Stakeholder Engagement: Achieving Sustainability in the Construction Sector

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Damian Fearon

2013-02-01

Full Text Available Achieving sustainability-related targets in construction projects is increasingly becoming a key performance driver. Yet sustainability is a complex concept in projects and there are many diverse stakeholders. Some stakeholders are generally recognized as important, i.e., the client and main contractor, yet there are others not always perceived as such and whose absence from the decision-making processes may result in a failure to address sustainability issues. Hence there is a need for a systematic approach to engage with stakeholders with high salience in relation to sustainability. This paper reports the results of an exploratory study involving interviews with construction project practitioners that are involved in sustainability in some way. Data were collected from the practitioners in terms of the processes for engaging with stakeholders to deliver sustainability. The data suggests six steps to a stakeholder engagement process: (i identification; (ii relating stakeholders to different sustainability-related targets; (iii prioritization; (iv managing; (v measuring performance; and (vi putting targets into action. The results suggest that understanding the different sustainability agendas of stakeholders and measuring their performance using key performance indicators are important stages to be emphasized in any stakeholder engagement process to achieve sustainability-related goals.

Achieving maximum sustainable yield in mixed fisheries

NARCIS (Netherlands)

Ulrich, Clara; Vermard, Youen; Dolder, Paul J.; Brunel, Thomas; Jardim, Ernesto; Holmes, Steven J.; Kempf, Alexander; Mortensen, Lars O.; Poos, Jan Jaap; Rindorf, Anna

2017-01-01

Achieving single species maximum sustainable yield (MSY) in complex and dynamic fisheries targeting multiple species (mixed fisheries) is challenging because achieving the objective for one species may mean missing the objective for another. The North Sea mixed fisheries are a representative example

Coaching bioethically with the purpose of achieving sustainable development

Directory of Open Access Journals (Sweden)

Striedinger-Meléndez, Martha Patricia

2016-12-01

Full Text Available The present article analyzes the problematic of teaching and learning bioethics in the context of higher education, with an emphasis in medicine and aiming towards sustainable development. The objective is to expose that one of the alternatives to get to know bioethics in higher education institutions, is to coach each community bioethically. This means that the educator must be a role model for the students: not only teaching, but, living bioethically. In the beginning, it makes reference to the general aspects of bioethics and sustainable development to explain the evolution of these concepts, its situation in the present and the challenges of the future. Further, it focuses on the methodological strategies in the process of educating bio ethically, directed in leading students of higher education institutions with the purpose of achieving sustainable development. Yet, not achieving it in a traditional manner, since sustainable development also refers to wellbeing. Thus, coaching bioethically, which improves the way society functions. The conclusion is that institutions must give educators and students the tools for problem solving the priorities of humanity, such sustainable development. This can be achieved through bioethics.

Achieving sustainable biomass conversion to energy and bio products

International Nuclear Information System (INIS)

Matteson, G. C.

2009-01-01

The present effort in to maximize biomass conversion-to-energy and bio products is examined in terms of sustain ability practices. New goals, standards in practice, measurements and certification are needed for the sustainable biomass industry. Sustainable practices produce biomass energy and products in a manner that is secure, renewable, accessible locally, and pollution free. To achieve sustainable conversion, some new goals are proposed. (Author)

Sustainable Health Development Goals (SHDG): breaking down the walls.

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Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

2015-01-01

The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world.

Seeking consensus on universal health coverage indicators in the sustainable development goals.

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Reddock, Jennifer

2017-01-01

There is optimism that the inclusion of universal health coverage in the Sustainable Development Goals advances its prominence in global and national health policy. However, formulating indicators for Target 3.8 through the Inter-Agency Expert Group on Sustainable Development Indicators has been challenging. Achieving consensus on the conceptual and methodological aspects of universal health coverage is likely to take some time in multi-stakeholder fora compared with national efforts to select indicators.

Sustaining Health for Wealth: Perspectives for the Post-2015 Agenda; Comment on “Improving the World’s Health Through the Post-2015 Development Agenda: Perspectives From Rwanda”

Directory of Open Access Journals (Sweden)

Bartholomew K. Armah

2015-10-01

Full Text Available The sustainable development goals (SDGs offer a unique opportunity for policy-makers to build on the millennium development goals (MDGs by adopting more sustainable approaches to addressing global development challenges. The delivery of health services is of particular concern. Most African countries are unlikely to achieve the health MDGs, however, significant progress has been made particularly in the area of child and maternal health due in part to significant external support. The weak global recovery, and persistent inequalities in access to healthcare, however, call into question the sustainability of the achievements made. Building on the principles articulated in Binagwaho and Scott, this commentary argues that addressing inequalities and promoting more integrated approaches to health service delivery is vital for consolidating and sustaining the health sector achievements in Africa.

Pedagogies to Achieve Sustainability Learning Outcomes in Civil and Environmental Engineering Students

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Angela R. Bielefeldt

2013-10-01

Full Text Available The civil and environmental engineering disciplines have identified the levels of knowledge about sustainability that are desirable for students to achieve as they graduate with a bachelor’s degree, as well as sustainability-related competencies to be obtained during a master’s degree, and on-the-job, prior to professional licensure. Different pedagogies are better suited to help students attain these levels of cognitive ability, while also developing affective outcomes. This paper provides examples of different methods that have been used at one institution to educate engineering students about sustainability, supported with data that indicates whether the method successfully achieved the targeted learning outcomes. Lectures, in-class active learning, readings, and appropriately targeted homework assignments can achieve basic sustainability knowledge and comprehension by requiring students to define, identify, and explain aspects of sustainability. Case studies and the application of software tools are good methods to achieve application and analysis competencies. Project-based learning (PBL and project-based service-learning (PBSL design projects can reach the synthesis level and may also develop affective outcomes related to sustainability. The results provide examples that may apply to a wider range of disciplines and suggest sustainability outcomes that are particularly difficult to teach and/or assess.

Achieving Sustainability: Insights from Biogas Ecosystems in India

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Gita Surie

2017-02-01

Full Text Available This paper focuses on how the use of renewable energy technologies such as biogas can help to achieve environmental and socio-economic sustainability. It combines research on sustainable consumption and production, natural and industrial ecosystems and renewable energy adoption to develop a framework for an industrial ecosystem for biogas for bottom-of-the-pyramid and rural populations. The framework suggests that three dimensions of industrial ecosystems and a meta-dimension can be embedded in the design of a new industrial ecosystem for biogas to facilitate environmental and socio-economic sustainability. Case studies of an organization engaged in using biogas to create a sustainable bioenergy ecosystem for rural populations and two organizations producing biogas in urban India provide support for the framework.

Measures For Achieving Sustainable Rabbit Production In ...

African Journals Online (AJOL)

A study was conducted to ascertain ways of achieving sustainable rabbits production in Ogba/Egbema/Ndoni Local Government Area of Rivers State. The study population involved 120 respondents comprising 40 students and 80 farmers. Two sets of structured questionnaire designed with a 4-point Likert type rating scale ...

Towards Sustainable Health Care Organizations

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Mauro ROMANELLI

2017-09-01

Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

Nottingham Health Science Biobank: a sustainable bioresource.

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Matharoo-Ball, Balwir; Thomson, Brian J

2014-10-01

Nottingham Health Science Biobank (NHSB) was established in 2011 by a 3-year "pump priming" grant from the United Kingdom National Institute of Health Research. Before biobanking operations began, NHSB commissioned a financial report on the full costs of biobanking and worked with key stakeholders and external consultants to develop a business plan with the aim of achieving financial and operational sustainability. The plan included: scanning published information, telephone interviews with commercial companies, Freedom of Information Requests, dialogue with prospective customers, and a market analysis of global trends in the use of human tissue samples in research. Our financial report provided a comprehensive and structured costing template for biobanking and confirmed the absolute requirement to ensure cost-efficient processes, careful staff utilization, and maximization of sample turnover. Together with our external consultants, we developed a business model responsive to global interest in healthcare founded on i) identification of key therapeutic areas that mapped to the strengths of the NHSB; ii) a systematic approach to identifying companies operating in these therapy areas; iii) engagement with noncommercial stakeholders to agree strategically aligned sample collection with the aim of ensuring the value of our tissue resource. By adopting this systematic approach to business modelling, the NHSB has achieved sustainability after less than 3 years of operation.

Launch of the ‘One Health Global Think-Tank for Sustainable Health & Well-being’ – 2030 (GHW-2030

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Ulrich Laaser

2016-04-01

Full Text Available The central mission of the GHW-2030 multi-sectoral think tank is to contribute to the implementation of the UN Sustainable Development Goals (SDGs by working toward achieving the education and health goals in cooperation with the Commonwealth Secretariat using an international interdisciplinary/multidisciplinary/transdisciplinary global One Health approach. A major focus of the think tank will be on the health and well-being – physical, emotional, aspirational – of children and young people particularly as these relate to their personal security, physical and emotional well-being, education and employment and the sustainability of life on the planet.

Indicators of sustainable capacity building for health research: analysis of four African case studies.

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Bates, Imelda; Taegtmeyer, Miriam; Squire, S Bertel; Ansong, Daniel; Nhlema-Simwaka, Bertha; Baba, Amuda; Theobald, Sally

2011-03-28

Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, we aimed to identify evidence that could indicate that capacity building was likely to be sustainable. Four projects were selected as case studies using pre-determined criteria, including the achievement of sustainable capacity. By mapping the capacity building activities in each case study onto a framework previously used for evaluating health research capacity in Ghana, we were able to identify activities that were common to all projects. We used these activities to derive indicators which could be used in other projects to monitor progress towards building sustainable research capacity. Indicators of sustainable capacity building increased in complexity as projects matured and included- early engagement of stakeholders; explicit plans for scale up; strategies for influencing policies; quality assessments (awareness and experiential stages)- improved resources; institutionalisation of activities; innovation (expansion stage)- funding for core activities secured; management and decision-making led by southern partners (consolidation stage).Projects became sustainable after a median of 66 months. The main challenges to achieving sustainability were high turnover of staff and stakeholders, and difficulties in embedding new activities into existing systems, securing funding and influencing policy development. Our indicators of sustainable capacity building need to be tested prospectively in a variety of projects to assess their usefulness. For each project the evidence required to show that indicators have been achieved should evolve with the project and they should be determined prospectively in collaboration with stakeholders.

The World Summit on Sustainable Development: reaffirming the centrality of health

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von Schirnding Yasmin

2005-05-01

Full Text Available Abstract The World Summit on Sustainable Development (WSSD was held in Johannesburg in 2002 to review progress since the Rio conference in 1992, and to agree a new global deal on sustainable development. Unlike its predecessor, it was primarily concerned with implementation rather than with new treaties and targets, although a number of new targets were agreed, for example one on sanitation. Failure to agree a target on renewable energy was regarded as a major disappointment of the conference. While relatively modest in its achievements, and with difficulties in achieving consensus in key areas such as energy, trade, finance and globalisation, WSSD nevertheless succeeded in placing sustainable development back on the political agenda, giving new impetus, in particular to the environment and development needs of Africa, with a strong focus on local issues like household energy, water and sanitation. Health was singled out as one of five priority areas, along with water, energy, agriculture and biodiversity, and was devoted a separate chapter in the resulting Plan of Implementation, which highlighted a range of environmental health issues as well as issues relating to health services, communicable and non-communicable diseases. A number of new partnerships were formed at WSSD, including the Healthy Environments for Children Alliance (HECA launched by WHO, which will form an important platform for implementation. The Commission on Sustainable Development has been designated main responsibility for monitoring and follow up, with its programme of work reorganised to focus on thematic clusters of issues. From the perspective of health, WSSD must be seen as a reaffirmation of the central place of health on the sustainable development agenda, and in the broader context of a process which began in Rio and was given added impetus with the Monterrey Financing for Development conference and the World Trade Organisation meeting held in Doha. Translating

Health Systems Sustainability and Rare Diseases.

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Ferrelli, Rita Maria; De Santis, Marta; Egle Gentile, Amalia; Taruscio, Domenica

2017-01-01

The paper is addressing aspects of health system sustainability for rare diseases in relation to the current economic crisis and equity concerns. It takes into account the results of the narrative review carried out in the framework of the Joint Action for Rare Diseases (Joint RD-Action) "Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases", that identified networks as key factors for health systems sustainability for rare diseases. The legal framework of European Reference Networks and their added value is also presented. Networks play a relevant role for health systems sustainability, since they are based upon, pay special attention to and can intervene on health systems knowledge development, partnership, organizational structure, resources, leadership and governance. Moreover, sustainability of health systems can not be separated from the analysis of the context and the action on it, including fiscal equity. As a result of the financial crisis of 2008, cuts of public health-care budgets jeopardized health equity, since the least wealthy suffered from the greatest health effects. Moreover, austerity policies affected economic growth much more adversely than previously believed. Therefore, reducing public health expenditure not only is going to jeopardise citizens' health, but also to hamper fair and sustainable development.

Is health workforce sustainability in Australia and New Zealand a realistic policy goal?

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Buchan, James M; Naccarella, Lucio; Brooks, Peter M

2011-05-01

This paper assesses what health workforce 'sustainability' might mean for Australia and New Zealand, given the policy direction set out in the World Health Organization draft code on international recruitment of health workers. The governments in both countries have in the past made policy statements about the desirability of health workforce 'self-sufficiency', but OECD data show that both have a high level of dependence on internationally recruited health professionals relative to most other OECD countries. The paper argues that if a target of 'self-sufficiency' or sustainability were to be based on meeting health workforce requirements from home based training, both Australia and New Zealand fall far short of this measure, and continue to be active recruiters. The paper stresses that there is no common agreed definition of what health workforce 'self-sufficiency', or 'sustainability' is in practice, and that without an agreed definition it will be difficult for policy-makers to move the debate on to reaching agreement and possibly setting measurable targets or timelines for achievement. The paper concludes that any policy decisions related to health workforce sustainability will also have to taken in the context of a wider community debate on what is required of a health system and how is it to be funded.

Advancing the application of systems thinking in health: sustainability evaluation as learning and sense-making in a complex urban health system in Northern Bangladesh.

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Sarriot, Eric G; Kouletio, Michelle; Jahan, Dr Shamim; Rasul, Izaz; Musha, Akm

2014-08-26

Starting in 1999, Concern Worldwide Inc. (Concern) worked with two Bangladeshi municipal health departments to support delivery of maternal and child health preventive services. A mid-term evaluation identified sustainability challenges. Concern relied on systems thinking implicitly to re-prioritize sustainability, but stakeholders also required a method, an explicit set of processes, to guide their decisions and choices during and after the project. Concern chose the Sustainability Framework method to generate creative thinking from stakeholders, create a common vision, and monitor progress. The Framework is based on participatory and iterative steps: defining (mapping) the local system and articulating a long-term vision, describing scenarios for achieving the vision, defining the elements of the model, and selecting corresponding indicators, setting and executing an assessment plan,, and repeated stakeholder engagement in analysis and decisions . Formal assessments took place up to 5 years post-project (2009). Strategic choices for the project were guided by articulating a collective vision for sustainable health, mapping the system of actors required to effect and sustain change, and defining different components of analysis. Municipal authorities oriented health teams toward equity-oriented service delivery efforts, strengthening of the functionality of Ward Health Committees, resource leveraging between municipalities and the Ministry of Health, and mitigation of contextual risks. Regular reference to a vision (and set of metrics (population health, organizational and community capacity) mitigated political factors. Key structures and processes were maintained following elections and political changes. Post-project achievements included the maintenance or improvement 5 years post-project (2009) in 9 of the 11 health indicator gains realized during the project (1999-2004). Some elements of performance and capacity weakened, but reductions in the equity gap

Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

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Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

2015-04-29

The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

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Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

2017-12-01

Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

Walking, sustainability and health: findings from a study of a Walking for Health group.

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Grant, Gordon; Machaczek, Kasia; Pollard, Nick; Allmark, Peter

2017-05-01

Not only is it tacitly understood that walking is good for health and well-being but there is also now robust evidence to support this link. There is also growing evidence that regular short walks can be a protective factor for a range of long-term health conditions. Walking in the countryside can bring additional benefits, but access to the countryside brings complexities, especially for people with poorer material resources and from different ethnic communities. Reasons for people taking up walking as a physical activity are reasonably well understood, but factors linked to sustained walking, and therefore sustained benefit, are not. Based on an ethnographic study of a Walking for Health group in Lincolnshire, UK, this paper considers the motivations and rewards of group walks for older people. Nineteen members of the walking group, almost all with long-term conditions, took part in tape-recorded interviews about the personal benefits of walking. The paper provides insights into the links between walking as a sustainable activity and health, and why a combination of personal adaptive capacities, design elements of the walks and relational achievements of the walking group are important to this understanding. The paper concludes with some observations about the need to reframe conventional thinking about adherence to physical activity programmes. © 2017 John Wiley & Sons Ltd.

Achieving Nuclear Sustainability through Innovation

International Nuclear Information System (INIS)

2013-01-01

In 2000, the IAEA Member States recognized that concerted and coordinated research and development is needed to drive innovation that ensures that nuclear energy can help meet energy needs sustainably in the 21st century. Following an IAEA General Conference resolution, an international 'think tank' and dialogue forum were established. The resulting organization, the IAEA's International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO), helps nuclear technology holders and users coordinate the national and international studies, research and other activities needed to achieve innovations in nuclear reactor designs and fuel cycles. Currently, 38 countries plus the European Commission are participating in the project. This group includes both developing and developed economies that represent more than 75% of the world's population and 85% of its gross domestic product. INPRO undertakes collaborative projects among IAEA Member States, which analyse development scenarios and examine how nuclear energy can support the United Nations' goals for sustainable development in the 21st century. The results of these projects can be applied by IAEA Member States in their national nuclear energy strategies and can lead to international cooperation resulting in beneficial innovations in nuclear energy technology and its deployment. For example, INPRO studies the 'back end' of the fuel cycle, including recycling of spent fuel to increase resource use efficiency and to reduce the waste disposal burdens.

Sustainable Transportation and Health

Directory of Open Access Journals (Sweden)

Norbert Mundorf

2018-03-01

Full Text Available We are experiencing a shift in thinking about Transportation and Mobility, which makes this Special Issue on Sustainable Transportation and Health in the International Journal of Environmental Research and Public Health especially timely.[...

Intelligent Buildings: Key to Achieving Total Sustainability in the Built Environment

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Tulika Gadakari

2014-01-01

Full Text Available ‘Are intelligent buildings a pragmatic approach towards achieving a sustainable built environment?’ is the research question that this review article aims to answer. It has been argued that there is a serious need for intelligent buildings to be evaluated against the parameters of total sustainability (environmental, economic and social so as to help the agenda of living in a technologically advanced, healthy and comfortable world. This paper reviews existing theoretical concepts of intelligence and sustainability in the built environment, through an exploration of various scientific literature and U.S Green Building Council’s LEED (Leadership in Energy and Environmental Design databases. A systematic qualitative review approach has been employed to select an appropriate definition of sustainable development and use it as a theoretical framework to assess the technological impact of intelligent buildings on the environmental, economic and social front. Subsequently five case study buildings from around the world, which exemplify the use of intelligent technologies to achieve sustainable gains were chosen and analyzed to further validate the literature findings. Outputs from the study highlight the various benefits of intelligent buildings, which include decrease in energy and water consumption, operational costs, as well as increase in productivity and investments. Additionally the analysis of the case studies revealed that the use of intelligent building technologies has contributed significantly towards a higher sustainability rating on the LEED rating scale. Moreover, the comparison of the attributes of intelligent buildings and sustainable practices in buildings, illustrates the fact that there is a considerable overlap between the two and intelligence can aid sustainability in the built environment. Thus the research suggests that green technologies and intelligence in combination may be a pragmatic approach towards the sustainability

The Science of Sustaining Health Behavior Change: The Health Maintenance Consortium

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Ory, Marcia G.; Smith, Matthew Lee; Mier, Nelda; Wernicke, Meghan M.

2013-01-01

Objective The Health Maintenance Consortium (HMC) is a multisite Grantee Consortium funded by the National Institutes of Health from 2004–2009. The goal of HMC is to enhance understanding of the long-term maintenance of behavior change, as well as effective strategies for achieving sustainable health promotion and disease prevention. Methods This introductory research synthesis prepared by the Resource Center gives context to this theme issue by providing an overview of the HMC and the articles in this journal. Results It explores the contributions to our conceptualization of behavior change processes and intervention strategies, the trajectory of effectiveness of behavioral and social interventions, and factors influencing the long-term maintenance of behavioral and social interventions. Conclusions Future directions for furthering the science of maintaining behavior change and reducing the gaps between research and practice are recommended. PMID:20604691

Sustainability of health information systems: a three-country qualitative study in southern Africa.

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Moucheraud, Corrina; Schwitters, Amee; Boudreaux, Chantelle; Giles, Denise; Kilmarx, Peter H; Ntolo, Ntolo; Bangani, Zwashe; St Louis, Michael E; Bossert, Thomas J

2017-01-10

Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, and strategic use of information. Many donors have worked to improve health information systems, particularly by supporting the introduction of electronic health information systems (EHIS), which are considered more responsive and more efficient than older, paper-based systems. As many donor-driven programs are increasing their focus on country ownership, sustainability of these investments is a key concern. This analysis explores the potential sustainability of EHIS investments in Malawi, Zambia and Zimbabwe, originally supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR). Using a framework based on sustainability theories from the health systems literature, this analysis employs a qualitative case study methodology to highlight factors that may increase the likelihood that donor-supported initiatives will continue after the original support is modified or ends. Findings highlight commonalities around possible determinants of sustainability. The study found that there is great optimism about the potential for EHIS, but the perceived risks may result in hesitancy to transition completely and parallel use of paper-based systems. Full stakeholder engagement is likely to be crucial for sustainability, as well as integration with other activities within the health system and those funded by development partners. The literature suggests that a sustainable system has clearly-defined goals around which stakeholders can rally, but this has not been achieved in the systems studied. The study also found that technical resource constraints - affecting system usage, maintenance, upgrades and repairs - may limit EHIS sustainability even if these other pillars were addressed. The sustainability of EHIS faces many challenges, which could be addressed through systems' technical design, stakeholder

Mitigating India's health woes: Can health insurance be a remedy to achieve universal health coverage?

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B Savitha

2016-01-01

Full Text Available A low level of public investments in preventive health facilities and medical care facilities and health professionals has given rise to poor health status for an average Indian. Insufficient government funding for health care, inadequate and ineffective health financing mechanisms, poor delivery of health care, especially in public facilities, and excessive reliance on unregulated high-cost private providers have contributed to the poor accomplishment of Millennium Development Goals, especially in the informal sector. Sustainable Development Goals (SDGs consider health to be one of the important objectives to be achieved by all the nations in the world. This paper reappraises the current status, unmet needs, challenges, and the way forward to implement and achieve universal health coverage (UHC in India by thrusting the focus on three elements (pillars of universal access to health services. Despite seven decades of independence, India does still face the formidable challenge of providing health services to its population at an affordable cost. One of the major obstacles in reaching universal coverage and universal health entitlement of every Indian citizen has been the absence of effective health financing mechanism that promotes affordable access to weaker and vulnerable sections of the society. In this respect, health insurance certainly does have the potential to expedite the process of UHC if various stakeholders work in cohesion under the government stewardship. In rural India, the health infrastructure and workforce are inadequate to serve the unserved and underserved population. Hence, the government should invest in public health facilities while promoting pan-India health insurance to ensure and guarantee easy access and affordability for its citizens. The way forward should not only be centered on financial protection, but also to have renewed emphasis on restructuring the health-care system, ensuring the adequate availability of

The Bangladesh paradox: exceptional health achievement despite economic poverty.

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Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

2013-11-23

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints. Copyright © 2013 Elsevier Ltd. All rights reserved.

Review: Animal health and sustainable global livestock systems.

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Perry, B D; Robinson, T P; Grace, D C

2018-04-10

This paper discusses the sustainability of livestock systems, emphasising bidirectional relations with animal health. We review conventional and contrarian thinking on sustainability and argue that in the most common approaches to understanding sustainability, health aspects have been under-examined. Literature review reveals deep concerns over the sustainability of livestock systems; we recognise that interventions are required to shift to more sustainable trajectories, and explore approaches to prioritising in different systems, focusing on interventions that lead to better health. A previously proposed three-tiered categorisation of 'hot spots', 'cold spots' and 'worried well' animal health trajectories provides a mental model that, by taking into consideration the different animal health status, animal health risks, service response needs and key drivers in each system, can help identify and implement interventions. Combining sustainability concepts with animal health trajectories allows for a richer analysis, and we apply this to three case studies drawn from North Africa and the Middle East; Bangladesh; and the Eastern Cape of South Africa. We conclude that the quest for sustainability of livestock production systems from the perspective of human and animal health is elusive and difficult to reconcile with the massive anticipated growth in demand for livestock products, mainly in low- and middle-income countries, as well as the aspirations of poor livestock keepers for better lives. Nevertheless, improving the health of livestock can contribute to health sustainability both through reducing negative health impacts of livestock and increasing efficiency of production. However, the choice of the most appropriate options must be under-pinned by an understanding of agro-ecology, economy and values. We argue that a new pillar of One Health should be added to the three traditional sustainability pillars of economics, society and environment when addressing

Improving the long-term sustainability of health aid: are Global Health Partnerships leading the way?

Science.gov (United States)

Dodd, Rebecca; Lane, Christopher

2010-09-01

Over the last decade development assistance for health has more than doubled. This increase provides an unprecedented opportunity to scale up health services, and in doing so, achieve the health Millennium Development Goals. However, sustaining scaling up will in turn require sustainable donor support until domestic health financing can substitute for it. The provision of long-term predictable finance is of particular concern in health because the bulk of costs are recurrent and many interventions require sustained, multi-year support to be successful. This is also true for health systems strengthening efforts. As the bulk of new aid resources flow through Global Health Partnerships (GHPs), their ability to make long-term commitments is critical to health systems development. In order to better understand the constraints that prevent development partners from making long-term commitments of health aid, the World Health Organization reviewed the practices of seven major health partners in committing development assistance funds over the long term. The review found increasing evidence of long-term commitments of aid for health in each of the seven agencies. The GHPs and their funders have been at the forefront of this trend, pioneering many of the new approaches. The study concludes that all partners have scope to improve the duration of aid within existing rules and regulations, and that the main constraints to doing so are political. Predictability is even more of a concern in current global economic circumstances, as access to resources begins to be squeezed. In this context it is important that we learn from GHPs, which have successfully tested innovative approaches to both raising and disbursing health funds. The prospects for change associated with the new administration in the United States-the largest health donor and the most unpredictable, but also a major supporter of GHPs-make this task even more urgent.

Roads from Rio+20. Pathways to achieve global sustainability goals by 2050

Energy Technology Data Exchange (ETDEWEB)

Van Vuuren, D. [ed.; Kok, M. [ed.; Van der Esch, S.; Jeuken, M.; Lucas, P.; Prins, Anne-Gerdien; Alkemade, R.; Van den Berg, M.; Hilderink, H.; Kram, T.; Stehfest, E.; De Vries, B. [Netherlands Environmental Assessment Agency PBL, Den Haag (Netherlands); Biermann, F.; Van der Grijp, N.; Pattberg, P. [Institute for Environmental Studies IVM, Vrije Universiteit, Amsterdam (Netherlands); Melamed, C.; Scott, A.; Te Velde, D. W.; Wiggins, S. [Overseas Development Institute ODI, London (United Kingdom)

2012-06-15

This report analyses how combinations of technological measures and changes in consumption patterns could contribute to achieving a set of sustainability objectives, taking into account the interlinkages between them. The potential exists for achieving all of the objectives.

Sustainable intensification in agriculture as a factor of achieving food security

Directory of Open Access Journals (Sweden)

Đurić Katarina

2016-01-01

Full Text Available Ending hunger, achieving food security and promoting sustainable development are at the top of the list of United Nations sustainable global development priorities after 2015. In addition to many positive effects, efforts of mankind regarding the reduction of rural poverty realized through the Green Revolution have had many negative effects, primarily related to natural resources. Irreversible devastation of land, air and water quality deterioration and jeopardizing biodiversity have been recognized as key elements of unsustainability of existing agricultural development concept. Consequently, there is a need for the adoption of a new concept of agricultural development, which will lie between intensive conventional and organic farming. The concept which has already been applied in some regions of the world and whose basic goal is to find a way to increase production with a negligible negative impact on the environment is sustainable agricultural intensification. The aim of this paper is to look at both positive and negative aspects of biotechnology development so far and point out the place and role the sustainable intensification concept should have in relation to conservation of natural resources and achievement of food security.

