Health-related Millennium Development Goals Research Articles

Progress towards health equity in Vietnam: evidence from nationwide official health statistics, 2010-2020

IntroductionOne of the ultimate goals of strengthening the health system is to achieve health equity. Vietnam is considered one of the ‘fast-track countries’ to achieve the health-related Millennium Development Goals,...

The Impact of COVID-19 Pandemic on Medical Education in a SubSaharan African Country (Kenya)

In 2019 the World was faced with a new infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), the corona virus disease 2019 (COVID-19). The disease was first reported in China in December 2019 and due to its rapid spread, the disease was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) on 30 January 2020 and a pandemic on 11 March 2020 [1]. However, by March 2023, the disease was no longer considered as a PHEIC by WHO, but an ongoing COVID-19 disease [1]. The COVID-19 pandemic and its current status as an on-going disease will affect medical education, healthcare and the achievement of the United Nations health-related Millennium Development Goals (MDGs), especially in the low and middle income countries (LMIC)

The female community health volunteers: unsung heroes

In the 1980s, Nepal commenced a programme of female community health volunteers (FCHVs), commonly known as “Mahila swoyemsewika”, which means “female volunteer”. Their roles were to support family planning in the early days, especially by distributing birth control pills and condoms. Gradually, their roles were extended to include other programmes. The volunteers are influential in achieving the health-related Millennium Development Goals and other targets. This programme has been the backbone of the health system in Nepal for the past three decades.

Interfacing Indigenous Knowledge Systems and Access to Healthcare in SADC through the Millennium Development Goals

There are eight health-related Millennium Development Goals (MDGs), the mandate of which is to ensure access to affordable healthcare for poor countries, especially in Africa. These MDGs were supposed to be reached by 2015, but six years have now passed with little success being realised. The cost of affordable medicines remains the main predicament for poor African countries. The focus of this paper is limited to the poor countries of the Southern African Development Community (SADC), a part of sub-Saharan Africa. I have previously written on other measures that have been employed to improve access to medicine, for example pooled procurement used by a number of SADC countries. Unfortunately the vast rural nature of SADC member states makes it prohibitively impossible to reach every citizen, let alone convince them of the usefulness of Western healthcare. A number of scholars have written about southern Africa’s riches in the area of Indigenous Knowledge Systems (IKS) that directly relate to healthcare. It is thus the objective of this paper to argue that both efforts of using IKS and the modern healthcare system can complement each other in the quest for the realisation of better healthcare and quality of life for the citizens of southern Africa. This paper starts with a motivation to indicate why IKS and access to healthcare are related. An analysis of the eight related MDGs follows as a way of measuring how far these have been realised post the anticipated date in 2015. In this analysis, it is critical to unearth how IKS can be used in the realisation of solutions to these shortcomings.

Millennium development goals (MDGs-2000-2015) to sustainable development goals (SDGs-2030): A chronological landscape of public sector health care segment of Pakistan.

To evaluate Pakistan's progress in the context of health-related Millennium Development Goals. The cross-sectional study was conducted from March 2016 to March 2017 at Quaid-i-Azam University Islamabad and National Institution of Health, assessed the chronological landscape of health conditions with temporal limit of 2000 to 2015 while measuring progress in 5, 10 and 15 years of Millennium Development Goals in the Public Sector Health Care Segment. Data was analysed using SPSS 21. No significant difference in infrastructure was observed during the 2000-2015 era of Millennium Development Goals (p>0.05) except in the number of dispensaries (p=0.001). There was a significant increase in workforce (p<0.05), but no significant difference was observed in health expenditure (p>0.05). Family planning sector was also without any significant change (p>0.05). There was no significant difference in most healthcare segments during 2000-2015 and Millennium Development Goals remained underachieved.

