Basic Public Health Research Articles

Guns and Butter: Child Mortality and the Mediators of Militarization

Which types of militarization affect child mortality? Which type appears to lower it; which appears to push it higher? This article focuses on social militarization (i.e., troops as a proportion of workforce-aged population) and praetorian militarization (i.e., the military’s control or strong influence over the government), investigating their impact on child mortality using pooled time series analysis covering 142 countries from 1996 through 2008. We find that social and praetorian militarization have opposite effects even after controlling for potentially confounding influences. Access to basic public health infrastructures and education mediates between each type of militarization and child mortality.

On the achievement of comprehensive control targets among type 2 diabetic patients managed by communities in Jiangsu province

Objective To explore the control levels of blood glucose, blood lipid, blood pressure (BP), and body mass index (BMI) in the community-managed patients with type 2 diabetes in Jiangsu and to provide the basis for better management of type 2 diabetes in communities. Methods From December 2013 to January 2014, 20 053 patients with type 2 diabetes and have received disease management according to the National Basic Public Health Service were recruited in Changshu County of Suzhou City, Huai′an and Qinghe Districts of Huai′an City. Questionnaire survey, anthropometric and laboratory measurements were conducted. According to the Chinese guidelines for type 2 diabetes prevention and treatment (2013), the control levels of blood glucose, blood lipid, BP, and BMI were assessed. Results Among 20 053 patients with type 2 diabetes, the proportions for controlled fasting plasma glucose (FPG) and HbA1C were 31.4% and 41.9% respectively, and 25.3% of the patients simultaneously achieved goals of FPG and HbA1C control. There were 23.9%, 55.7%, 75.5% and 24.2% of the patients met goals for total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C), respectively. Only 10.3% of the patients achieved all the 4 targets of blood lipid. Furthermore, there were 25.4% and 35.9% patients achieved BP and BMI targets respectively, and the control rates for BP and BMI of females were higher than those of males (all P<0.05). Less than 1% of the patients had all eights indices controlled at target levels. Conclusions The achievement of comprehensive targets among community patients with type 2 diabetes remains poor in Jiangsu. Follow-up and management of type 2 diabetes should be strengthened in communities, health education and comprehensive intervention on disease complications should also be reinforced accordingly. (Chin J Endocrinol Metab, 2018, 34: 112-120) Key words: Diabetes mellitus, type 2; Community; Comprehensive control; Achievement

A survey on service status of rural doctors in Beijing suburb

Objective To survey the service status of rural doctors in Beijing suburb. Methods Twenty one village officials, 21 rural doctors and 42 local residents from 21 villages in Beijing Huairou district were selected with purposive sampling method as the objects of this qualitative study. The service status of rural doctors was assessed from four aspects: basic public health service, basic medical service, management ability, responsibility and communication ability. Results All the 21 village clinics provided basic public health services, including hypertension management (100.0%), diabetes management (100.0%); 11 clinics (52.4%) also provided vaccination services. Eighteen village doctors (85.7%) assisted township health center to provide signing health service, but were lack of knowledge about the types of service the general practitioners (GPs) should provide. The well performed basic medical services among 21 village clinics included diagnosis and differential diagnosis of common diseases in 19 (90.5%) clinics, home visits in 18 (85.7%) and physical examinations in 15 (71.4%), but the service like trauma management, changing dressing, subcutaneous injection, intravenous infusion were performed less well. The top three most satisfied aspects in the medical service were the service attitude (4.14 points), the quality of service (3.98 points) and service time (3.66 points), and the bottom three were equipment facilities, the types and varieties of drug, and the environment of clinics. In aspect of emergency service, 7 village doctors (33.3%) would choose self-referral by patients without preliminary on-site emergency treatment, 5(23.8%) would give on-site emergency treatment before self-referral by patients. In aspect of training needs, 18 (42.9%) local residents and 9 (42.9%) village officials considered that it was not necessary to provide training for village doctor because of relatively older age. In aspect of patient′s satisfaction, 21 village doctors (100.0%), 21 village officials (100.0%) and 34 villagers (81.0%) considered that the village doctor had a high professional sense of responsibility and medical ethics, and their doctor-patient communication skills were strong. Conclusion The survey reveals the current service status of village doctors in Beijing suburb, and it is necessary to take comprehensive measures to upgrade the competence of village doctors and to improve the quality of service in village clinics. Key words: Rural doctors; Professional competence; Qualitative research