A computer-aided approach for achieving sustainable process design by process intensification

DEFF Research Database (Denmark)

Anantasarn, Nateetorn; Suriyapraphadilok, Uthaiporn; Babi, Deenesh Kavi

2017-01-01

to generate flowsheet alternatives that satisfy the design targets thereby, minimizing and/or eliminating the process hot-spots. The application of the framework is highlighted through the production of para-xylene via toluene methylation where more sustainable flowsheet alternatives that consist of hybrid......Process intensification can be applied to achieve sustainable process design. In this paper, a systematic, 3-stage synthesis-intensification framework is applied to achieve more sustainable design. In stage 1, the synthesis stage, an objective function and design constraints are defined and a base...... case is synthesized. In stage 2, the design and analysis stage, the base case is analyzed using economic and environmental analyses to identify process hot-spots that are translated into design targets. In stage 3, the innovation design stage, phenomena-based process intensification is performed...

Health care financing and the sustainability of health systems.

Science.gov (United States)

Liaropoulos, Lycourgos; Goranitis, Ilias

2015-09-15

The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

Making mental health an integral part of sustainable development: the contribution of a social determinants framework.

Science.gov (United States)

De Silva, M J

2015-04-01

There have been repeated calls to include mental health in the sustainable development goals (SDGs), arguing that progress in development will not be made without improvements in mental health. Although these calls are starting to gain political traction, currently only a tiny fraction of international development work includes mental health. A social determinants framework may be useful in incorporating mental health into sustainable development because it promotes a multi-sectorial and multi-disciplinary approach which is the corner stone of good development practice. Two approaches are suggested to make mental health a part of sustainable development: (1) integrate mental health into existing development programmes to promote social and economic environments that prevent mental health problems developing; (2) ensure that mental health programmes are better at promoting sustainable development by preventing the negative social and economic consequences of mental illness. Real-world examples of these approaches are provided. To achieve this, the mental health impact of wider development programmes, and the social and economic consequences of mental health interventions, must be evaluated. Development agencies should ensure that they have equity for mental health in all their policies, and investment must be increased for those mental health prevention, promotion and treatment programmes which have the greatest impact on sustainable development. The SDGs bring the promise of a more holistic approach to development. It is now the task of global mental health to demonstrate not just that mental health is an integral part of sustainable development, but that affordable and effective solutions exist which can improve mental health and development more broadly.

Holistic Performance Measurement to Achieve Sustainable Competitive Advantage

OpenAIRE

Keni Keni

2013-01-01

In the past, companies used balanced scorecard to measure its performance. Now, balanced scorecard as a performance measurement tool is no longer sufficient because business has been affected by changes to the natural environment and developing social expectations. In order to achieve sustainable competitive advantage, companies are beginning to address the risks and opportunities associated with these changes in their longer-term business planning. To turn risks into opportunities, companies...

Duality of Health Promotion and Sustainable Development

DEFF Research Database (Denmark)

Pedersen, Kirsten Bransholm; Land, Birgit; Kjærgård, Bente

2015-01-01

reduction and how these strategies affect the prospects for promoting health and sustainable food production and consumption. Danish food waste reduction strategies are used as examples with references to selected policy documents on food waste reduction strategies launched by international organisations...... sustainability and, vice versa, sustainability conditions health. Thus, to avoid unintended, negative effects the strategies directed towards sustainable development must be correlated with strategies for health promotion. The conceptual model is used to take a closer look at the complexities of food waste...... of food as food waste is reduced. The lack of attention given to reducing the oversupply of food calls for governance initiatives directed towards reducing the overproduction of primary food produce in order to reap the environmental benefits and the health promotion benefits of reducing food waste...

Water Quality and Sustainable Environmental Health

Science.gov (United States)

Setegn, S. G.

2014-12-01

Lack of adequate safe water, the pollution of the aquatic environment and the mismanagement of resources are major causes of ill-health and mortality, particularly in the developing countries. In order to accommodate more growth, sustainable fresh water resource management will need to be included in future development plans. One of the major environmental issues of concern to policy-makers is the increased vulnerability of ground water quality. The main challenge for the sustainability of water resources is the control of water pollution. To understand the sustainability of the water resources, one needs to understand the impact of future land use and climate changes on the natural resources. Providing safe water and basic sanitation to meet the Millennium Development Goals will require substantial economic resources, sustainable technological solutions and courageous political will. A balanced approach to water resources exploitation for development, on the one hand, and controls for the protection of health, on the other, is required if the benefits of both are to be realized without avoidable detrimental effects manifesting themselves. Meeting the millennium development goals for water and sanitation in the next decade will require substantial economic resources, sustainable technological solutions and courageous political will. In addition to providing "improved" water and "basic" sanitation services, we must ensure that these services provide: safe drinking water, adequate quantities of water for health, hygiene, agriculture and development and sustainable sanitation approaches to protect health and the environment.

Towards Intelligently - Sustainable Cities? From Intelligent and Knowledge City Programmes to the Achievement of Urban Sustainability

NARCIS (Netherlands)

Gargiulo Morelli, V.; Weijnen, M.P.C.; Van Bueren, E.M.; Wenzler, I.; De Reuver, G.A.; Salvati, L.

2013-01-01

In the quest for achieving sustainable cities, Intelligent and Knowledge City Programmes (ICPs and KCPs) represent cost-efficient strategies for improving the overall performance of urban systems, especially when compared with the costs of physical restructuring and/or retrofitting projects.

Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions.

Science.gov (United States)

Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian

2016-01-01

The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

Climate change: A threat towards achieving ‘Sustainable Development Goal number two’ (end hunger, achieve food security and improved nutrition and promote sustainable agriculture in South Africa

Directory of Open Access Journals (Sweden)

Shingirai S. Mugambiwa

2017-02-01

Full Text Available This article aims to assess the impacts of climate change towards the achievement of Sustainable Development Goal number two (SDG 2 as well as examining the poverty alleviation strategies by subsistence farmers in South Africa. Widespread hunger and poverty continue to be among the most life-threatening problems confronting mankind. Available statistics show that global poverty remains a serious challenge around the world. Across the globe, one in five people lives on less than $1 a day and one in seven suffers from chronic hunger. Similarly, the developing world is adversely affected by poverty and hunger. In the sub-Saharan Africa, research has revealed a higher prevalence of hunger, malnutrition, poverty and food insecurity. SDG 2 focuses more on eliminating hunger and promoting sustainable agriculture. The study employed an exploratory design and a qualitative method. Snowball sampling was used in selecting relevant sources which led the researchers to other research work on the same field through keywords and reference lists. The researchers employed discourse analysis to analyse data. The study discovered that there are numerous potential effects climate change could have on agriculture. It affects crop growth and quality and livestock health. Farming practices could also be affected as well as animals that could be raised in particular climatic areas. The impact of climate change as well as the susceptibility of poor communities is very immense. The article concludes that climate change reduces access to drinking water, negatively affects the health of people and poses a serious threat to food security.

Measuring sustainability as a programming tool for health sector investments: report from a pilot sustainability assessment in five Nepalese health districts.

Science.gov (United States)

Sarriot, Eric; Ricca, Jim; Ryan, Leo; Basnet, Jagat; Arscott-Mills, Sharon

2009-01-01

Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries of the local system being examined. This local system-the unit of analysis of the study-was defined as the health district.We developed a standardized set of assessment tools to measure 53 indicators. Data collection was carried out over 4 weeks by a Nepalese agency. Scaling and combining indicators into six component indices provided a map of progress toward sustainable maternal, child, health, and family planning results for the five districts included in this pilot study, ranked from "no sustainability" to "beginning of sustainability."We conclude that systematic application of the Sustainability Framework could improve the health sector investment decisions of development agencies. It could also give districts an information base on which to build autonomy and accountability. The ability to form and test hypotheses about the sustainability of outcomes under various funding strategies-made possible by this approach-will be a prerequisite for more efficiently meeting the global health agenda.

How to achieve a sustainable future for Europe?

Directory of Open Access Journals (Sweden)

Blinc Robert

2008-01-01

Full Text Available According to the Lisbon declaration from 2000 the goal of European Union is to become by 2010 the most competitive and dynamic knowledge-driven economy and by 2025 a sustainable knowledge society. The EU however faces some strong challenges on the road toward these goals and is evidently lagging behind both USA and Japan. Our analysis is based on six dimensions of these challenges, including the economic challenge, the demographic challenge, the scientific challenge, the challenge of higher education, the challenge of European governance and identity/system of values, and the environmental/ecotechnological challenge. We argue that if we are to provide a sustainable secure environment and prosperity for next generations, we have to act now at least with developments in particular in the direction of clean, cheap, and renewable energy sources with an emphasis on basic, curiosity driven research which through scientific breakthroughs, is the only realistic solution to solving world's energy requirements. Such an action could for example facilitate the transition from fossil fuels to solar power in a relatively short time of about two decades, and help EU achieve its declared sustainability targets.

Radiation environment assessment, measurement and its impact on health and sustainable development

International Nuclear Information System (INIS)

Kumar, Pradeep; Panwar, Brijandra Singh

2012-01-01

Present paper deals with Radiation Environment Assessment, Measurement and its Impact on Health, its meaning and in particular with sustainable development perspective. Health and Environment appears to be different subjects and concepts, but in reality they are interrelated and interdependent. One cannot exist without the other. For good health hygienic environment is a sine qua non. Article 3 of Universal Declaration of Human Right 1948 incorporates the right to life. It has been interpreted by the international court that the word life does not means simply to live but it means to live with dignity and in well and pollution and radiation free environment which is a gift of nature on this universe. There is no doubt about the nuclear revolution that has taken place and has made life of human beings worth living on this earth with comfort. It is growing development of the nation. But in the process the development that has been done at the cost of human life, public health and environment which will prove fatal in the long run. So there is a need for Sustainable Development of the human and environment of the world. Precisely and concisely, the sustainable development is a process that meets the needs of the present without compromising ability of future generations to meet their own needs. A hygienic and redaction free environment will ensure the better Health of the people. Environment and nuclear power plant can coexist. The harmonization of the two needs has led to the concept of Radiation Environment Assessment and sustainable development, so much so that it has become the most significant and focal point of environmental legislation relating to the same. Sustainable development, simply put, is a process in which development can be sustained over generations effects of radiation on humans and on the environment. Finally, this paper deals with the impact of radiation on environment and the need of sustainable development for achieving a better human. (author)

A future task for health-promotion research: Integration of health promotion and sustainable development.

Science.gov (United States)

Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper; Kjærgård, Bente; Andersen, Heidi Myglegård; From, Ditte-Marie; Land, Birgit; Pedersen, Kirsten Bransholm

2018-02-01

Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health-promotion research regarding integration of sustainable development principles. Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified. These are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development, as well as the politics and implementation of policy goals in both areas. Three focal points are proposed as important challenges to address in future research: (a) the duality of health promotion and sustainability and how it can be handled in order to enhance mutually supportive processes between them; (b) the social dimension of sustainability and how it can be strengthened in the development of strategies for health promotion and sustainable development; and (c) exploring and identifying policy approaches and strategies for integrating health promotion and sustainable development.

Societal health and urban sustainability indicators

Energy Technology Data Exchange (ETDEWEB)

Petrich, C.H.; Tonn, B.E.

1996-08-27

Without the social will, no city can successfully Undertake the planning and programs necessary for meaningful progress toward sustainability. Social will derives from wellsprings of vital societal health. This paper presents an approach to helping cities in APEC member economies initiate a program for developing indicators of sustainability. Representative indicators of social capital and other aspects of civic engagement, as proxies for societal health, are presented.

Challenges, responses and partnership for achieving sustainable tourism and heritage preservation

Directory of Open Access Journals (Sweden)

Maksin Marija

2010-01-01

Full Text Available The process of globalization has created the situation where the expectations of tourists are the same both with respect to the quality of services in all destinations and with respect to the authencity based on local attractions and experiences, which should be unique and different for each destination. The key element in maintaining destination attractiveness is the protection and presentation of natural and cultural heritage and its sustainable utilization for tourism development. The sustainability concept is of equal importance for long-term tourism development, destination competitiveness and heritage protection. The paper deals with the main challenges to achieving sustainable tourism and points to some key responses to them. Participation, cooperation and partnership should be a vital prerequisite for the implementation and performance of sustainable tourism and heritage protection. This attitude has been tested on several examples of good practice in heritage protection and the sustainable development of tourism destinations in Serbia. .

Sustainable practice change: Professionals' experiences with a multisectoral child health promotion programme in Sweden

Directory of Open Access Journals (Sweden)

Mogren Ingrid

2011-03-01

requirements for programme sustainability. Conclusions These results contribute to the knowledge of processes involved in achieving sustainability in health promotion initiatives. Facilitating factors include involving front-line professionals in intervention development and using small scale testing; however, the success of a programme requires paying attention to the role of managerial support and an overall supportive system. In summary, these results emphasise the importance for both practitioners and researchers to pay attention to parallel processes at different levels in multidisciplinary improvement efforts intended to ensure sustainable practice change.

Tracking health-related Sustainable Development Goals (SDGs in Nepal

Directory of Open Access Journals (Sweden)

Meghnath Dhimal

2017-07-01

Full Text Available Sustainable Development Goals (SDGs comprise of 17 goals and 169 targets. All SDGs are interlinked to produce synergetic eff ects and emphasize health in all policies. Among the 17 Goals, Goal 3 has a central focus on health, which is underpinned by 13 targets. The other 16 goals are also directly or indirectly related to health and will contribute to achieving the associated targets for Goal 3. The ambitious SDG agenda and their progress can be tracked by measuring numerous goals, targets, and indicators. The main objective of this paper is to provide an overview about how health- related SDGs and their targets and indicators are being tracked in the national context of Nepal. Adequate investment in research for knowledge generation, capacity building and innovation, and continous research communication among policy makers, researchers and external development partners will contribute to tracking the progress of SDGs in Nepal.

Sustainable Development is the only path to achieve the green economy

Directory of Open Access Journals (Sweden)

Ahmed Abou Elseoud

2015-12-01

Full Text Available Sustainable development is the management of renewable resources for the good of the entire human and natural community. Built into this concept is an awareness of the animal and plant life of the surrounding environment .The goal of sustainable development is to provide resources for the use of present populations without compromising the availability of those resources for future generations, and without causing environmental damage that challenges the survival of natural ecosystems. Consequently, sustainable economies cannot be based on the use of non-renewable resources. Ultimately, sustainable economies must be supported by the use of renewable resources such as biological productivity, and solar, wind, geothermal, and biomass energy sources. However, even renewable resources may be subjected to overexploitation and other types of environmental degradation. Central to the notion of sustainable development is the requirement that renewable resources are utilized in ways that do not diminish their capacity for renewal, so that they will always be present to sustain future generations of humans. On the other hand, Egypt welcomes the concept of the green economy to achieve sustainable development ,within the framework of respect for national priorities of each country, in order to achieve more decent work opportunities, and developments continued, and use environmental resources. Egypt have passed already in the implementation of a number of pilot projects in this regard, and look forward to witnessing the next stage for more cooperation with development. The energy is the main driver of economic and social development with the necessity to development of primary energy resources and the proper management and use of the most important policies and development strategies Egypt depends in achieving economic development and technological several sources of energy available to a power and petroleum and natural gas, but that recently Egypt has seen

From the Earth Summit to Rio+20: integration of health and sustainable development.

Science.gov (United States)

Haines, Andy; Alleyne, George; Kickbusch, Ilona; Dora, Carlos

2012-06-09

In 2012, world leaders will meet at the Rio+20 conference to advance sustainable development--20 years after the Earth Summit that resulted in agreement on important principles but insufficient action. Many of the development goals have not been achieved partly because social (including health), economic, and environmental priorities have not been addressed in an integrated manner. Adverse trends have been reported in many key environmental indicators that have worsened since the Earth Summit. Substantial economic growth has occurred in many regions but nevertheless has not benefited many populations of low income and those that have been marginalised, and has resulted in growing inequities. Variable progress in health has been made, and inequities are persistent. Improved health contributes to development and is underpinned by ecosystem stability and equitable economic progress. Implementation of policies that both improve health and promote sustainable development is urgently needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Public health program capacity for sustainability: a new framework.

Science.gov (United States)

Schell, Sarah F; Luke, Douglas A; Schooley, Michael W; Elliott, Michael B; Herbers, Stephanie H; Mueller, Nancy B; Bunger, Alicia C

2013-02-01

Public health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health. This developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention). The literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program's capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity-89% of the individual items composing the framework had specific support in the sustainability literature. The sustainability framework presented here suggests that a number of selected factors may be related to a program's ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing

Sustainable diets: The interaction between food industry, nutrition, health and the environment.

Science.gov (United States)

Alsaffar, Ayten Aylin

2016-03-01

Everyday great amounts of food are produced, processed, transported by the food industry and consumed by us and these activities have direct impact on our health and the environment. The current food system has started causing strain on the Earth's natural resources and that is why sustainable food production systems are needed. This review article discusses the need for sustainable diets by exploring the interactions between the food industry, nutrition, health and the environment, which are strongly interconnected. The most common environmental issues in the food industry are related to food processing loss, food wastage and packaging; energy efficiency; transportation of foods; water consumption and waste management. Among the foods produced and processed, meat and meat products have the greatest environmental impact followed by the dairy products. Our eating patterns impact the environment, but the environment can impact dietary choices as well. The foods and drinks we consume may also affect our health. A healthy and sustainable diet would minimise the consumption of energy-dense and highly processed and packaged foods, include less animal-derived foods and more plant-based foods and encourage people not to exceed the recommended daily energy intake. Sustainable diets contribute to food and nutrition security, have low environmental impacts and promote healthy life for present and future generations. There is an urgent need to develop and promote strategies for sustainable diets; and governments, United Nations agencies, civil society, research organisations and the food industry should work together in achieving this. © The Author(s) 2016.

MARKETING PROGRAMS FOR GREEN PRODUCTS IN ACHIEVING ECOLOGICAL SUSTAINABILITY

OpenAIRE

Gabriela CĂPĂȚÎNĂ; Roxana-Denisa STOENESCU

2015-01-01

This article explores one dimension of green marketing programs: their potential application as a solution in achieving and maintaining the ecological sustainability on global market. We examine the necessity to develop and launch green products which can respond to environment degradation as a treatment against this phenomenon. This paper is structured in three sections: the first section is related to a clear delimitation and a better understanding of terms; the second one is an overvi...

A future task for Health Promotion research: Integration of Health Promotion and sustainable development

DEFF Research Database (Denmark)

Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper

2018-01-01

Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health promotion research regarding integration of sustainable development principles....... Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired...... and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified: these are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development...

Bayelsa, in search of a sustainable health financing scheme ...

African Journals Online (AJOL)

Journal Home > Vol 23, No 1 (2017) > ... Background: A sustainable health care financing scheme has been difficult to ... These meagre allocations were because the same source that funds patient care services also funds health research, capital ... a sustainable health financing scheme will depend on a health system that ...

Searching for the Right to Health in the Sustainable Development Agenda Comment on "Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?".

Science.gov (United States)

Hawkes, Sarah; Buse, Kent

2016-02-24

The United Nations (UN) Sustainable Development Agenda offers an opportunity to realise the right to health for all. The Agenda's "interlinked and integrated" Sustainable Development Goals (SDGs) provide the prospect of focusing attention and mobilising resources not just for the provision of health services through universal health coverage (UHC), but also for addressing the underlying social, structural, and political determinants of illness and health inequity. However, achieving the goals' promises will require new mechanisms for inter-sectoral coordination and action, enhanced instruments for rational priority-setting that involve affected population groups, and new approaches to ensuring accountability. Rights-based approaches can inform developments in each of these areas. In this commentary, we build upon a paper by Forman et al and propose that the significance of the SDGs lies in their ability to move beyond a biomedical approach to health and healthcare, and to seize the opportunity for the realization of the right to health in its fullest, widest, most fundamental sense: the right to a health-promoting and health protecting environment for each and every one of us. We argue that realizing the right to health inherent in the SDG Agenda is possible but demands that we seize on a range of commitments, not least those outlined in other goals, and pursue complementary openings in the Agenda - from inclusive policy-making, to novel partnerships, to monitoring and review. It is critical that we do not risk losing the right to health in the rhetoric of the SDGs and ensure that we make good on the promise of leaving no one behind. © 2016 by Kerman University of Medical Sciences.

The role of science in achieving sustainability

International Nuclear Information System (INIS)

Dragan, Gleb

2004-01-01

Over the last few decades research in the natural sciences has unveiled a number of specific complex relations between human activity an environmental change on a global scale. Scientific assesment confirm that global life support systems, such as climate, biodiversity and water resources are significantly affected by human activities. System change became the key in the research plan that emerged - systems being defined as the socio-economic and technical chains of production, distribution, consumption and disposal activities. Predicting the impact of a changing world on human health is a hard task and requires an interdisciplinary approach drawn from the fields of evaluation, biogeography, ecology and social sciences, and relying on various methodologies such as mathematical modelling as well as historical analysis. However, the great majority of public health researchers are empiricists by training and tradition, studying the past and the present via direct observation. By definition empirical methods cannot be used to study the future. To extent that the advent of global environmental changes obliges scientists to estimate future impacts, should current or foreseeable trends continue, then empiricism must be supplemented by integrated assessment modelling. The prediction of environmental change and its health impacts encounters uncertainties at various level. Some of the uncertainties are of scientific kind or are referring to the conceptualisation and construction of mathematical models where the specification of linked processes may be uncertain. Research on transformation towards sustainability puts emphasis on the interaction of innovation (production), consumption and institution and incentive structure. The specific challenges and research needs are: - Understand the dynamics of structural change in sociotechno-ecological system and anticipate transformation paths (knowledge of system dynamics); - Assess and evaluate the impacts of specific paths of

Lake Naivasha Sustainability : Ecosystem Improvement for Health ...

International Development Research Centre (IDRC) Digital Library (Canada)

Lake Naivasha Sustainability : Ecosystem Improvement for Health and ... The overall goal is to make recommendations for the sustainable management of natural ... to improve livestock vaccine development and production to benefit farmers ...

Development of a culture of sustainability in health care organizations.

Science.gov (United States)

Ramirez, Bernardo; West, Daniel J; Costell, Michael M

2013-01-01

This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

Using a framework to implement large-scale innovation in medical education with the intent of achieving sustainability.

Science.gov (United States)

Hudson, Judith N; Farmer, Elizabeth A; Weston, Kathryn M; Bushnell, John A

2015-01-16

Particularly when undertaken on a large scale, implementing innovation in higher education poses many challenges. Sustaining the innovation requires early adoption of a coherent implementation strategy. Using an example from clinical education, this article describes a process used to implement a large-scale innovation with the intent of achieving sustainability. Desire to improve the effectiveness of undergraduate medical education has led to growing support for a longitudinal integrated clerkship (LIC) model. This involves a move away from the traditional clerkship of 'block rotations' with frequent changes in disciplines, to a focus upon clerkships with longer duration and opportunity for students to build sustained relationships with supervisors, mentors, colleagues and patients. A growing number of medical schools have adopted the LIC model for a small percentage of their students. At a time when increasing medical school numbers and class sizes are leading to competition for clinical supervisors it is however a daunting challenge to provide a longitudinal clerkship for an entire medical school class. This challenge is presented to illustrate the strategy used to implement sustainable large scale innovation. A strategy to implement and build a sustainable longitudinal integrated community-based clerkship experience for all students was derived from a framework arising from Roberto and Levesque's research in business. The framework's four core processes: chartering, learning, mobilising and realigning, provided guidance in preparing and rolling out the 'whole of class' innovation. Roberto and Levesque's framework proved useful for identifying the foundations of the implementation strategy, with special emphasis on the relationship building required to implement such an ambitious initiative. Although this was innovation in a new School it required change within the school, wider university and health community. Challenges encountered included some resistance to

Configurational Paths to Social Performance in SMEs: The Interplay of Innovation, Sustainability, Resources and Achievement Motivation

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Sascha Kraus

2017-10-01

Full Text Available In today’s world of increasing ecological, social and economic issues, the question as to how businesses can become a vehicle towards more sustainable development has become more relevant than ever. Crucial to a more sustainable economy is the successful implementation of sustainable practices through entrepreneurial activities. Although there are attempts to describe how sustainable entrepreneurs differentiate themselves, the question of how some entrepreneurs manage to successfully create a sustainable enterprise, while others do not, remains unanswered. The aim of this research is to find causal patterns that explain the success of sustainable entrepreneurs, using their social performance as a measure. Using a configuration approach-based fuzzy set qualitative comparative analysis (fsQCA of 598 Austrian small- and medium-sized enterprises (SMEs, we could identify four different combinations of the interconnected variables of innovation orientation, environmental sustainability, resource leveraging and achievement motivation, which all lead to social performance depending on the respective networking intensity of the firms. The only variable that is included in all combinations is environmental sustainability, thus indicating it may be either crucial to or a prerequisite for achieving social performance in SMEs.

Building health research systems to achieve better health

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González Block Miguel

2006-11-01

Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics

Attitudes of the Lifestyle of Health and Sustainability Segment in Hungary

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Zoltán Szakály

2017-09-01

Full Text Available The aim of the research was to define the size of the Hungarian LOHAS (Lifestyle of Health and Sustainability consumer group by analyzing its lifestyle based on sustainable values. To achieve this goal, a representative questionnaire-based survey was carried out involving 1000 individuals in Hungary. During the value-orientated research, 25 lifestyle statements were drawn up. According to the results, five value-based segments could be distinguished. The largest cluster, the young trend followers group, reflects the characteristics of the LOHAS consumers’ lifestyle to the greatest extent. However, this segment cannot entirely be regarded as a consumer group devoted to LOHAS values, which is why a further segmentation of this group was necessary. As a result of this further segmentation, the third sub-cluster, which emphasizes the ethical (competence statements the most, can be identified with the LOHAS consumer group, which makes up 8.7% of the Hungarian population. Further research is necessary to find out whether the situation regarding value orientation in Hungary is similar to that in other Eastern European countries whose social and cultural backgrounds are very similar. Revealing the values of the Lifestyle of Health and Sustainability segment contributes to the extension of the literature.

MARKETING PROGRAMS FOR GREEN PRODUCTS IN ACHIEVING ECOLOGICAL SUSTAINABILITY

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Gabriela CĂPĂȚÎNĂ

2015-04-01

Full Text Available This article explores one dimension of green marketing programs: their potential application as a solution in achieving and maintaining the ecological sustainability on global market. We examine the necessity to develop and launch green products which can respond to environment degradation as a treatment against this phenomenon. This paper is structured in three sections: the first section is related to a clear delimitation and a better understanding of terms; the second one is an overview of the literature about ecological sustainability; the third section is the most relevant part of this paper because is trying to shape a framework of marketing programs for the development of green products, considering the decisions related to marketing mix elements. Even if green marketing programs make sense, current understanding of how managers can start to develop or transform their marketing efforts is far from comprehensive; therefore, this study is addressed to this knowledge gap.

Health Policy Brief: Global Mental Health and the United Nations' Sustainable Development Goals.

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Cratsley, Kelso; Mackey, Tim K

2018-01-25

Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013-2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs) of the UN's 2030 Agenda for Sustainable Development (United Nations, 2015). The WHO's Action Plan calls for several specific objectives and targets, with a focus on improving global mental health governance and service coverage. In contrast, the UN's Sustainable Development Goals include only one goal specific to mental health, with a single indicator tracking suicide mortality rates. The discrepancy between the WHO and UN frameworks suggests a need for increased policy coherence. Improved global health governance can provide the basis for ensuring and accelerating progress in global mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Factors influencing perceived sustainability of Dutch community health programs

NARCIS (Netherlands)

Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.

2015-01-01

We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health

The laboratory efficiencies initiative: partnership for building a sustainable national public health laboratory system.

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Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles

2013-01-01

Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.

Achieving Energy Efficiency Through Real-Time Feedback

Energy Technology Data Exchange (ETDEWEB)

Nesse, Ronald J.

2011-09-01

Through the careful implementation of simple behavior change measures, opportunities exist to achieve strategic gains, including greater operational efficiencies, energy cost savings, greater tenant health and ensuing productivity and an improved brand value through sustainability messaging and achievement.

Barriers and Facilitators to Sustaining School Health Teams in Coordinated School Health Programs.

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Cheung, Karen; Lesesne, Catherine A; Rasberry, Catherine N; Kroupa, Elizabeth; Fisher, Deborah; Robin, Leah; Pitt Barnes, Seraphine

2017-05-01

Coordinated school health (CSH) programs address multiple factors related to students' overall health, thereby increasing their physical and mental readiness to learn. A formative evaluation of three school districts in 2010-2011 examined strategies for sustaining the school health teams (SHTs) that lead CSH efforts. Qualitative data from 39 interviews and 13 focus groups revealed facilitators and barriers for sustaining SHTs. Quantitative data from 68 questionnaires completed by SHT members and school principals examined factors associated with having more active SHTs and district and school characteristics SHT members believed to be important to their schools' efforts to implement CSH. Facilitators of sustaining SHTs included administrative support, staff engagement in the SHT, and shared goals and responsibility. Barriers to sustaining SHTs included limited time and competing priorities, budget and funding constraints, and staff turnover. Findings provide valuable insight into challenges and potential solutions for improving the sustainability of SHTs to enable them to better support CSH efforts.

Health promotion and sustainability programmes in Australia: barriers and enablers to evaluation.

