Multi-sectoral Cooperation Research Articles

BIMSTEC: BAY OF BENGAL INITIATIVE FOR MULTI-SECTORAL TECHNICAL AND ECONOMIC COOPERATION: SWOT ANALYSIS FROM INDIAN PERSPECTIVES

The Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) is a regional organization comprising seven member states: Bangladesh, Bhutan, India, Myanmar, Nepal, Sri Lanka, and Thailand. Multi-sectoral cooperation can be seen in the case of BIMSTEC, which is the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation. Thus, this paper aims to analyze a comprehensive SWOT analysis of BIMSTEC based on the Indian perspective. They cover India's strategic considerations related to geopolitics, economic cooperation, energy security, and soft power. Finally, the literature review reveals that the tag is inclined towards the advancement of technology, the need for strong institutional frameworks, and competent ways of eradicating economic imbalance among the member nations. Based on the study, it can be concluded that there are inherent opportunities for cooperation within BIMSTEC, but the issues of geopolitical competition, problems with the organization's management, and political unpredictability should be solved. Finally, the paper provides suggestions to make BIMSTEC a more effective organization with a better institutional basis to support members, inclusive growth for the region's people, better connectivity, optimum use of energy resources, and target environmental conservation. Therefore, India has a significant opportunity to ensure turning BIMSTEC into an active and efficient organization, which will help to provide stability, security, and further developments in the South Asian region in the Bay of Bengal.

The Icehearts Europe Implementation Guide to promote a mentoring programme for youth mental health

Abstract Issue/problem In Europe, 9 million young people (10-19) suffer from mental disorders and 70% of children and adolescents with mental health problems do not receive appropriate interventions at a sufficiently early age. Moreover, during the Covid-19 pandemic a high prevalence of depressive symptoms, anxiety and sleep disorders was observed in the population aged 4-19 years. The Icehearts Europe project (funding: EU4Health 2022 Programme) aims to disseminate at EU level a long-term programme for supporting health and wellbeing of disadvantaged children and adolescents. It is inspired by the Finnish best practice Icehearts, a 12-year long mentoring programme. Five pilot countries (Italy, Denmark, Spain, Slovenia, Estonia) will test the model to raise European awareness of how it works and to get more countries and organisations involved. Description of the problem Icehearts Europe is a preventive mentoring programme based on team sports, recreation and school support activities, with a child-centred community approach. To facilitate its implementation, a practical guide has been developed for grassroots sport and social promotion organisations to help them implement the model in their own contexts. The guide is the result of both a multisectoral cooperation between grassroots sport, health, universities, NGOs, and qualitative study activities (bibliographic research, study visit, group work, analysis of the situation and needs of local contexts). Results From February 2024 the Icehearts Europe Implementation Guide is available in six languages at https://www.icehearts.eu/resources. It is now being adapted by the Icehearts Europe partners into an online training programme for managers. Lessons The guide has incorporated lessons learnt from the Finnish model, considered as an evidence-based approach. It contains several operational tools to implement Icehearts Europe and can be adopted using different approaches: there is no one-size-fits-all solution. Key messages • Developed as a support to the Icehearts Europe piloting partners and as a basis for a fully-fledged online training programme for future Icehearts Europe managers. • To facilitate the implementation of early interventions to promote health and wellbeing of children and adolescents and enable them to cope with disadvantaged conditions.

Agroterrorism: Assessing the Growing Threat to Global Food Security and Economic Stability

Agroterrorism, the deliberate introduction of harmful agents into agriculture to cause disease and economic damage, poses a growing threat to global food security and economic stability. Motivated by deep-seated conflicts and often perpetrated by both state and non-state actors, agroterrorism targets livestock, crops and water supplies, aiming to destabilize economies and social systems. Historical incidents, such as the mercury contamination of Jaffa oranges and cyanide-tainted grapes, underscore its severe impact. Recent concerns, intensified by advancements in biotechnology and increasing global trade, highlight the vulnerability of agriculture to such attacks. The potential economic damage from a single agroterrorism incident could reach billions of dollars, exacerbating food shortages and undermining public trust. Effective prevention and preparedness require multi-sectoral cooperation involving law enforcement, agricultural and scientific communities. Strategies include enhancing detection methods, developing biosecurity measures and improving international trade regulations. The World Organization for Animal Health (WOAH) and related organizations advocate for a comprehensive approach to bolster global resilience against agro-crime and agro-terrorism, emphasizing the need for robust preparedness and inter-agency collaboration to mitigate this evolving threat.