District level inequality in reproductive, maternal, neonatal and child health coverage in India

BackgroundAs India already missed maternal and child health related millennium development goals, the maternal and child health outcomes are a matter of concern to achieve sustainable development goals (SDGs). This study is focused to assess the gap in coverage and inequality of various reproductive, maternal, neonatal and child health (RMNCH) indicators in 640 districts of India, using data from most recent round of National Family Health Survey.MethodsA composite index named Coverage Gap Index (CGI) was calculated, as the weighted average of eight preventive maternal and child care interventions at different administrative levels. Bivariate and spatial analysis were used to understand the geographical diversity and spatial clustering in districts of India. A socio-economic development index (SDI) was also derived and used to assess the interlinkages between CGI and development. The ratio method was used to assess the socio-economic inequality in CGI and its component at the national level.ResultsThe average national CGI was 26.23% with the lowest in Kerala (10.48%) and highest in Nagaland (55.07%). Almost half of the Indian districts had CGI above the national average and mainly concentrated in high focus states and north-eastern part. From the geospatial analysis of CGI, 122 districts formed hotspots and 164 districts were in cold spot. The poorest households had 2.5 times higher CGI in comparison to the richest households and rural households have 1.5 times higher CGI as compared to urban households.ConclusionEvidence from the study suggests that many districts in India are lagging in terms of CGI and prioritize to achieve the desired level of maternal and child health outcomes. Efforts are needed to reduce the CGI among the poorest and rural resident which may curtail the inequality.

A Comparative Study of India and Brics Nations’ Public Health Care with A special reference to India’s Position

Public health care is an important public good in a modern society. At the domestic extent, it has been development in the commitment of the BRICS nations as Brazil, Russia, India, China and South Africa to rise up public health care financing. In the international level, it is observed by the global community progress on the three health-related Millennium Development Goals. In spite of successes in curbing infectious diseases and curtailing CMR and MMR, old risks continues and new challenges emerge, coming post the 2008 global financial meltdown, the present slower economic growth and increasing economic inequality. The BRICS nations see these obstacles and have started cooperation on public health delivery.

The role of Global Health Diplomacy in advancing the Sustainable Development Goals

Global Health Diplomacy has been instrumental in achieving many of the world’s global health goals, such as the Millennium Development Goals. The new Sustainable Development Goals are ambitious, and all tools need to be employed to make sure they are achieved by the 2030 deadline. This paper reviews the successes and failures of the health-related Millennium Development Goals. It uses the lessons learned to put forward a sustainable approach toward the Sustainable Development Goals, and explores the role of Global Health Diplomacy in advancing the health goals.

The Impact of Public Health Expenditure on Health Outcomes in South Africa.

Health holds an important position in maintaining economic development since it is both a prerequisite for and an outcome of economic development. This means that health contributes greatly to the attainment of sustainable development and health outcomes. The importance of health is demonstrated in the Millennium Development Goals (MDGs) where three of the eight goals are aimed at improving health outcomes. Despite progress made by other middle-income countries in achieving health-related MDGs, South Africa is still worse off in respect of health outcomes and experiences a challenge in attaining positive outcomes for these goals. This study’s main focus was to identify the association between public health expenditure and health outcomes in South Africa’s nine provinces from 2002 to 2016. The study implemented fixed effects and a random effects panel data estimation technique to control for time effects and individual provincial heterogeneity. This was followed by employing the Hausman specification test to identify the fixed effects model as the appropriate estimator for the study. The study also employed the seemingly unrelated regression (SUR) model and the least squares dummy variable (LSDV) model to examine the impact of public health expenditure on each province separately. The findings elucidated that the relationship between public health expenditure and health outcomes in South Africa varied across provinces depending on provincial management and infrastructure availability.