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Patrick, Rebecca; Kingsley, Jonathan

2017-08-01

In an era characterised by the adverse impacts of climate change and environmental degradation, health promotion programmes are beginning to actively link human health with environmental sustainability imperatives. This paper draws on a study of health promotion and sustainability programmes in Australia, providing insights to evaluation approaches being used and barriers and enablers to these evaluations. The study was based on a multi-strategy research involving both quantitative and qualitative methods. Health promotion practitioners explained through surveys and semi-structured interviews that they focused on five overarching health and sustainability programme types (healthy and sustainable food, active transport, energy efficiency, contact with nature, and capacity building). Various evaluation methods and indicators (health, social, environmental, economic and demographic) were identified as being valuable for monitoring and evaluating health and sustainability programmes. Findings identified several evaluation enablers such as successful community engagement, knowledge of health and sustainability issues and programme champions, whereas barriers included resource constraints and competing interests. This paper highlights the need for ecological models and evaluation tools to support the design and monitoring of health promotion and sustainability programmes.

Emerging sustainable/green cleaning products: health and environmental risks

OpenAIRE

Aydin, Mehmet Cihan; Işik, Ercan; Ulu, Ali Emre

2016-01-01

Sustainable development aims to bring a new perspective to our lives without compromising customer needs and quality. Along with sustainable development many innovative solutions came out. One of them is sustainable green cleaning products and techniques. Today, emissions from conventional cleaning products may cause severe health and environmental issues. Especially sick building syndromes such as eye, skin and respiratory irritations are main health effects of them. They may also contrib...

Searching for the Right to Health in the Sustainable Development Agenda; Comment on “Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?”

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Sarah Hawkes

2016-05-01

Full Text Available The United Nations (UN Sustainable Development Agenda offers an opportunity to realise the right to health for all. The Agenda’s “interlinked and integrated” Sustainable Development Goals (SDGs provide the prospect of focusing attention and mobilising resources not just for the provision of health services through universal health coverage (UHC, but also for addressing the underlying social, structural, and political determinants of illness and health inequity. However, achieving the goals’ promises will require new mechanisms for inter-sectoral coordination and action, enhanced instruments for rational priority-setting that involve affected population groups, and new approaches to ensuring accountability. Rights-based approaches can inform developments in each of these areas. In this commentary, we build upon a paper by Forman et al and propose that the significance of the SDGs lies in their ability to move beyond a biomedical approach to health and healthcare, and to seize the opportunity for the realization of the right to health in its fullest, widest, most fundamental sense: the right to a healthpromoting and health protecting environment for each and every one of us. We argue that realizing the right to health inherent in the SDG Agenda is possible but demands that we seize on a range of commitments, not least those outlined in other goals, and pursue complementary openings in the Agenda – from inclusive policy-making, to novel partnerships, to monitoring and review. It is critical that we do not risk losing the right to health in the rhetoric of the SDGs and ensure that we make good on the promise of leaving no one behind.

Linking health education and sustainability education in schools

DEFF Research Database (Denmark)

Madsen, Katrine Dahl; Nordin, Lone Lindegard; Simovska, Venka

2015-01-01

, the focus is on transformation processes occurring on the trajectory from international policy frameworks to the national context. The chapter considers the consequences of these transformation processes for educational practices within schools in light of the current major reform of basic general education......This chapter addresses the relationships between international and national (Danish) policies regarding sustainability and health promotion which have the potential to affect school-based health education/promotion and education for sustainable development. Based on policy mapping and analysis...... in Denmark with its aims of ensuring overall school improvement, increasing pupil wellbeing and improving academic outcomes. Analysis of international policy documents, as well as of research literature in both fields, shows that school-based health education (HE) and education for sustainable development...

An international waste convention: measures for achieving sustainable development.

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Meyers, Gary D; McLeod, Glen; Anbarci, Melanie A

2006-12-01

Waste is a by-product of economic growth. Consequently, economic growth presents challenges for sustainable resource management and development because continued economic growth implies continued growth in waste outputs. Poor management of waste results in the inappropriate depletion of natural resources and potentially adverse effects on the environment, health and the economy. It is unsustainable. This paper begins by outlining the magnitude of and the current response to the growth in the quantity of waste outputs. This is followed by a consideration of why the international response to date, including the Rio Declaration and Agenda 21, fails to address the issue adequately. The paper concludes with a discussion on why and how an international treaty or other measure could advance sustainable development by providing an appropriate framework within which to address the problem.

The Implementation of Knowledge Strategy-Based Entrepreneurial Capacity to Achieve Sustainable Competitive Advantage

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Widodo

2013-08-01

Full Text Available This study aims to develop a model of knowledge strategy-based entrepreneurial capacity to achieve sustainable competitive advantage of rurol banking in Central Java province. The sampling method is ‘‘Purposive sampling’’ by considering the characteristics of the population items, namely: operational experience for at least 5 years and representatives of each area of rurol banking in Semarang, Surakarta and Purwokerto. Then, the sample size is 150 of 251 (59.7% of top managers of rurol banking. To analyze the data in this study, it used the Structural Equation Modeling (SEM, of the, AMOS software package. The findings of this study explain that 1. The first step in promoting a sustainable competitive advantage through knowledge sharing is by prioritizing the quality of interaction, willingness and ability. 2. Efforts to improve a sustainable competitive advantage through knowledge exploitation built by knowledge sharing are by prioritizing to actively accept changes and introduction, solve problems together, use and combine new knowledge in operation. 3. Efforts to improve a sustainable competitive advantage through the knowledge exploitation built by risk-taking are by prioritizing a strong tendency for high-risk projects (with the possibility of gaining high-return, a high courage for the actions necessary to achieve the goal, having an aggressive attitude to optimize the possibility of utilizing existing potential opportunities and enjoying the challenge of the risk situation. 4. Efforts to improve a sustainable competitive advantage through knowledge exploitation built by a pro-active are by prioritizing to anticipate problem more quickly than competitors, future oriented, addressed by technology, launching product selectively and systematically search for new ideas. 5. Efforts to improve a sustainable competitive advantage through knowledge exploitation built by the innovativeness are by prioritizing the speed of developing products

Sustainable development and public health: rating European countries

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Seke Kristina

2013-01-01

Full Text Available Abstract Background Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe’s current situation of sustainable development in the area of public health. Methods A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. Results According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union’s newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80% in rating countries are found to be “healthy life years at birth, females” (r2 = 0.880, “healthy life years at birth, males” (r2 = 0.864, “death rate due to chronic diseases, males” (r2 = 0.850, and “healthy life years, 65, females” (r2 = 0.844. Conclusions Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved. After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS, this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem.

Sustainable development and public health: rating European countries.

Science.gov (United States)

Seke, Kristina; Petrovic, Natasa; Jeremic, Veljko; Vukmirovic, Jovanka; Kilibarda, Biljana; Martic, Milan

2013-01-28

Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe's current situation of sustainable development in the area of public health. A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT) has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union's newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80%) in rating countries are found to be "healthy life years at birth, females" (r2 = 0.880), "healthy life years at birth, males" (r2 = 0.864), "death rate due to chronic diseases, males" (r2 = 0.850), and "healthy life years, 65, females" (r2 = 0.844). Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved.After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS), this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem.

Developing and implementing health and sustainability guidelines for institutional food service.

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Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

2012-05-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

Sustainable agriculture in the picture

International Nuclear Information System (INIS)

Brouwer, F.M.; De Bont, C.J.A.M.; Leneman, H.; Van der Meulen, H.A.B.

2004-01-01

Sustainable agriculture in the picture provides a systematic overview of the available data that are relevant for debate on transitions towards sustainable agriculture. Review for the agrocomplex, greenhouse horticulture, dairy farming and pig farming. Indicators on economy, environment, nature, animal welfare, human and animal health. Results achieved in practice for the three dimensions of sustainable agriculture, namely economics ('profit'), ecology ('planet') and socio-cultural ('people') [nl

[Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level].

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Walter, U; Nöcker, G; Pawils, S; Robra, B-P; Trojan, A; Franz, M; Grossmann, B; Schmidt, T-A; Lehmann, H; Bauer, U; Göpel, E; Janz, A; Kuhn, J; Naegele, G; Müller-Kohlenberg, H; Plaumann, M; Stender, K-P; Stolzenberg, R; Süß, W; Trenker, M; Wanek, V; Wildner, M

2015-05-01

Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard

Global achievements in sustainable land management

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Peter Motavalli

2013-06-01

Full Text Available Identification and development of sustainable land management is urgently required because of widespread resource degradation from poor land use practices. In addition, the world will need to increase food production to meet the nutritional needs of a growing global population without major environmental degradation. Ongoing climate change and its impacts on the environment is an additional factor to consider in identifying and developing sustainable land use practices. The objectives of this paper are to: (1 provide a background to the need for sustainable land management, (2 identify some of its major components, and (3 discuss some examples of sustainable land management systems that are being practiced around the world. Some common components of this type of management are: (1 understanding the ecology of land management, (2 maintenance or enhancement of land productivity, (3 maintenance of soil quality, (4 increased diversity for higher stability and resilience, (5 provision of economic and ecosystem service benefits for communities, and (6 social acceptability. Several examples of sustainable land management systems are discussed to illustrate the wide range of systems that have been developed around the world including agroforestry, conservation agriculture, and precision agricultural systems. Improved technology, allowing for geater environmental measurement and for improved access and sharing of information, provides opportunities to identify and develop more sustainable land management practices and systems for the future.

Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan.

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Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn

2017-02-01

The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Health care financing in Nigeria: Implications for achieving universal health coverage.

Science.gov (United States)

Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

2015-01-01

The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

An Agenda for Research on the Sustainability of Public Health Programs

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Dearing, James W.

2011-01-01

Funders of programs in public health and community health are increasingly concerned about the sustainability of changes they initiate. Despite a recent increase in sustainability research and evaluation, this literature has not developed a widely used paradigm for conducting research that can accumulate into generalizable findings. We provide guidance for research and evaluation of health program sustainability, including definitions and types of sustainability, specifications and measurements of dependent variables, definitions of independent variables or factors that influence sustainability, and suggestions for designs for research and data collection. We suggest viewing sustainability research as a further stage in the translation or dissemination of research-based interventions into practice. This perspective emphasizes ongoing relationships with earlier stages of a broader diffusion framework, including adoption and implementation processes. PMID:21940916

Mapping of Policies Shaping the Agenda within Health and Sustainability Education

DEFF Research Database (Denmark)

Madsen, Katrine Dahl; Simovska, Venka

This paper maps the key international and national policy documents influencing work with health education/promotion and education for sustainable development within primary and lower secondary education in Denmark. This mapping will provide the foundation for further analysis of: - the ways...... in which the concepts of health and sustainability are articulated, with particular focus on stated aims, strategies and competences required for health promotion and sustainable development - the relevance of the above-mentioned conceptualizations for school-based health education/promotion and education...... for sustainable development - the transformation processes which take place when international/national policies are interpreted and put into practice at municipal and school levels...

Achieving and sustaining full employment.

Science.gov (United States)

Rosen, S M

1995-01-01

Human rights and public health considerations provide strong support for policies that maximize employment. Ample historical and conceptual evidence supports the feasibility of full employment policies. New factors affecting the labor force, the rate of technological change, and the globalization of economic activity require appropriate policies--international as well as national--but do not invalidate the ability of modern states to apply the measures needed. Among these the most important include: (I) systematic reduction in working time with no loss of income, (2) active labor market policies, (3) use of fiscal and monetary measures to sustain the needed level of aggregate demand, (4) restoration of equal bargaining power between labor and capital, (5) social investment in neglected and outmoded infrastructure, (6) accountability of corporations for decisions to shift or reduce capital investment, (7) major reductions in military spending, to be replaced by socially needed and economically productive expenditures, (8) direct public sector job creation, (9) reform of monetary policy to restore emphasis on minimizing unemployment and promoting full employment. None are without precedent in modern economies. The obstacles are ideological and political. To overcome them will require intellectual clarity and effective advocacy.

A life-course approach to health: synergy with sustainable development goals.

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Kuruvilla, Shyama; Sadana, Ritu; Montesinos, Eugenio Villar; Beard, John; Vasdeki, Jennifer Franz; Araujo de Carvalho, Islene; Thomas, Rebekah Bosco; Drisse, Marie-Noel Brunne; Daelmans, Bernadette; Goodman, Tracey; Koller, Theadora; Officer, Alana; Vogel, Joanna; Valentine, Nicole; Wootton, Emily; Banerjee, Anshu; Magar, Veronica; Neira, Maria; Bele, Jean Marie Okwo; Worning, Anne Marie; Bustreo, Flavia

2018-01-01

A life-course approach to health encompasses strategies across individuals' lives that optimize their functional ability (taking into account the interdependence of individual, social, environmental, temporal and intergenerational factors), thereby enabling well-being and the realization of rights. The approach is a perfect fit with efforts to achieve universal health coverage and meet the sustainable development goals (SDGs). Properly applied, a life-course approach can increase the effectiveness of the former and help realize the vision of the latter, especially in ensuring health and well-being for all at all ages. Its implementation requires a shared understanding by individuals and societies of how health is shaped by multiple factors throughout life and across generations. Most studies have focused on noncommunicable disease and ageing populations in high-income countries and on epidemiological, theoretical and clinical issues. The aim of this article is to show how the life-course approach to health can be extended to all age groups, health topics and countries by building on a synthesis of existing scientific evidence, experience in different countries and advances in health strategies and programmes. A conceptual framework for the approach is presented along with implications for implementation in the areas of: (i) policy and investment; (ii) health services and systems; (iii) local, multisectoral and multistakeholder action; and (iv) measurement, monitoring and research. The SDGs provide a unique context for applying a holistic, multisectoral approach to achieving transformative outcomes for people, prosperity and the environment. A life-course approach can reinforce these efforts, particularly given its emphasis on rights and equity.

Perspectives on using prescribed fire to achieve desired ecosystem conditions

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James M. Vose

2000-01-01

Fire is a potentially powerful tool for achieving desired conditions of forest ecosystems. From an ecological perspective, the use of fire requires affirmative answers to either of the following questions: (1) does it increase ecosystem health and sustainability? and (2) does it preserve or restore unique species or habitats? Health and sustainability can be measured...

Mountain Forests and Sustainable Development: The Potential for Achieving the United Nations' 2030 Agenda

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Georg Gratzer

2017-08-01

Full Text Available The world is facing numerous and severe environmental, social, and economic challenges. To address these, in September 2015 the General Assembly of the United Nations adopted the resolution Transforming our World: The 2030 Agenda for Sustainable Development. The United Nations' 17 sustainable development goals (SDGs and their 169 targets are ambitious, broadly encompassing, and indivisible. They are intended to guide nations and communities toward attaining healthy and peaceful livelihoods free of poverty and hunger. Collectively the goals envision sound and safe environments, where global threats like climate change are successfully combated through both mitigation and adaptation. Agenda 2030 envisages sustainable production patterns with inclusive, effective economies and institutions. It is of specific relevance to mountain communities, where the population is predominantly rural and half of the rural inhabitants experience food insecurity and are often highly dependent on forest resources. Mountain forests also contribute to human welfare well beyond the local community: through functions such as climate and hydrological services provided at regional and global scales, and harvested commodities traded at multiple economic scales. In this introductory essay we argue that sustainable forest management in mountain areas disproportionately contributes to achieving the SDGs. We discuss (1 the potential of mountain forests to help achieve SDGs in mountainous regions and beyond, (2 the potential of the SDGs to help solve severe socioeconomic and ecological problems in forested mountain areas, and (3 challenges and opportunities associated with implementing the SDGs. We base our argumentation also on the 8 papers presented in this Focus Issue of Mountain Research and Development. Together, they establish a clear connection between sustainable use and protection of mountain forests and vital ecosystem services upon which many regions depend. We

Sustaining health education research programs in Aboriginal communities.

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Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

2017-09-01

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

University Students and Sustainability Skills in Occupational Health and Safety Master Degree

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Míguez-Álvarez, Carla; Arce, Maria Elena; Souto-Gestal, Antonio

2016-01-01

Education is one of the key instruments to achieving global sustainability. In fact, sustainable development has to be integrated into higher education curricula. One of the difficulties of this challenge is to know if students are able to achieve the basic skills, something that is extremely important in emergency management. Thus, assessment of…

Evaluating the Sustainability of School-Based Health Centers.

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Navarro, Stephanie; Zirkle, Dorothy L; Barr, Donald A

2017-01-01

The United States is facing a surge in the number of school-based health centers (SBHCs) owing to their success in delivering positive health outcomes and increasing access to care. To preserve this success, experts have developed frameworks for creating sustainable SBHCs; however, little research has affirmed or added to these models. This research seeks to analyze elements of sustainability in a case study of three SBHCs in San Diego, California, with the purpose of creating a research-based framework of SBHC sustainability to supplement expertly derived models. Using a mixed methods study design, data were collected from interviews with SBHC stakeholders, observations in SBHCs, and SBHC budgets. A grounded theory qualitative analysis and a quantitative budget analysis were completed to develop a theoretical framework for the sustainability of SBHCs. Forty-one interviews were conducted, 6 hours of observations were completed, and 3 years of SBHC budgets were analyzed to identify care coordination, community buy-in, community awareness, and SBHC partner cooperation as key themes of sustainability promoting patient retention for sustainable billing and reimbursement levels. These findings highlight the unique ways in which SBHCs gain community buy-in and awareness by becoming trusted sources of comprehensive and coordinated care within communities and among vulnerable populations. Findings also support ideas from expert models of SBHC sustainability calling for well-defined and executed community partnerships and quality coordinated care in the procurement of sustainable SBHC funding.

Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

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Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

2012-01-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

Results of a workplace health campaign: what can be achieved?

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Leyk, Dieter; Rohde, Ulrich; Hartmann, Nadine D; Preuß, Philipp A; Sievert, Alexander; Witzki, Alexander

2014-05-02

Effective health promotion in the workplace is now essential because of the rising health-related costs for businesses, the increasing pressure arising from international competition, prolonged working lives, and the aging of the work force. The basic problem of prevention campaigns is that the target groups are too rarely reached and sustainable benefits too rarely achieved. In 2011, we carried out a broad-based health and fitness campaign to assess how many personnel could be motivated to participate in a model study under nearly ideal conditions. 1010 personnel were given the opportunity to participate in various kinds of sports, undergo sports-medicine examinations, attend monthly expert lectures, and benefit from nutritional offerings and Intranet information during work hours. Pseudonymized questionnaires were used to classify the participants according to their exercise behavior as non-active, not very active, and very active. The participants' subjective responses (regarding, e.g., health, exercise, nutrition, and the factors that motivated them to participate in sports or discouraged them from doing so) were recorded, as were their objective data (measures of body size and strength). The duration of the study was one year. 490 of the 1010 personnel (48.5%, among whom 27.2% were nonactive, 44.1% not very active, and 28.7% very active) participated in the initial questionnaire and testing. By the end of the study, this figure had dropped to 17.8%; diminished participation affected all three groups to a comparable extent. A comparison of dropouts and non-dropouts revealed that older age was a stable predictor for drop-out (bivariate odds ratio [OR] 1.028, p = 0.006; multivariate OR 1.049, p = 0.009). The study participants reported beneficial effects on their health and health awareness, performance ability, psychological balance, stress perception, exercise and dietary behavior. Even under optimal conditions and with high use of staff resources, this model

Position of the academy of nutrition and dietetics: nutrition security in developing nations: sustainable food, water, and health.

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Nordin, Stacia M; Boyle, Marie; Kemmer, Teresa M

2013-04-01

It is the position of the Academy of Nutrition and Dietetics that all people should have consistent access to an appropriately nutritious diet of food and water, coupled with a sanitary environment, adequate health services, and care that ensure a healthy and active life for all household members. The Academy supports policies, systems, programs, and practices that work with developing nations to achieve nutrition security and self-sufficiency while being environmentally and economically sustainable. For nations to achieve nutrition security, all people must have access to a variety of nutritious foods and potable drinking water; knowledge, resources, and skills for healthy living; prevention, treatment, and care for diseases affecting nutrition status; and safety-net systems during crisis situations, such as natural disasters or deleterious social and political systems. More than 2 billion people are micronutrient deficient; 1.5 billion people are overweight or obese; 870 million people have inadequate food energy intake; and 783 million people lack potable drinking water. Adequate nutrient intake is a concern, independent of weight status. Although this article focuses on nutritional deficiencies in developing nations, global solutions for excesses and deficiencies need to be addressed. In an effort to achieve nutrition security, lifestyles, policies, and systems (eg, food, water, health, energy, education/knowledge, and economic) contributing to sustainable resource use, environmental management, health promotion, economic stability, and positive social environments are required. Food and nutrition practitioners can get involved in promoting and implementing effective and sustainable policies, systems, programs, and practices that support individual, community, and national efforts. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Communicable disease control programmes and health systems: an analytical approach to sustainability.

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Shigayeva, Altynay; Coker, Richard J

2015-04-01

There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

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Mitra, Amal K; Rodriguez-Fernandez, Gisela

2010-05-01

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

Sustainable Phosphorus Measures: Strategies and Technologies for Achieving Phosphorus Security

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Stuart White

2013-01-01

Full Text Available Phosphorus underpins the world’s food systems by ensuring soil fertility, maximising crop yields, supporting farmer livelihoods and ultimately food security. Yet increasing concerns around long-term availability and accessibility of the world’s main source of phosphorus—phosphate rock, means there is a need to investigate sustainable measures to buffer the world’s food systems against the long and short-term impacts of global phosphorus scarcity. While the timeline of phosphorus scarcity is contested, there is consensus that more efficient use and recycling of phosphorus is required. While the agricultural sector will be crucial in achieving this, sustainable phosphorus measures in sectors upstream and downstream of agriculture from mine to fork will also need to be addressed. This paper presents a comprehensive classification of all potential phosphorus supply- and demand-side measures to meet long-term phosphorus needs for food production. Examples range from increasing efficiency in the agricultural and mining sector, to technologies for recovering phosphorus from urine and food waste. Such measures are often undertaken in isolation from one another rather than linked in an integrated strategy. This integrated approach will enable scientists and policy-makers to take a systematic approach when identifying potential sustainable phosphorus measures. If a systematic approach is not taken, there is a risk of inappropriate investment in research and implementation of technologies and that will not ultimately ensure sufficient access to phosphorus to produce food in the future. The paper concludes by introducing a framework to assess and compare sustainable phosphorus measures and to determine the least cost options in a given context.

Achieving Our Environmental Sustainability Goals: The Opportunities and Pitfalls of Applying Life Cycle Thinking

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An increasing number of people around the world are beginning to realize that a systems approach, such as life cycle thinking, is necessary to truly achieve environmental sustainability. Without the holistic perspective that life cycle thinking provides, our actions risk leading ...

Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care.

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Klinga, Charlotte; Hasson, Henna; Andreen Sachs, Magna; Hansson, Johan

2018-06-04

Change initiatives face many challenges, and only a few lead to long-term sustainability. One area in which the challenge of achieving long-term sustainability is particularly noticeable is integrated health and social care. Service integration is crucial for a wide range of patients including people with complex mental health and social care needs. However, previous research has focused on the initiation, resistance and implementation of change, while longitudinal studies remain sparse. The objective of this study was therefore to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy. A retrospective and qualitative case-study research design was used, and data from the model organisation's steering-committee minutes covering 1995-2015 were gathered and analysed. The analysis generated a narrative case description, which was mirrored to the key elements of the Dynamic Sustainability Framework (DSF). The development of inter-sectoral cooperation was characterized by a participatory approach in which a shared structure was created to support cooperation and on-going quality improvement and learning based on the needs of the service user. A key management principle was cooperation, not only on all organisational levels, but also with service users, stakeholder associations and other partner organisations. It was shown that all these parts were interrelated and collectively contributed to the creation of a structure and a culture which supported the development of a dynamic sustainable health and social care. This study provides valuable insights into the dynamics of organizational sustainability and understanding of key managerial actions taken to establish, develop and support integration of health and social care for people with complex mental health needs. The service user involvement and regular reviews of service users' needs were essential in order

Leveraging Smart Open Innovation for Achieving Cultural Sustainability: Learning from a New City Museum Project

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Luisa Errichiello

2018-06-01

Full Text Available In recent years, cultural sustainability has attracted increasing attention within the discourse of sustainable development and sustainable cities. Notwithstanding some effort put on conceptualizing the relationship between culture and sustainability, research on the issue is still in a pre-paradigmatic stage and related empirical studies are scant. In particular, further knowledge is required to understand not only how cultural sustainability has been addressed strategically but also implemented in practice. In this direction, research has pointed out the role of social structures (e.g., partnerships, collaborations, etc. for achieving cultural sustainability goals. However, focusing on smart cities, attention is limited to how collaborative arrangements can be leveraged within the development of new city services (e.g., smart open innovation to sustain goals of environmental, economic and social sustainability, with cultural sustainability still playing a marginal role. This paper develops a new framework linking together the strategic level and the practice level in addressing cultural sustainability and conceptualizing the role of collaborative structures in the development of smart innovation. The framework is then used as a frame of reference for analyzing the case of MuseoTorino, a new city museum realized within the smart city strategy of Turin (Italy. The analysis provides evidence of some practices adopted to leverage collaboration and stakeholders’ engagement to strategically address cultural sustainability and to realize it in practice throughout the new service development process.

Sustainability Strategies for Regional Health Information Organization Startups

DEFF Research Database (Denmark)

Winkler, Till J.; Ozturk, Pinar; Brown, Carol V.

2016-01-01

the population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare landscape that rewards care coordination across suburban hospitals and physician practices. Conclusions: We propose two models of technology and sustainability strategies for developing bottom...... initiatives by states and regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated sustainability with non-renewable SHIECAP funding...

Predictors of Saudi nursing students' attitudes towards environment and sustainability in health care.

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Cruz, J P; Alshammari, F; Felicilda-Reynaldo, R F D

2018-02-09

This study aimed to investigate the predictors of Saudi nursing students' attitudes towards the environment and sustainability in health care. With rising temperature and decreasing annual rainfall, Saudi Arabia is threatened by the harmful effects of climate change on its population. In response to these threats, the Ministry of Health adapted sustainable development and environmental preservation in their National E-Health strategy. To implement these policies successfully, healthcare practitioners should be educated on how climate change could impact human health negatively. A secondary analysis of 280 questionnaires from baccalaureate nursing students of a university in Hail City, Saudi Arabia, was completed. The New Ecological Paradigm (NEP) Scale and Sustainability Attitudes in Nursing Survey 2 (SANS-2) were used to investigate the predictors of student attitudes towards the environment and sustainable development in health care. The NEP score indicated moderate pro-environment attitudes, whereas the SANS-2 mean score showed very positive attitudes towards sustainability in health care. Learning about the environment and related issues in the nursing programme, raising climate change awareness and attending environment-related seminars and training positively influenced the environmental and sustainability attitudes of nursing students. Saudi nursing students moderately manifested pro-environment attitudes but exhibited extremely positive attitudes towards sustainability in health care. The results support the need to strengthen the education of nursing students about environmental and sustainability concepts and the inclusion of these topics in the nursing curricula. The study underscores the critical role of enriching the awareness of nursing students on environmental issues and concerns and sustainability in health care. The findings of this study can support the inclusion of course contents, which deal specifically with environmental health and

Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

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Mohammed Hamed Ahmed

2013-06-01

Full Text Available Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor using some lean techniques and tools. What was not clear is that this required from Toyota a long process of leadership development, and a high commitment to training and coaching their employee. A Failure to achieve and sustain the improvement is a problem of both management and leadership as well as the improper understanding of the human behavior, and the required culture to success.

Establishing and sustaining a technical program to achieve zero fuel failures

International Nuclear Information System (INIS)

Deshon, J.; Whiteside, K.; Burnham, R.