Relative workload measurement based on RBRVS theory for village level basic public health service projects

Objective To scientifically measure the workload of basic public health services project on village level. Methods 257 village doctors and 24 public health administrators who work in rural health clinics in Qianjiang city, Hubei province and Qianjiang distrcit, Chongqing city were sampled, with questionnaire survey and key informant in-depth interview methods used to screen basic public health service projects affordable on village level, for workload measurement. Results 35 basic public health service projects were chosen as the measurement projects regarding their relative workload.Hypertension follow-up workload 100 was set as the benchmark, finding the rest relative workload of other projects range from 11 to 936. Conclusions It is reasonable to use the relative value measurement based on RBRVS theory on village level basic public health service projects.Results of this study can support the pricing and further dynamic modification of the basic public health service projects. Key words: Rural health services; Basic public health service project; Resource-based relative value scale; Workload; Measurement

Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes

Objective: To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods: From December 2013 to January 2014, a total of 7 763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results: The prevalence of current smoking was 45.5% in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers (P<0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95%CI: 0.05%-0.49%) and 0.38% (95%CI: 0.23%-0.53%), respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers (P<0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion: Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

Progress in basic public health service projects in China

The paper systematically reviewed the progress in policy making for national basic public health service projects in China from 2009 to 2016.Starting from the Opinions on facilitating the implementation of equalization of public health and Guidance for basic public health services in floating populations,the paper mainly focused on the national basic public health service specification,funding and management approach,performance evaluation and other related policies and the progress and challenges in the implementation of the projects.Data were extracted from China Health and Family Planning Statistical Year Book of 2010-2017,National Financial Annual Report of Health Service,2009-2016 and survey data on primary care comprehensive reform of 2014-2016 in key contacted areas were analyzed.The progress and achievement in the national basic public health service projects were summarized; challenges and problems in the implementation of the projects were discussed; and some suggestions were proposed.

SPATIOTEMPORAL TRANSMISSION DYNAMICS OF RECENT EBOLA OUTBREAK IN SIERRA LEONE, WEST AFRICA: IMPACT OF CONTROL MEASURES

In this paper, we have formulated a compartmental epidemic model with exponentially decaying transmission rates to understand the Ebola transmission dynamics and study the impact of control measures to basic public health. The epidemic model exhibits two equilibria, namely, the disease-free and unique endemic equilibria. We have calculated the basic reproduction number through next generation matrix and investigated the spatial spread of the epidemic via reaction–diffusion modeling. Instead of fitting the model to the observed pattern of spread, we have used previously estimated parameter values and examined the efficacy of predictions of the designed model vis-à-vis the pattern of spread observed in Sierra Leone, West Africa. Further, we conducted a sensitivity analysis to determine the extent to which improvement in predictions is achievable through better parameterization.We performed numerical simulations with and without control measure for the designed model system. A significant reduction in infection and death cases were observed when proper control measures are incorporated in the model system. Two-dimensional simulation experiments show that infectious population and the number of deaths will increase up to one and a half years without control, but it will decline after two years. We have reported the numerical results, and it closely matches with the real situation in Sierra Leone.