Exposure of HIV-exposed uninfected infants to antiretrovirals

As various national HIV/AIDS control programmes worldwide continue to adopt WHO's option B+ approach, 1 WHOAntiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach. World Health Organization, Geneva, Switzerland2010: 1-105 Google Scholar , 2 WHOProgamme update: use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. World Health Organization, Geneva:, SwitzerlandApril, 2012 Google Scholar we will continue to have a growing population of infants who have been exposed not only to in-utero HIV infection, but also to prolonged exposure to ante-partum and post-partum antiretroviral drugs, including around 6 weeks of infant prophylaxis with nevirapine combined with triple antiretroviral exposure through breastfeeding. 3 Schouten E Midiani M Makombe S et al. Prevention of mother-to-child transmission of HIV and the health related Millennium Development Goals: time for a public health approach. Lancet. 2011; 378: 282-284 Summary Full Text Full Text PDF PubMed Scopus (195) Google Scholar Most of these infants remain free from HIV infection, and are currently referred to as HIV-exposed and uninfected. There is growing evidence that mortality is higher for these infants than for those who are HIV-unexposed and uninfected. 4 Newell M Coovadia H Cortina-Borja M et al. Mortality of infected and uninfected infants born to HIV infected mothers in Africa: a pooled analysis. Lancet. 2004; 364: 1236-1243 Summary Full Text Full Text PDF PubMed Scopus (907) Google Scholar , 5 Kuhn L Sinkala M Semrau K et al. Elevations in mortality associated with weaning persist into the second year of life among uninfected children born to HIV-infected mothers. Clin Infect Dis. 2010; 50: 437-444 Crossref PubMed Scopus (80) Google Scholar Additionally, in this age of heightened awareness of the importance of early childhood development, one major concern for parents of HIV-exposed and uninfected infants and health-care workers taking care of the family is whether these children have normal neurological development. Are we saving HIV-exposed infants from HIV infection but leaving them with higher morbidity from exposure to the virus and perhaps also exposure to the antiretroviral drugs than unexposed infants? 6 Hutchins J Potterton J Developmental delay in HIV exposed infants in Harare, Zimbabwe. Vulnerable Child Youth Stud. 2013; 9: 43-55 Crossref Scopus (22) Google Scholar Neurodevelopmental effects of ante-partum and post-partum antiretroviral exposure in HIV-exposed and uninfected children versus HIV-unexposed and uninfected children in Uganda and Malawi: a prospective cohort studyMaternal triple antiretroviral exposure during both the ante-partum and post-partum phases did not result in greater developmental risks for the mothers' HIV-exposed and uninfected children through age 60 months, compared with children who were HIV-unexposed and uninfected. This might be because ante-partum triple antiretroviral protection of the health of mothers with HIV during pregnancy might be neuroprotective for the child, and when continued post partum, could enhance the quality of caregiving for the child through better clinical care for the mother. Full-Text PDF

India in Pursuit of Millennium Development Goals: Were the Targets Really Feasible?

In recent years, the Indian National Health Mission (NHM) was introduced by the Government of India as an umbrella of health programs to cover reproductive and child health, adolescent health, and selected disease control programs. These programs were given a mandate to accelerate the achievement of the health-related Millennium Development Goals (MDGs) by 2015. Considerable progress toward realizing the MDG objectives has been achieved, especially reductions in infant and child mortality and improvement in measles vaccination coverage (MDG Goal 4), as well as the reduction of maternal mortality and an increase in the number of births attended by skilled personnel (MDG Goal 5). Nevertheless, an overall appraisal of the status of the indicators in 2015 reveals that many of the targets remained to be achieved. The analytical issue explored here is whether the targets were too high to achieve or whether Indian health policies were flawed or too long delayed. This article offers a state-wise analysis of the achievements in health indicators relating to MDGs 4 and 5. The rate of achievement for two time periods, pre-NHM and NHM until 2015, is analyzed here. Our key finding is that most of the targets were indeed infeasible, but that lack of achievement could be attributed to delays in planning; sometimes poor execution of the policies and programs; and to the economic, social, and political disparities within the country. Better organized and more innovative approaches at the state level could improve the realization of vital MDG targets, providing improved public health for all.

The diffusion of pay for performance in health system reforms in sub-Saharan Africa and the depoliticization of health intervention

Since its commencement in Rwanda in 2006, the study ofperformance-based financing (PBF) in Africa has focusedresearch attention on its effects regarding improving thehealth care system or achieving health-related MillenniumDevelopment Goals (MDGs). Similarly, critics of PBF haveconcentrated more on its inability to transform structuralindicators of the health system positively and sustainably.So far, the scientific literature has not sufficiently exploredthe implications concerning the ideological and operationalmutations that the PBF is operating. This study investigatesthese aspects of PBF in conception and operationalization ofpublic health intervention. The concept of depoliticization ofpublic health action is proposed in this analysis to describe thecapacity of the PBF to redraw health policy from the realmof political and State intervention, and from the primacy ofpublic sector to field of market-based competition betweenGovernment sponsored and non-State actors.