The Impact of the Peculiarities of EVA Characterization on Its Commercialization

At present, the issue of Japanese anime pop culture has received widespread attention from all walks of life. However, there are still insufficient studies on the relationship between character creation and commercialization. This paper analyzes the particularity of character building in Neon Genesis Evangelion and the influence and connection of character building on the commercialization of EVA. It is concluded that the characterization of EVA has the particularity of the times. It contains a lot of negative shaping and human nature analysis, and this characteristic has gained the audience's sense of recognition and empathy, thus promoting the development of commercialization. The commercialization of EVA is inseparable from the Japanese production committee system, and at the same time, character building is the fundamental reason that affects whether fans buy or not, character appearance is an important reason that affects the desire to buy. Based on this, this paper puts forward the following suggestions: Start with marketing and innovation to retain old audiences and attract new ones. Seize the hot spots of the times and maintain multi-sector cooperation.

Vulnerability factors of snake bite patients in China

ObjectiveTo analyze the vulnerability factors of snakebite patients in China.MethodsMulti-stage random sampling was used as the main sampling method and snowball sampling as the auxiliary sampling method. The knowledge, attitude and behavior of snakebite among Chinese residents were investigated. Non-parametric test was used to compare the percentage differences in residents’ knowledge, attitude and behavior of snakebite, and generalized linear regression analysis was used to analyze the influencing factors, and the vulnerability factors of snakebite patients were comprehensively analyzed.ResultsA total of 6338 subjects were included in this study, of which 68.4% were males, and 58.6% were farmers, workers and service personnel. The median total score of knowledge, attitude, and behavior was 26 (22,36). The patients who were improperly treated after injury were ligation proximal to the affected area (23.43%), squeezing (21.82%), and oral and suction wounds (8.74%). Did not go to hospital due to poverty (1351 cases) and did not receive antivenom (2068 cases). There were 21.32% and 32.63%, respectively. Among 4270 patients injected with antivenom 30.7% were vaccinated within 2 h. Among the patients who went to the hospital for treatment (4987), 75.0% arrived at the hospital within 6 h; Among the 4,761 patients who made emergency calls, 37.4% were treated within 0.5 h.ConclusionsSnakebite patients in China have weak knowledge about snakebite, low awareness of medical treatment, lack of correct prevention and emergency treatment measures, dependence on folk remedies, poor housing and so on. In addition, there are low availability of antivenoms and unreasonable distribution of medical resources in some areas of China. Multisectoral and multidisciplinary cooperation should be developed to prevent and control snakebites in order to reduce the burden caused by snakebites.

Macro and microplastic pollution in Romania: addressing knowledge gaps and potential solutions under the circular economy framework.

This review reveals the role of linear economy prevalence and mismanagement practices in plastic pollution of aquatic and terrestrial environments and related knowledge gaps in Romania while outlining downstream and upstream solutions to reduce plastic pollution and adopt circular economy strategies. Thus, the major aim of this study is the investigation of the stage of scientific knowledge concerning all these demands in the Romanian context. This work integrates two main approaches: (i) a bibliometric analysis fed by Web of Science and Scopus databases to reveal the current coverage of peer-reviewed literature related to plastic waste in Romania and (ii) a subject-based review to underline the main themes related to plastic waste management, plastic pollution, and mitigating options in Romania in line with circular economy principles. Reducing plastic pollution requires scientific knowledge, multi-sectoral cooperation, and societal awareness. Following this, the topics of plastic waste and plastic pollution appeared to be under-investigated in the literature considering Romania as a case study and concentrated around the 2020 year, emphasizing, in this way, the trendiness of plastic waste concerns and their management in the current research landscape. Our analysis points out that: (i) Romania is facing massive plastic pollution requiring solid improvements in waste management performances; (ii) few peer-reviewed research studies are performed in Romania for both macro and microplastic concerns with unknown pollution levels in most of its geographical regions; (iii) the plastic waste management is still understudied here, while waste statistics are poorly available at local levels; (iv) the perspectives of circular economy transition are still limited, feeding the plastic pollution in the coming years. Several knowledge gaps are identified and must be covered by future research such as (i) adjusting mismanaged plastic waste levels to regional waste management performances and determining littering rates in urban and rural areas to improve the plastic pollution modeling inputs; (ii) examining plastic pollution associated with landfill sites and waste imports; (iii) assessing the sectoral contributions to macro and microplastic pollution of aquatic environments related to municipalities, tourist destinations, agriculture, etc.; (iv) determining retention levels of plastic in river basins and role of riparian vegetation; (v) analyzing microplastics presence in all types of freshwater environments and interlinkage between macroplastic fragmentation and microplastic; (vi) assessing the plastic loads of transboundary rivers related to mismanagement practices; (vii) determining concentrations of microplastics in air, soil, and other land use ecosystems.

