Intersectoral Coordination Research Articles

The Importance of Implementing Sustainable Practices in Municipalities of the Araguaia River Valley, Mato Grosso, Brazil

Objective: The present work aims to identify and analyze strategies for implementing the Sustainable Development Goals (SDGs) in municipalities in Vale do Araguaia in the state of Mato Grosso - Brazil, as well as their benefits and challenges, providing recommendations for promoting sustainable development at the local level. Theoretical Framework: The text addresses essential strategies for implementing sustainable practices in local communities, such as solid waste management, conservation of water resources, use of renewable energy and promotion of sustainable agriculture. Highlights include recycling and composting to reduce waste, water reuse systems and renewable energy, such as solar, for energy self-sufficiency. Sustainable agriculture strengthens the local economy, while conscious consumption is encouraged by educational campaigns. Community participation and government support are crucial for balancing economic development, social justice and environmental preservation. Method: This comparative case study analyzed the implementation of the Sustainable Development Goals (SDGs) in 25 municipalities in Mato Grosso, in the Araguaia river basin. Different municipal strategies and contexts were examined, using data from public sources such as the Water and Sanitation Institute and the Sustainable Cities Development Index – Brazil (IDSC-BR). The analysis was organized in a table and the average of the results made it possible to evaluate the level of sustainable development of each city. Results and Discussion: The research points out that, although the implementation of sustainable practices in municipalities is essential to achieve the Sustainable Development Goals (SDGs), the results are still below expectations. Only three municipalities achieved average rates, and none achieved satisfactory results. This reveals structural challenges, such as a lack of adequate public policies and budget limitations. The research highlights the need for greater coordination between government spheres, the private sector and civil society, in addition to more concrete and inclusive planning to promote sustainable development. Research Implications: The practical implications of this study suggest the need for greater integration between government spheres and the private sector to optimize the implementation of the SDGs in municipalities, highlighting the importance of effective public policies and investments in priority areas. Theoretically, the study offers insights into the structural challenges faced by cities, contributing to the debate on sustainable urban management and the development of policy models that can accelerate the achievement of global sustainability goals. Originality/Value: The originality of the study lies in its detailed analysis of the implementation of the SDGs in municipalities, revealing the specific structural challenges that limit their progress. The value lies in providing a practical overview of the gaps in public policies and local management, in addition to highlighting the need for greater intersectoral coordination to achieve sustainable development, offering valuable guidelines for future urban planning and sustainability policies.

Maternal and newborn health prioritization in Yobe State, Nigeria: analysis of stakeholders' perspective.

Maternal and newborn mortality and morbidity in conflict-affected northeastern areas of Nigeria, such as Yobe State, are disproportionately higher than those in the rest of the country. There is limited evidence on the factors that influence maternal and newborn health (MNH) policymaking and implementation in this region, particularly with respect to the impact of conflict and context-specific issues. This study explores the political, economic and health system factors that drive the prioritization of MNH policies in Yobe State. The aim of this study was to elucidate the conflict-related factors influencing MNH outcomes, which could inform targeted interventions to improve MNH. The study is a descriptive case study that relies on multiple data sources and is guided by the Health Policy Analysis Triangle. We reviewed national and subnational research, technical reports and policies related to reproductive health and the MNH in Nigeria since 2010. Following stakeholder mapping, we identified and invited prospective participants in the MNH policymaking space. Nineteen stakeholders from the government, civil society and nongovernmental organizations, donor agencies, and public and private sector health providers in Yobe State participated in the semistructured in-depth interviews. Data were collected from November 2022 through January 2023 and were thematically analysed via Dedoose software. MNH services in Yobe State have received considerable attention through initiatives such as the National Midwifery Service Scheme, free MNH services, training of midwives with deployment to rural areas, and health facility renovations. The effective implementation of MNH services and policies faces challenges due to insufficient funding, and sustainability is hampered by changes in governance and political transitions. The Boko Haram insurgency exacerbated the humanitarian crisis in Yobe State and disrupted MNH services due to the displacement of populations and the decline in the number of health workers. Additionally, sociocultural and religious beliefs hinder timely access to and utilization of MNH services. Although policies and guidelines for MNH services exist in the state, they are inadequately disseminated to health providers, which affects their effective implementation across facilities. Collaboration and intersectoral coordination platforms exist, but competition and rivalries among unions, political entities, and implementing agencies sometimes impede progress. Enhancing MNH services in Yobe state requires increased commitment for funding through the Northeast Development Commission rehabilitation fund; strengthening the health workforce, safety and retention plan; promoting gender inclusivity within the health sector; and addressing sociocultural barriers to women's health-seeking behaviors. Concrete, time-bound plans for policy dissemination are necessary to ensure effective service implementation.