2015-01-01

In 2006, Chief Nuclear Officers (CNOs) of electric utilities operating 103 commercial reactors in the United States (U.S.) formally endorsed an initiative to achieve failure-free fuel performance by the end of 2010. This became known as the Zero-by- Ten Fuel Failure Initiative. The endorsement manifested during a meeting at the Institute of Nuclear Power Operations (INPO) while nuclear fuel performance trends were being reviewed. Declining fuel performance generated backing for the Initiative. This paper provides a brief review of some of the drivers that caused those trends, the Initiative elements designed to address them, and a review of the technical program that helped achieve, and thus far sustain, improved fuel performance. (author) Key Words: Nuclear Fuel, Fuel, Fuel Failures, Fuel Failure Initiative, Zero by Ten Initiative

Sustainable Organic Farming For Environmental Health A Social Development Model

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Ijun Rijwan Susanto

2015-05-01

consider the loss that may be experienced by others as the principles for profit has become very prominent. As a result the development of organic agriculture simply stuck into a commercial activity which would be a criticism of the founders One of the factors that led to the involvement of the government regulated organic farming is because of the bickering about what is called organic agricultural products and because many nonorganic products sold as organic products Organic farmers have difficulty in finding locally based seed for organic farming certification of organic farming has changed it is not just the assurance processes into a tradable commodity 3 The Benefits of Organic Farming in Support for Environmental Health organic farming gives a positive impact on public health because it does not cause environmental pollution water air soil by the residues of chemical fertilizers and synthetic chemical pesticides. Besides organic farming also healthy communities through the provision of agricultural products that are free of pesticides and chemical fertilizer residues 4 The Social Development Model of Sustainable Organic Farming Sustainable agriculture organic farming seeks acre balance of three long-term goals namely a Social-cultural to create quality of life to satisfy personal and community needs for health food safety and happines b Environment to Enhance utilization of soil water air and other resourches limited c Economics to be profitable market forces. These objectives can be achieved if supported by organizational-oriented good governance principles of sustainable agriculture. Sustainable agriculture is the implementation of the principles of sustainable development. Sustainable development will be achieved if conducted prior social development within the broad scope of stakeholders 5 The Policy Recomendation for Organic Farming a National Strategic Agenda The Program Go Organic must be forwarded with the 2010 program Go Organic 2020 where the formulation of

Developing Sustainable Workplaces with Leadership: Feedback about Organizational Working Conditions to Support Leaders in Health-Promoting Behavior

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Paul Jiménez

2017-10-01

Full Text Available Organizations should support leaders in promoting their employees’ health in every possible way to achieve a sustainable workplace. A good way to support leaders could include getting feedback about their health-promoting behavior from their employees. The present study introduces an instrument (Health-Promoting Leadership Conditions; HPLC that enables the provision of feedback about the leaders’ efforts to create health-promoting working conditions in seven key aspects: health awareness, workload, control, reward, community, fairness and value-fit. The instrument was used in employee surveys and in an online study, obtaining a sample of 430 participants. The results showed that all seven key aspects of health-promoting leadership can be assigned to a main factor of health-promoting leadership. In addition, the HPLC shows high construct validity with dimensions of stress, resources and burnout (Recovery-Stress- Questionnaire for Work [RESTQ-Work] and Maslach Burnout Inventory General Survey [MBI-GS]. The results indicate that the HPLC can be used as a basis on which to assess health-promoting leadership behavior with a focus on changing working conditions. By getting feedback about their leadership behavior from their employees, leaders can identify their potential and fields for improvement for supporting their employees’ health and developing a sustainable workplace.

Linking Environmental Sustainability, Health, and Safety Data in Health Care: A Research Roadmap.

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Kaplan, Susan B; Forst, Linda

2017-08-01

Limited but growing evidence demonstrates that environmental sustainability in the health-care sector can improve worker and patient health and safety. Yet these connections are not appreciated or understood by decision makers in health-care organizations or oversight agencies. Several studies demonstrate improvements in quality of care, staff satisfaction, and work productivity related to environmental improvements in the health-care sector. A pilot study conducted by the authors found that already-collected data could be used to evaluate impacts of environmental sustainability initiatives on worker and patient health and safety, yet few hospitals do so. Future research should include a policy analysis of laws that could drive efforts to integrate these areas, elucidation of organizational models that promote sharing of environmental and health and safety data, and development of tools and methods to enable systematic linkage and evaluation of these data to expand the evidence base and improve the hospital environment.

Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

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Amal K. Mitra

2010-05-01

Full Text Available To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs, that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1 eradicating extreme poverty and hunger; (2 achieving universal primary education; (3 promoting gender equality; (4 reducing child mortality; (5 improving maternal health; (6 combating HIV/AIDS, malaria and other diseases; (7 ensuring environmental sustainability; and (8 developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC. The paper also identifies areas of deficits for the achievement of MDGs in LAC.

How to connect bioethics and environmental ethics: health, sustainability, and justice.

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Dwyer, James

2009-11-01

In this paper, I explore one way to bring bioethics and environmental ethics closer together. I focus on a question at the interface of health, sustainability, and justice: How well does a society promote health with the use of no more than a just share of environmental capacity? To address this question, I propose and discuss a mode of assessment that combines a measurement of population health, an estimate of environmental sustainability, and an assumption about what constitutes a fair or just share. This mode of assessment provides an estimate of the just and sustainable life expectancy of a population. It could be used to monitor how well a particular society promotes health within just environmental limits. It could also serve as a source of information that stakeholders use when they deliberate about programs, policies, and technologies. The purpose of this work is to focus attention on an ethical task: the need to fashion institutions and forms of life that promote health in ways that recognize the claims of sustainability and justice.

How do small rural primary health care services sustain themselves in a constantly changing health system environment?

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Buykx Penny

2012-03-01

Full Text Available Abstract Background The ability to sustain comprehensive primary health care (PHC services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. Methods A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of, sustainability have been identified from evaluation data (audit of service indicators, community surveys, key stakeholder interviews and focus groups and our own observations. These are mapped against an overarching framework of service sustainability requirements: workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure. Results Four years into the evaluation, the evidence indicates EPHS has responded effectively to external and internal changes to ensure viability. The specific steps taken by the service to address risks and capitalise on opportunities are identified. Conclusions This evaluation highlights lessons for health service providers, policymakers, consumers and researchers about the importance of ongoing monitoring of sentinel service indicators; being attentive to changes that have an impact on sustainability; maintaining community involvement; and succession planning.

How is the sustainability of chronic disease health programmes empirically measured in hospital and related healthcare services?—a scoping review

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Francis, Linda; Dunt, David; Cadilhac, Dominique A

2016-01-01

Objectives Programmes to address chronic disease are a focus of governments worldwide. Despite growth in ‘implementation science’, there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. Settings A scoping review of the literature spanning 1985–2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Participants Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Primary and secondary outcome measures Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Results Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with ‘maintenance of programme activities’ most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Conclusions Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to

Achieving sustainable cultivation of potatoes

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Every phase of the production cycle impacts the sustainability of potato. Potato physiology determines how genetically encoded developmental attributes interact with local environmental conditions as modified through agricultural practice to produce a perishable crop. In this chapter we highlight ho...

Strategies for sustainability and equity of prepayment health ...

African Journals Online (AJOL)

Background: Despite the long existence of community health insurance schemes (CHI) in Uganda, their numbers and coverage levels have remained small with limited accessibility by the poor. Objectives: To examine issues of equity and sustainability in CHI schemes, which are prerequisites to health sector financing.

How can health remain central post-2015 in a sustainable development paradigm?

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Hill, Peter S; Buse, Kent; Brolan, Claire E; Ooms, Gorik

2014-04-03

In two years, the uncompleted tasks of the Millennium Development Goals will be merged with the agenda articulated in the 2012 United Nations Conference on Sustainable Development. This process will seek to integrate economic development (including the elimination of extreme poverty), social inclusion, environmental sustainability, and good governance into a combined sustainable development agenda. The first phase of consultation for the post-2015 Sustainable Development Goals reached completion in the May 2013 report to the Secretary-General of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda. Health did well out of the Millennium Development Goal (MDG) process, but the global context and framing of the new agenda is substantially different, and health advocates cannot automatically assume the same prominence. This paper argues that to remain central to continuing negotiations and the future implementation, four strategic shifts are urgently required. Advocates need to reframe health from the poverty reduction focus of the MDGs to embrace the social sustainability paradigm that underpins the new goals. Second, health advocates need to speak--and listen--to the whole sustainable development agenda, and assert health in every theme and every relevant policy, something that is not yet happening in current thematic debates. Third, we need to construct goals that will be truly "universal", that will engage every nation--a significant re-orientation from the focus on low-income countries of the MDGs. And finally, health advocates need to overtly explore what global governance structures will be needed to finance and implement these universal Sustainable Development Goals.

What Is an Education for Sustainable Development Supposed to Achieve--A Question of What, How and Why

Science.gov (United States)

Hofman, Maria

2015-01-01

This is a theoretical article to open the discussion of what an education for sustainable development is supposed to achieve and how teachers can help students to develop skills that might be needed in order to support a sustainable future. The focus in the article will be on education. As it is an article aiming to open this kind of discussion…

A TWO CENTURY HISTORY OF PACIFIC NORTHWEST SALMON: LESSONS LEARNED FOR ACHIEVING A SUSTAINABLE FUTURE

Science.gov (United States)

Achieving ecological sustainability is a daunting challenge. In the Pacific Northwest one of the most highly visible public policy debates concerns the future of salmon populations. Throughout the Pacific Northwest, many wild salmon stocks have declined and some have disappeare...

Sustainable drugs and global health care

Directory of Open Access Journals (Sweden)

Geoffrey A. Cordell

2009-01-01

Full Text Available Each day, Earth's finite resources are being depleted for energy, for material goods, for transportation, for housing, and for drugs. As we evolve scientifically and technologically, and as the population of the world rapidly approaches 7 billion and beyond, among the many issues with which we are faced is the continued availability of drugs for future global health care. Medicinal agents are primarily derived from two sources, synthetic and natural, or in some cases, as semi-synthetic compounds, a mixture of the two. For the developed world, efforts have been initiated to make drug production "greener", with milder reagents, shorter reaction times, and more efficient processing, thereby using less energy, and reactions which are more atom efficient, and generate fewer by-products. However, most of the world's population uses plants, in either crude or extract form, for their primary health care. There is relatively little discussion as yet, about the long term effects of the current, non-sustainable harvesting methods for medicinal plants from the wild, which are depleting these critical resources without concurrent initiatives to commercialize their cultivation. To meet future public health care needs, a paradigm shift is required in order to adopt new approaches using contemporary technology which will result in drugs being regarded as a sustainable commodity, irrespective of their source. In this presentation, several approaches to enhancing and sustaining the availability of drugs, both synthetic and natural, will be discussed, including the use of vegetables as chemical reagents, and the deployment of integrated strategies involving information systems, biotechnology, nanotechnology, and detection techniques for the development of medicinal plants with enhanced levels of bioactive agents.

[Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

Science.gov (United States)

Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

2016-01-01

To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Promoting sustainability through green chemistry

Energy Technology Data Exchange (ETDEWEB)

Kirchhoff, Mary M. [American Chemical Society, 1155 Sixteenth Street, NW, Washington, DC 20036 (United States)

2005-06-15

Green chemistry is an important tool in achieving sustainability. The implementation of green chemistry, the design of chemical products and processes that reduce or eliminate the use and generation of hazardous substances, is essential if the expanding global population is to enjoy an increased standard of living without having a negative impact on the health of the planet. Cleaner technologies will allow the chemical enterprise to provide society with the goods and services on which it depends in an environmentally responsible manner. Green chemistry provides solutions to such global challenges as climate change, sustainable agriculture, energy, toxics in the environment, and the depletion of natural resources. A collaborative effort by industry, academia, and government is needed to promote the adoption of the green chemistry technologies necessary to achieve a sustainable society.

NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

Science.gov (United States)

Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

2018-01-01

The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

Searching for sustainability within public health policy: insights from an injury prevention perspective.

Science.gov (United States)

Errington, Gail; Evans, Catrin; Watson, Michael C

2017-04-01

Sustaining public health programmes in the long-term is key to ensuring full manifestation of their intended benefits. Although an increasing interest in sustainability is apparent within the global literature, empirical studies from within the European setting are few. The factors that influence sustainability are generally conceptualized at three levels: programme level, the immediate context and the wider environment. To-date attention has focused primarily on the former two. Using a community-based child injury prevention programme in England as an exemplar, this paper explores the concept of sustainability within the wider policy environment, and considers the impact of this on local programmes. A content review of global and UK national public health policies (1981-2014) relevant to child safety was undertaken. Interviews were held with senior representatives of global and UK agencies involved in developing child safety policy. Forty-nine policies were reviewed. The term 'sustain', or its derivatives, featured in 36 (73%) of these. Its' use however, related primarily to conservation of resources rather than continued programme operation. Potential mechanisms for supporting programme sustainability featured within some documents; however, the approach to sustainability was inconsistent between policies and over time. Policy stakeholders identified programme sustainability as relevant to their core business, but its' conceptualization varied according to individual interpretation. Programme sustainability is poorly addressed within global and UK-based public health policy. Strengthening a national and international policy focus on sustainability and incorporating sustainability into public health planning frameworks may create a more supportive environment for local programmes. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations.

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Asi, Yara M; Williams, Cynthia

2018-06-01

The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently developed Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prioritizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world's most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas. First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict-affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environments, and discuss potential policy solutions. Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were supported, and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of

Factors influencing perceived sustainability of Dutch community health programs.

Science.gov (United States)

Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

2015-09-01

We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization

OpenAIRE

Naowarut Charoenca; Nipapun Kungskulniti; Jeremiah Mock; Stephen Hamann; Prakit Vathesatogkit

2015-01-01

Background: Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure.Objective: In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health.De...

How is the sustainability of chronic disease health programmes empirically measured in hospital and related healthcare services?-a scoping review.

Science.gov (United States)

Francis, Linda; Dunt, David; Cadilhac, Dominique A

2016-05-31

Programmes to address chronic disease are a focus of governments worldwide. Despite growth in 'implementation science', there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. A scoping review of the literature spanning 1985-2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with 'maintenance of programme activities' most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to evaluate sustainability are diverse with some emerging patterns in measurement found. Use of mixed

Design health village with the approach of sustainable architecture ...

African Journals Online (AJOL)

Journal Home > Vol 8, No 3 (2016) > ... a natural environment and away from the pollution of urban life , traditional medical care, hydrotherapy, sports and ... Keywords: Health; city health; smart; sustainability in architecture; architectural design ...

An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study

Science.gov (United States)

2018-01-01

Background The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. Objective The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. Methods A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. Results This study identifies 3 core current perceived value factors and 5 potential perceived value factors—how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Conclusions Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. PMID:29712623

An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study.

Science.gov (United States)

Feldman, Sue S

2018-04-30

The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. This study identifies 3 core current perceived value factors and 5 potential perceived value factors-how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. ©Sue S Feldman. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 30.04.2018.

How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization.

Science.gov (United States)

Charoenca, Naowarut; Kungskulniti, Nipapun; Mock, Jeremiah; Hamann, Stephen; Vathesatogkit, Prakit

2015-01-01

Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure. In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority - road accidents - to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth) to address a range of pressing health priorities, including programs that substantially reduced road accidents. Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.

Achieving the sustainable development goals: a case study of the complexity of water quality health risks in Malawi.

Science.gov (United States)

Holm, Rochelle; Wandschneider, Philip; Felsot, Allan; Msilimba, Golden

2016-07-15

Suppose 35 % of the households with children under 5 years of age in a low-income suburban neighborhood in a developing country have diarrhea where improved water sources are available. Clearly, something is amiss-but what? In addition to focusing on the need to examine water quality among water sources that meet the 'improved' category when assessing health risk, the relative importance of the range of transmission routes for diarrhea is unknown. In Malawi, relevant baseline data affecting human health are simply not available, and acquiring data is hampered by a lack of local analytical capacity for characterizing drinking water quality. The objective of this work is to develop a risk communication program with partnership among established regional development professionals for effectively meeting the sustainable development goals. A field study was conducted in the city of Mzuzu, Malawi, to study water quality (total coliform and Escherichia coli) and human dimensions leading to development of a public health risk communication strategy in a peri-urban area. A structured household questionnaire was administered to adult residents of 51 households, encompassing 284 individuals, who were using the 30 monitored shallow wells. The water quality data and human dimension questionnaire results were used to develop a household risk presentation. Sixty-seven percent and 50 % of well water and household drinking water samples, respectively, exceeded the WHO health guideline of zero detections of E. coli. Technology transfer was advanced by providing knowledge through household risk debriefing/education, establishing a water quality laboratory at the local university, and providing training to local technicians. Communicating the science of water quality and health risks in developing countries requires sample collection and analysis by knowledgeable personnel trained in the sciences, compiling baseline data, and, ultimately, an effective risk presentation back to

Leveraging best practices to promote health, safety, sustainability, and stewardship.

Science.gov (United States)

Weiss, Marjorie D

2013-08-01

Strategically leveraging health and safety initiatives with sustainability and stewardship helps organizations improve profitability and positively impact team member and customer attachment to the organization. Collective efficacy enhances the triple bottom line: healthy people, healthy planet, and healthy profits. The HS(3)™ Best Practice Exchanges group demonstrated that collective efficacy can leverage the social cohesion, communication channels, and activities within workplaces to promote a healthy, sustainable work culture. This in turn (1) protects the health and safety of workers, (2) preserves the natural environment, and (3) increases attachment to the organization. Community-based participatory research using the Attach21 survey assessed the progress of these companies in their efforts to integrate health, safety, sustainability, and stewardship. Monthly Best Practice Exchanges promoted collective efficacy by providing support, encouragement, and motivation to share and adopt new ideas. Copyright 2013, SLACK Incorporated.

Measuring Sustainability within the Veterans Administration Mental Health System Redesign Initiative

Science.gov (United States)

Ford, James H.; Krahn, Dean; Wise, Meg; Oliver, Karen Anderson

2011-01-01

Objective To examine how attributes affecting sustainability differ across VHA organizational components and by staff characteristics. Subjects Surveys of 870 change team members and 50 staff interviews within the VA’s Mental Health System Redesign initiative. Methods A one-way ANOVA with a Tukey post-hoc test examined differences in sustainability by VISN, job classification, and tenure from staff survey data of the Sustainability Index. Qualitative interviews used an iterative process to identify “a priori” and “in vivo” themes. A simple stepwise linear regression explored predictors of sustainability. Results Sustainability differed across VISN and staff tenure. Job classification differences existed for: 1) Benefits and Credibility of the change and 2) staff involvement and attitudes toward change. Sustainability barriers were: staff and institutional resistance, and non-supportive leadership. Facilitators were: commitment to veterans, strong leadership, and use of QI Tools. Sustainability predictors were outcomes tracking, regular reporting, and use of PDSA cycles. Conclusions Creating homogeneous implementation and sustainability processes across a national health system is difficult. Despite the VA’s best evidence-based implementation efforts, there was significant variance. Locally tailored interventions might better support sustainability than “one-size-fits all” approaches. Further research is needed to understand how participation in a QI collaborative affects sustainability. PMID:21971024

Impacts of flood on children and adults’ health and ways to sustainable development

Science.gov (United States)

Mohamed, S.; Ebenehi, I. Y.; Adaji, A.; Seow, T. W.; Chan, N. W.; Goh, K. C.; Rahim, M. H. I. Abd

2017-11-01

One of the events that will remain fresh in the minds of Kelantanese is the 2014 massive flood that occurred at the end of that year. Heavy rains fell initiating vast flooding in most areas of Kelantan leading to great destruction of livelihood of local communities. Natural hazard such as floods are not only caused by natural processes but also by human activities. The flood recorded severe fatalities, injuries and exposed many vulnerable to diseases. This paper through critical review of literature considered the long-term impact of floods on human’s health as the effects could meaningfully contribute to the worldwide burden of disease. Also, its outcomes are relentless hence need to be adequately comprehended and addressed through sustainability. This study revealed vulnerability to flood inclined ailments as psychological distress in the survivors is liable for a quota of all physical ailments. Hence, sustainable approach to flood preparedness and prevention is instantly needed. Accolades should be given to the Malaysian government for taken bold steps in that direction in recent time but success will be achieved if implementation is in compliance with sustainability agenda spelt in the New Sendai Framework for Disaster Risk Reduction 2015-2030.

Achieving a More Sustainable Process Design for the Production of Methanol

DEFF Research Database (Denmark)

Plaza, Cristina Calvera; Gonzalez Garcia, Marta; Callau, Ana Diez

Methanol is an important chemical product because it can be used as a raw material for the production of other chemicals (1), for example dimethyl carbonate, formaldehyde and methyl tert-butyl ether and it is also one of the most produced bulk chemicals with an annual global production of 100...... million metric tonnes per year (1). Methanol can be produced using different reaction paths, for example natural gas. If natural gas is used for methanol production then CO2 is produced, utilized and can be emitted. Therefore, achieving a more sustainable design for the production of methanol...

Enterprising health: creating the conditions for entrepreneurial behaviour as a strategy for effective and sustainable change in health services.

Science.gov (United States)

Exton, Rosemary

2010-01-01

This paper seeks to investigate conditions under which entrepreneurs emerge as agents of effective and sustainable change in UK National Health Service Trusts. The research synthesises literature on changing regulatory structures ("post-bureaucracy") and entrepreneurial behaviour to understand how individual identity construction is informed both by context and by individual attributes. Thematic analysis of interview data involving managers from 11 NHS Trusts, including detailed analysis of six transcripts, focuses on regulatory processes, the emergence of entrepreneurial behaviour and outcome variations in workplace innovation and improvement. This study identifies co-existing modes of regulation, which interact with individual behaviour, generating strategies differentiated as entrepreneurial or conformist. Four ideal types are identified: organisational entrepreneurship, resisted or dissonant entrepreneurship, conformity, and symbolic entrepreneurship. Analysis reinforces those literature findings, which suggest that the interaction of regulatory structures and the identity work of individuals influence the emergence of entrepreneurial behaviour and the effectiveness of change. The ability to achieve effective and sustainable outcomes varies considerably even between NHS Trusts faced with comparable challenges in implementing nationally prescribed targets. This variance is explained in terms of the organisation's ability to generate the structures, processes, individual competence and motivation which enable employees at all levels to act entrepreneurially with the ability and legitimacy to achieve strategic goals by working creatively in the spaces between formal organisational structures. The study identifies specific conditions, which stimulate the emergence of entrepreneurs as agents of effective and sustainable change in the NHS, identifying factors that policymakers should consider when implementing change.

The System of Indicators for Monitoring the Achievement of the Goals of Sustainable Development in the Agrarian Sector

Directory of Open Access Journals (Sweden)

Chala Tеtyana G.

2017-06-01

Full Text Available The article describes the results of statistical evaluation of the system of indicators for monitoring the achievement of the goals of sustainable development (GSD in the agrarian sector. It has been determined that, in order to achieve sustainable development, the following three pillars need to be reconciled: economic growth, social integration, and environmental protection. The objectives and indicators of the GSD 2 «Overcoming hunger, achieving food security, improving nutrition, and facilitating sustainable development of agriculture» were considered in detail. It has been determined that the indicator, which illustrates vividly the status and perspective of development of the agrarian sector, is the indicator 2.a.1 «Index of orientation towards agriculture, defined by the public expenditure structure». Methods for calculation of the Agriculture Orientation Index (AOI were considered. The dynamics of the AOI for Ukraine and world-wide for 2004-2013 were analyzed. The values of the AOI index for Ukraine, the neighboring countries, and the EU Member States in 2013 have been provided. It has been determined that Ukraine has a low AOI among the EU countries and among the neighboring countries, which indicates a poor orientation towards agriculture.

Health is a sustainable state.

Science.gov (United States)

King, M

1990-09-15

-term population-increasing consequences?" He suggests that other factors such as ecological deterioration, integrity of the ecosystem, and the welfare of future communities need to be taken into consideration. King presents a new global strategy based on the concept of "sustainability". He says that "sustainability should be the maintenance of the capacity of the ecosystem to support life in quantity and variety". Specifically, he advocates for consumption control in the industrial North with intensive energy conservation and recycling. In the South, he calls for renewed vigor in family planning efforts. Public health measures need to be understood in terms of their demographic and ecological implications. If measures are found to be desustaining, King says that complementary ecologically sustaining measures should be introduced with them. He also believes that desustaining measures, such as oral rehydration, should not be introduced on a public health scale if no adequately sustaining complementary measures are possible. He asserts that desustaining measures, without complementary interventions, can ultimately increase the man-years of human misery.

Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries.

Science.gov (United States)

Stenberg, Karin; Hanssen, Odd; Edejer, Tessa Tan-Torres; Bertram, Melanie; Brindley, Callum; Meshreky, Andreia; Rosen, James E; Stover, John; Verboom, Paul; Sanders, Rachel; Soucat, Agnès

2017-09-01

The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published. We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries' advancement towards global targets is constrained by their health system's assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability. We estimate that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario-the equivalent of an additional $41 (range 15-102) or $58 (22-167) per person, respectively, by the final years of scale-up. In the ambitious scenario, total health-care spending would increase to a population-weighted mean of $271 per person (range 74-984) across country contexts, and the share of gross

How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization

Science.gov (United States)

Charoenca, Naowarut; Kungskulniti, Nipapun; Mock, Jeremiah; Hamann, Stephen; Vathesatogkit, Prakit

2015-01-01

Background Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure. Objective In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority – road accidents – to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. Results In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth) to address a range of pressing health priorities, including programs that substantially reduced road accidents. Conclusions Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization. PMID:26328948

How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization

Directory of Open Access Journals (Sweden)

Naowarut Charoenca

2015-08-01

Full Text Available Background: Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs have not established adequate sustainable funding for health promotion and health infrastructure. Objective: In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design: We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority – road accidents – to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. Results: In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth to address a range of pressing health priorities, including programs that substantially reduced road accidents. Conclusions: Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.

Sustainability and scalability of a volunteer-based primary care intervention (Health TAPESTRY): a mixed-methods analysis.

Science.gov (United States)

Kastner, Monika; Sayal, Radha; Oliver, Doug; Straus, Sharon E; Dolovich, Lisa

2017-08-01

Chronic diseases are a significant public health concern, particularly in older adults. To address the delivery of health care services to optimally meet the needs of older adults with multiple chronic diseases, Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) uses a novel approach that involves patient home visits by trained volunteers to collect and transmit relevant health information using e-health technology to inform appropriate care from an inter-professional healthcare team. Health TAPESTRY was implemented, pilot tested, and evaluated in a randomized controlled trial (analysis underway). Knowledge translation (KT) interventions such as Health TAPESTRY should involve an investigation of their sustainability and scalability determinants to inform further implementation. However, this is seldom considered in research or considered early enough, so the objectives of this study were to assess the sustainability and scalability potential of Health TAPESTRY from the perspective of the team who developed and pilot-tested it. Our objectives were addressed using a sequential mixed-methods approach involving the administration of a validated, sustainability survey developed by the National Health Service (NHS) to all members of the Health TAPESTRY team who were actively involved in the development, implementation and pilot evaluation of the intervention (Phase 1: n = 38). Mean sustainability scores were calculated to identify the best potential for improvement across sustainability factors. Phase 2 was a qualitative study of interviews with purposively selected Health TAPESTRY team members to gain a more in-depth understanding of the factors that influence the sustainability and scalability Health TAPESTRY. Two independent reviewers coded transcribed interviews and completed a multi-step thematic analysis. Outcomes were participant perceptions of the determinants influencing the sustainability and scalability of Health TAPESTRY. Twenty

Supporting Structures for Education for Sustainable Development and School-Based Health Promotion

Science.gov (United States)

Madsen, Katrine Dahl; Nordin, Lone Lindegaard; Simovska, Venka

2016-01-01

The article aims to explore the following question: "How is education for sustainable development and health education in schools approached and contextualized at a municipal level, and what contradictions and tensions might local structures imply for sustainable health promoting school development?" Based on interviews with key agents…

How to achieve care coordination inside health care organizations

DEFF Research Database (Denmark)

Prætorius, Thim; C. Becker, Markus

2015-01-01

Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

The photovoltaic industry on the path to a sustainable future--environmental and occupational health issues.

Science.gov (United States)

Bakhiyi, Bouchra; Labrèche, France; Zayed, Joseph

2014-12-01

As it supplies solar power, a priori considered harmless for the environment and human health compared with fossil fuels, the photovoltaic (PV) industry seems to contribute optimally to reduce greenhouse gas emissions and, overall, to sustainable development. However, considering the forecast for rapid growth, its use of potentially toxic substances and manufacturing processes presenting health and safety problems may jeopardize its benefits. This paper aims to establish a profile of the PV industry in order to determine current and emerging environmental and health concerns. A review of PV system life cycle assessments, in light of the current state of the industry and its developmental prospects, reveals information deficits concerning some sensitive life cycle indicators and environmental impacts, together with incomplete information on toxicological data and studies of workers' exposure to different chemical and physical hazards. Although solar panel installation is generally considered relatively safe, the occupational health concerns related to the growing number of hazardous materials handled in the PV industry warrants an all-inclusive occupational health and safety approach in order to achieve an optimal equilibrium with sustainability. To prevent eco-health problems from offsetting the benefits currently offered by the PV industry, manufacturers should cooperate actively with workers, researchers and government agencies toward improved and more transparent research, the adoption of specific and stricter regulations, the implementation of preventive risk management of occupational health and safety and, lastly, greater responsibilization toward PV systems from their design until their end of life. Copyright © 2014 Elsevier Ltd. All rights reserved.

British Columbia's fish health regulatory framework's contribution to sustainability goals related to salmon aquaculture.