Coupling efficiency and spatial dynamic evolution of urban water–energy–food in China–A case of evidence from 94 cities

Quantifying and interpreting the water–energy–food (WEF) nexus is critical to achieve the sustainable development of urban resources. The mismatch between urban water, energy and food allocations is a prominent problem that is particularly acute in the Yellow River Basin (YRB) of China. In this study, models for the WEF coupling degree and coupling efficiency were constructed. The WEF coupling efficiencies of the 94 cities in the YRB from 2011 to 2020 were quantified using a data envelopment analysis (DEA) model. On this basis, the spatial distribution characteristics and evolutionary trends of different urban WEF coupling efficiencies were analysed and explored using an exploratory spatial data analysis (ESDA) model and a parametric kernel density estimation model. The results show that the energy subsystem constrain the development of the WEF nexus, and the food subsystem, in turn, regulates the development of the WEF nexus. In some years, the phenomenon of ‘resource curse’ occurred, in which the WEF coupling degree increased while the coupling efficiency decreased. Overall, the values of the urban WEF coupling efficiency were low, ranging from 0.5300 to 0.6300, which is not effective. Spatial clustering was detected in the urban WEF coupling efficiency. The clustering types were ‘high–high’ clustering areas in less developed regions and ‘low–low’ clustering areas in developed regions. The two clusters and the median contiguous group had different evolutionary trends. Both efficiency and polarisation increased in the high-clustering group, efficiency improved in the low-clustering group, and a new efficiency pole was formed in the median contiguous group. Among the three grouped cities, we discuss the potential of policies such as cross-city cooperation, intra-city multi-sectoral cooperation and cultivating new central growth cities to improve the WEF coupling efficiency in the YRB.

The magnitude of gender-based violence, health consequences, and associated factors among women living in post-war woredas of North Shewa zone, Amhara, Ethiopia, 2022.

Gender-based violence (GBV) is a pervasive global public health concern and a violation of human rights, particularly pronounced in conflict settings where it is often used as a tool of warfare to instill fear and control populations. Assessment of Magnitude, Associated Factors, and Health Consequences of GBV among women living in war-affected woredas of North Shewa zone, Ethiopia, 2022. A community-based cross-sectional study was conducted, involving 845 randomly selected women living in conflict zones. Data on GBV experiences over the previous 3 months were collected through interviewer-administered questionnaires developed from literature review. The collected data underwent validation, entry into EPI data, and analysis using SPSS. Findings are summarized using descriptive statistics, AOR and 95% confidence interval. The magnitude of GBV in this study was (490, 58.0%) where, (466, 55.0%) psychological violence, (254, 30.1%) physical violence, and (135, 16.0%) reported sexual violence. A majority of the physical violence, (161, 63.4%), occurred during conflict period, with (143, 56.3%) of these cases involving armed forces, and (161, 63.4%) women experiencing physical violence in their homes. Urban Residence AOR = 2.65, CI, (1.82-3.89), Educational status of Secondary education AOR = 0.33, CI, (0.19-0.57, and ≥College AOR = 0.17, CI, (0.09-0.35), Occupation of Housewife AOR = 1.88, CI, (1.20-2.94), Private employee AOR = 6.95, CI, (3.70-13.04), Gov't employee AOR = 5.80, CI, (2.92-11.50), and others (Students) AOR = 3.46, CI, (1.98-6.01), Ever had sexual intercourse AOR = 0.46, CI, (0.25-0.83), Have heard about SRH AOR = 0.59, CI, (0.40-0.89), Have had previous GBV exposure AOR = 0.24, CI, (0.15-0.38), having a previous history of sexual violence AOR = 0.30, CI, (0.16-0.57), and Number of sexual partner AOR = 1.84, CI, (1.13-2.99) were identified to be associated factors of GBV in our study area. The most commonly reported consequences of GBV were Anxiety, depression, physical injuries, self-blame, women had school dropout, and abortion. The study reveals a higher prevalence of GBV, resulting in profound physical, social, mental, and reproductive health challenges for survivors. To address this, multi-sectoral cooperation is advised to enhance women's empowerment, access to information, and psycho-social support in affected areas. Furthermore, national policymakers are urged to implement preventive measures during conflict and establish legal mechanisms to ensure accountability for perpetrators.