Integrated health system strengthening can generate rapid population impacts that can be replicated: lessons from Rwanda to Madagascar

At the turn of the century, the Millennium Development Goals (MDGs) set targets to dramatically improve human welfare by 2015. These ambitious aims included reducing extreme poverty by 50%, under-5...

Use of post-graduate students' research in evidence informed health policies: a case study of Makerere University College of Health Sciences, Uganda

BackgroundWorld over, stakeholders are increasingly concerned about making research useful in public policy-making. However, there are hardly any reports linking production of research by students at institutions of higher learning to its application in society. We assessed whether and how post-graduate students’ research was used in evidence-informed health policies.MethodsThis is a multiple case study of master’s students’ dissertations at Makerere University College of Health Sciences (MakCHS) produced between 1996 and 2010. In a structured review, we applied a theoretical framework of ‘research use’ and used content analysis to map how research was used in public policy documents. We categorised content of these documents according to the health-related Millennium Development Goals (MDG). We defined a case of ‘use’ as citation of research products from a master’s student’s dissertation in a public policy-related document.ResultsWe found 22 cases of research use in policy-related documents (0.5%) out of a total 4230 citations from 16 of 1172 total dissertations (1.4%). Additionally, research was mostly cited in primary studies (95.4%), systematic reviews (3%), narrative reviews (0.8%) and cost-effectiveness analyses (0.2%). Research was predominantly used instrumentally, to either frame the problem (burden of disease or health condition) or select an intervention (treatment or diagnostic option) and rarely symbolically to justify strategies already selected. The bulk of the cases of research use addressed child health (MDG 4), focusing on infectious diseases (MDG 6), mainly in international clinical or public health guidelines, working papers, a consensus statement and a global report. We distilled ‘synergistic relationships’ among organisations or interest groups, ‘globalisation of local evidence’, ‘trade-offs’ in the use of research and use of ‘negative results’ from the documents and text content.ConclusionsResearch from dissertations of post-graduate students at MakCHS is used in evidence-informed health policies, particularly for infectious diseases in child health. Further, we have delineated pathways of research use in the global arena and highlighted the importance of ‘negative results’ from dissertations of post-graduate students at MakCHS.

Correlates of healthy life expectancy in low- and lower-middle-income countries

BackgroundHealthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country’s population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries.MethodsIn accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives.ResultsThe lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors.ConclusionTo increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Human Resources Quality and Organizational Support with Performance of Health Operation Aid Fund Manager

Health Operational Aid Fund (HOA) is an aid to accelerate the achievement of the health-related Millennium Development Goals 2015 through improvement of primary health care performance. This study aimed to analyze relationship between quality of human resources and organizational support with performance of HOA fund manager performance. This is an explanatory quantitative study using cross section survey approach. Total sampling technique had been used to determined 48 people as the samples. Univariate analysis showed that 91.7% respondents had good performances and as many as 8.3% respondents had poor performances. Bivariate analysis showed a significant association between facilities (0.049), incentives (0.049), consulting services (0.016) and HOA fund manager performance. Multivariate analysis demonstrated a positive and significant correlation (0.043) between consultancy services and performance of HOA fund manager performance. For quality improvement, it is suggested to coordinate the public health office should better coordinate its programs via consultancy service in Plan Of of Action verification. in the consultancy service.

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel.

BackgroundThe contributions that community–based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health–related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence.MethodsAn Expert Panel convened to guide the review of the effectiveness of community–based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review’s findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer–reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health).ResultsThe Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs – through engagement with planning, implementation (including the full use of community–level workers), and evaluation. CBPHC programs need to reach every community and household in order to achieve universal coverage of key evidence–based interventions that can be implemented in the community outside of health facilities and assure that those most in need are reached.ConclusionsStronger CBPHC programs that foster community engagement/empowerment with the implementation of evidence–based interventions will be essential for achieving universal coverage of health services by 2030 (as called for by the Sustainable Development Goals recently adopted by the United Nations), ending preventable child and maternal deaths by 2030 (as called for by the World Health Organization, UNICEF, and many countries around the world), and eventually achieving Health for All as envisioned at the International Conference on Primary Health Care in 1978. Stronger CBPHC programs can also create entry points and synergies for expanding the coverage of family planning services as well as for accelerating progress in the detection and treatment of HIV/AIDS, tuberculosis, malaria, hypertension, and other chronic diseases. Continued strengthening of CBPHC programs based on rigorous ongoing operations research and evaluation will be required, and this evidence will be needed to guide national and international policies and programs.