Assessing the Alignment and Implementation Challenges of the Sustainable Development Goals (SDGS) 2030 in Morocco: A Relevant Inquiry

Morocco, a North African nation known for its rich cultural heritage and diverse landscapes, has been actively pursuing the Sustainable Development Goals (SDGs) as a framework to guide its development efforts1. The country has made significant progress in aligning its national development strategies with the SDGs, particularly prioritizing goals such as quality education2, clean water and sanitation, and clean energy3. This paper aims to evaluate the effectiveness of SDGs implementation in Morocco, highlighting achievements, challenges, and future prospects. (Smith, 2020). The SDGs, adopted by the United Nations in 20154, represent a global commitment to address pressing challenges including poverty, inequality, climate change, environmental degradation, peace, and justice. This review provides an analysis of the SDGs' effectiveness in driving positive change across various dimensions5. By examining academic literature, reports, it evaluates progress towards achieving the SDGs, identifies key implementation challenges, and assesses potential for successful realization. The article explores how effectively Morocco aligns its policies and addresses implementation challenges to achieve the SDGs by 20306, considering factors such as cultural diversity, economic structures, and geographic disparities. The integration of the SDGs into Morocco's development agenda presents both challenges and opportunities. By addressing issues like adaptation, inter-sectoral coordination, data availability, climate resilience, and policy integration, Morocco seeks to overcome these challenges. Understanding these obstacles and their solutions is crucial for assessing the relevance and effectiveness of SDGs' implementation, ultimately contributing to Morocco's sustainable development journey by 2030.

Los instrumentos integradores en los sistemas de cuidados en América Latina: una visión de política pública

Some Latin American governments have developed systems that seek to comprehensively guarantee the right to provide and receive care. These initiatives aim to recognize, redistribute, or reduce caregiving work within households by coordinating a set of policies, implemented by different agencies, around the same individual. Achieving this requires overcoming the challenge of intersectoral coordination, based on management instruments that allow interventions to be articulated around the diverse care needs of the population. Based on the policy integration literature, we conduct a comparative analysis of four emblematic care systems in the region using official data and semi structured interviews. In contrast to recent research that analyzes programs, services, and target populations, we focus on how systems manage to operate in a coordinated manner. We argue that building care systems requires the construction of instruments that ensure the integrated operation of the system around a person or territory. We examine how the deployment of specific decisions to guide the operation of care systems address a key contemporary challenge in public policy and administration: the coordinated operation of policy sectors around complex problems and the construction of comprehensive responses to multidimensional challenges.