India’s National Suicide Prevention Strategy, 2022: A Critical Appraisal

Abstract India recently published its National Suicide Prevention Strategy aimed at reducing suicide mortality in the country by 10% by the year 2030. This strategy laid out time-bound objectives and action plans, targeting biological, psychosocial, and cultural risk factors for suicide, which are specific to the region. The strategy is to be implemented by utilizing existing national and regional mental health-care infrastructure and enlisting multisectoral cooperation. This discussion provides a critical appraisal of the National Suicide Prevention Strategy of India, 2022.

Multi-sector stakeholder consensus on tackling the complex health and social needs of the growing population of people leaving prison in older age

BackgroundAs populations age globally, cooperation across multi-sector stakeholders is increasingly important to service older persons, particularly those with high and complex health and social needs. One such population is older people entering society after a period of incarceration in prison. The ‘ageing epidemic’ in prisons worldwide has caught the attention of researchers, governments and community organisations, who identify challenges in servicing this group as they re-enter the community. Challenges lie across multiple sectors, with inadequate support leading to dire consequences for public health, social welfare and recidivism. This is the first study to bring together multi-sector stakeholders from Australia to form recommendations for improving health and social outcomes for older people re-entering community after imprisonment.ResultsA modified nominal group technique was used to produce recommendations from N = 15 key stakeholders across prison health, corrections, research, advocacy, aged care, community services, via online workshops. The importance and priority of these recommendations was validated by a broader sample of N = 44 stakeholders, using an online survey. Thirty-six recommendations for improving outcomes for this population were strongly supported. The key issues underlying the recommendations included: improved multi-stakeholder systems and services, targeted release preparation and practices that ensure continuity of care, advocacy-focused initiatives in the community, and extended funding for effective programs.ConclusionsThere is consensus across stakeholders on ways forward, with intervention and policy updates required at the individual, systems and community levels. These recommendations entail two important findings about this population: (1) They are a high-needs, unique, and underserved group at risk of significant health and social inequity in the community, (2) Multi-sector stakeholder cooperation will be crucial to service this growing group.

Rehabilitation of Drug Users in Makassar City

The spread and abuse of narcotics is a complex problem, which requires comprehensive mitigation efforts involving multidisciplinary, multisectoral cooperation and active community participation carried out continuously, consistently and consistently. Even though in medical science, most classes of narcotics are still useful for treatment, if they are misused or used not according to medical indications or treatment standards, especially if accompanied by illegal distribution, it will have very detrimental consequences for individuals and society at large. The cumulative number of AIDs cases in Indonesia in the second quarter of 2010 was 21,770 cases. The spread of HIV/AIDS among Injection Drug Use/IDUs has reached 8,795 cases. Methadone substitution therapy needs to be carried out with the aim of reducing adverse health, social and economic impacts, reducing the risk of contracting and transmitting HIV to other people, however therapy failure often occurs due to non-compliance or poor adherence. The research is observational with a cross sectional approach. Data were collected using questionnaires through interviews with informants following the therapy program. The results of the study showed good compliance in following therapy. Factors related to compliance in therapy are knowledge, attitudes, motivation, self-efficacy, family role, peer role, and health worker role. Multivariate analysis of multiple Logistic Regression, the most influential factors are motivation and the role of peers.

Construction of an evaluation index system for the capability of comprehensive control of mountain - type zoonotic visceral leishmaniasis based on the One Health concept

To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach. A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process. The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators "external environment", "internal support" and "comprehensive control" were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator "external environment", the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator "internal support", the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator "comprehensive control", the weight was 16.67% for each indicator. An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.