Coping and compromise: a qualitative study of how primary health care providers respond to health reform in China

BackgroundHealth reform in China since 2009 has emphasized basic public health services to enhance the function of Community Health Services as a primary health care facility. A variety of studies have documented these efforts, and the challenges these have faced, yet up to now the experience of primary health care (PHC) providers in terms of how they have coped with these changes remains underdeveloped. Despite the abundant literature on psychological coping processes and mechanisms, the application of coping research within the context of human resources for health remains yet to be explored. This research aims to understand how PHC providers coped with the new primary health care model and the job characteristics brought about by these changes.MethodsSemi-structured interviews with primary health care workers were conducted in Jinan city of Shandong province in China. A maximum variation sampling method selected 30 PHC providers from different specialties. Thematic analysis was used drawing on a synthesis of theories related to the Job Demands-Resources model, work adjustment, and the model of exit, voice, loyalty and neglect to understand PHC providers’ coping strategies.ResultsOur interviews identified that the new model of primary health care significantly affected the nature of primary health work and triggered a range of PHC providers’ coping processes. The results found that health workers perceived their job as less intensive than hospital medical work but often more trivial, characterized by heavy workload, blurred job description, unsatisfactory income, and a lack of professional development. However, close relationship with community and low work pressure were satisfactory. PHC providers’ processing of job demands and resources displayed two ways of interaction: aggravation and alleviation. Processing of job demands and resources led to three coping strategies: exit, passive loyalty, and compromise with new roles and functions.ConclusionsPrimary health care providers employed coping strategies of exit, passive loyalty, and compromise to deal with changes in primary health work. In light of these findings, our paper concludes that it is necessary for the policymakers to provide further job resources for CHS, and involve health workers in policy-making. The introduction of particular professional training opportunities to support job role orientation for PHC providers is advocated.

Basic Sciences Fertilizing Clinical Microbiology and Infection Management.

Basic sciences constitute the most abundant sources of creativity and innovation, as they are based on the passion of knowing. Basic knowledge, in close and fertile contact with medical and public health needs, produces distinct advancements in applied sciences. Basic sciences play the role of stem cells, providing material and semantics to construct differentiated tissues and organisms and enabling specialized functions and applications. However, eventually processes of “practice deconstruction” might reveal basic questions, as in de-differentiation of tissue cells. Basic sciences, microbiology, infectious diseases, and public health constitute an epistemological gradient that should also be an investigational continuum. The coexistence of all these interests and their cross-fertilization should be favored by interdisciplinary, integrative research organizations working simultaneously in the analytical and synthetic dimensions of scientific knowledge.

Study on the Status of Health Service Utilization among Caregivers of Left-Behind Children in Poor Rural Areas of Hunan Province: A Baseline Survey.

Background: The caregivers of left-behind children (CLBC) in China’s poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their health service utilization and to provide a scientific basis for guiding effective implementation of health policy in rural Hunan. Methods: Random cluster sampling was used to survey CLBC in two rural counties. Face-to-face interviews and questionnaires were used to collect data, including socioeconomic status and health service utilization. The two-week prevalence rate was used to reflect health service needs, while the two-week visiting rate, annual hospitalization rate and participation in basic public health services were used to evaluate health service utilization. Results: Of the 518 respondents in the study, 95.9% were farmers and 88.4% were over 40 years old. The two-week prevalence rate was 36.1%. Furthermore, 40.1% of ill caregivers’ activities were partly restricted by illness and 3.7% needed to be on bed rest. The two-week visiting rate was 21.0%. The main reasons for not seeing a doctor were “self-medication” (39.1%) or “financial difficulties” (32.6%). The annual hospitalization rate of the CLBC was 22.6% and the non-hospitalization rate of those who needed hospitalization was 41.5%. “Lack of time” (22.3%) and “financial difficulties” (50.5%) were the major factors affecting the utilization of hospitalization services. In terms of participation in basic public health services, only 35.1% CLBC clearly knew that township hospitals have established health records for them. Only 50.6% of caregivers received free health examinations in village clinics or township hospitals and 81.3% of the caregivers did not participate in health education or lectures organized by local health institutions in 2014. Conclusions: The utilization rate of health services was extremely low, which may affect the quality of care for left-behind children. Better public health education through multi-sector cooperation is urgently needed to improve health cognition among CLBC in rural China.