Science.gov (United States)

Stephen, Craig; Dicicco, Emiliano; Munk, Brandon

2008-12-01

Salmon farming is a significant contribution to the global seafood market to which the goal of sustainability is often applied. Diseases related to farms are perhaps the most contentious issues associated with sustainable salmon farming. We reviewed literature and policies in British Columbia, Canada, as well as interviewed key informants to examine how fish health regulations do or could support sustainability goals. We found four main obstacles to the development and application of a sustainability-based health management system. First, salmon farming faced the same challenges as other industries when trying to establish an operational definition of sustainability that captures all stakeholders' interests. Second, there was no program responsible for integrating the various regulations, responsible departments, and monitoring efforts to develop a comprehensive view of sustainability. Third, there was inadequate research base and social consensus on the criteria that should be used to track health outcomes for sustainability purposes. Fourth, the regulatory and management paradigm for salmon farming has been focused on diseases and pathogens as opposed to embracing a more inclusive health promotion model that includes biotic, abiotic, and social determinants of health. A transparent and inclusive participatory process that effectively links expert views with community and industry concerns should serve as the foundation for the next generation of health management regulations for salmon farming.

Green Open Space: Awareness for Health or Sustainability?

Science.gov (United States)

Dewi, O. C.; Chairunnisa, I.; Hidayat, T.; Anggraini, M.; Napitupulu, A.

2018-03-01

Universitas Indonesia in cooperation with American Red Cross and Indonesian Red Cross have been assisting green open space revitalisation program in 7 locations in Bogor Regency (2016-2017). The program was held under The Urban Disaster Risk Reduction Greater Jakarta Project; an initiative program from American Red Cross Indonesia. This project was not only improving the existing green open space quality, but also creating one adapted from public land. The revitalization project figures what happened on daily basis on the existing land, proposing new programming facilities, community-based construction, monitoring and handing over. This paper discovers the meaning of a green space for the community, whether the community aware of its benefit on human health or environmental sustainability. The research question is does the community aware of green open space benefit for human health or environmental sustainability? Or both? The original data from the community was gathered and grouped based on its relevance with environmental quality and public health.

Global Health Engagement and The Department of Defense as a Vehicle for Security and Sustainable Global Health.

Science.gov (United States)

Moten, Asad; Schafer, Daniel; Burkett, Edwin K

2018-01-01

The Unites States Department of Defense (DoD) is viewed by many in the general public as a monolithic government entity whose primary purpose is to coordinate this country's ability to make war and maintain a military presence around the world. However, the DoD is in fact a multidimensional organization whose global impact is as expansive as it is varying and is responsible for far-reaching global health interventions. The United States has worked toward providing long-term care among host nation populations by providing training in several areas related to medicine, with positive results. These efforts can be built upon with substantial positive effects. Building health infrastructure and capacity around the world is essential. The DoD is the most generously funded agency in the world, and the resources at its disposal provide the opportunity to make great gains in the long term in terms of both health and security worldwide. With efficient and careful use of DoD resources, and partnerships with key non-governmental organizations with specialized knowledge and great passion, partnerships can be forged with communities around the world to ensure that public health is achieved in even the most underserved communities. A move toward creating sustainable health systems with long-term goals and measurable outcomes is an essential complement to the already successful disaster and emergency relief that the United States military already provides. By ensuring that communities around the world are both provided with access to the sustainable health care they need and that emergency situations can be responded to in an efficient way, the United States can serve its duty as a leader in sharing expertise and resources for the betterment and security of all humankind. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A Systematic Review of the Literature on the Sustainability of Community Health Collaboratives.

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Hearld, Larry R; Bleser, William K; Alexander, Jeffrey A; Wolf, Laura J

2016-04-01

Recent interest in community health collaboratives has been driven by the potential of these types of organizations to solve complex health problems at the local level by bringing together stakeholders that have traditionally operated independently, and often at cross-purposes. Much of the work that is central to the mission of collaboratives can take years to reach fruition, however, and there are a number of challenges to sustaining their activities. In this article, we systematically reviewed the theoretical and empirical literature on health care collaborative sustainability, focusing on definitions and antecedents of sustainability. Given the diversity and fragmentation of this literature, we used this review as a foundation to develop a synthesized definition, conceptual groups of antecedents, and potential research propositions to help guide future research, planning, and practice of sustainable community health collaboratives. © The Author(s) 2015.

Nursing and the barriers to sustainable health care: a literature review.

Science.gov (United States)

Griggs, Chloe; Fernandez, Ana; Callanan, Margie

2017-12-14

global warming poses a serious threat to human health, yet healthcare organisations and staff have been relatively slow to engage with sustainable healthcare practices. This review of the literature seeks to frame what is already known about nurses and their views on global warming and sustainable health care. 11 primary research articles were sourced from a search of five mainstream databases. These articles were subject to a basic thematic analysis. six themes were identified: sustainability, endemic blindness to global issues, environmental numbness, social norms, priority assigned to sustainability, and psychology of responsibility and blame. from the literature reviewed, there are a number of social, cultural and psychological barriers that have led to widespread inaction. This article recommends further research to understand the psychological barriers in more depth as this is a poorly understood area.

Finding Sustainability: University-community collaborations focused on arts in health

Directory of Open Access Journals (Sweden)

Mike White

2011-11-01

Full Text Available This article describes a number of community-based arts in health projects in schools and disadvantaged communities in Northern England that connect with the interdisciplinary research interests of the Centre for Medical Humanities at Durham University (www.dur.ac.uk/cmh. It examines issues about what makes for sustainability in both practice and research of arts in health when operating from a university base and stresses the importance of relationship-based work in health promotion interventions in communities. It attempts to set arts development work in the policy context of how community health has been addressed over the last decade. It provides both practical and metaphorical illustrations of how community cohesion and emotional literacy can be developed and recognised in schools and communities when supported by ethnographic research that is underpinned by theories of social capital, resilience and participatory arts practice. The significance that the artwork can attain as a social gift, with a special meaning for its creators, is examined from an anthropological perspective. Looking historically and comparatively at some longitudinal projects in community-based arts in health, the article assesses what makes for both success and failure in practice, and looks particularly at the significance of the arts in helping to deliver strategies for improving child health and education. In a strategic development context, explanation is given of several strands of university-community collaboration in arts in health, with interlinked project examples drawn from Tyneside and West Yorkshire. Finally, the article looks at the prospects for sustaining arts in health within the coming transfer of the public health function to local government. Keywords Sustainability, arts in community health, resilience, child mental health, social capital

Challenges in managing and sustaining urban slum health ...

African Journals Online (AJOL)

Challenges in managing and sustaining urban slum health programmes in Kenya. ... These were hardly implemented in the projects, according to the data gathered. ... Conclusion: Land and income were big issues according to the responses.

The Implementation of Knowledge Strategy-Based Entrepreneurial Capacity to Achieve Sustainable Competitive Advantage

OpenAIRE

Widodo

2013-01-01

This study aims to develop a model of knowledge strategy-based entrepreneurial capacity to achieve sustainable competitive advantage of rurol banking in Central Java province. The sampling method is ‘‘Purposive sampling’’ by considering the characteristics of the population items, namely: operational experience for at least 5 years and representatives of each area of rurol banking in Semarang, Surakarta and Purwokerto. Then, the sample size is 150 of 251 (59.7%) of top managers of rurol bank...

Public Health Engineering for the Built Environment: Completing Sustainability

NARCIS (Netherlands)

Bronswijk, van J.E.M.H.; Koren, L.G.H.; Pernot, C.E.E.; Vliet, van A.A.M.; Rameckers, E.M.A.L.; Erkelens, P.A.; Jonge, de S.; Vliet, van A.A.M.

2000-01-01

Good health is a prerequisite for sustainable development. From ancient times on environments are built with the good of man in mind, especially to extend his vital life span. At first most building could be considered as public health engineering. Built environments, however, always posed new risks

Contributions of national and global health estimates to monitoring health-related sustainable development goals.

Science.gov (United States)

Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

2016-01-01

The millennium development goals triggered an increased demand for data on child and maternal mortalities for monitoring progress. With the advent of the sustainable development goals and growing evidence of an epidemiological transition toward non-communicable diseases, policymakers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper discusses lessons learned from Thailand's burden of disease (BOD) study on capacity development on NHEs and discusses the contributions and limitations of GHEs in informing policies at the country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and subnational levels. Initially, the quality of cause-of-death reporting in death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This method helped to improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the Global Burden of Disease 2010 study estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and an effective interface between researchers and decision-makers contribute to enhanced country policy responses, whereas subnational data are intended to be used by various subnational partners. Although GHEs contribute to benchmarking country achievement compared with global health

Sustainability of green jobs in Portugal: a methodological approach using occupational health indicators.

Science.gov (United States)

Moreira, Sandra; Vasconcelos, Lia; Silva Santos, Carlos

2017-09-28

This study aimed to develop a methodological tool to analyze and monitor the green jobs in the context of Occupational Health and Safety. A literature review in combination with an investigation of Occupational Health Indicators was performed. The resulting tool of Occupational Health Indicators was based on the existing information of "Single Report" and was validated by national's experts. The tool brings together 40 Occupational Health Indicators in four key fields established by World Health Organization in their conceptual framework "Health indicators of sustainable jobs." The tool proposed allows for assessing if the green jobs enabled to follow the principles and requirements of Occupational Health Indicators and if these jobs are as good for the environment as for the workers' health, so if they can be considered quality jobs. This shows that Occupational Health Indicators are indispensable for the assessment of the sustainability of green jobs and should be taken into account in the definition and evaluation of policies and strategies of the sustainable development.

Achieving the 1.5 °C Objective: Just Implementation Through a Right to (Sustainable) Development Approach

NARCIS (Netherlands)

J. Gupta (Joyeeta); C.J.M. Arts (Karin)

2017-01-01

textabstractAchieving the 1.5 C objective of the Paris Agreement on Climate Change in a just manner requires equitably sharing the responsibilities and rights that relate to this objective. This paper examines how international law concerning the Right to Promote (Sustainable) Development can

Addressing China's grand challenge of achieving food security while ensuring environmental sustainability.

Science.gov (United States)

Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C; Bailey, Mark; Gordon, Iain J; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin

2015-02-01

China's increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies.

Building a sustainable Academic Health Department: the South Carolina model.

Science.gov (United States)

Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A

2014-01-01

Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.

Sustainability considerations for health research and analytic data infrastructures.

Science.gov (United States)

Wilcox, Adam; Randhawa, Gurvaneet; Embi, Peter; Cao, Hui; Kuperman, Gilad J

2014-01-01

The United States has made recent large investments in creating data infrastructures to support the important goals of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER), with still more investment planned. These initial investments, while critical to the creation of the infrastructures, are not expected to sustain them much beyond the initial development. To provide the maximum benefit, the infrastructures need to be sustained through innovative financing models while providing value to PCOR and CER researchers. Based on our experience with creating flexible sustainability strategies (i.e., strategies that are adaptive to the different characteristics and opportunities of a resource or infrastructure), we define specific factors that are important considerations in developing a sustainability strategy. These factors include assets, expansion, complexity, and stakeholders. Each factor is described, with examples of how it is applied. These factors are dimensions of variation in different resources, to which a sustainability strategy should adapt. We also identify specific important considerations for maintaining an infrastructure, so that the long-term intended benefits can be realized. These observations are presented as lessons learned, to be applied to other sustainability efforts. We define the lessons learned, relating them to the defined sustainability factors as interactions between factors. Using perspectives and experiences from a diverse group of experts, we define broad characteristics of sustainability strategies and important observations, which can vary for different projects. Other descriptions of adaptive, flexible, and successful models of collaboration between stakeholders and data infrastructures can expand this framework by identifying other factors for sustainability, and give more concrete directions on how sustainability can be best achieved.

The Sustainable Development Goals and the Global Health Security Agenda: exploring synergies for a sustainable and resilient world.

Science.gov (United States)

Bali, Sulzhan; Taaffe, Jessica

2017-05-01

Both the Sustainable Development Goals (SDGs) and the Global Health Security Agenda (GHSA) represent bold initiatives to address systematically gaps in previous efforts to assure that societies can be resilient when confronted with potentially overwhelming threats to health. Despite their obvious differences, and differing criticisms of both, they shift away from vertical (problem- or disease-specific) to horizontal (comprehensive) solutions. Despite the comprehensiveness of the SDGs, they lack a specific target for global health security. The GHSA focuses primarily on infectious diseases and neglects non-communicable diseases and socioeconomic drivers of health. Even though each agenda has limitations and unique challenges, they are complementary. We discuss ways to understand and implement the two agendas synergistically to hasten progress toward a more sustainable and resilient world.

Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

Directory of Open Access Journals (Sweden)

Emily R Mangone

Full Text Available There is increasing evidence that mobile phone health interventions ("mHealth" can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH, a national text-message (SMS based health communication service in Tanzania.We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320 and at any possible break-even volume.In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs.These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners

Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

Science.gov (United States)

Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

2016-01-01

There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this

Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

Science.gov (United States)

Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

2017-01-01

The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Global health governance in the sustainable development goals: Is it grounded in the right to health?

Science.gov (United States)

Van de Pas, Remco; Hill, Peter S; Hammonds, Rachel; Ooms, Gorik; Forman, Lisa; Waris, Attiya; Brolan, Claire E; McKee, Martin; Sridhar, Devi

2017-01-01

This paper explores the extent to which global health governance - in the context of the early implementation of the Sustainable Development Goals is grounded in the right to health. The essential components of the right to health in relation to global health are unpacked. Four essential functions of the global health system are assessed from a normative, rights-based, analysis on how each of these governance functions should operate. These essential functions are: the production of global public goods, the management of externalities across countries, the mobilization of global solidarity, and stewardship. The paper maps the current reality of global health governance now that the post-2015 Sustainable Development Goals are beginning to be implemented. In theory, the existing human rights legislation would enable the principles and basis for the global governance of health beyond the premise of the state. In practice, there is a governance gap between the human rights framework and practices in global health and development policies. This gap can be explained by the political determinants of health that shape the governance of these global policies. Current representations of the right to health in the Sustainable Development Goals are insufficient and superficial, because they do not explicitly link commitments or right to health discourse to binding treaty obligations for duty-bearing nation states or entitlements by people. If global health policy is to meaningfully contribute to the realization of the right to health and to rights based global health governance then future iterations of global health policy must bridge this gap. This includes scholarship and policy debate on the structure, politics, and agency to overcome existing global health injustices.

Corporate Governance as a Crucial Factor in Achieving Sustainable Corporate Performance

Directory of Open Access Journals (Sweden)

Julija Bistrova

2014-06-01

Full Text Available In the developed stock markets the corporate governance aspect is crucial in the stock portfolio selection process for investor seeking to achieve shareholder value sustainability. In the emerging markets the importance of the corporate governance role just starts to be realized by the investors and by the corporate managers. The present research, looking at the stock performance leaders and laggards, analyzes whether the corporate governance system matters to achieve long-term shareholder value within the Central and Eastern European stock markets universe. Corporate governance quality was assessed and compared among the out- and underperformers. The financial results plausibility and the ownership structure were considered as well. Additionally, the authors analyzed whether the quality of corporate governance influences the economic performance of the company. The obtained results provide the proof that the corporate governance does matter as the market outperformers have above average corporate governance quality and provide trustworthy financial results more often than the underperforming companies. Besides, well-governed companies are also able to deliver more attractive financial results.

From Science, Engineering and Innovation to Sustainable Development: The Path Forward

Science.gov (United States)

Turekian, Vaughan

2017-01-01

In September 2015, world leaders committed to a new 2030 Agenda for Sustainable Development, with 17 Sustainable Development Goals (SDGs) aimed at ending poverty, hunger and inequality, taking action on the environment and climate change, and improving access to health and education. Science, technology and innovation (STI) underpin the achievement of all of the SDGs, whether it is expanding access to health services and quality education; improving food security; and access to clean water and sanitation; building transparent, accountable, and stable institutions; empowering women and minorities; or promoting the sustainable management and use of renewable energy and natural resources. The goals speak to a broad range of directions the world needs to go to promote economic, environmental, and social well-being. The goals are interdependent and achieving one will only be possible by achieving all. We have an obligation to take necessary steps that integrate all the different stakeholders and constant advances in innovation, science, and technology.

[Sustainability analysis of an evaluation policy: the case of primary health care in Brazil].

Science.gov (United States)

Felisberto, Eronildo; Freese, Eduardo; Bezerra, Luciana Caroline Albuquerque; Alves, Cinthia Kalyne de Almeida; Samico, Isabella

2010-06-01

This study analyzes the sustainability of Brazil's National Policy for the Evaluation of Primary Health Care, based on the identification and categorization of representative critical events in the institutionalization process. This was an evaluative study of two analytical units: Federal Management of Primary Health Care and State Health Secretariats, using multiple case studies with data collected through interviews and institutional documents, using the critical incidents technique. Events that were temporally classified as specific to implementation, sustainability, and mixed were categorized analytically as pertaining to memory, adaptation, values, and rules. Federal management and one of the State Health Secretariats showed medium-level sustainability, while the other State Secretariat showed strong sustainability. The results indicate that the events were concurrent and suggest a weighting process, since the adaptation of activities, adequacy, and stabilization of resources displayed a strong influence on the others. Innovations and the development of technical capability are considered the most important results for sustainability.

The Role of a Provider-Sponsored Health Plan in Achieving Scale and Integration.

Science.gov (United States)

Johnson, Steven P

2016-01-01

In pursuit of two primary strategies-to become an integrated delivery network (IDN) on the local level and to achieve additional overall organizational scale to sustain operations-Health First, based in Rockledge, Florida, relies on the success of its provider-sponsored health plan (PSHP) as a critical asset. For Health First, the PSHP serves as an agent for holding and administering financial risk for the health of populations. In addition, we are learning that our PSHP is a critical asset in support of integrating the components of our care delivery system to manage that financial risk effectively, efficiently, and in a manner that creates a unified experience for the customer.Health First is challenged by continuing pressure on reimbursement, as well as by a substantial regulatory burden, as we work to optimize the environments and tools of care and population health management. Even with strong margins and a healthy balance sheet, we simply do not have the resources needed to bring an IDN robustly to life. However, we have discovered that our PSHP can be the vehicle that carries us to additional scale. Many health systems do not own or otherwise have access to a PSHP to hold and manage financial risk. Health First sought and found a not-for-profit health system with complementary goals and a strong brand to partner with, and we now provide private-label health plan products for that system using its strong name while operating the insurance functions under our license and with our capabilities.

A methodological approach and framework for sustainability assessment in NGO-implemented primary health care programs.

Science.gov (United States)

Sarriot, Eric G; Winch, Peter J; Ryan, Leo J; Bowie, Janice; Kouletio, Michelle; Swedberg, Eric; LeBan, Karen; Edison, Jay; Welch, Rikki; Pacqué, Michel C

2004-01-01

An estimated 10.8 million children under 5 continue to die each year in developing countries from causes easily treatable or preventable. Non governmental organizations (NGOs) are frontline implementers of low-cost and effective child health interventions, but their progress toward sustainable child health gains is a challenge to evaluate. This paper presents the Child Survival Sustainability Assessment (CSSA) methodology--a framework and process--to map progress towards sustainable child health from the community level and upward. The CSSA was developed with NGOs through a participatory process of research and dialogue. Commitment to sustainability requires a systematic and systemic consideration of human, social and organizational processes beyond a purely biomedical perspective. The CSSA is organized around three interrelated dimensions of evaluation: (1) health and health services; (2) capacity and viability of local organizations; (3) capacity of the community in its social ecological context. The CSSA uses a participatory, action-planning process, engaging a 'local system' of stakeholders in the contextual definition of objectives and indicators. Improved conditions measured in the three dimensions correspond to progress toward a sustainable health situation for the population. This framework opens new opportunities for evaluation and research design and places sustainability at the center of primary health care programming.

Achieve real gender equality for adolescent health | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-11-03

Nov 3, 2016 ... Achieve real gender equality for adolescent health ... yet limited access to sexual and reproductive health services is preventing women and girls ... forms of sexual violence, trafficking, and abuse and gender discrimination.

Neglecting legumes has compromised human health and sustainable food production.

Science.gov (United States)

Foyer, Christine H; Lam, Hon-Ming; Nguyen, Henry T; Siddique, Kadambot H M; Varshney, Rajeev K; Colmer, Timothy D; Cowling, Wallace; Bramley, Helen; Mori, Trevor A; Hodgson, Jonathan M; Cooper, James W; Miller, Anthony J; Kunert, Karl; Vorster, Juan; Cullis, Christopher; Ozga, Jocelyn A; Wahlqvist, Mark L; Liang, Yan; Shou, Huixia; Shi, Kai; Yu, Jingquan; Fodor, Nandor; Kaiser, Brent N; Wong, Fuk-Ling; Valliyodan, Babu; Considine, Michael J

2016-08-02

The United Nations declared 2016 as the International Year of Pulses (grain legumes) under the banner 'nutritious seeds for a sustainable future'. A second green revolution is required to ensure food and nutritional security in the face of global climate change. Grain legumes provide an unparalleled solution to this problem because of their inherent capacity for symbiotic atmospheric nitrogen fixation, which provides economically sustainable advantages for farming. In addition, a legume-rich diet has health benefits for humans and livestock alike. However, grain legumes form only a minor part of most current human diets, and legume crops are greatly under-used. Food security and soil fertility could be significantly improved by greater grain legume usage and increased improvement of a range of grain legumes. The current lack of coordinated focus on grain legumes has compromised human health, nutritional security and sustainable food production.

Achieving a Sustainable Urban Form through Land Use Optimisation: Insights from Bekasi City’s Land-Use Plan (2010–2030

Directory of Open Access Journals (Sweden)

Rahmadya Trias Handayanto

2017-02-01

Full Text Available Cities worldwide have been trying to achieve a sustainable urban form to handle their rapid urban growth. Many sustainable urban forms have been studied and two of them, the compact city and the eco city, were chosen in this study as urban form foundations. Based on these forms, four sustainable city criteria (compactness, compatibility, dependency, and suitability were considered as necessary functions for land use optimisation. This study presents a land use optimisation as a method for achieving a sustainable urban form. Three optimisation methods (particle swarm optimisation, genetic algorithms, and a local search method were combined into a single hybrid optimisation method for land use in Bekasi city, Indonesia. It was also used for examining Bekasi city’s land-use-plan (2010–2030 after optimising current (2015 and future land use (2030. After current land use optimisation, the score of sustainable city criteria increased significantly. Three important centres of land use (commercial, industrial, and residential were also created through clustering the results. These centres were slightly different from centres of the city plan zones. Additional land uses in 2030 were predicted using a nonlinear autoregressive neural network with external input. Three scenarios were used for allocating these additional land uses including sustainable development, government policy, and business-as-usual. Future land use allocation in 2030 found that the sustainable development scenario showed better performance compared to government policy and business-as-usual scenarios.

[Transition from Millennium Development Goals to Sustainable Development Goals from the perspective of the social determinants of health and health equity].

Science.gov (United States)

Urbina-Fuentes, Manue; Jasso-Gutiérrez, Luis; Schiavon-Ermani, Raffaela; Lozano, Rafael; Finkelman, Jacobo

2017-01-01

The United Nations Declaration of 2000 agreed on eight millennium development goals (MDGs) to be met in 2015. The results show that poverty continues through population growth and advances in both rich and poor countries are threatened by economic crises and inequities in geographic areas and population groups within countries. In a globalized world with great social and economic inequalities, from the perspective of the social determinants of health (SDH), the relevance of the new 17 sustainable development goals (SDGs) is greater. Faced with the health challenges in our country to achieve SDGs, the symposium "The transition from MDGs to SDGs from the perspective of SDH and health equity" was presented at the XLIV Congress of the National Academy of Medicine. The presentations dealt with five important aspects of the transition in Mexico: background and context; the current state of the MDGs in childhood; the impact on gender equity and adolescent fertility; the health system and the theme of environmental health and were presented by Dr. Raffaela Schiavon, Jacobo Finkelman, Luis Jasso and Rafael Lozano.

Technical assistance from state health departments for communities engaged in policy, systems, and environmental change: the ACHIEVE Program.

Science.gov (United States)

Hefelfinger, Jenny; Patty, Alice; Ussery, Ann; Young, Walter

2013-10-24

This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches' meetings, webinars, and technical assistance conference calls. This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events.

Community capacity building and sustainability: outcomes of community-based participatory research.

Science.gov (United States)

Hacker, Karen; Tendulkar, Shalini A; Rideout, Catlin; Bhuiya, Nazmim; Trinh-Shevrin, Chau; Savage, Clara P; Grullon, Milagro; Strelnick, Hal; Leung, Carolyn; DiGirolamo, Ann

2012-01-01

For communities, the value of community-based participatory research (CBPR) is often manifested in the outcomes of increased capacity and sustainable adoption of evidence-based practices for social change. Educational opportunities that promote discourse between community and academic partners can help to advance CBPR and better define these outcomes. This paper describes a community-academic conference to develop shared definitions of community capacity building and sustainability related to CBPR and to identify obstacles and facilitators to both. "Taking It to the Curbside: Engaging Communities to Create Sustainable Change for Health" was planned by five Clinical Translational Science Institutes and four community organizations. After a keynote presentation, breakout groups of community and academic members met to define community capacity building and sustainability, and to identify facilitators and barriers to achieving both. Groups were facilitated by researcher-community partner teams and conversations were recorded and transcribed. Qualitative analysis for thematic content was conducted by a subset of the planning committee. Important findings included learning that (1) the concepts of capacity and sustainability were considered interconnected; (2) partnership was perceived as both a facilitator and an outcome of CBPR; (3) sustainability was linked to "transfer of knowledge" from one generation to another within a community; and (4) capacity and sustainability were enhanced when goals were shared and health outcomes were achieved. Community capacity building and sustainability are key outcomes of CBPR for communities. Co-learning opportunities that engage and mutually educate both community members and academics can be useful strategies for identifying meaningful strategies to achieve these outcomes.

Occupational safety and health, green chemistry, and sustainability: a review of areas of convergence.

Science.gov (United States)

Schulte, Paul A; McKernan, Lauralynn T; Heidel, Donna S; Okun, Andrea H; Dotson, Gary Scott; Lentz, Thomas J; Geraci, Charles L; Heckel, Pamela E; Branche, Christine M

2013-04-15

With increasing numbers and quantities of chemicals in commerce and use, scientific attention continues to focus on the environmental and public health consequences of chemical production processes and exposures. Concerns about environmental stewardship have been gaining broader traction through emphases on sustainability and "green chemistry" principles. Occupational safety and health has not been fully promoted as a component of environmental sustainability. However, there is a natural convergence of green chemistry/sustainability and occupational safety and health efforts. Addressing both together can have a synergistic effect. Failure to promote this convergence could lead to increasing worker hazards and lack of support for sustainability efforts. The National Institute for Occupational Safety and Health has made a concerted effort involving multiple stakeholders to anticipate and identify potential hazards associated with sustainable practices and green jobs for workers. Examples of potential hazards are presented in case studies with suggested solutions such as implementing the hierarchy of controls and prevention through design principles in green chemistry and green building practices. Practical considerations and strategies for green chemistry, and environmental stewardship could benefit from the incorporation of occupational safety and health concepts which in turn protect affected workers.

Future-Proofed Energy Design Approaches for Achieving Low-Energy Homes: Enhancing the Code for Sustainable Homes

Directory of Open Access Journals (Sweden)

Maria Christina Georgiadou

2014-09-01

Full Text Available Under the label “future-proofing”, this paper examines the temporal component of sustainable construction as an unexplored, yet fundamental ingredient in the delivery of low-energy domestic buildings. The overarching aim is to explore the integration of future-proofed design approaches into current mainstream construction practice in the UK, focusing on the example of the Code for Sustainable Homes (CSH tool. Regulation has been the most significant driver for achieving the 2016 zero-carbon target; however, there is a gap between the appeal for future-proofing and the lack of effective implementation by building professionals. Even though the CSH was introduced as the leading tool to drive the “step-change” required for achieving zero-carbon new homes by 2016 and the single national standard to encourage energy performance beyond current statutory minima, it lacks assessment criteria that explicitly promote a futures perspective. Based on an established conceptual model of future-proofing, 14 interviews with building practitioners in the UK were conducted to identify the “feasible” and “reasonably feasible” future-proofed design approaches with the potential to enhance the “Energy and CO2 Emissions” category of the CSH. The findings are categorised under three key aspects; namely: coverage of sustainability issues; adopting lifecycle thinking; and accommodating risks and uncertainties and seek to inform industry practice and policy-making in relation to building energy performance.

Building sustainability indicators in the health dimension for solid waste management

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Tatiane Bonametti Veiga

Full Text Available ABSTRACT Objective: to prepare a list of sustainability indicators in the health dimension, for urban solid waste management. Methods: a descriptive and exploratory study performed jointly with 52 solid waste specialists, using a three-steps Delphi technique, and a scale measuring the degree of importance for agreement among the researchers in this area. Results: the subjects under study were 92,3% PhD's concentrated in the age group from 30 to 40 years old (32,7% and 51% were men. At the end of the 3rd step of the Delphi process, the average and standard deviation of all the proposed indicators varied from 4,22 (±0,79 to 4,72 (±0,64, in a scale of scores for each indicator from 1 to 5 (from "dispensable" to "very important". Results showed the level of correspondence among the participants ranging from 82% to 94% related to those indicators. Conclusion: the proposed indicators may be helpful not only for the identification of data that is updated in this area, but also to enlarge the field of debates of the environmental health policies, directed not only for urban solid waste but for the achievement of better health conditions for the Brazilian context.