Introduction to the Transformative Potential of the Internet of Things (IoT) in East Africa

The internet of things (IoT) has emerged as a global transformational force, connecting physical devices and transmitting data remotely over the internet. In East Africa, this shift has the potential to bring socio-economic development by solving local challenges. The region-specific topics are mentioned here. Various diverse economies and cultures within the region have already started to use IoT in agriculture, healthcare, transportation, and utilities. This abstract primarily focuses on presenting the key concepts, challenges, and opportunities associated with IoT networking in East Africa. The author highlights the potential of IoT in addressing social issues and promoting sustainable growth. The study examines the networking aspects of IoT, the social and economic factors that influence its adoption, state policies, financial incentives, and the role of public-private partnerships. This study likely takes into account network infrastructure, which includes broadband connectivity and emerging buzzwords such as LoRaWAN and NB-IoT, and also discusses the obstacles associated with these technologies. This study investigates emerging buzzwords such as LoRaWAN and NB-IoT, as well as the challenges associated with these technologies. This study unveils the role of IoT in East Africa, highlighting its usefulness in sectors such as agriculture, healthcare, transport, and utilities. It highlights its role in combating various issues, enhancing productivity, and promoting inclusivity. It addresses various issues and contributes to boosting access, productivity, and inclusive growth. We utilised relevant published data (2004–2014) from diverse, reliable databases. Therefore, policymakers must emphasise the need for broad IoT policies, investment in digital infrastructure, and inter-sectoral coordination to fully leverage the IoT opportunities for the sustainable development of East Africa. Keywords: Internet of Things (IoT), East Africa, socio-economic development, networking infrastructure, transformative potential.

Rabies control in Ghana: Stakeholders interventions, challenges and opportunities.

Rabies remains a significant public health issue in Ghana, predominantly affecting rural communities with limited access to health care and veterinary services. The disease is primarily transmitted through bites from infected domestic dogs and leads to many deaths worldwide each year. Despite various interventions, Ghana continues to struggle with rabies control and prevention. This narrative paper focuses on rabies control in Ghana, examining stakeholders' interventions, challenges faced, and opportunities available. The paper reviews existing rabies control measures in Ghana, including dog vaccination efforts and One Health strategies. It also discusses the limitations of these interventions, such as minimal vaccination coverage, weak surveillance, and inadequate intersectoral coordination. Ghana has implemented dog vaccination campaigns, but coverage remains minimal. Additionally, weak disease surveillance, cultural perceptions, and inadequate coordination across sectors have hampered the country's ability to control rabies effectively. Adopting One Health principles, which integrate human, animal, and environmental health efforts, is emphasized as a critical strategy to eliminate rabies in Ghana by 2030. By addressing these challenges and leveraging available opportunities, Ghana can strengthen its rabies control programs and work toward a rabies-free future.

Connecting internal and external dynamics in European intersectoral policy coordination – the case of education and employment

ABSTRACT Intersectoral policy coordination has garnered considerable attention in the study of the European Commission (EC) over the past few decades. Within the EC, a logic of hierarchy and a logic of policy portfolios coexist, often leading to a conflictual and complex relationship. While the literature has extensively explored the internal dynamics of the EC, there has been less focus on the role of external dynamics in influencing intersectoral policy coordination. This paper addresses this gap by examining the case of European policy coordination in education and employment and how both internal and external dynamics can hinder or facilitate policy coordination within the EC. Based on the analysis of interviews with EC actors and various EU policy documents, the paper discusses how these internal and external dynamics have affected policy coordination, highlighting elements of both positive and negative coordination.

Comprehensive care for childhood obesity in Brazilian municipalities.

To understand the potential and limits of care for childhood obesity from the perspective of comprehensiveness, in the context of Primary Health Care, in Brazilian municipalities. A qualitative approach was adopted, with an electronic form of a dissertative nature being applied in 11 municipalities in the five Brazilian regions, derived from the four axes of comprehensiveness defined by Ayres (needs, purposes, articulations, and interactions). Among the strengths for comprehensive care, the following were observed: the provision of services at different levels of care; the relevance of intersectoral programs in the development of actions aimed at the multidimensionality of childhood obesity; the implementation of strategies for systematizing care and tools that encourage the expansion of dialogue and humanization; and intersectoral coordination to create appropriate responses to the expanded needs of children and their families. Limitations include: the centralization of actions in nutrition professionals and in the care sphere; the failure to prioritize childhood obesity in health agendas; and the lack of trained professionals to deal with the complexity of obesity. The findings suggest that child obesity care practices, in order to be transformative, need to be understood in the context of comprehensiveness. And this includes (re)thinking public policies, professional practices, and the organization of work processes so that they are, in fact, more inclusive, participatory, dialogical, humanized, supportive, fair, and, therefore, effective.