The Case Study of Gestational Diabetes Mellitus (GDM) Underwent Elective Lower Segment Caesarean Section

This case study is written for Family Health Practitioners and Nurse Case managers. To add, reflective critical analysis, frameworks, exploration of advanced role of case manager, ethical and professional issues which contribute enhancing the health and care needs, reflection on roles and responsibilities in relation to interdisciplinary teams is discussed in the report. It is to revitalize health systems in under-developed countries based on the tenets of the Alma Ata Declaration of Health Care, presented by the World Health Organization remains essential for attaining the maternal and child health related Millennium Development Goals (MGDs). Ehiri [1] informed that MGDs have a target date of 2015 and synthesize many of the commitments made in achieving that target.

Leveraging on Cloud Technology for Reporting Maternal and Child Health Services at the Community Level in Ghana

Background and Purpose: The millennium development goals (MDG) have served as a catalyst in galvanizing governments and ministries to refocus their development agenda to meet set MDG targets. Similarly the Ghana Health Service (GHS) recognizes the importance of an efficient health information system (HIS) for generating quality data for monitoring progress towards achieving set targets of the health related MDGs 4, 5 and 6. This paper is therefore about the GHS effort in using electronic health record system called the e-Tracker to support the provision and reporting of primary healthcare in the area of maternal and child health services at the community level. Methods: The research approach was case study of selected facilities in one pilot district. Empirical data was collected using qualitative methods such as participant observations, interviews and supplemented by secondary data sources such as training manuals and other official documents. Philosophically the research was informed by interpretive paradigm through subjective meaning for understanding the sociotechnical complexities of implementing the e-Tracker in the health domain. Actor-Network theory (ANT) was considered as an appropriate theoretical lens to conceptualize and investigate the dynamics of introducing a technological artefact into a social system such as the health domain. Results: Findings were that there was realignment of work practices with resultant reflexive effects (positive and negative) on the working environment as a result of introducing information technology artefact into the health domain. And that the sociotechnical effects are emergent and cannot be determined a priori because of the multiplicities in complexity when the social reacts with the technical. Conclusions: These findings corroborates findings in similar studies in the IS literature in that effects of technological artefacts in complex social-technical system are emergent and cannot be predetermined due to their unpredictability. Furthermore in sociotechnical systems such as the health domain best practice is for the coexistence of electronic and paper systems. Therefore an attempt to completely replace the paper system with the electronic may result in system challenges. Keywords: e-Tracker, Electronic Health Record, Maternal and Child Health

Burden of Misconception in Sexual Health Care Setting: A Cross-Sectional Investigation among the Patients Attending a Psychiatric Sex Clinic of Bangladesh.

Background Bangladesh is a country in South Asia with about 160 million people and achieved health related Millennium Development Goals (MDG) significantly. But sexual health is still an untapped issue with predominant myths and misconception. Objective We aimed to look into the proportions of patients attending sexual health care services due to misconceptions. Methods The descriptive, cross-sectional study was conducted among 110 patients attending Psychiatric Sex Clinic (PSC) of Bangabandhu Sheikh Mujib Medical University. Respondents were included in the study with convenient sampling from November 2016 to March 2017. Data were collected through face-to-face interview with semistructured preformed, pretested questionnaire and analyzed by SPSS software 16.0 version. Results Most of the patients (93%) were male, 60% were married, 62% were urban habitant, 42% were under grade 10, and 33% were service holder. Total 55% of the patients had misconceptions and 29% visited only for misconception; 14% had Premature Ejaculation; and 12% had desire disorder. 32% of the patients had psychiatric disorders and among them depression was most common, 13%. Conclusion Positive openness in sexual health and appropriate strategy should be taken to improve the quality of sexual life as well as reduce the misconception in the people of Bangladesh.