The history of wealth concept and ways to achieve it for sustainable development

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O. A. Kalchenko

2016-01-01

Full Text Available The evolution of well-known philosophers and economists views on wealth is considered: Voltaire, Adam Smith, JeanJacques Rousseau, Karl Marx, John Stuart Mill, Milton Friedman, John Maynard Keynes, Joseph Schumpeter, Georg von Wallwitz and others. Economics was initially studying ways and means of achieving wealth. The essence of wealth has changed dramatically in people's minds after the first and the second industrial revolutions. The world today is on the verge of the third industrial revolution (according to Jeremy Rifkin, or, as it is called by many scientists, the new tenor of technology. In the history of any civilization comes the moment of a radical direction change for new prospects or endangered. Not all civilizations were able to transform in time. However, in the past, the effects of civilizations collapse were limited in time, space, and never addressed the species. Currently, the high probability of temperature and planet geochemistry changes as a result of climate change can lead to mass extinction of animals, plants, and people. Humanity has the ability to transit into a stable post-carbon era in the middle of the century and to prevent catastrophic climate change. Currently, sustainable development is the mechanism used to achieve the ultimate goal of any country, enterprise and human development, which is wealth. Under controlled sustainable development we understand the system unity of not only economic, social, environmental, but also resource, technological, institutional activities, as well as a permanent interaction between development and economic safety.

Sustainability and Organizational Change by Sustainable Crediting Therapy

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Dragoş Ilie

2012-06-01

Full Text Available The objective of this paper is to demonstrate that one of the therapies to achieve sustainability and organizational change in the context of current challenges in the national economies is sustainable crediting. The research method is based on a survey of 30 commercial companies from various fields of activity that have or have not implemented, at the leadership level, the concept of sustainable crediting. The data collecting and processing approach has resulted in the determination of the main economic-financial indicators for a period of 5 years, indicators used by banks in relation with the credited organizations. The main results show that companies that have implemented the sustainable crediting concept are more able to achieve sustainability in their developed activity, as well as organizational change with positive effects on their business and on the company as a whole. The concept of sustainable crediting implies the capitalization of the commercial companies, the increase of the loan portfolio quality, the achievement of the financial balance and environmental protection

New initiative to further global sustainable development goals in ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-03-17

Mar 17, 2016 ... Representatives from some 60 think tanks met in November 2015 in Geneva to discuss how to further global objectives in health. ... Read the first submission, Accelerating achievement of the sustainable development goals, co-authored by the Graduate Institute, IDRC, the Harvard School of Public Health, ...

Institutionalizing and sustaining social change in health systems: the case of Uganda.

Science.gov (United States)

Hage, Jerald; Valadez, Joseph J

2017-11-01

The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used

Sustainable Livestock Production, Health, and Environment in the ...

International Development Research Centre (IDRC) Digital Library (Canada)

This project aims to promote evidence-based policies for improving livestock production, environmental sustainability, and health in the Bolivian Altiplano's rural communities. Traditional farming under threat in Bolivia Raising sheep and llamas is a fundamental economic activity that is threatened by current agricultural ...

Consumer perception and trends about health and sustainability

DEFF Research Database (Denmark)

Aschemann-Witzel, Jessica

2015-01-01

Modern affluent societies encounter the challenge of the so-called obesity pandemic in terms of health, and the environmental strain of resource intensive production and consumption in terms of sustainability. Consumer’s role and the consumption side of the supply chain have been identified...

The Role of Deliberative Collaborative Governance in Achieving Sustainable Cities

Directory of Open Access Journals (Sweden)

Margaret Gollagher

2013-05-01

Full Text Available Sustainability issues involve complex interactions between social, economic, and environmental factors that are often viewed quite differently by disparate stakeholder groups. Issues of non-sustainability are wicked problems that have many, often obscure causes, and for which there is no single, straightforward solution. Furthermore, the concept of sustainability is itself contested. For example there are disputes over whether a strong or weak interpretation of sustainability should be adopted. In cities, as elsewhere, sustainability therefore requires discursive plurality and multiple sites of action. It is the thesis of this paper that effective problem solving, decision-making and enacting of a sustainability agenda require deliberative collaborative governance (DCG, a logical hybrid of the closely related fields of deliberative democracy and collaborative governance. We provide a provisional typology of different modes of deliberative collaborative governance, explaining each with a sustainability example, with a particular focus on DCG initiatives for planning in Western Australia. It is argued that the lens provided by such a typology can help us to understand the factors likely to promote better resolution of wicked problems and increased sustainability.

Securing Communal Land Rights to Achieve Sustainable Development in Sub-Saharan Africa: Critical Analysis and Policy Implications

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Ross Andrew Clarke

2009-09-01

Full Text Available While the concept of sustainable development gains increasing traction under international law, effective and scalable policies to translate these principles into practice remain largely beyond reach. This article analyses one possible strategy in Sub-Saharan Africa - increasing security of communal tenure to improve resource management and achieve rural sustainable development. Although this approach has attracted some attention, particularly with management responsibility of communal property increasingly devolved to the community-level, the expected results in terms of more sustainable resource exploitation and sounder environmental management have yet to be realised. Through critical analysis, with particular emphasis on the Gestion Terroir approach in Burkina Faso , the article explores the reasons behind the limited success. The article suggests that greater emphasis must be placed on bridging statutory command-and-control regimes with community-based models. Focusing on the links between communal land tenure and environmental management, and effectively embedding community land management institutions within existing environmental governance structures offers a practical model to promote sustainable development.

Achieving sustainable plant disease management through evolutionary principles.

Science.gov (United States)

Zhan, Jiasui; Thrall, Peter H; Burdon, Jeremy J

2014-09-01

Plants and their pathogens are engaged in continuous evolutionary battles and sustainable disease management requires novel systems to create environments conducive for short-term and long-term disease control. In this opinion article, we argue that knowledge of the fundamental factors that drive host-pathogen coevolution in wild systems can provide new insights into disease development in agriculture. Such evolutionary principles can be used to guide the formulation of sustainable disease management strategies which can minimize disease epidemics while simultaneously reducing pressure on pathogens to evolve increased infectivity and aggressiveness. To ensure agricultural sustainability, disease management programs that reflect the dynamism of pathogen population structure are essential and evolutionary biologists should play an increasing role in their design. Copyright © 2014 Elsevier Ltd. All rights reserved.

Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador.

Science.gov (United States)

Spiegel, Jerry M; Breilh, Jaime; Beltran, Efrain; Parra, Jorge; Solis, Fernanda; Yassi, Annalee; Rojas, Alejandro; Orrego, Elena; Henry, Bonnie; Bowie, William R; Pearce, Laurie; Gaibor, Juan; Velasquez, Patricio; Concepcion, Miriam; Parkes, Margot

2011-11-08

The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: "Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?" To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. By 2009, train-the-trainer project initiation involved 27 participatory action research Master's theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master's and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Strengthening capabilities for producing and applying knowledge through direct engagement with affected populations and

Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

Directory of Open Access Journals (Sweden)

Henry Bonnie

2011-11-01

Full Text Available Abstract Background The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. Methods In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: “Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?” To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. Results By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Discussion Strengthening capabilities for producing and

Water Sciences - Connecting the dots to achieve the 2030 Agenda for Sustainable Development

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Uhlenbrook, Stefan; Ortigara, Angela; Minelli, Lucilla

2017-04-01

Land use change, urbanisation, climate change, demographic development and migration, conflicts and peace, change of diets, industry 4.0, globalisation etc. are among the challenges that water sciences need to address to serve societal needs. Water availability per capita is decreasing, water quality is deteriorating at many places, but water demand is continuously escalating. Business as usual in water science is not up to the related challenges. In fact, business as usual cannot be the answer in all aspects, i.e. also current policy making processes will need to improve and take stock of evidences provided by science in order to better address societal challenges. However, exciting developments have been taking place. The global community agreed on a new and ambitious agenda for development, which aims to be comprehensive and include the participation of all stakeholders in one integrated framework. The 2030 Agenda for Sustainable Development provides a stimulating new era, with unique opportunities to reconcile science, society and policy making. Hydrology and water management - in all its facets including wastewater - play a central role in the Agenda 2030, as it is not only central in Sustainable Development Goal (SDG) 6, but it is fundamental for the realization of other SDGs related to, for instance, poverty reduction, sustainable growth, health, food security, climate change, ecosystems (land and sea), gender equality, etc. Despite the recognition of the critical importance of water in this agenda, the implementation of related policies and use of scientific developments represent a difficult task. Two main challenges remain: (i) the utilization of the knowledge and developments already available, and (ii) the need to overcome current and future knowledge gaps ensuring that scientific results support sustainable development effectively. The UN system will produce a Synthesis Report for SDG 6, which is currently being prepared by a UN-Water Task Force that

Y-12 Site Sustainability Plan

Energy Technology Data Exchange (ETDEWEB)

Spencer, Charles G

2012-12-01

The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the U.S. Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) vision for a commitment to energy effi ciency and sustainability and to achievement of the Guiding Principles. Specifi cally, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan, while promoting overall sustainability and reduction of greenhouse gas emissions. The mission of the Y-12 Energy Management program is to incorporate energy-effi cient technologies site-wide and to position Y-12 to meet NNSA energy requirement needs through 2025 and beyond. The plan addresses greenhouse gases, buildings, fleet management, water use, pollution prevention, waste reduction, sustainable acquisition, electronic stewardship and data centers, site innovation and government-wide support.

Health system strengthening: prospects and threats for its sustainability on the global health policy agenda.

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Naimoli, Joseph F; Saxena, Sweta; Hatt, Laurel E; Yarrow, Kristina M; White, Trenton M; Ifafore-Calfee, Temitayo

2018-01-01

In 2013, Hafner and Shiffman applied Kingdon's public policy process model to explain the emergence of global attention to health system strengthening (HSS). They questioned, however, HSS's sustainability on the global health policy agenda, citing various concerns. Guided by the Grindle and Thomas interactive model of policy implementation, we advance and elaborate a proposition: a confluence of developments will contribute to maintaining HSS's prominent place on the agenda until at least 2030. Those developments include (1) technical, managerial, financial, and political responses to unpredictable public health crises that imperil the routine functioning of health systems, such as the 2014-2015 Ebola virus disease (Ebola) epidemic in West Africa; (2) similar responses to non-crisis situations requiring fully engaged, robust health systems, such as the pursuit of the new Sustainable Development Goal for health (SDG3); and (3) increased availability of new knowledge about system change at macro, meso, and micro levels and its effects on people's health and well-being. To gauge the accuracy of our proposition, we carried out a speculative assessment of credible threats to our premise by discussing all of the Hafner-Shiffman concerns. We conclude that (1) the components of our proposition and other forces that have the potential to promote continuing attention to HSS are of sufficient strength to counteract these concerns, and (2) prospective monitoring of HSS agenda status and further research on agenda sustainability can increase confidence in our threat assessment. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Informatics Approach to Establishing a Sustainable Public Health Community

Science.gov (United States)

Kriseman, Jeffrey Michael

2012-01-01

This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

Health Care Infrastructure for Financially Sustainable Clinical Genomics.

Science.gov (United States)

Lennerz, Jochen K; McLaughlin, Heather M; Baron, Jason M; Rasmussen, David; Sumbada Shin, Meini; Berners-Lee, Nancy; Miller Batten, Julie; Swoboda, Kathryn J; Gala, Manish K; Winter, Harland S; Schmahmann, Jeremy D; Sweetser, David A; Boswell, Marianne; Pacula, Maciej; Stenzinger, Albrecht; Le, Long P; Hynes, William; Rehm, Heidi L; Klibanski, Anne; Black-Schaffer, Stephen W; Golden, Jeffrey A; Louis, David N; Weiss, Scott T; Iafrate, A John

2016-09-01

Next-generation sequencing has evolved technically and economically into the method of choice for interrogating the genome in cancer and inherited disorders. The introduction of procedural code sets for whole-exome and genome sequencing is a milestone toward financially sustainable clinical implementation; however, achieving reimbursement is currently a major challenge. As part of a prospective quality-improvement initiative to implement the new code sets, we adopted Agile, a development methodology originally devised in software development. We implemented eight functionally distinct modules (request review, cost estimation, preauthorization, accessioning, prebilling, testing, reporting, and reimbursement consultation) and obtained feedback via an anonymous survey. We managed 50 clinical requests (January to June 2015). The fraction of pursued-to-requested cases (n = 15/50; utilization management fraction, 0.3) aimed for a high rate of preauthorizations. In 13 of 15 patients the insurance plan required preauthorization, which we obtained in 70% and ultimately achieved reimbursement in 50%. Interoperability enabled assessment of 12 different combinations of modules that underline the importance of an adaptive workflow and policy tailoring to achieve higher yields of reimbursement. The survey confirmed a positive attitude toward self-organizing teams. We acknowledge the individuals and their interactions and termed the infrastructure: human pipeline. Nontechnical barriers currently are limiting the scope and availability of clinical genomic sequencing. The presented human pipeline is one approach toward long-term financial sustainability of clinical genomics. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

The role of meat in strategies to achieve a sustainable diet lower in greenhouse gas emissions: A review.

Science.gov (United States)

Hyland, John J; Henchion, Maeve; McCarthy, Mary; McCarthy, Sinéad N

2017-10-01

Food consumption is responsible for a considerable proportion of greenhouse gas emissions (GHGE). Hence, individual food choices have the potential to substantially influence both public health and the environment. Meat and animal products are relatively high in GHGE and therefore targeted in efforts to reduce dietary emissions. This review first highlights the complexities regarding sustainability in terms of meat consumption and thereafter discusses possible strategies that could be implemented to mitigate its climatic impact. It outlines how sustainable diets are possible without the elimination of meat. For instance, overconsumption of food in general, beyond our nutritional requirements, was found to be a significant contributor of emissions. Non-voluntary and voluntary mitigation strategies offer potential to reduce dietary GHGE. All mitigation strategies require careful consideration but on-farm sustainable intensification perhaps offers the most promise. However, a balance between supply and demand approaches is encouraged. Health should remain the overarching principle for policies and strategies concerned with shifting consumer behaviour towards sustainable diets. Copyright © 2017. Published by Elsevier Ltd.

Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

Science.gov (United States)

Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

2014-02-01

Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Key performance indicators for measuring sustainability in health ...

African Journals Online (AJOL)

Key performance indicators for measuring sustainability in health care industry in Malaysia. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Journal Home > Vol 10, No 1S (2018) > ... Next, an in-depth meeting was conducted to gain insights and feedbacks with the management of a private hospital.

Approaches to Sustainable Development in Poland

International Nuclear Information System (INIS)

Kostrzewa, Karina; ); Piasecki, Ryszard

2009-01-01

The sustainable development principle was introduced into the legal system of Poland when the Constitution of the Polish Republic was adopted in 1997. Paradoxically, in Poland - one of the few countries in the world which have introduced the concept of sustainable development at the level of the Constitution, it is difficult to find a reference to it in the political debate. The national sustainable development strategy Poland 2025 has met no response among society and today it seems to be hardly remembered by anybody. An average citizen does not know the concept of sustainable development, or has a vague notion of it, often identifying it exclusively with environmental protection. Solving social problems (the labour market, education, health protection, equality of the sexes, etc.) is not associated with sustainable development whatsoever, and neither is engagement into achieving these development targets on the global scale

The new United Nations approach to sustainable development post-2015: Findings from four overviews of systematic reviews on interventions for sustainable development and health.

Science.gov (United States)

Galvão, Luiz A C; Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Câmara, Volney Magalhães; Luiz, Ronir Raggio; Becerra-Posada, Francisco

2016-03-01

Objective To identify reported interventions that facilitate sustainable development and have had a positive impact on health in four areas: sustainable food production; sustainable energy use; sustainable jobs ("decent work"); and prevention of toxic exposure to chemicals. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted of at least 14 databases and 8 websites for each of the four overviews, using pre-defined protocols, including clear inclusion criteria. To qualify as "sustainable," interventions needed to aim (explicitly or implicitly) to positively impact at least two dimensions of the integrated framework for sustainable development and had to include measures of health impact. Results In total, 47 systematic reviews and 10 economic evaluations met the inclusion criteria. The most promising interventions, such as agricultural policies, were identified for each of the four topics. While the evidence for the interventions is not strong because of the limited number of studies, there is no evidence of a definite negative impact on health. The only possible exception is that of taxes and subsidies-though this intervention also has the potential to be pro-equity with higher relative impacts for lower income groups. Conclusions The evidence found for effective interventions is useful for guiding countries toward the best options for non-health sector interventions that can positively impact health. This overviews shows that intersectoral work benefits every sector involved.

Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

OpenAIRE

Mohammed Hamed Ahmed

2013-01-01

Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor us...

Sustainability of public health in diadema, 2000 - 2011: a picture of SUS building limits

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Mariana Alves Melo

2015-12-01

Full Text Available Introduction: between 2000 to 2011, Diadema paulista municipality has faced many obstacles in health management, struggling to ensure the sustainability of its health system. Objective: to contribute to the discussion of the Unified Health System (SUS and its foreseable turbulent future, based on the analysis of the municipal point of view, identifying the limits of its building in Diadema. Methods: Diadema is characterized as one of the first municipalities that adhered to the principles of the SUS, since its implementation, allowing an analysis as a case study in view of the system's sustainability at the local level. The term sustainability used was addressed in two dimensions: the structure of this system and its process. Results: in SUS implementation period, Diadema stood out by increasing investment in health, reaching an average allocation of about 30% of its tax revenues, including constitutional transfers. Results diagnosed by observing the structure of dimensions and the process indicate that the sustainability of the municipal health system is threatened, as the significant expansion of the range of services and health actions was not followed by sufficient resources to its health maintenance. Conclusions: the existence of obstacles justified and formed the basis for the diagnosis of the main limits on SUS conformation, in health policy and management of resources, funding and budgetary impacts.

Y-12 Site Sustainability Plan

Energy Technology Data Exchange (ETDEWEB)

Erhart, Steven C. [National Nuclear Security Administration (NNSA), Washington, DC (United States); Spencer, Charles G. [Y-12 National Security Complex, Oak Ridge, TN (United States)

2013-12-01

The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the U.S. Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) vision for a commitment to energy effi ciency and sustainability and to achievement of the Guiding Principles. Specifi cally, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan (SSPP), while promoting overall sustainability and reduction of greenhouse gas (GHG) emissions. The mission of the Y-12 Energy Management program is to incorporate energy-efficient technologies site-wide and to position Y-12 to meet NNSA energy requirement needs through 2025 and beyond. This plan addresses: Greenhouse Gas Reduction and Comprehensive Greenhouse Gas Inventory; Buildings, ESPC Initiative Schedule, and Regional and Local Planning; Fleet Management; Water Use Efficiency and Management; Pollution Prevention and Waste Reduction; Sustainable Acquisition; Electronic Stewardship and Data Centers; Renewable Energy; Climate Change; and Budget and Funding.

Contributions of national and global health estimates to monitoring health-related Sustainable Development Goals in Thailand.

Science.gov (United States)

Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

2017-01-01

The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper draws lessons learned from Thailand's burden of disease study (BOD) on capacity development for NHEs, and discusses the contributions and limitation of GHEs in informing policies at country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and sub-national levels. Initially, the quality of cause of death reporting in the death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This helped improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the 2010 Global Burden of Diseases (GBD) estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and effective interfaces between researchers and decision makers contribute to enhanced country policy responses, while sub-national data are intended to be used by various sub-national-level partners. Though GHEs contribute to benchmarking country achievement compared with global health

Distributed renewable energies for off-grid communities strategies and technologies toward achieving sustainability in energy generation and supply

CERN Document Server

El Bassam, Nasir; Schlichting, Marcia

2012-01-01

Energy is directly related to the most critical economic and social issues which affect sustainable development such as mobility, food production, environmental quality, regional and global security issues. Two-thirds of the new demand will come from developing nations, with China accounting for 30%. Without adequate attention to the critical importance of energy to all these aspects, the global, social, economic and environmental goals of sustainability cannot be achieved. Indeed the magnitude of change needed is immense, fundamental and directly related to the energy produced and consumed na

Achieving Health SDG 3 in Africa through NGO Capacity Building ...

African Journals Online (AJOL)

AJRH Managing Editor

2016-09-01

Sep 1, 2016 ... Résumé. Comme les investisseurs mondiaux d'impact se préparent à soutenir le ... Sustainable Development Goals (SDGs) and ... innovative financing plans. .... agencies with the support of consultants. ... Centre for Health Science Training, Research and .... place consistent project management systems.

A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

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Kanellopoulos Dimitros

2011-12-01

Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

Assessment of Environmental Sustainability in Health Care Organizations

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María Carmen Carnero

2015-06-01

Full Text Available Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite the extensive literature analysing environmental matters, there is no objective model for assessing the environmental sustainability of HCOs in such a way that the results may be compared over time for an organization, and between different organizations, to give a comparison or benchmarking tool for HCOs. This paper presents a Multi-Criteria Decision Analysis model integrating a Fuzzy Analytic Hierarchy Process and utility theory, to evaluate environmental sustainability in HCOs. The model uses criteria assessed as a function of the number of annual treatments undertaken. The model has been tested in two HCOs of very different sizes.

India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

Science.gov (United States)

Narayana, Muttur Ranganathan

2016-12-01

India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public

Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis.

Science.gov (United States)

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2016-10-18

Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

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Subramanian Savitha

2011-12-01

Full Text Available Abstract Background There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs. But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. Methods A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. Results We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. Conclusions The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

Science.gov (United States)

Subramanian, Savitha; Naimoli, Joseph; Matsubayashi, Toru; Peters, David H

2011-12-14

There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.

Health-Related Education for Sustainability: Public Health Workforce Needs and the Role of Higher Education

Science.gov (United States)

Patrick, Rebecca; Kingsley, Jonathan; Capetola, Teresa

2016-01-01

Public health practitioners have important roles to play in addressing environmental sustainability imperatives that have an impact on human health. Yet, to date, the extent to which practitioners are willing and able to address these issues is an understudied subject. This article draws on the findings of two qualitative studies involving 49…

Building sustainability indicators in the health dimension for solid waste management 1

Science.gov (United States)

Veiga, Tatiane Bonametti; Coutinho, Silvano da Silva; Andre, Silvia Carla Silva; Mendes, Adriana Aparecida; Takayanagui, Angela Maria Magosso

2016-01-01

ABSTRACT Objective: to prepare a list of sustainability indicators in the health dimension, for urban solid waste management. Methods: a descriptive and exploratory study performed jointly with 52 solid waste specialists, using a three-steps Delphi technique, and a scale measuring the degree of importance for agreement among the researchers in this area. Results: the subjects under study were 92,3% PhD's concentrated in the age group from 30 to 40 years old (32,7%) and 51% were men. At the end of the 3rd step of the Delphi process, the average and standard deviation of all the proposed indicators varied from 4,22 (±0,79) to 4,72 (±0,64), in a scale of scores for each indicator from 1 to 5 (from "dispensable" to "very important"). Results showed the level of correspondence among the participants ranging from 82% to 94% related to those indicators. Conclusion: the proposed indicators may be helpful not only for the identification of data that is updated in this area, but also to enlarge the field of debates of the environmental health policies, directed not only for urban solid waste but for the achievement of better health conditions for the Brazilian context. PMID:27508905

Environment of sustainable job in construction: the interface risk and right to health

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Nilton Cesar Flores

2016-04-01

Full Text Available This study analyzes the right to health in the middle of construction work environment, through risk perspective, prevention, sustainability and public policy, with an emphasis on activity that exposes the worker to solar radiation and, therefore, implies a means not sustainable environment. The analysis will focus on the environmental risk arising from exposure to radiation and its legal effects. In this context of risk, prevention is essential to the realization of the right to health in the workplace, and the extension of the right to health is the result of a constitutional reading for a sustainable environment, particularly from the art. 196 and art. 7, item XXII, which refers to prevention in the working environment. In this context, public policies show up as a guarantor instrument of disease prevention and the implementation of the right to health in the workplace. For this study, we use the theory of social systems as a theoretical framework

Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

Science.gov (United States)

Fusheini, Adam; Eyles, John

2016-10-07

Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

Innovative approach for achieving of sustainable urban water supply system by using of solar photovoltaic energy

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Jure Margeta

2017-01-01

Full Text Available Paper describes and analyses new and innovative concept for possible integration of solar photovoltaic (PV energy in urban water supply system (UWSS. Proposed system consists of PV generator and invertor, pump station and water reservoir. System is sized in such a manner that every his part is sized separately and after this integrated into a whole. This integration is desirable for several reasons, where the most important is the achievement of the objectives of sustainable living in urban areas i.e. achieving of sustainable urban water supply system. The biggest technological challenge associated with the use of solar, wind and other intermittent renewable energy sources RES is the realization of economically and environmentally friendly electric energy storage (EES. The paper elaborates the use of water reservoires in UWSS as EES. The proposed solution is still more expensive than the traditional and is economically acceptable today in the cases of isolated urban water system and special situations. Wider application will depend on the future trends of energy prices, construction costs of PV generators and needs for CO2 reduction by urban water infrastructure.

Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens.

Science.gov (United States)

Desmond, Sharon

2017-03-02

The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.

Window of opportunity--positioning food and nutrition policy within a sustainability agenda.

Science.gov (United States)

Yeatman, Heather

2008-04-01

Public health professionals have an opportunity to refocus national attention on food and nutrition policy, within a sustainability agenda. A broadly based national Food and Nutrition Policy was developed in 1992. However, its implementation has been selective and primarily based within the health sector. Other major policy areas, for example; industry, agriculture and trade, have dominated Australian nutrition and health policy. A broad, whole-of-government commitment to a comprehensive food and nutrition policy that engages with the community is required to achieve outcomes in terms of public health, a sustainable environment and viable food production for future generations.

Empowering the Citizen-Consumer: Re-Regulating Consumer Information to Support the Transition to Sustainable and Health Promoting Food Systems in Canada

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Sandi Trillo

2012-09-01

Full Text Available Both health and sustainability are stated public policy objectives in Canada, but food information rules and practices may not be optimal to support their achievement. In the absence of a stated consensus on the purposes of public information about food, the information provided is frequently determined by the marketers of product. No institution or agency has responsibility for determining the overall coherence of consumer food messages relative to these broader social goals of health and sustainability. Individual firms provide information that shows their products to best advantage, which may contradict what is provided about the product by another firm or government agency. Individual consumers do not have the resources to determine easily the completeness of any firm's messages, particularly in light of the size of food industry advertising budgets. Government rules confound this problem because there is also little coherence between the parts of government that have responsibility for point of purchase, advertising rules, and labelling. The healthy eating messages of health departments are often competing with contradictory messages permitted by the regulatory framework of other arms of government. Investments in programs that successfully promote environmental stewardship in agriculture are undercut in the market because consumers cannot support those efforts with their dollars. This problem exists despite the emergence of “citizen-consumers” who have a broader approach to food purchasing than individual maximization. Only recently have some health professionals and sustainable agriculture proponents turned their attention to these factors and designed interventions that take them into account. In this paper, which builds upon earlier work by MacRae [1], we outline key short, medium and long term initiatives to facilitate the citizen-consumer phenomenon and better support consumers in their efforts to promote health and sustainability

Redefining public health leadership in the sustainable development goal era.

Science.gov (United States)

Reddy, K Srinath; Mathur, Manu Raj; Negi, Sagri; Krishna, Bhargav

2017-06-01

Adoption of the Sustainable Development Goals (SDGs) by member states of the United Nations (UN) has set a new agenda for public health action at national and global levels. The changed context calls for a reframing of what constitutes effective leadership in public health, through a construct that reflects the interdependence of leadership at multiple levels across the health system and its partners in other sectors. This is especially important in the context of Low and Middle Income Countries (LMICs) that are facing complex demographic and epidemiological transitions. The health system needs to exercise leadership that effectively mobilises all its resources for maximising health impact, and channels trans-disciplinary learning into well-coordinated multi-sectoral action on the wider determinants of health. Leadership is essential not only at the level of inspirational individuals who can create collective vision and commitment but also at the level of supportive institutions situated in or aligned to the health system. In turn, the health system as a whole has to exercise leadership that advances public health in the framework of sustainable development. This commentary examines the desirable attributes of effective leadership at each of these levels and explores the nature of their inter-dependence. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Promotion of sustainable employability : Occupational health in the meat processing industry

NARCIS (Netherlands)

van Holland, Breunis Johannes

2016-01-01

Due to rising retirement age, sustainable employability is gaining interest among employers. Such is the case in the meat processing industry. A strategy to address these challenges is health promotion at work. Therefore, the largest Dutch meat processing company has implemented a Workers’ Health

VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM.

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Claudia Marotta

2017-10-01

Full Text Available Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.

Improving animal health for poverty alleviation and sustainable livelihoods.