Project Vayoraksha: Implementation of novel mHealth technology for healthcare delivery during COVID-19 in geriatric population of Kerala.

Background & objectives mHealth technologies, with their potential in improving public health, have recently gained considerable interest in India, offering an opportunity to deliver tailored and low cost interventions to the selected populations, especially in resource-poor settings. Project Vayoraksha aimed at developing and pilot testing mHealth technology-assisted strategies (Vayoraksha mobile application and field Vayoraksha network) to improve healthcare delivery and reverse quarantine at the field level among the geriatric population. Methods This field operational research study was implemented in Pathanamthitta, Kerala, from October 2020 to July 2021. The Vayoraksha mobile phone application for the geriatric users and a web interface used by healthcare workers involved in the field Vayoraksha network was developed with multisectoral expertise. Vayoraksha had facilities for symptom surveillance, teleconsultation and assessment of needs and included a community-based system to monitor and meet their needs that can help in reverse quarantine of the geriatric population. Results The project was implemented using the field Vayoraksha campaign involving frontline health workers and community volunteers. A baseline survey of 4782 geriatric population in the study area was conducted in Phase I, and 2383 (49.8%) had access to a smartphone facility to use Vayoraksha. Of these, 1257 (52.7%) were covered under the 'field Vayoraksha campaign' using intersectoral coordination and community participation. A total of 750 (59.6%) geriatric individuals downloaded the application of whom, 452 (60.3%) used the services of Vayoraksha. Needs were registered by 56 (12.3%) individuals of which 46 (82.1%) were medical needs related to the management of chronic diseases. More than 70 per cent of the needs were met through the Vayoraksha field network under the local primary health centre. More than 80 per cent of the geriatric individuals reported symptoms related to COVID-19 during the intervention period. Compliance with quarantine was observed in 77.7 per cent of the geriatric populations. Among those who used Vayoraksha, 26 (5.7%) availed tele-counselling services, and 3 (0.6%) used teleconsultation facilities. It was observed that Vayoraksha users had a higher proportion of the geriatric population who were young, educated, having chronic morbidity and living with family. Regular symptom surveillance was done within this group; only 12 (2.6%) of them tested positive for COVID-19 during this study. Interpretation & conclusions Results of this pilot study are promising, with 60 per cent of the geriatric population downloading and using Vayoraksha within a short time. Technology-assisted interventions can supplement the existing system for improved healthcare delivery among the vulnerable groups and have good potential for scale-up in the near future in developing countries.

Governance of the wildlife trade and the prevention of emerging zoonoses: a mixed methods network analysis of transnational organisations, silos, and power dynamics