Distribution of Stunting and Determinants of Stunting in the Province of East Nusa Tenggara, Indonesia in 2021:A Spatial Analysis

The problem of stunting is still fundamental in Indonesia's human development. East Nusa Tenggara Province is an archipelago dryland area with the highest prevalence of stunted children under five in Indonesia. This study aims to determine the relationship of child characteristics with the prevalence of stunting. This type of research is an observational study with a cross-sectional design. This study used individual secondary data from the Indonesian Nutritional Status Survey in 2021 consisting of 7,835 children under five. The results of the spatial analysis showed that in the child's characteristic factor, there was a relationship between short birth length and low birth weight with stunting prevalence. It is hoped that there will be a special model of stunting control interventions that are integrated and of high quality through multisectoral cooperation in the dryland areas of the islands of East Nusa Tenggara Province.

One Health in practice: Benefits and challenges of multisectoral coordination and collaboration in managing public health risks: A meta-analysis

Background and Aim: One Health (OH) approach is crucial for the effective management of emerging and re-emerging infectious diseases and other public health threats. A meta-analysis was conducted to explore the benefits and challenges encountered in the practical implementation of multisectoral coordination in the fight against public health threats and to identify similarities between countries in the practical implementation of multisectoral coordination and cooperation across sectors in OH. Materials and Methods: To identify relevant studies published globally between 2010 and 2023, a literature search was conducted online using Google Scholar and PubMed search engines. Inclusion criteria were adopted based on key search terms “One Health,” “multisectoral coordination,” “One Health framework,” and related terms “multisectoral collaboration” and “multidisciplinary.” Unpublished manuscripts, dissertations, and conference reports were excluded from the review. A total of 307 articles were retrieved. Titles, abstracts, and keywords were screened for inclusion criteria. We extracted and analyzed 46 full-text articles published in English. Unpublished manuscripts, dissertations, and conference reports were excluded from the study. Results: This study found that most countries have similar challenges that hamper the coordination of OH activities implementation. Of the 46 articles reviewed, 69.6% (n = 32) focused on the benefits of adopting the OH approach and 73.9% (n = 34) focused on multisectoral coordination and collaboration among sectors. In addition, 58.7% (n = 27) of the articles indicated that governments need to invest more resources in OH implementation, and 50% (n = 23) proposed that policies, guidelines, and plans should be integrated to facilitate multisectoral coordination and collaboration. In addition to inadequate coordination and funding, other reported challenges were limited knowledge (34.8%) (n = 16) and inadequate resources (32.6%) (n = 15). In addition, 21.7% (n = 10) highlighted different sectoral priorities and interests as obstacles to effective coordination in the implementation of OH activities. Conclusion: Multisectoral coordination plays a key role in the effective management of public health threats through OH. The creation of mechanisms for regular communication, the promotion of mutual trust, and the strengthening of relations between sectors will enhance cooperation. The similarity in challenges across regions observed in this study calls for countries across regions to prioritize OH operationalization and collaboration among sectors, strengthen collaboration, and synergize activities to enhance future changes in the mitigation of public health threats. Keywords: multisectoral collaboration and multidisciplinary, multisectoral coordination, One Health, One Health framework.

Promoting the development of ethnic medicine in China: policy evaluation and optimization countermeasures.

The coordinated development of ethnic medicine is a basic necessity for steady construction of a healthy China. This process includes closely following domestic and foreign policies, including changes, through the optimization of policies; shaping the new direction of the development of national medicine; and achieving comprehensive technological and industrial upgrades. As such, ensuring the all-round development of national medicine in China remains a great challenge. This paper takes the relevant policies of national and local ethnic medicine issued by the government as the research object, and, through the full interpretation of the policy-issuing body, policy content, and policy effectiveness, deeply analyzes the current situation of the policy's role in ethnic medicine and explores the distribution of policy types, subject-cooperation modes, and scoring levels in various dimensions. This study found that, in the new era of pharmaceutical reform, the State lacks a variety of special policies on ethnomedicine, and there is also an imbalance in the use of policy tools at both the central and local levels as well as synergies in the implementation of policies that need to be further strengthened. There remains a need to continue to improve the policy-evaluation system, optimize the structure for the use of policy tools, and improve the rates of application and implementation of the national medicine policy by strengthening cross-provincial and multisectoral cooperation to promote the revitalization of the national medicine industry in China.

