases: http://unstats.un.org/unsd/databases.htm
– Millennium Development Goal Indicators: http://mdgs.un.org/unsd/mdg/default.aspx
World Health Organization:
– Children’s Environmental Health Indicators: http://www.who.int/ceh/indicators/en/
– Global Burden of Disease: http://www.who.int/healthinfo/global_burden_disease/en/index.html
– Health Metrics Network Secretariat WHO: http://www.who.int/healthmetrics/en/
– Health Statistics and health information systems: http://www.who.int/healthinfo/en/
– WHOSIS: World Health Organization Statistical Service: http://www.who.int/whosis/en/
– World Health Statistics: http://www.who.int/whosis/whostat/en/
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23. 20 Children’s Environmental Health Indicators (CEHI)
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This brochure summarizes the process, outcomes and key fi ndings of the children’s environmental
health indicator projects implemented as part of the global initiative on Children’s Environmental Health
Indicators. Discussions took place at the Children’s Environmental Health Indicators (CEHI) workshop
“Children’s Environmental Health Indicators: Five Years After the Global Commitment at the World Summit
on Sustainable Development” in Tunisia in 2008. The participants of this workshop included technical
experts, representatives from governments, public health offi cers, medical doctors and representatives of
partner agencies. Challenges faced and the lessons learned from the experience of collecting indicators
were discussed; 10 key ideas to move forward were agreed upon.
The global initiative on Children’s Environmental Health Indicators was launched at the World Summit on
Sustainable Development in 2002 with partners from fi ve governments, three nongovernmental organizations
and fi ve intergovernmental organizations with support from the Offi ce of Children’s Health Protection at the
United States Environmental Protection Agency.