Comunicação e mídia: uma questão social no serviço da saúde

This article aims to analyze the communicational process between the basic health units and Public health officials in the city of Bauru-SP as a methodology, we note unsystematic, applying descriptive-exploratory character questionnaires and bibliographical and documentary. As a result, the survey showed the need for improvement in the informational strategies with your users, in addition to a valuation in the role of social service as a mediator and promoter of health campaigns.

Spatial accessibility to basic public health services in South Sudan.

At independence in 2011, South Sudan’s health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.

Determinants of village doctors\u2019 job satisfaction under China\u2019s health sector reform: a cross-sectional mixed methods study

BackgroundTo strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform. The purpose of this mixed-method study is to describe village doctors’ job satisfaction under the context of health sector reform and investigate the associated factors.MethodsData was obtained from a survey of village doctors across three Chinese provinces in 2014. Using a multistage sampling process, quantitative data was collected from village doctors through the self-administered questionnaire and analyzed by multilevel logistic regression models. Qualitative data was collected through face-to-face semi-structured interviews on both village doctors and health managers. Theoretical coding was then conducted to analyze qualitative data.ResultsAmong the 1221 respondents, 48.6% felt satisfied with their job. Older village doctors with less of a workload and under high-level integrated management were more likely to feel satisfied with their job. Village doctors who earned the top level of monthly income felt more satisfied, while on the county level, those who lived in counties with the highest GDP felt less satisfied. However, enrollment in a pension plan showed no significant difference in regards to village doctors’ job satisfaction.Among 34 participants of qualitative interviews, most believed that age, income, and integrated management had a positive influence on the job satisfaction, while pension plan and basic public health care policies exhibited negative effects. Also, the increasing in availability of healthcare and health resources along with local economic development had negative effects on village doctors’ job satisfaction.ConclusionVillage doctors’ job satisfaction was quite low in regards to several determinants including age, income, workload, enrollment in a pension plan, integrated management, and county economic and medical availability development.

On National Demonstration Areas: a cluster analysis

Objective: To understand the 'backward' provinces and the relatively poor work among the construction of National Demonstration Area, so as to promote communication and future visions among different regions. Methods: Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces, including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system. Results: According to the results from the construction of National Demonstration Area, all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories: Shanghai; Beijing, Zhejiang, Chongqing; Tianjin, Shandong, Guangdong and Xinjiang Production and Construction Corps; Hebei, Fujian, Hubei, Jiangsu, Liaoning, Xinjiang, Hunan and Guangxi; Shanxi, Jilin, Henan, Hainan,Sichuan, Anhui and Jiangxi; Inner Mongolia, Shaanxi, Ningxia, Guizhou, Yunnan, Gansu and Heilongjiang. Based on the scores gathered from this study, 24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories: Manpower, special day on NCD, information materials development, policy/strategy support, financial support, mass media, enabled environment, community fitness campaign, health promotion for children and teenage, institutional structure and patient self-management; healthy diet, risk factors on NCDs surveillance, tobacco control and community diagnosis; intervention of high-risk groups, identification of high-risk groups, reporting system on cardiovascular and cerebrovascular events, popularization of basic public health service, workplace intervention programs, construction of demonstration units and mortality surveillance; oral hygiene and tumor registration. Contents including oral hygiene, tumor registration, intervention on high-risk groups, identification of high-risk population, reporting system on cardiovascular and cerebrovascular events, popularization of basic public health service, workplace intervention programs, construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area. Conclusions: Western regions, especially in some remote provinces had the poorest performance during the construction of National Demonstration Area. Programs regarding chronic disease surveillance, identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on, during the next term of review, in these areas.

Reconstructing the Temporal Progression of Biological Data Using Cluster Spanning Trees.