IntroductionThe wildlife trade is an important arena for intervention in the prevention of emerging zoonoses, and leading organisations have advocated for more collaborative, multi-sectoral approaches to governance in this area. The aim of this study is to characterise the structure and function of the network of transnational organisations that interact around the governance of wildlife trade for the prevention of emerging zoonoses, and to assess these network characteristics in terms of how they might support or undermine progress on these issues.MethodsThis study used a mixed methods social network analysis of transnational organisations. Data were collected between May 2021 and September 2022. Participants were representatives of transnational organisations involved in the governance of wildlife trade and the prevention of emerging zoonoses. An initial seed sample of participants was purposively recruited through professional networks, and snowball sampling was used to identify additional participants. Quantitative data were collected through an online network survey. Measures of centrality (degree, closeness, and betweenness) were calculated and the network’s largest clique was identified and characterised. To understand the extent to which organisations were connected across sectors, homophily by sector was assessed using exponential random graph modelling. Qualitative data were collected through semi-structured interviews. The findings from the quantitative analysis informed the focus of the qualitative analysis. Qualitative data were explored using thematic analysis.ResultsThirty-seven participants completed the network survey and 17 key informants participated in semi-structured interviews. A total of 69 organisations were identified as belonging to this network. Organisations spanned the animal, human, and environmental health sectors, among others including trade, food and agriculture, and crime. Organisation types included inter-governmental organisations, non-governmental organisations, treaty secretariats, research institutions, and network organisations. Participants emphasised the highly inter-sectoral nature of this topic and the importance of inter-sectoral work, and connections were present across existing sectors. However, there were many barriers to effective interaction, particularly conflicting goals and agendas. Power dynamics also shaped relationships between actors, with the human health sector seen as better resourced and more influential, despite having historically lower engagement than the environmental and animal health sectors around the wildlife trade and its role in emerging zoonoses.ConclusionThe network of transnational organisations focused on the governance of wildlife trade and the prevention of emerging zoonoses is highly multi-sectoral, but despite progress catalysed by the COVID-19 pandemic, barriers still exist for inter-sectoral interaction and coordination. A One Health approach to governance at this level, which has gained traction throughout the COVID-19 pandemic, was shared as a promising mechanism to support a balancing of roles and agendas in this space. However, this must involve agreement around equity, priorities, and clear goal setting to support effective action.

Rethinking organizational culture in intersectoral coordination: the perspective of boundary work

PurposeThe purpose of this paper is to rethink the concept of organizational culture as something that emerges bottom-up by using the sociological concepts of boundary object and boundary work as an analytical lens and to show how this approach can help understand and facilitate intersectoral coordination.Design/methodology/approachWe used observations and qualitative interviews to develop “deep” knowledge about processes of intersectoral coordination. The study draws on a conceptual framework of “boundary work” and “boundary objects” to show how a bottom-up perspective on organizational culture can produce better understanding of and pave the way for intersectoral coordination. We use a case of health professionals engaged in two Danish intersectoral programs developing and providing health promotion services for women with gestational diabetes mellitus (GDM).FindingsThe study showed how boundary work revolves around negotiations on how to define, understand and act on the diagnosis of GDM. This diagnosis has the characteristics of a “boundary object”, being more loosely structured in general terms, but strongly structured in local settings. Boundary objects help connect different professionals and facilitate coordination. The analysis showed how the introduction of time and the concept of “lifelong health promotion” helped to transgress existing organizational and professional boundaries.Research limitations/implicationsThe findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination and collaboration. While the theoretical implications will be general applicable when studying organizational culture, the implications for practice are sensitive to context and the processes we have described as the outcomes of boundary work are generated from cases that were most likely to provide deep insight into our research topic.Practical implicationsFor practice this can build bridges between organizational and professional boundaries.Originality/valueThe findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination. This may build bridges between organizational and professional boundaries in practice settings.

EXPLORING STAKEHOLDERS' PSYCHOSOCIAL PERSPECTIVES IN ADDRESSING MENTAL HEALTH ISSUES WITHIN THE LOCAL COMMUNITY: A CASE STUDY IN MATARAM, WEST NUSA TENGGARA