Science.gov (United States)

Stringer, Andy

2014-11-29

Animals are vital to ensuring food security for individuals, families and communities in countries around the world. In this, the latest article in Veterinary Record's series promoting One Health, Andy Stringer, director of veterinary programmes at the Society for the Protection of Animals Abroad, discusses how improving animal health, particularly of poultry and working equids, has the potential to reduce poverty and promote food security and sustainable livelihoods in low-income countries. British Veterinary Association.

Food system sustainability for health and well-being of Indigenous Peoples.

Science.gov (United States)

Kuhnlein, Harriet V

2015-09-01

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions. Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries. The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas. Leaders of the Indigenous Peoples' case studies, their communities and their academic partners. Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples. Indigenous Peoples' reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study.

Science.gov (United States)

Scheirer, Mary Ann; Santos, Sherie Lou Z; Tagai, Erin K; Bowie, Janice; Slade, Jimmie; Carter, Roxanne; Holt, Cheryl L

2017-03-28

Sustainability of evidence-based health promotion interventions has received increased research attention in recent years. This paper reports sustainability data from Project HEAL (Health through Early Awareness and Learning) a cancer communication implementation trial about early detection, based in African American churches. In this paper, we used a framework by Scheirer and Dearing (Am J Publ Health 101:2059-2067, 2011) to evaluate multiple dimensions of sustainability from Project HEAL. We examined the following dimensions of sustainability: (a) continued benefits for intervention recipients, (b) continuation of intervention activities, c) maintaining community partnerships, (d) changes in organizational policies or structures, (e) sustained attention to the underlying issues, (f) diffusion to additional sites, or even (g) unplanned consequences of the intervention. Project HEAL provided a three-workshop cancer educational series delivered by trained lay peer community health advisors (CHAs) in their churches. Multiple sources of sustainability were collected at 12 and 24 months after the intervention that reflect several levels of analysis: participant surveys; interviews with CHAs; records from the project's management database; and open-ended comments from CHAs, staff, and community partners. Outcomes differ for each dimension of sustainability. For continued benefit, 39 and 37% of the initial 375 church members attended the 12- and 24-month follow-up workshops, respectively. Most participants reported sharing the information from Project HEAL with family or friends (92% at 12 months; 87% at 24 months). For continuation of intervention activities, some CHAs reported that the churches held at least one additional cancer educational workshop (33% at 12 months; 24% at 24 months), but many more CHAs reported subsequent health activities in their churches (71% at 12 months; 52% at 24 months). No church replicated the original series of three workshops

Sustainable Improvement of Animal Production and Health

International Nuclear Information System (INIS)

Odongo, N.E.; Garcia, M.; Viljoen, G.J.

2010-01-01

The world's poorest people, some one billion living mostly in Africa and Asia, depend on livestock for their day-to-day livelihood. To reduce poverty, fight hunger and ensure global food security, there is an urgent need to increase livestock production in sustainable ways. However, livestock production in developing countries is constrained by low genetic potential of the animals, poor nutrition and husbandry practices and infectious diseases. Nuclear techniques, when applied in conjunction with conventional methods, can identify constraints to livestock productivity as well as interventions that lead to their reduction or elimination in ways that are economically and socially acceptable. The challenge is how best to exploit these techniques for solving problems faced by livestock keepers within the many agricultural production systems that exist in developing countries and demonstrating their advantages to owners, local communities and government authorities. This publication is a compilation of the contributions emanating from an international Symposium on Sustainable Improvement of Animal Production and Health organised by the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture in cooperation with the Animal Production and Health Division of FAO. It provides invaluable information not only on how nuclear and related techniques can be used to support sustainable livestock production systems, but also about the constraints and opportunities for using these techniques in developing countries; it also attempts to identify specific research needs and gaps and new options for using these techniques for solving established and emerging problems. As such, it is hoped that the information presented and suggestions made will provide valuable guidance to scientists in both the public and private sectors as well as to government and institutional policy and decision makers. The Symposium comprised a plenary session and four thematic sessions, covering (i

Sustainable Improvement of Animal Production and Health

Energy Technology Data Exchange (ETDEWEB)

Odongo, N E; Garcia, M; Viljoen, G J [Animal Production and Health Subprogramme, Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, Department of Nuclear Sciences and Applications, International Atomic Agency, Vienna (Austria)

2010-07-01

The world's poorest people, some one billion living mostly in Africa and Asia, depend on livestock for their day-to-day livelihood. To reduce poverty, fight hunger and ensure global food security, there is an urgent need to increase livestock production in sustainable ways. However, livestock production in developing countries is constrained by low genetic potential of the animals, poor nutrition and husbandry practices and infectious diseases. Nuclear techniques, when applied in conjunction with conventional methods, can identify constraints to livestock productivity as well as interventions that lead to their reduction or elimination in ways that are economically and socially acceptable. The challenge is how best to exploit these techniques for solving problems faced by livestock keepers within the many agricultural production systems that exist in developing countries and demonstrating their advantages to owners, local communities and government authorities. This publication is a compilation of the contributions emanating from an international Symposium on Sustainable Improvement of Animal Production and Health organised by the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture in cooperation with the Animal Production and Health Division of FAO. It provides invaluable information not only on how nuclear and related techniques can be used to support sustainable livestock production systems, but also about the constraints and opportunities for using these techniques in developing countries; it also attempts to identify specific research needs and gaps and new options for using these techniques for solving established and emerging problems. As such, it is hoped that the information presented and suggestions made will provide valuable guidance to scientists in both the public and private sectors as well as to government and institutional policy and decision makers. The Symposium comprised a plenary session and four thematic sessions, covering (i

Working toward financial sustainability of integrated behavioral health services in a public health care system.

Science.gov (United States)

Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

2012-06-01

The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

Textiles and clothing sustainability sustainable technologies

CERN Document Server

2017-01-01

This is the first book to deal with the innovative technologies in the field of textiles and clothing sustainability. It details a number of sustainable and innovative technologies and highlights their implications in the clothing sector. There are currently various measures to achieve sustainability in the textiles and the clothing industry, including innovations in the manufacturing stage, which is the crux of this book.

Assessing the universal health coverage target in the Sustainable Development Goals from a human rights perspective.

Science.gov (United States)

Chapman, Audrey R

2016-12-15

The UN's Sustainable Development Goals (SDGs), adopted in September 2015, include a comprehensive health goal, "to ensure healthy lives and promote well-being at all ages." The health goal (SDG 3) has nine substantive targets and four additional targets which are identified as a means of implementation. One of these commitments, to achieve universal health coverage (UHC), has been acknowledged as central to the achievement of all of the other health targets. As defined in the SDGs, UHC includes financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. This article evaluates the extent to which the UHC target in the SDGs conforms with the requirements of the right to health enumerated in the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, and other international human rights instruments and interpreted by international human rights bodies. It does so as a means to identify strengths and weaknesses in the framing of the UHC target that are likely to affect its implementation. While UHC as defined in the SDGs overlaps with human rights standards, there are important human rights omissions that will likely weaken the implementation and reduce the potential benefits of the UHC target. The most important of these is the failure to confer priority to providing access to health services to poor and disadvantaged communities in the process of expanding health coverage and in determining which health services to provide. Unless the furthest behind are given priority and strategies adopted to secure their participation in the development of national health plans, the SDGs, like the MDGs, are likely to leave the most disadvantaged and vulnerable communities behind.

[Political ecology, ecological economics, and public health: interfaces for the sustainability of development and health promotion].

Science.gov (United States)

Porto, Marcelo Firpo; Martinez-Alier, Joan

2007-01-01

This article proposes to focus contributions from political ecology and ecological economics to the field of collective health with a view towards integrating the discussions around health promotion, socio-environmental sustainability, and development. Ecological economics is a recent interdisciplinary field that combines economists and other professionals from the social, human, and life sciences. The field has developed new concepts and methodologies that seek to grasp the relationship between the economy and ecological and social processes such as social metabolism and metabolic profile, thereby interrelating economic, material, and energy flows and producing indicators and indexes for (un)sustainability. Meanwhile, political ecology approaches ecological issues and socio-environmental conflicts based on the economic and power dynamics characterizing modern societies. Collective health and the discussions on health promotion can expand our understanding of territory, communities, and the role of science and institutions based on the contributions of political ecology and ecological economics in analyzing development models and the distributive and socio-environmental conflicts generated by them.

Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework.

Science.gov (United States)

Iwelunmor, Juliet; Blackstone, Sarah; Veira, Dorice; Nwaozuru, Ucheoma; Airhihenbuwa, Collins; Munodawafa, Davison; Kalipeni, Ezekiel; Jutal, Antar; Shelley, Donna; Ogedegebe, Gbenga

2016-03-23

Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained. We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region. The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment

The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

Science.gov (United States)

Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

2010-11-01

There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

The sustainable company: new challenges and strategies for more sustainability

Directory of Open Access Journals (Sweden)

Victor DANCIU

2013-09-01

Full Text Available The sustainability becomes a model of development only if countries, industries, businesses and citizens become sustainable. The contribution of the business to a promising future should come from a fully integrated sustainability in its DNA and strategies.This paper focuses on the needed sustainable strategies for scaling up the contribution of the companies to sustainable development in the future. At the beginning, we analyze the main theoretical points of view on sustainability. Then, we explain how companies could achieve the sustainability by following the steps of a difficult process and the present performances in sustainability of large companies around the world. Finally, we suggest four strategies that businesses could design and implement in order to scaling up their sustainability in the future.The research has two important conclusions on sustainability in business. One is that the sustainability pays off if it is integrated in the DNA of the companies. The other conclusion says that the companies will succeed to make the needed transformation for achieving a better sustainability in the future only if they design and perform strategies focused on improving sustainability.

INEQUALITY IN CHINA IN THE CONTEXT OF SUSTAINABLE DEVELOPMENT

Directory of Open Access Journals (Sweden)

Чжан Чжань

2017-12-01

Full Text Available The research object is the sociopolitical foundations of sustainable development in China. Research subject is the problem of inequality as one of the obstacles to sustainable development in China. In the article, different aspects of the issue are reviewed in the context of sustainable development, especially through the requirements of the UN Agenda 2030. These aspects include income inequality, inequality in education and health care, gender inequality. It is shown that despite the improvement trend in some specific aspects, the inequality gap in China is still large, further reduction of the inequality level remains one of the main tasks for achieving sustainable development goals in China.

Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials

Directory of Open Access Journals (Sweden)

Regina Winzer

2018-04-01

Full Text Available Background Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. Material and Methods A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995–2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges’ g used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3–6 months, 7–12 months, and 13–18 months of post-intervention follow-up. Results About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7–12 months post-intervention (standardized mean difference (Hedges’ g effect size (ES = −0.28 (95% CI [−0.49, −0.08]. Further

Accountable priority setting for trust in health systems - the need for research into a new approach for strengthening sustainable health action in developing countries

Directory of Open Access Journals (Sweden)

Olsen Øystein E

2009-10-01

applied in an action research framework to examine the potential of AFR to support sustainable improvements to health systems performance. This paper reports on the project design and progress and argues that there is a high need for research into legitimate and fair priority setting to improve the knowledge base for achieving sustainable improvements in health outcomes.

Accountable priority setting for trust in health systems--the need for research into a new approach for strengthening sustainable health action in developing countries.

Science.gov (United States)

Byskov, Jens; Bloch, Paul; Blystad, Astrid; Hurtig, Anna-Karin; Fylkesnes, Knut; Kamuzora, Peter; Kombe, Yeri; Kvåle, Gunnar; Marchal, Bruno; Martin, Douglas K; Michelo, Charles; Ndawi, Benedict; Ngulube, Thabale J; Nyamongo, Isaac; Olsen, Oystein E; Onyango-Ouma, Washington; Sandøy, Ingvild F; Shayo, Elizabeth H; Silwamba, Gavin; Songstad, Nils Gunnar; Tuba, Mary

2009-10-24

framework to examine the potential of AFR to support sustainable improvements to health systems performance.This paper reports on the project design and progress and argues that there is a high need for research into legitimate and fair priority setting to improve the knowledge base for achieving sustainable improvements in health outcomes.

Cultural development and environment: a necessity to achieve sustainable development

International Nuclear Information System (INIS)

Azhari, A.

2003-01-01

This paper stresses on the important role of cultural development and protection of environment as the main pillars of sustainable development. one of the article's goals to make link among culture, protection of environment and sustainable development. according to the article, part of our commitment to sustainable development is to keep balance among different dimensions of development (cultural/ economic/ political/ social) considering environmental ethics

Towards Intelligently - Sustainable Cities?

Directory of Open Access Journals (Sweden)

Luca Salvati

2013-04-01

Full Text Available In the quest for achieving sustainable cities, Intelligent and Knowledge City Programmes (ICPs and KCPs represent cost-efficient strategies for improving the overall performance of urban systems. However, even though nobody argues on the desirability of making cities “smarter”, the fundamental questions of how and to what extent can ICPs and KCPs contribute to the achievement of urban sustainability lack a precise answer. In the attempt of providing a structured answer to these interrogatives, this paper presents a methodology developed for investigating the modalities through which ICPs and KCPs contribute to the achievement or urban sustainability. Results suggest that ICPs and KCPs efficacy lies in supporting cities achieve a sustainable urban metabolism through optimization, innovation and behavior changes.

An ecological public health approach to understanding the relationships between sustainable urban environments, public health and social equity.

Science.gov (United States)

Bentley, Michael

2014-09-01

The environmental determinants of public health and social equity present many challenges to a sustainable urbanism-climate change, water shortages and oil dependency to name a few. There are many pathways from urban environments to human health. Numerous links have been described but some underlying mechanisms behind these relationships are less understood. Combining theory and methods is a way of understanding and explaining how the underlying structures of urban environments relate to public health and social equity. This paper proposes a model for an ecological public health, which can be used to explore these relationships. Four principles of an ecological public health-conviviality, equity, sustainability and global responsibility-are used to derive theoretical concepts that can inform ecological public health thinking, which, among other things, provides a way of exploring the underlying mechanisms that link urban environments to public health and social equity. Theories of more-than-human agency inform ways of living together (conviviality) in urban areas. Political ecology links the equity concerns about environmental and social justice. Resilience thinking offers a better way of coming to grips with sustainability. Integrating ecological ethics into public health considers the global consequences of local urban living and thus attends to global responsibility. This way of looking at the relationships between urban environments, public health and social equity answers the call to craft an ecological public health for the twenty-first century by re-imagining public health in a way that acknowledges humans as part of the ecosystem, not separate from it, though not central to it. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sustainable Pest Management : Achievements and Challenges

OpenAIRE

World Bank

2005-01-01

The objective of this paper is to: (a) review World Bank's pest management activities during 1999-2004; (b) assess those in view of the changes in the external and internal contexts; (c) identify appropriate opportunities of engagement on pest and pesticide issues; and (d) suggest means to further promote sound pest management in the World Bank operations. The importance of sound pest management for sustainable agricultural production is being recognized by many developing countries. Many cou...

Beyond good intentions: the role of proactive coping in achieving sustained behavioural change in the context of diabetes management.

NARCIS (Netherlands)

Thoolen, B.J.; Ridder, D. de; Bensing, J.; Gorter, K.; Rutten, G.

2009-01-01

This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

Science.gov (United States)

Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

A public health perspective

African Journals Online (AJOL)

user

EDITORIAL. Enabling local health departments to save more lives: A public ... promoting health through the organized efforts of society” (1) ... and synergistic with achieving the sustainable development goals because its furtherance brings a ...

Financial sustainability planning for immunization services in Cambodia.

Science.gov (United States)

Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann

2006-07-01

The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.

Selecting, adapting, and sustaining programs in health care systems

Directory of Open Access Journals (Sweden)

Zullig LL

2015-04-01

Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

[Efficiency indicators to contribute to sustainability of health services in Spain].

Science.gov (United States)

García, E I; Mira Solves, J J; Guilabert Mora, M

2014-01-01

Identifying a minimum set of efficiency indicators calculated from current information sources. Interventions adopted from the analysis of these indicators could contribute to health services sustainability. We applied the discussion group technique. A total of 23 quality coordinators from around the country and the representatives of the regional quality societies in SECA (Spanish Society for Quality in Healthcare) participated. Ten efficiency indicators useful for integrated management areas were identified and accepted, 5 in the area of primary care and 5 for hospital management. The efficiency indicators agreed upon could contribute to the sustainability of the health system without this affecting the quality of care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Environmentally sustainable transport in the CEI countries

International Nuclear Information System (INIS)

Thaler, R.; Wiederkehr, P.

2004-01-01

Moving people and freight in an environmentally sustainable manner that reduces environmental pollution and health hazards is a key challenge for transport and environment policies in Europe. Present mobility patterns of passenger and freight transport in Central and Eastern Europe do not correspond to the objectives of sustainable development. This paper presents the results of a transport futures study for the CEI region as a whole using backcasting methodology with long-term sustainability criteria to be met by 2030. Achieving environmentally sustainable transport (EST) doesn't mean less transport and mobility than we have today, but it means primarily maintaining a balanced modal split that results in less environmental and health impacts than it would be under projected future trends. Rail, trams, busses and new forms of flexible inter-modal public transport mobility would have to take a large share and rail transport for passenger and freight as well as inland shipping would have to be nearly doubled by 2030 while road freight could still increase if it is based on alternative fuels reducing its impacts. Technological advancements for passenger cars and lorries, fuels and infrastructure will play an important part to achieve EST, but also ''smart'' mobility management (e.g. transport avoidance, increasing load factors and modal shift), innovative mobility services and freight logistics would be critical. The implementation of these policies and strategies will require coherent and comprehensive packages of instruments and measures, including: economic instruments, regulatory instruments, changes in infrastructure investment, mobility management, information and education programmes as well as better integration of land use, transport and environment policies. Realising EST will provide new opportunities for businesses to develop and invest in innovative solutions for passenger and freight transport. Overall, achieving EST would constitute a net benefit for

Exploring an innovative watershed management approach: From feasibility to sustainability

International Nuclear Information System (INIS)

Said, A.; Sehlke, G.; Stevens, D.K.; Sorensen, D.; Walker, W.; Hardy, T.; Glover, T.

2006-01-01

Watershed management is dedicated to solving watershed problems on a sustainable basis. Managing watershed development on a sustainable basis usually entails a balance between the needs of humans and nature, both in the present and in the future. From a watershed or water resources development basis, these problems can be classified into five general categories: lack of water quantity, deterioration in water quality, ecological impacts, weak public participation, and weak economic value. The first three categories can be combined to make up physical sustainability while the last two categories can be defined as social and economic sustainability. Therefore, integrated watershed management should be designed to achieve physical sustainability utilizing, to the greatest extent possible, public participation in an economically viable manner. This study demonstrates an innovative approach using scientific, social, and motivational feasibilities that can be used to improve watershed management. Scientific feasibility is tied to the nature of environmental problems and the scientific means to solve them. Social feasibility is associated with public participation. Motivational feasibility is related to economic stimulation for the stakeholders to take actions. The ecological impacts, lack of water quantity and deterioration in water quality are problems that need scientific means in order to improve watershed health. However, the implementation of these means is typically not achievable without the right public participation. In addition, public participation is typically accelerated by economic motivation for the stakeholders to use the resources in a manner that improves watershed health. The Big Lost River in south-central Idaho has been used as an illustration for implementing scientific, social and motivational feasibilities and in a manner that can achieve sustainability relative to water resources management. However, the same approach can be used elsewhere after

Exploring an innovative watershed management approach: From feasibility to sustainability

Energy Technology Data Exchange (ETDEWEB)

Said, A. [Department of Civil and Environmental Engineering, University of South Florida, Tampa, FL 33620 (United States); Sehlke, G. [Idaho National Laboratory, Idaho Falls, ID 83415 (United States); Stevens, D.K.; Sorensen, D.; Walker, W.; Hardy, T. [Civil and Environmental Department, Utah State University, Logan, UT 84321 (United States); Glover, T. [Economics Department, Utah State University, Logan, UT 84321 (United States)

2006-10-15

Watershed management is dedicated to solving watershed problems on a sustainable basis. Managing watershed development on a sustainable basis usually entails a balance between the needs of humans and nature, both in the present and in the future. From a watershed or water resources development basis, these problems can be classified into five general categories: lack of water quantity, deterioration in water quality, ecological impacts, weak public participation, and weak economic value. The first three categories can be combined to make up physical sustainability while the last two categories can be defined as social and economic sustainability. Therefore, integrated watershed management should be designed to achieve physical sustainability utilizing, to the greatest extent possible, public participation in an economically viable manner. This study demonstrates an innovative approach using scientific, social, and motivational feasibilities that can be used to improve watershed management. Scientific feasibility is tied to the nature of environmental problems and the scientific means to solve them. Social feasibility is associated with public participation. Motivational feasibility is related to economic stimulation for the stakeholders to take actions. The ecological impacts, lack of water quantity and deterioration in water quality are problems that need scientific means in order to improve watershed health. However, the implementation of these means is typically not achievable without the right public participation. In addition, public participation is typically accelerated by economic motivation for the stakeholders to use the resources in a manner that improves watershed health. The Big Lost River in south-central Idaho has been used as an illustration for implementing scientific, social and motivational feasibilities and in a manner that can achieve sustainability relative to water resources management. However, the same approach can be used elsewhere after

E-waste: A Challenge for Sustainable Development

Directory of Open Access Journals (Sweden)

Md. Sahadat Hossain

2015-01-01

Conclusions. Sustainability is being prioritized for all development activities by integrating societal, economic, environmental, technological, cultural, and gender perspectives. Considering the adverse potential eco-toxicological impacts and diverse health effects of e-waste, an urgent global multilateral agreement is needed addressing its management (i.e., handling, storage, transportation, recycling, and final disposal, whether by land filling or incineration. Due to the global nature of the issue and the difficulty of establishing sustainable and environmentally sound processing of e-waste in low-income countries, multinational negotiation and collaboration is the only realistic solution. Furthermore, comprehensive global e-waste management and policies could help to off-set the hazards of e-waste and are the best approach for achieving sustainable development.

[Ecosystemic and communicative approaches in the implementation of territorial agendas for sustainable development and health promotion].

Science.gov (United States)

Gallo, Edmundo; Setti, Andréia Faraoni Freitas

2012-06-01

This paper analyzes the sustainability of ecosystemic and communicative approaches in terms of strategic planning for the implementation of territorial agendas that seek to integrate the principles of Sustainable Development and Health Promotion. It takes the Sustainable Development and Health Promotion project: Implementation of the Healthy Cities Agenda integrated with Agenda 21 in Traditional Communities of Protected Areas of the Bocaina Region" as a point of reference. It involves action-research that strives to contribute to the promotion of quality of life by means of the implementation of a participative strategic agenda and the promotion of mutual economic sustainability. The work seeks to build theoretical/practical bridges between the approaches and the methodologies and technologies used, assessing their consistency and effectiveness in relation to the principles of sustainable development and health promotion, especially in the empowerment of the local population and the broadening of the autonomy of the community.

Progress towards sustainable development : 1997 sustainable development report

International Nuclear Information System (INIS)

1998-01-01

The ways in which Shell Canada has been able to incorporate sustainable development concepts into the Company's business strategies were highlighted. The report describes Shell Canada's plans for protecting the air, water, wilderness, wildlife, soil and groundwater. Land reclamation of abandoned well sites, building a solid capability in emergency preparedness and a strong program to ensure health and safety, are also high on Shell Canada's priorities list. Achievements in 1997, led by the completion of environmental and socio-economic impact assessment of the Sable Offshore Energy Project and the announcement of plans for the construction of a mine and extraction plant north of Fort McMurray (Musked River Mine) Alberta, were reviewed. An ambitious list of objectives and targets for 1998 were also outlined. While in 1997 improvements in safety and sustainable development performance were impressive, financial results were also gratifying, with the Company reporting its best financial results ever. tabs., figs

Winning the sustainable development debate

International Nuclear Information System (INIS)

Ritch, John; Cornish, Emma

2002-01-01

Full text: This year - in Johannesburg from 26 August to 4 September - the world will witness what is expected to be the largest environmental gathering yet: the World Summit on Sustainable Development. Some 60,000 participants, including Heads of State, government officials, intergovernmental organizations, and environmental, business and scientific lobbies, will debate the world's progress in implementing 'Agenda 2 V - the sustainable development principles agreed in Rio de Janeiro in 1992. Some kind of deal, perhaps in the form of a declaration, will emerge from Johannesburg, reasserting international commitment to sustainable development. At this stage the content cannot be predicted. Experience warns us to expect a strong and virulent anti-nuclear lobby, not only as part of the 'environmental community', but within some of the governments themselves. Their role will be to achieve a text declaring nuclear an unsustainable energy source. The nuclear industry has six months to make its case, in the preparatory fora and elsewhere, that nuclear energy must be recognized - and at a minimum, not excluded - as a sustainable development technology. Twin goals of sustainable development: meeting human need and achieving environmental security. The principle of sustainable development aims at the long-term environmental protection of the planet - sparing our children and their children from living on a planet irredeemably spoilt through human action. An equally pressing issue is that of bridging the wealth gap between the North and South. In this vein, UN Secretary General Kofi Annan recently published his priorities for attention at the World Summit. These include: - Poverty eradication and achieving sustainable livelihoods; - Promoting health through sustainable development; - Access to energy and energy efficiency; - Managing the world's freshwater resources; - Sustainable development initiatives for Africa. The central element of sustainable development: clean energy

Opportunities and challenges within urban health and sustainable development

DEFF Research Database (Denmark)

Fisher, Jack E.; Andersen, Zorana J.; Loft, Steffen

2017-01-01

The United Nations’ Sustainable Development Goals mark aunique window of opportunity for both human and planetaryhealth. With rising life expectancy and rapidly expanding urbanpopulations exposed to pollution and sedentary lifestyles, thereis a greater focus on reducing the gap between life...... expectancyand number of healthy years lived, whilst limiting anthropogenicactivities contributing to pollution and climate change. Thus,urban development and policies, which can create win–winsituations for our planet and human health, falls into the realmand expertise of public health. However, some...

[Environmental health and inequalities: building indicators for sustainable development].

Science.gov (United States)

Carneiro, Fernando Ferreira; Franco Netto, Guilherme; Corvalan, Carlos; de Freitas, Carlos Machado; Sales, Luiz Belino Ferreira

2012-06-01

Despite its progress in terms of socio-economic indicators, Brazil is still unequal, which is due to an unequal and exclusionary historical process. In this paper we selected the Human Development Index - HDI and other social, economic, environmental and health indicators to exemplify this situation. We selected the municipalities that had the lowest HDI in the country in 2000 comparing their evolution over time between 2000 and 2010 by means of indicators linked to the economic, environmental and social pillars of sustainable development. These municipalities have an HDI classified as low (sustainable development with quality of life, the improvement of sanitation and education indicators should be a priority for Brazil.

Sexual and reproductive health and rights in the sustainable development goals and the post-2015 development agenda: less than a year to go.

Science.gov (United States)

Haslegrave, Marianne

2014-11-01

Since the International Conference on Population and Development (ICPD) in Cairo in 1994 there have been significant achievements in moving towards the goal of sexual and reproductive health and rights. Yet there have also been disappointments, as demonstrated in the Millennium Development Goals, even though in 2007 a target on reproductive health was added. Most recently, the 20-year review of the implementation of the ICPD Programme of Action, ICPD Beyond 2014, has taken place, which has moved forward the sexual and reproductive health and rights agenda. But, the main arena for future negotiations has changed and the UN is in the process of negotiating the post-2015 development agenda and the sustainable development goals (SDGs). This paper assesses what has been taking place since 2013 and provides information as to how the process for the post-2015 development agenda and the SDGs are likely to move forward. An understanding of what has been achieved, the processes as they are now proceeding and their future development are important for moving towards the ultimate goal of achieving sexual and reproductive health and rights in the next 15 years. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

INFLUENCE OF WORKING ENVIRONMENT ON SUSTAINABLE DEVELOPMENT THROUGH THE HEALTH PROTECTION OF THE ENTERPRISE STAFF

Directory of Open Access Journals (Sweden)

Yuliya V. Karpovich

2017-06-01

Full Text Available The article investigates the processes of health protection at modern industrial enterprises. Occupational health of workers is considered in the article as an important component of the sustainable development of the enterprise. The process of health protection is described in the study not only as a social component, but also as a process relating to all areas of sustainable development. The article attempts to show the place of ‘health-protection subsystem’ as part of an integrated system of industrial enterprises’ sustainable development. Four independent spheres of health protection programs implementation were pointed out at the level of enterprise – professional environment, the quality of workplace, involvement of employees in the process of health protection, involvement of the enterprise in the processes of health protection. The article emphasizes the interrelationship of biological and economic characteristics of human life and society in the formation of health protection processes. Programs for sustainable development taking into account the management of health protection should include two sets of activities: corrective and special ones. Tools used in health management programs aimed at expanding the choices of healthier behavior and altering the character of individual preferences in behavior within the framework of the formation of health tastes and preferences are defined. The authors present the results of the analysis of occupational diseases on the example of the three companies of the Perm region (Saranovskaya shakhta ‘Rudnaya’ OJSC, Motovilikhinskie zavody PJSC and Proton-PM PJSC. The results allowed to offer a list of universal and special arrangements for the implementation of health protection control programs within the mentioned industrial enterprises.