Identifying the temporal progression of a set of biological samples is crucial for comprehending the dynamics of the underlying molecular interactions. It is often also a basic step in data denoising and synchronization. Finally, identifying the progression order is crucial for problems like cell lineage identification, disease progression, tumor classification, and epidemiology and thus impacts the spectrum of disciplines spanning basic biology, drug discovery, and public health. Current methods that attempt solving this problem, face difficulty when it is necessary to factor-in complex relationships within the data, such as grouping, partial ordering or bifurcating or multifurcating progressions. We propose the notion of cluster spanning trees (CST) that can model both linear as well as the aforementioned complex progression relationships in temporally evolving data. Through a number of experimental investigations involving synthetic data sets as well as data sets from the cell cycle, cellular differentiation, phenotypic screening, and genetic variation, we show that the proposed CST approach outperforms existing methods in reconstructing the temporal progression of the data.

Assessment of Impact and Recovery Needs in Communities Affected by the Elk River Chemical Spill, West Virginia, April 2014.

In January 2014, 4-methylcyclohexanemethanol spilled into the Elk River near Charleston, West Virginia, contaminating the water supply for about 120 000 households. The West Virginia American Water Company (WVAWC) issued a "do not use" water order for 9 counties. After the order was lifted (10 days after the spill), the communities' use of public water systems, information sources, alternative sources of water, and perceived impact of the spill on households were unclear to public health officials. To assist in recovery efforts, the West Virginia Bureau for Public Health and the Centers for Disease Control and Prevention conducted a Community Assessment for Public Health Emergency Response (CASPER). We used the CASPER 2-stage cluster sampling design to select a representative sample of households to interview, and we conducted interviews in 171 households in April 2014. We used a weighted cluster analysis to generate population estimates in the sampling frame. Before the spill, 74.4% of households did not have a 3-day alternative water supply for each household member and pet. Although 83.6% of households obtained an alternative water source within 1 day of the "do not use" order, 37.4% of households reportedly used WVAWC water for any purpose. Nearly 3 months after the spill, 36.1% of households believed that their WVAWC water was safe, and 33.5% reported using their household water for drinking. CASPER results identified the need to focus on basic public health messaging and household preparedness efforts. Recommendations included (1) encouraging households to maintain a 3-day emergency water supply, (2) identifying additional alternative sources of water for future emergencies, and (3) increasing community education to address ongoing concerns about water.

Health Consequences of Typhoon Haiyan in the Eastern Visayas Region Using a Syndromic Surveillance Database.

Introduction: Typhoon Haiyan was the strongest storm recorded in Philippine history. Surveillance in Post Extreme Emergencies and Disasters (SPEED) was activated during the typhoon response. This study analyzes the health impact of different diseases during different timeframes post-disaster during Typhoon Haiyan in 2013 using a syndromic surveillance database.Methods: SPEED reports medical consultations based on 21 syndromes covering a range of conditions from three syndrome groups: communicable diseases, injuries, and non-communicable diseases (NCDs). We analyzed consultation rates for 150 days post-disaster by syndrome, syndrome group, time period, and health facility type for adults as well as for children under the age of five.Results: Communicable diseases had the highest consultation rates followed by similar rates for both injuries and NCDs. While communicable diseases were the predominant syndrome group for children, wounds and hypertension were common syndromes observed in adults. Village health centers had the most consultations amongst health facilities, but also showed the highest variability.Discussion: Children were more vulnerable to communicable diseases compared to adults. Community health centers showing consistently high consultation rates point out a need for their prioritization. The predominance of primary care conditions requires disaster managers to focus on basic health care and public health measures in community health centers that target the young, elderly and impoverished appropriate to the time period.