Abstract: This article presented a case study conducted in Mataram, West Nusa Tenggara, Indonesia, to explore stakeholders' psychosocial perspectives in addressing mental health issues within the local community. The study adopts a qualitative research approach, utilizing in-depth interviews, observation, and documentation as data collection methods. Purposive sampling was employed to select participants from the Health Department, Public Health Centers (Puskesmas), and the Social Department of Mataram, representing different stakeholders involved in psychosocial support roles. The data is analyzed descriptively using ATLAS.ti, a qualitative data analysis software. The findings highlight stakeholders' perspectives on their roles as psychosocial supporters, categorized into three prevention efforts: primary, secondary, and tertiary. Primary prevention involves coordination, disability assistance, information provision, and program management. Secondary prevention focuses on screening and assessment, providing recommendations, delivering care, supporting recovery, and patient evacuation. Tertiary prevention emphasizes family education on the recovery process and preventing relapse. The study underscores the importance of intersectoral coordination, collaboration, and a multi-sectoral approach to addressing mental health issues. This research contributes to understanding stakeholders' perspectives and experiences related to psychosocial support for mental health within the local community. The findings can inform the development of effective strategies and interventions to enhance mental health services and support systems in similar contexts. Keywords: Stakeholder; Psychosocial; Mental Health Issue

SCOT analysis of implementing One Health Approach from the stakeholders’ perspective in Puducherry, South India

BackgroundThe implementation of the One Health (OH) approach improves the prevention and control of zoonotic diseases and ensures a better understanding of the emergence of infectious diseases. ObjectiveThis study aimed to identify the key stakeholders’ knowledge of the One Health concept and assess attitudes toward the need for collaboration and explore the viewpoints of stakeholders regarding One Health Collaboration. MethodsIt is an explanatory mixed-method study conducted in the Puducherry district, South India. The study involved quantitative data collection among 70 stakeholders from various departments using quota sampling. Followed by qualitative data exploration of the viewpoints of stakeholders on One Health Collaboration through key informant interviews among 10 key stakeholders selected using purposive sampling. Knowledge of the stakeholders on One Health was assessed by using a self-administered semi-structured questionnaire. Knowledge and attitudes were summarized as frequency and percentage. A manual content analysis of the transcripts of the interviews was done. ResultA total of 70 (Male-55.7 % & female-44.3 %) stakeholders were included in the study. 57.1 % of the stakeholders heard about One Health and the rest did not know. A few numbers of stakeholders (18.8 %) were aware of the formal connection between various departments. 86%of stakeholders suggested that intersectoral coordination is very much needed at the grass root level. The interviews found that a lack of standard guidelines, weak political commitment, poor departmental coordination, and a lack of community awareness were the most frequent challenges encountered. ConclusionThe operationalization of OH could be enhanced by providing standard guidelines and ensuring the coordination between the stakeholders.

IJCM_247A: Perception of Medical Students on Family Adoption Programme; A Study conducted in a Medical College of Odisha.

Background: Community engagement in medical education gives the students an insight into the living conditions of the public and how they influence their health. Community Medicine department accomplish this through field practice and family health studies. The Family Adoption Programme (FAP), newly mandated for all medical undergraduate students, brings its own set of challenges and opportunities. Family Adoption Programme aims to provide an experiential learning opportunity to Indian medical graduates towards community-based health care and thereby equity in health Objectives: 1. To study the perceptions of Phase I MBBS Students on Family Adoption Program. 2. To determine the output of FAP implementation in MBBS curriculum. Methodology: A Cross-sectional study was conducted between August to November 2023 including 1st year MBBS students of MKCG Medical College, Berhampur, Odisha. A brief orientation was conducted by Dept. of Community Medicine on needs and competencies of FAP as recommended by the National Medical Commission(NMC). Students were sensitized to the FAP proforma prepared by the department. Periodic FAP visits for students in 4 groups was planned & conducted along with their assigned mentors at the selected nearby village. During these visits, students interacted with the families and details regarding health profile of the family were documented. Students perception & feedback was taken by Questionnaire using Google Form. A total 250 students were enrolled in FAP and 172 submitted their feedback. Data was analyzed using appropriate statistical tests and software. Results: The study included 172 1st year MBBS students with age range of 18-26 years & mean age of 20.58± 1.315 years. Among them, 66.9% were males & 33.1% were females.66.9% of students responded that FAP was a very good experience.55.2% of study participants were satisfied with their adopted family. Most of the students were interested to be a part of such activity throughout the professional years. Conclusion: Implementation of FAP requires meticulous planning, intersectoral co-ordination, good sensitization and training activities

Strengths and weaknesses of food eco-labeling: a review.