Developing the Interprofessional MyTeam Model with Clients and Professionals in Social and Health Care Services

Background: Clients with complex life situations and increased health problems are often bounced between different services because they need services which are provided by different organizations and professionals (Manning &amp; Gagnon 2017, Blumenthal et al 2016). The client-oriented approach means that professionals are combining their competencies and working together based on clients’ needs. To strengthen the interprofessional co-operation it is necessary to develop practical model for professionals. Health and social service reform in Finland also aims to improve multi-sectoral cooperation for better quality of care, equality, and lower costs (Health and Social Services Reform 2022).&#x0D; Aim and implementation of the project: The aim of this project is to further develop a practical model for interprofessional cooperation to meet clients´ complex needs. The origin of this model is from geriatric health care. The project aimed to expand the original concept to wider customer groups.&#x0D; The phases of the project were following: &#x0D; A.Four working groups were formed which were led by the project manager.&#x0D; B.Education and workshops were offered for professionals and service managers to gain understanding about the interprofessional cooperation with clients and systemic approach in teamwork.&#x0D; C.Recruiting clients to pilot-test and evaluate the new model.&#x0D; D.Modify the model based on the experience from pilot-testing. &#x0D; The phases were overlapping, and the model was developed in all phases.&#x0D; Results: The clients who participated to test the model experienced that their situation and problems were taken more seriously, and they got more comprehensive assistance and support in their life. The professionals were relieved because the responsibility of complex clients’ situations became shared between professionals. The service plan was written in every meeting with clients and professionals. The customer-oriented, systemic MyTeam-practical model for interprofessional cooperation was established, as well as instructions for documenting the clients´ service planning, quality monitoring guide for MyTeam-practical model and material for clients.&#x0D; &#x0D; &#x0D; Conclusions: To promote fluent working between different professionals for the clients best, requires agreed working methods in client orientation, competence in interaction and skillful management to lead interprofessional working groups (Timperi 2022). The clients´ and professionals´ experiences are valuable, when developing interprofessional work. With interprofessional teamwork it is possible to avoid overlapping and separate plans, which are not promoting but hindering clients´ complex life situations. In the future it is necessary to explore the effectiveness of MyTeam-practical model.&#x0D;

Path analysis model for preventing stunting in dryland area island East Nusa Tenggara Province, Indonesia.

The problem of stunting is still a fundamental problem in Indonesia's human development. East Nusa Tenggara Province is an archipelago dryland area where in 2007-2021 it has contributed to the highest number of stunting children prevalence in Indonesia. This study aims to determine the relationship of variables in individual, household and district level with the prevalence of stunting. This type of research is observational study with a cross sectional design. This study used individual secondary data from the Indonesian Nutritional Status Survey in 2021 consisting of 7,835 toddlers and National Social Economics Survey 2021. This research found that both specific & sensitive intervention programs had an influence in accelerating the decline in stunting prevalence (higher score on Z Score). Results also revealed the positive influence of the food access variable on nutritional intake. The results of the path analysis test showed that sensitive intervention program variables have a positive effect on food access variable and environmental variable (environmental sanitation) such as the habit of open defecation and healthcare. There was significant relationship on disease history, environment and intake to Height for Age (HAZ) score. In conclusion, direct and indirect factors have important roles to prevent stunting. Sensitive and specific intervention program, food access, macro determinants and environment are the indirect indicators which contribute significantly to the stunting. The risk of children under five years old experiencing malnourished nutritional status increases with a history of infectious disease (diarrhea, ARI, worms). The risk of children under five years experiencing malnourished nutritional status decreases with adequate nutritional intake. It is hoped that there will be a special model of stunting control interventions at the individual level and at the family, household and district level that are integrated and of high quality through multisectoral cooperation in the dryland areas of the islands of East Nusa Tenggara Province.