People trying to lose weight dislike calorie counting apps and want motivational support to help them achieve their goals

BackgroundTwo thirds of UK adults are overweight or obese and at increased risk of chronic conditions such as heart disease, diabetes and certain cancers. Basic public health support for weight loss comprises information about healthy eating and lifestyle, but internet and mobile applications (apps) create possibilities for providing long-term motivational support. AimsTo explore among people currently trying to lose weight, or maintaining weight loss, (i) problems, experiences and wishes in regards to weight management and weight loss support including e-health support; (ii) reactions to Functional Imagery Training (FIT) as a possible intervention. MethodSix focus groups (N=24 in total) were recruited from a public pool of people who had expressed an interest in helping with research. The topics considered were barriers to weight loss, desired support for weight loss and acceptability of FIT including the FIT app. The focus group discussions were transcribed and thematically analysed. ResultsAll groups spontaneously raised the issue of waning motivation and expressed the desire for motivational app support for losing weight and increasing physical activity. They disliked calorie counting apps and those that required lots of user input. All groups wanted behavioural elements such as setting and reviewing goals to be included, with the ability to personalise the app by adding picture reminders and choosing times for goal reminders. Participants were positive about FIT and FIT support materials. ConclusionThere is a mismatch between the help provided via public health information campaigns and commercially available weight-loss self-help (lifestyle information, self-monitoring), and the help that individuals actually desire (motivational and autonomous e-support), posing an opportunity to develop more effective electronic, theory-driven, motivational, self-help interventions.

Pakistan Journal of Medical Sciences: A bibliometric assessment 2001-2010

Objective:The aim of this study was to measure the growth of scientific research, authors’ productivity, affiliation with the institute and geographic locations published in the Pakistan Journal of Medical Sciences during the period of 2001 – 2010.Methods:This numerical analysis was conducted during mid-August 2016 to mid-October, 2016. The data for the study was downloaded from websites of e-journal of Pakistan Journal of Medical Sciences (PJMS) and Pak Medi-Net Com.Results:A total number of 1199 articled were covered by PJMS in 10 volumes and 40 issues with contribution of 3798 (3%) authors during 2001 – 2010. The average number of papers per issue is 30%. A gender wise contribution of males was higher 3050 (80%) than the females 748 (20%). A majority of articles were multi-authored 1052 (87%) as opposed to single author contribution 147 (13%). All 1199 articles were covered under four major disciplines i.e Basic medical sciences, medicine & allied, surgery & allied and radiological sciences and 39 sub-specialties according to medical subject headings (MeSH). It observed that 467 (39%) articles were published in Pakistan and 732 (61%) articles produced by other 32 countries. The Karachi city of Pakistan has produced 199 (16%) articles as highest as its national level and followed by Tehran (Iran) 77 (6%) as followed internationally.Conclusion:This study reveals that the participation of 32 countries in the PJMS publications proves it to be an internationally circulated journal to support research with the constant approach of publishing articles to each volume in basic medical sciences, biomedical, clinical and public health sciences.Abbreviations:DOAJ: Directory of Open Access JournalsIMEMR: Index Medicus Eastern Mediterranean RegionHEC: Higher Education Commission (Pakistan)PJMS: Pakistan Journal of Medical SciencesMeSH: Medical Subject HeadingsPMDC: Pakistan Medical & Dental CouncilSCIE: Science Citation Index Expanded

Ten years of the WHO Framework Convention on Tobacco Control: progress in the Americas

The objective of this article is to analyze the progress made in the Americas in the implementation of the World Health Organization Framework Convention on Tobacco Control (FCTC) after its tenth anniversary of entry into force. At the time of the analysis, 30 of the 35 countries of the Americas are Parties to the FCTC. While progress has been made in implementing the measures contained in the FCTC, the level of implementation has not been homogeneous either across mandates or across countries. Forty percent of Parties to the Convention in the Americas are yet to implement any of the measures at their highest level of implementation according to the WHO classification. It is crucial that the countries of the Americas continue to progress towards the full implementation of the FCTC progressively. In these efforts, it is important to take into account that FCTC measures such as those related to smoke-free environments and adoption of effective health warnings are basic public health measures, which are almost entirely within the competence of health authorities and therefore susceptible to be implemented in a prompt fashion in all countries of the region.