Food labeling is increasingly expanding and adding more information to the food package. There is strong evidence about nutrition labeling effectiveness in driving food choice, especially if displayed in the front of package (FoP). Despite the growing attention to nutrition and sustainable diets, few countries have implemented sustainable labels or eco-labels that could address economic, social and/or environmental concerns. Implementing new techniques of eco-labeling emerges as a consumer-focused solution. However, evidence of the effectiveness of eco-labeling in driving consumers' choices is heterogeneous and not univocal. Thus, this review aims to summarize the evidence about the effectiveness of FoP eco-labeling in driving food choice and provide a reference framework of the eco-labeling initiatives relative to food package labeling. This narrative review addresses both the potential benefits as well as the main concerns that arise from the use of eco-labels. Although eco-labeling seems to provide a series of sustainability benefits for producers and consumers, the implementation of such policies should take into consideration potential trade-offs and inter-sectorial coordination to obtain bigger impacts, assuming that a policy itself cannot transform the whole food system. Eco-labeling could be encouraged and implemented within a set of policies shaping sustainable food systems.

Climate Change Mitigation in Agriculture beyond 2030: Options for Carbon Pricing and Carbon Border Adjustment Mechanisms

SummaryIn the EU's climate policy, agriculture is covered as an Effort‐Sharing (ESR) sector, i.e. a sector beyond the Emission Trading System and LULUCF. Despite ambitious climate targets for the ESR sectors and an emerging focus on the need for agriculture to make a substantial contribution to climate change mitigation, agriculture has contributed much less to achieving climate targets than other ESR sectors in most EU Member States. A more radical mitigation instrument is required since the potential to increase climate efficiency in EU agriculture is limited. Carbon pricing is considered an effective instrument and is widely adopted in other sectors worldwide. Options on how to reduce related carbon leakage are discussed. Our recommendations for efficient climate change mitigation policy in agriculture are threefold. First, the agricultural sector needs more precise guidance and clear climate targets. Second, although preventing all conflicts between climate change mitigation actions and other policy goals is impossible and inefficient, a policy could minimise adverse effects. Third, since agricultural GHG emissions can only be minimised and compensated by negative emissions in other sectors, well‐defined intersectoral coordination is required.

Enablers and barriers to rotavirus vaccine coverage in Assam, India- A qualitative study

BackgroundEstimates suggest that 78,000 children died due to rotavirus gastroenteritis annually between 2011 and 2013 in India. The north eastern state of Assam reported 38.4% pediatric diarrheal admissions testing positive for rotavirus. Rotavirus vaccine (RVV) was introduced in Assam in 2017 following which the National Family Health Survey-5 (NFHS-5) (2019) revealed low RVV coverage in Assam with wide variation between the districts. the current study was conceptualized and undertaken to capture the enablers and barriers to RVV coverage in Assam. MethodsQualitative study conducted in 5 randomly selected districts in Assam. Participants (key informants) were recruited by purposive sampling at each level of the health system including healthcare officials, service providers and caregivers based on availability. Thirty-five in-depth interviews (IDIs) and five focus group discussions (FGDs) were conducted. Interviews were tape recorded and transcribed. Data was coded and analyzed using the thematic framework approach. ResultsFindings from the qualitative data collection were collated and analyzed under 7 identified themes. Difficult terrain, limited service provider availability and no catch-up training for new recruits were some of the barriers to RVV coverage. In contrast, Information, Education & Communication (IEC) in vernacular language, RVV safety profile, development partner support and adequate RVV supply were identified as some of the enablers of RVV coverage. ConclusionFew broad recommendations to overcome identified barriers include comprehensive inter-sectoral coordination, regular monitoring and frequent refresher training sessions. There is a need for a future study utilizing existing coverage data and larger sample size to triangulate the findings of this study.