S9-3 Keep up -groups support fall prevention

Abstract Purpose In Finland one third of home dwelling older adults 70+ fall at least once a year. Falling causes injuries and suffering. The cost of one hip fracture is about 30 000 € on the first treatment year. Balance and functional training is effective in preventing falls. Half of hip fractures can be prevented by exercising. Project or policy description Development: Age Institute is a partner in Age-friendly South Karelia project coordinated by Wellbeing Services County of South Karelia. The project acts through a network with municipalities, NGO’s, congregations, and older people councils. Preventing falls became an important goal of project since the number of hip fractures was increasing and higher than the average in Finland. Several actions were developed: educating professionals, giving information to older people, and improving exercise groups. Implementation ‘Keep up’ exercise group for older adults with increased risk of falling was implemented in every municipality (9) of the county. The risk of falling was assessed using a screening questionnaire in health care centers or in events, where participants with high scores were guided to the groups. Municipal sport sector organized the strength and balance training group once a week. The participants were encouraged to do home exercise weekly. The groups also included discussion and tasks about falls prevention. Themes were e.g. nutrition, fear of falling, medication and safe environment. Age Institute made the material for the group. Evaluation SPPB test was made in the beginning and in the end of the 10 weeks training period. Majority of participants improved their physical performance. According to a questionnaire the participants perceived mostly good or strong benefits. Especially mood, strength, and knowledge of preventing falls improved. After the training period the participants were guided to continue exercising. Dissemination The municipalities continue to organize Keep up groups. The good practice will be disseminated to other municipalities and counties involved in Strength in Old Age Programme. Conclusions With multisectoral co-operation you can find older adults with increased risk of falling and guide them to exercise group. Strength and balance training combined with getting more knowledge is a feasible good practice.

Risk factors and molecular epidemiology of canine rabies in Beijing

Rabies is a serious public health problem in Asia and Africa. Approximately 99% of cases result from a bite by an infected dog. The high rabies risk countries are generally characterized by rapid urbanization; however, the prevalence and risk factors for rabies in urban dogs in developing countries remain unclear. Beijing, the capital of China, has been undergoing rapid urbanization, and implemented compulsory rabies immunization for dogs on October 1, 2014. We evaluated the effects of this immunization policy and investigated the dynamics and determinants of the spread of dog rabies virus (RABV) in Beijing. Between 2013 and 2018, the positive rate of rabies in biting dogs declined significantly; 79.6% of these were stray dogs. Reconstructed spatiotemporal diffusion for RABV presents a more central distribution within Beijing and a surrounding dissemination of virus lineage toward suburban areas, indicating that rabies is self-sustaining in Beijing. Continuous RABV phylogeographic reconstructions and logistic regression analysis of rabies cases revealed that rabies tended to remain in commercial areas, high-rise residences, demolition areas, and high-GDP, high-population and high-accessibility areas. Demolition areas, where many residents have abandoned their pets, are recognized as high-risk areas for rabies. Our findings reveal that the implementation of the immunization policy in Beijing has been effective in prevention and control of canine rabies, and because the prevalence of canine rabies results from multiple factors, emphasize the important role of multi-sectoral cooperation in rabies prevention and control.

Good Practices for Reducing Stunting in Sumedang Regency

Referring to the 2022 Indonesian Nutrition Status Study (SSGI) data, several regions have succeeded in reducing the prevalence of stunting. Sumedang Regency, West Java is one of the areas that fall into this category. Based on SSGI data for 2022, Sumedang Regency has reduced stunting from 32.2 % in 2018 to 27.6 % in 2022. In this achievement, of course, there is a strategy and cooperation of all parties so that the area can significantly reduce stunting rates. Sumedang Regency has implemented an Electronic-Based Government System (SPBE) in carrying out its government activities. This system supports targets that must be achieved in various fields, one of which is the health sector, namely reducing the stunting rate. Based on the results of fieldwork conducted by the BRIN team, this system is very supportive of efforts at the Regency level and even down to the village level in monitoring the prevalence of stunting. However, this system is a tool that is meaningless if it is not accompanied by leadership commitment and cooperation of all parties in achieving the stunting reduction target. Therefore, it is important to carry out multi-sectoral cooperation in efforts to reduce the prevalence of stunting. The stunting reduction efforts carried out by Sumedang Regency and declared successful are a combination of various factors. The existence of SPBE, the government's commitment, as well as the cooperation of all parties are the keys to achieving a reduction in the prevalence of stunting. The recommendation proposed as a policy consideration is if SPBE is to be implemented in all districts/cities throughout Indonesia whose stunting is below the national reduction target. To reduce stunting sustainably, the following prerequisites are needed: 1) Availability of adequate internet access and digital technology; 2) Transparency and Accountability; 3) Data protection and privacy; and 4) Leadership and Resources.