Donors’ Participation the Health System: A Double-Edged Sword

The presence of donors in health system, despite its positive results, can also have weaknesses that sometimes act as a double-edged sword in achieving health priorities. In some cases, the needs are considered by donors as unnecessarily the real ones in health system. On the other hand; sometimes, benevolent actions are involved in political intentions and pressures.
 In order to eliminate deficiencies, it is necessary to comply with standards, priorities, and real needs of health system in any field. What helps this alignment and action towards goals is using the capacity of scientific evidence. With the help of scientific evidence, the real needs of health sector can be identified and prioritized, and the capacity of donors can be used to meet those needs. Moreover, reforming and re-engineering the processes of benefactors' activities in the field of health, directing benefactors' aid, developing rules and standards, and creating transparency in costs for inter-sectoral coordination are solutions that will help to improve the conditions about this issue.

Knowledge, awareness and perception about equine glanders among veterinarians and medical professionals in India.

Glanders is a highly infectious and notifiable disease of equines that occurs due to Burkholderia mallei. In India, glanders re-emerged in 2006 and thereafter regular outbreaks have been reported in various states (n = 14). Frequent and prolonged contact with equids with glanders may transmit B. mallei infection to humans. This study was designed to learn more about the Knowledge, Awareness and Perception (KAP) of veterinarians, para veterinarians, and physicians about equine glanders, which will help in enhancing the nation-wide glanders eradication programme. A total of 165 respondent's from 11 Indian states and one union territory were surveyed. Most of the respondents (n = 160) were from equine glanders affected or endemic states. Knowledge gap analysis revealed that 40.3 and 22% of the participants were not aware of government regulations and the transmission of glanders, respectively. These are major concerns given the wide spread occurrence of disease in the country. Awareness test on glanders revealed that 65(39.4%) participants would collect biological samples for laboratory confirmation, 67(40.6%) would inform the concerned authorities and 106 (64.2%) replied that they would eliminate the glanders infected equines. Analysis of perception towards equine glanders showed that majority of the participants (n = 113, 68.4%) observed that equine keepers were reluctant to disclose the clinical symptoms of B. mallei infection. Furthermore, non-co-operation and unwillingness by superiors (33.9%), financial (31%), administrative (28.4%), and technical limitations (27.8%) were major constraints under the perception analysis. This study reveals that veterinarians need to be educated on governmental policies and guidelines on equine glanders with regular training and awareness programs. Intersectoral co-ordination to investigate human glanders is also needed.

Water as a social determinant of health: bringing policies into action

Water is one of the social determinants of health and a key factor towards improving health outcomes and inequalities. Access to safe and adequate water has been identified as an essential component for protecting, maintaining and promoting public health and reducing the total burden of diseases. Though India has made substantial progress in increasing access to safe drinking water in rural areas through household tap connections, there is a lack of contemporary evidence reflecting the progress achieved so far. A desk review of India’s schemes, programmes, and policies on access to drinking water was undertaken for review. Programme and policy documents from various central government websites such as the Ministry of Jal Shakti, Department of Drinking Water and Sanitation, Jal Jeevan Mission, and Central Water Commission websites were reviewed. The paper focuses on the recently launched Jal Jeevan Mission (JJM) in addressing the identified gaps of the former initiatives in rural areas. The broad vision of JJM also aims to reduce the incidence of acute diarrhoeal diseases. It was found that with the launch of JJM in 2019, tap water connections in rural households have increased from 16.69% (2019) to 62.79% (2023). The Government of India (GoI)’s commitment and citizen-centric approach to decentralised governance in providing safe drinking water to all is reflected in the financial allocations made under the JJM to states and fifteen finance commission (FC-XV) grants. The review highlights the need for intersectoral coordination across the levels to realise better results and health outcomes.