Sustainability at the Edge of Chaos: Its Limits and Possibilities in Public Health

Directory of Open Access Journals (Sweden)

Christopher G. Hudson

2013-01-01

Full Text Available This paper critically reviews the expanding literature on applications of sustainability to healthcare policy and planning. It argues that the concept has been overgeneralized and has become a buzzword masking disparate agendas. It ignores the insights of the newest generation of systems theory on complex systems on the ubiquity of far-from-equilibrium conditions. Yet, a central meaning often ascribed to sustainability is the level continuation of healthcare programs and their institutionalization. Sustainability is only coherent in health care when it is more narrowly delimited to involve public health and treated as only one of several evaluative criteria that informs not only the continuation of programs but more often their expansion or contraction as needs dynamically change.

Understanding sustainable diets: a descriptive analysis of the determinants and processes that influence diets and their impact on health, food security, and environmental sustainability.

Science.gov (United States)

Johnston, Jessica L; Fanzo, Jessica C; Cogill, Bruce

2014-07-01

The confluence of population, economic development, and environmental pressures resulting from increased globalization and industrialization reveal an increasingly resource-constrained world in which predictions point to the need to do more with less and in a "better" way. The concept of sustainable diets presents an opportunity to successfully advance commitments to sustainable development and the elimination of poverty, food and nutrition insecurity, and poor health outcomes. This study examines the determinants of sustainable diets, offers a descriptive analysis of these areas, and presents a causal model and framework from which to build. The major determinants of sustainable diets fall into 5 categories: 1) agriculture, 2) health, 3) sociocultural, 4) environmental, and 5) socioeconomic. When factors or processes are changed in 1 determinant category, such changes affect other determinant categories and, in turn, the level of "sustainability" of a diet. The complex web of determinants of sustainable diets makes it challenging for policymakers to understand the benefits and considerations for promoting, processing, and consuming such diets. To advance this work, better measurements and indicators must be developed to assess the impact of the various determinants on the sustainability of a diet and the tradeoffs associated with any recommendations aimed at increasing the sustainability of our food system. © 2014 American Society for Nutrition.

Sustainable Health Development Goals (SHDG): breaking down the ...

African Journals Online (AJOL)

The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year.

Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

Science.gov (United States)

Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

2014-01-01

It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

Dietary change – consumer preferences, marketing barriers and enablers, and the role of meat alternative choice(s) in achieving sustainable consumption

OpenAIRE

Apostolidis, Chrysostomos; McLeay, Fraser

2012-01-01

This research builds upon existing theories of consumer behaviour, sustainable and ethical consumption and social marketing. It aims to improve academic and practical understanding of the effect of socio-environmental attributes on consumer preferences regarding meat and meat alternative products and examine how more sustainable consumption patterns can be achieved. It is based upon the idea that marketing strategies can be used with the ultimate aim of changing behavior in order to benefit t...

Understanding sustained domestic violence identification in maternal and child health nurse care: process evaluation from a 2-year follow-up of the MOVE trial.

Science.gov (United States)

Hooker, Leesa; Small, Rhonda; Taft, Angela

2016-03-01

To investigate factors contributing to the sustained domestic violence screening and support practices of Maternal and Child Health nurses 2 years after a randomized controlled trial. Domestic violence screening by healthcare professionals has been implemented in many primary care settings. Barriers to screening exist and screening rates remain low. Evidence for longer term integration of nurse screening is minimal. Trial outcomes showed sustained safety planning behaviours by intervention group nurses. Process evaluation in 2-year follow-up of a cluster randomized controlled trial. Evaluation included a repeat online nurse survey and 14 interviews (July-September 2013). Survey analysis included comparison of proportionate group difference between arms and between trial baseline and 2 year follow-up surveys. Framework analysis was used to assess qualitative data. Normalization Process Theory informed evaluation design and interpretation of results. Survey response was 77% (n = 123/160). Sustainability of nurse identification of domestic violence appeared to be due to greater nurse discussion and domestic violence disclosure by women, facilitated by use of a maternal health and well-being checklist. Over time, intervention group nurses used the maternal checklist more at specific maternal health visits and found the checklist the most helpful resource assisting their domestic violence work. Nurses' spoke of a degree of 'normalization' to domestic violence screening that will need constant investment to maintain. Sustainable domestic violence screening and support outcomes can be achieved in an environment of comprehensive, nurse designed and theory driven implementation. Continuing training, discussion and monitoring of domestic violence work is needed to retain sustainable practices. © 2015 John Wiley & Sons Ltd.

Sustainable development goals and the human resources crisis.

Science.gov (United States)

Freer, Joseph

2017-01-01

Achieving universal health coverage by 2030 requires that lessons from the Millennium Development Goals must be heeded. The most important lesson is that the workforce underpins every function of the health system, and is the rate-limiting step. The three dimensions that continue to limit the success of the development agenda are availability, distribution and performance of health workers - and the Sustainable Development Goals cannot be achieved without addressing all three. Hence, the traditional response of scaling up supply is inadequate: a paradigm shift is required in the design of systems that can properly identify, train, allocate and retain health workers. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Achieving universal health coverage in small island states: could importing health services provide a solution?

Science.gov (United States)

Walls, Helen; Smith, Richard

2018-01-01

Background Universal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option. Methods Analysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu. Findings Medical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS. Interpretation Our findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control. PMID:29527349

Improving human health. One of the five key areas to sustainable development where progress is possible with the resources and technologies at our disposal today

International Nuclear Information System (INIS)

2002-01-01

Good health is an essential requisite for sustainable human development. Despite encouraging progress made to date, however, in many parts of the world, poor nutrition and disease-causing pathogens continue to be significant barriers to achieving good health, particularly for children. The problems are diverse; the consequences can be devastating, not just to individuals, but to the societies affected as well. The International Atomic Energy Agency (IAEA) is building capabilities of developing Member States to address these important health problems using nuclear techniques. In many instances, these techniques offer unique and cost effective means to prevent, diagnose, and treat a wide variety of diseases and conditions that affect health

Bridging miles to achieve milestones: Corporate social responsibility for primary health care.

Science.gov (United States)

Gulati, Ruchie

2017-01-01

Sustainable Developmental Goals aim to provide "Good health for all". The task though immense ,requires equitable and efficient distribution of health resources to the community, reached predominantly by the Primary Health Centres. Strengthening these centres is essential to attain the goal. Adequate health financing is one of the important determinants for utilizing the optimal potential of these centres . Pooling funds from alternate financing strategies as Corporate Social Responsibility (CSR) funds may give impetus and facilitate healthcare affordability to the underserved population. This convergence of vision of corporate funding for "basic health services" may bridge the gap arising out of inadequate funding and facilitate "Good Health for all" in India.

Sustenance and sustainability: maximizing the impact of school gardens on health outcomes.

Science.gov (United States)

Davis, Jaimie N; Spaniol, Mackenzie R; Somerset, Shawn

2015-09-01

. Some of the garden programmes resulted in increased vegetable intake, which has positive implications for both environment sustainability and health-related outcomes. Further, the majority resulted in some improvement in behaviour determinants more generally. However, more research is warranted to understand how to achieve long-term improvements in dietary behaviours and how to sustain the garden-based programmes in schools.

The contracting round: achieving health gain or financial balance?

Science.gov (United States)

McCarthy, M

1998-12-01

In the 1991 National Health Service reforms, health authorities became responsible for the health of their resident population, and they contract for health services from NHS providers - trusts and primary care services. A case study in Camden and Islington, an inner London health district, during 1996-1997 shows that contracting was directed more towards achieving financial balance than health objectives. Reasons include the inflationary effect of competition within an internal market, the power of administrators in decision-making within the health authority, and lack of adequate financial accounting in the NHS to relate costs to health outcomes. The introduction of programme budgets for districts would provide more cost-effective use of the nation's resources.

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

Science.gov (United States)

Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

2016-01-01

Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

Assessing capacity for sustainability of effective programs and policies in local health departments

Science.gov (United States)

Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

2015-01-01

Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

Socially cooperative choices: An approach to achieving resource sustainability in the coastal zone

Science.gov (United States)

Crance, Colin; Draper, Dianne

1996-03-01

Achieving resource sustainability, particularly in the coastal zone, is complicated by a variety of interdependencies and trade-offs between economic, social, and ecological variables. Although trade-offs between each of these variables are important, this paper emphasizes the social components of resource management. In this regard a distinction is made between individual and cooperative choices. Individual choices frequently are made from a shortterm, self-interested perspective, whereas cooperative choices are made from a long-term, community and resource-sustainability perspective. Typically, when presented with a spectrum of resource management decisions, individuals have a tendency to act in a self-interested manner. Thus, cooperative benefits, such as reduced conflict and improved resource certainty, are not realized. An overview of selected aspects of social dilemma theory suggests that socially cooperative choice outcomes are attainable in coastal zone management by integrating structural and behavioral solutions in resource use decision making. Three barriers to successful integration of structural and behavioral solutions are identified as self-interest, mistrust, and variable perceptions of resource amenities. Examples from coastal zone management indicate that these barriers may be overcome using approaches such as scopereduction, co-management, community education, and local participation. The paper also provides comment on the potential benefits of integrating structural and behavioral solutions in international coastal zone management efforts.

Achieving More Sustainable Designs through a Process Synthesis-Intensification Framework

DEFF Research Database (Denmark)

Babi, Deenesh Kavi; Woodley, John; Gani, Rafiqul

2014-01-01

More sustainable process designs refer to design alternatives that correspond to lowervalues of a set of targeted performance criteria. In this paper, a multi-level frameworkfor process synthesis-intensification that leads to more sustainable process designs ispresented. At the highest level of a...

Promoting nuclear power, achieving sustainable development of nuclear industry in China

International Nuclear Information System (INIS)

Kang, R.

2006-01-01

The past 5 decades witnessed the rapid growth of China's nuclear industry. The sustained and rapid economic growth and continuous improvement of people's living standards have placed higher requirements for energy and power supplies. As a safe and clean energy source, nuclear energy has been gradually and widely accepted by the Chinese government and the public. The Chinese government has adopted the policy a ctively pushing forward the nuclear power development , set up the target to reach 40GWe of nuclear power installed capacity by 2020, accounting for about 4% of the total installed capacity in China. In this regard, this paper presents the China's nuclear program to illustrate how China is going to achieve the target. The paper is composed of 3 parts. The first part gives a review of the achievements in nuclear power in the last 20 years. The second part presents China's ''three approach'' strategy for furthering the nuclear power development: carrying out duplication projects at the existing plant sites; introducing GUI technology via international bidding; developing the brand C NP1000 , i.e. Chinese Nuclear Power lOOOMwe class, with China's own intellectual property. This part also explores the ways of securing the fuel supply for nuclear power development. The third part concludes with CNNC's ''3221'' strategy which aims at building a world class conglomerate, and expresses its sincere wish to work with the nuclear community to push the nuclear industry worldwide by strengthening international cooperation

[Sustainability and excellence of the Catalan health system. New paradigms, challenges and responses].

Science.gov (United States)

Fernández i Alegre, Roser; Argenter i Giralt, Miquel; Rodríguez i Guasch, Xavier

2015-11-01

The aim of a health system and the priority of any government is to anticipate problems before they appear, provide an innovative response to these new needs and healthcare models, improve access of the general public and patients to health care, especially care for the most vulnerable groups, improve healthcare results and implement the structural reforms necessary to maintain a viable and sustainable quality public healthcare system for everyone. In the current environment, health systems are facing new economic, demographic, care, social, technological and political paradigms to which health policy must respond. Faced with these challenges, health systems, especially in the case of Catalonia, are challenged to take decisions on how best to approach the implementation of structural reform designed to facilitate the necessary economic and fiscal sustainability in the service of fresh and innovative health policies and patient-centred care within a system marked by excellence and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

The economy and the environment. In search of sustainable development. Extensive summary

International Nuclear Information System (INIS)

1996-10-01

In recent years, there has been much debate regarding environmental policy and ways of achieving sustainable development. Several definitions of sustainable development have been proposed. Most, however, are highly abstract and do not provide environmental policymakers with an operational framework. The problem is addressed in this working paper by attempting to identify ways of achieving sustainable growth in the Netherlands. As the title suggests, a clear and practicable definition of sustainable development has yet to be found. The report has been part of a project organized in conjunction with the National Institute of Public Health and Environmental Protection (RIVM). It starts with a theoretical examination of the concept of sustainable development. After a brief review of events in the Netherlands in the last ten years and projections for the next twenty years, the report goes on to present four case-study reports on specific environmental problems (greenhouse gases, manure, traffic and transport and the depletion of natural resources)

Accelerating Digital Mental Health Research From Early Design and Creation to Successful Implementation and Sustainment.

Science.gov (United States)

Mohr, David C; Lyon, Aaron R; Lattie, Emily G; Reddy, Madhu; Schueller, Stephen M

2017-05-10

Mental health problems are common and pose a tremendous societal burden in terms of cost, morbidity, quality of life, and mortality. The great majority of people experience barriers that prevent access to treatment, aggravated by a lack of mental health specialists. Digital mental health is potentially useful in meeting the treatment needs of large numbers of people. A growing number of efficacy trials have shown strong outcomes for digital mental health treatments. Yet despite their positive findings, there are very few examples of successful implementations and many failures. Although the research-to-practice gap is not unique to digital mental health, the inclusion of technology poses unique challenges. We outline some of the reasons for this gap and propose a collection of methods that can result in sustainable digital mental health interventions. These methods draw from human-computer interaction and implementation science and are integrated into an Accelerated Creation-to-Sustainment (ACTS) model. The ACTS model uses an iterative process that includes 2 basic functions (design and evaluate) across 3 general phases (Create, Trial, and Sustain). The ultimate goal in using the ACTS model is to produce a functioning technology-enabled service (TES) that is sustainable in a real-world treatment setting. We emphasize the importance of the service component because evidence from both research and practice has suggested that human touch is a critical ingredient in the most efficacious and used digital mental health treatments. The Create phase results in at least a minimally viable TES and an implementation blueprint. The Trial phase requires evaluation of both effectiveness and implementation while allowing optimization and continuous quality improvement of the TES and implementation plan. Finally, the Sustainment phase involves the withdrawal of research or donor support, while leaving a functioning, continuously improving TES in place. The ACTS model is a step

How to ensure sustainable interoperability in heterogeneous distributed systems through architectural approach.

Science.gov (United States)

Pape-Haugaard, Louise; Frank, Lars

2011-01-01

A major obstacle in ensuring ubiquitous information is the utilization of heterogeneous systems in eHealth. The objective in this paper is to illustrate how an architecture for distributed eHealth databases can be designed without lacking the characteristic features of traditional sustainable databases. The approach is firstly to explain traditional architecture in central and homogeneous distributed database computing, followed by a possible approach to use an architectural framework to obtain sustainability across disparate systems i.e. heterogeneous databases, concluded with a discussion. It is seen that through a method of using relaxed ACID properties on a service-oriented architecture it is possible to achieve data consistency which is essential when ensuring sustainable interoperability.

Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention

Directory of Open Access Journals (Sweden)

Norbert Mundorf

2018-01-01

Full Text Available Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST using the Transtheoretical Model of Change (TTM, which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604 that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices.

Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention.

Science.gov (United States)

Mundorf, Norbert; Redding, Colleen A; Paiva, Andrea L

2018-01-18

Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices.

Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention

Science.gov (United States)

Mundorf, Norbert; Redding, Colleen A.; Paiva, Andrea L.

2018-01-01

Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices. PMID:29346314

Is sustainability achievable? Exploring the limits of sustainability with model systems.

Science.gov (United States)

Shastri, Yogendra; Diwekar, Urmila; Cabezas, Heriberto; Williamson, James

2008-09-01

Successful implementation of sustainability ideas in ecosystem management requires a basic understanding of the often nonlinear and nonintuitive relationships among different dimensions of sustainability, particularly the system-wide implications of human actions. This basic understanding further includes a sense of the time scale of possible future events and the limits of what is and is not likely to be possible. With this understanding, systematic approaches can then be used to develop policy guidelines for the system. This article presents an illustration of these ideas by analyzing an integrated ecological-economic-social model, which comprises various ecological (natural) and domesticated compartments representing species along with a macroeconomic price setting model. The stable and qualitatively realistic model is used to analyze different relevant scenarios. Apart from highlighting complex relationships within the system, it identifies potentially unsustainable future developments such as increased human per capita consumption rates. Dynamic optimization is then used to develop time-dependent policy guidelines for the unsustainable scenarios using objective functions that aim to minimize fluctuations in the system's Fisher information. The results can help to identify effective policy parameters and highlight the tradeoff between natural and domesticated compartments while managing such integrated systems. The results should also qualitatively guide further investigations in the area of system level studies and policy development.

Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study

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Ascher-Svanum Haya

2011-08-01

Full Text Available Abstract Background This study of chronically ill patients with schizophrenia aimed to identify patients who achieve sustained favorable long-term outcome - when the outcome incorporates severity of symptoms, level of functioning, and use of acute care services - and to identify the best baseline predictors of achieving this sustained favorable long-term outcome. Methods Using data from the United States Schizophrenia Care and Assessment Program (US-SCAP (N = 2327, a large 3-year prospective, multisite, observational study of individuals treated for schizophrenia in the US, a hierarchical cluster analysis was performed to group patients based upon baseline symptom severity. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS scores, level of functioning, and use of acute care services. Level of functioning reflected patient-reported productivity and clinician-rated occupational role functioning. Use of acute care services reflected self-reported psychiatric hospitalization and emergency service use. Change of health state was determined over the 3-year period. A patient was classified as having a sustained favorable long-term outcome if their health state values had the closest distance to the defined "best baseline cluster" at each point over the length of the study. Stepwise logistic regression was used to determine baseline predictors of sustained favorable long-term outcome. Results At baseline, 5 distinct health state clusters were identified, ranging from "best" to "worst." Of 1635 patients with sufficient data, only 157 (10% experienced sustained favorable long-term outcome during the 2-years postbaseline. The baseline predictors associated with sustained favorable long-term outcome included better quality of life, more daily activities, patient-reported clearer thinking from medication, better global functioning, being employed, not being a victim of a crime, not having received individual therapy, and not

Identification of core objectives for teaching sustainable healthcare education.

Science.gov (United States)

Teherani, Arianne; Nishimura, Holly; Apatira, Latifat; Newman, Thomas; Ryan, Susan

2017-01-01

Physicians will be called upon to care for patients who bear the burden of disease from the impact of climate change and ecologically irresponsible practices which harm ecosystems and contribute to climate change. However, physicians must recognize the connection between the climate, ecosystems, sustainability, and health and their responsibility and capacity in changing the status quo. Sustainable healthcare education (SHE), defined as education about the impact of climate change and ecosystem alterations on health and the impact of the healthcare industry on the aforementioned, is vital to prevention of adverse health outcomes due to the changing climate and environment. To systematically determine which and when a set of SHE objectives should be included in the medical education continuum. Fifty-two SHE experts participated in a two-part modified-Delphi study. A survey was developed based on 21 SHE objectives. Respondents rated the importance of each objective and when each objective should be taught. Descriptive statistics and an item-level content validity index (CVI) were used to analyze data. Fifteen of the objectives achieved a content validity index of 78% or greater. The remaining objectives had content validity indices between 58% and 77%. The preclinical years of medical school were rated as the optimal time for introducing 13 and the clinical years for introducing six of the objectives. Respondents noted the definition of environmental sustainability should be learned prior to medical school and identifying ways to improve the environmental sustainability of health systems in post-graduate training. This study proposes SHE objectives for the continuum of medical education. These objectives ensure the identity of the physician includes the requisite awareness and competence to care for patients who experience the impact of climate and environment on health and advocate for sustainability of the health systems in which they work. CVI: Content validity

Health transformation plan: Goals achievement in Nemazee hospital

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Ali Akbar Ahmadi

2016-01-01

Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

The roles of veterinary, medical and environmental professionals to achieve ONE HEALTH

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Mahendra Pal

2014-12-01

Full Text Available According to the WHO- “Health is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity”. The good health is the fundamental right of all the people on earth. The concept of ‘One Medicine’ coined by Calvin W. Schwabe evolves towards ’One Health’ which comprises collaborative efforts of multiple disciplines to achieve perfect health of people, animals, and our environment. ‘One Health’ deals with the challenges at the intersection of animal, human and environment health including the infectious diseases, the global food crises, and climate change due to global warming. The cordial and active association of various disciplines such as medicine, veterinary, public health, environment, wildlife, ecology, and food hygiene is highly emphasized in order to achieve the goal of ‘One Health’. This mini-review describes brief history of ‘one health’, the roles of veterinary, medical and environmental professionals, and developing collaboration with various concern professionals to achieve ‘one health’. In addition, the selected achievements of ‘one health’ in the past 10 years have been described along with the challenges ahead for the successful implementation of such concept.

International institutions, global health initiatives and the challenge of sustainability: lessons from the Brazilian AIDS programme.

Science.gov (United States)

Le Loup, G; Fleury, S; Camargo, K; Larouzé, B

2010-01-01

The sustainability of successful public health programmes remains a challenge in low and middle income settings. These programmes are often subjected to mobilization-demobilization cycle. Indeed, political and organizational factors are of major importance to ensure this sustainability. The cooperation between the World Bank and the Brazilian AIDS programme highlights the role of international institutions and global health initiatives (GHI), not only to scale up programmes but also to guarantee their stability and sustainability, at a time when advocacy is diminishing and vertical programmes are integrated within health systems. This role is critical at the local level, particularly when economic crisis may hamper the future of public health programmes. Political and organizational evolution should be monitored and warnings should trigger interventions of GHI before the decline of these programmes.

Population, sexual and reproductive health, rights and sustainable development: forging a common agenda.

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Newman, Karen; Fisher, Sarah; Mayhew, Susannah; Stephenson, Judith

2014-05-01

This article suggests that sexual and reproductive health and rights activists seeking to influence the post-2015 international development paradigm must work with sustainable development advocates concerned with a range of issues, including climate change, environmental issues, and food and water security, and that a way of building bridges with these communities is to demonstrate how sexual and reproductive health and rights are relevant for these issues. An understanding of population dynamics, including urbanization and migration, as well as population growth, can help to clarify these links. This article therefore suggests that whether or not sexual and reproductive health and rights activists can overcome resistance to discussing "population", become more knowledgeable about other sustainable development issues, and work with others in those fields to advance the global sustainable development agenda are crucial questions for the coming months. The article also contends that it is possible to care about population dynamics (including ageing and problems faced by countries with a high proportion of young people) and care about human rights at the same time. It expresses concern that, if sexual and reproductive health and rights advocates do not participate in the population dynamics discourse, the field will be left free for those for whom respecting and protecting rights may be less of a priority. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Can biosimilars help achieve the goals of US health care reform?

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Boccia, Ralph; Jacobs, Ira; Popovian, Robert; de Lima Lopes, Gilberto

2017-01-01

The US Patient Protection and Affordable Care Act (ACA) aims to expand health care coverage, contain costs, and improve health care quality. Accessibility and affordability of innovative biopharmaceuticals are important to the success of the ACA. As it is substantially more difficult to manufacture them compared with small-molecule drugs, many of which have generic alternatives, biologics may increase drug costs. However, biologics offer demonstrated improvements in patient care that can reduce expensive interventions, thus lowering net health care costs. Biosimilars, which are highly similar to their reference biologics, cost less than the originators, potentially increasing access through reduced prescription drug costs while providing equivalent therapeutic results. This review evaluates 1) the progress made toward enacting health care reform since the passage of the ACA and 2) the role of biosimilars, including the potential impact of expanded biosimilar use on access, health care costs, patient management, and outcomes. Barriers to biosimilar adoption in the USA are noted, including low awareness and financial disincentives relating to reimbursement. The evaluated evidence suggests that the ACA has partly achieved some of its aims; however, the opportunity remains to transform health care to fully achieve reform. Although the future is uncertain, increased use of biosimilars in the US health care system could help achieve expanded access, control costs, and improve the quality of care.

A transition program to primary health care for new graduate nurses: a strategy towards building a sustainable primary health care nurse workforce?

Science.gov (United States)

Gordon, Christopher J; Aggar, Christina; Williams, Anna M; Walker, Lynne; Willcock, Simon M; Bloomfield, Jacqueline

2014-01-01

This debate discusses the potential merits of a New Graduate Nurse Transition to Primary Health Care Program as an untested but potential nursing workforce development and sustainability strategy. Increasingly in Australia, health policy is focusing on the role of general practice and multidisciplinary teams in meeting the service needs of ageing populations in the community. Primary health care nurses who work in general practice are integral members of the multidisciplinary team - but this workforce is ageing and predicted to face increasing shortages in the future. At the same time, Australia is currently experiencing a surplus of and a corresponding lack of employment opportunities for new graduate nurses. This situation is likely to compound workforce shortages in the future. A national nursing workforce plan that addresses supply and demand issues of primary health care nurses is required. Innovative solutions are required to support and retain the current primary health care nursing workforce, whilst building a skilled and sustainable workforce for the future. This debate article discusses the primary health care nursing workforce dilemma currently facing policy makers in Australia and presents an argument for the potential value of a New Graduate Transition to Primary Health Care Program as a workforce development and sustainability strategy. An exploration of factors that may contribute or hinder transition program for new graduates in primary health care implementation is considered. A graduate transition program to primary health care may play an important role in addressing primary health care workforce shortages in the future. There are, however, a number of factors that need to be simultaneously addressed if a skilled and sustainable workforce for the future is to be realised. The development of a transition program to primary health care should be based on a number of core principles and be subjected to both a summative and cost

THE DEVELOPMENT AND USE OF A MODEL TO PREDICT SUSTAINABILITY OF CHANGE IN HEALTH CARE SETTINGS.

Science.gov (United States)

Molfenter, Todd; Ford, James H; Bhattacharya, Abhik

2011-01-01

Innovations adopted through organizational change initiatives are often not sustained leading to diminished quality, productivity, and consumer satisfaction. Research explaining variance in the use of adopted innovations in health care settings is sparse, suggesting the need for a theoretical model to guide research and practice. In this article, we describe the development of a hybrid conjoint decision theoretic model designed to predict the sustainability of organizational change in health care settings. An initial test of the model's predictive validity using expert scored hypothetic profiles resulted in an r-squared value of .77. The test of this model offers a theoretical base for future research on the sustainability of change in health care settings.

Y-12 Site Sustainability Plan

Energy Technology Data Exchange (ETDEWEB)

Sherry, T D; Kohlhorst, D P; Little, S K

2011-12-01

The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the DOE and the National Nuclear Security Administration (NNSA) vision for a commitment to energy efficiency and sustainability and to achievement of the Guiding Principles. Specifically, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan (SSPP) while promoting overall sustainability and reduction of greenhouse gas (GHG) emissions. Table ES.2 gives a comprehensive overview of Y-12's performance status and planned actions. B&W Y-12's Energy Management mission is to incorporate renewable energy and energy efficient technologies site-wide and to position Y-12 to meet NNSA energy requirement needs through 2025 and beyond. During FY 2011, the site formed a sustainability team (Fig. ES.1). The sustainability team provides a coordinated approach to meeting the various sustainability requirements and serves as a forum for increased communication and consistent implementation of sustainability activities at Y-12. The sustainability team serves as an information exchange mechanism to promote general awareness of sustainability information, while providing a system to document progress and to identify resources. These resources are necessary to implement activities that support the overall goals of sustainability, including reducing the use of resources and conserving energy. Additionally, the team's objectives include: (1) Foster a Y-12-wide philosophy to conserve resources; (2) Reduce the impacts of production operations in a cost-effective manner; (3) Increase materials recycling; (4) Use a minimum amount of energy and fuel; (5) Create a minimum of waste and pollution in achieving Y-12-strategic objectives; (6) Develop and implement techniques, technologies, process modifications, and programs that support sustainable acquisition; (7) Minimize the

Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

NARCIS (Netherlands)

Alhassan, R.K.; Duku, S.O.; Janssens, W.; Nketiah-Amponsah, E.; Spieker, N.; Van Ostenberg, P.; Arhinful, D.K.; Pradhan, M.P.; Rinke de Wit, T.F.

2015-01-01

Background: Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

NARCIS (Netherlands)

Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

2015-01-01

Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

NARCIS (Netherlands)

Alhassan, R.K.; Duku, S.O.; Janssens, W.; Nketiah-Amponsah, E.; Spieker, N.; van Ostenberg, P.; Arhinful, D.K.; Pradhan, M.; Rinke de Wit, T.F.

2015-01-01

Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

Developing and sustaining adolescent-friendly health services: A multiple case study from Ecuador and Peru.

Science.gov (United States)

Goicolea, Isabel; Coe, Anna-Britt; San Sebastián, Miguel; Hurtig, Anna-Karin

2017-08-01

Adolescent-Friendly Health Services (AFHSs) are those that are accessible, acceptable, equitable, appropriate and effective for different youth sub-populations. This study investigated the process through which four clinics in two countries - Peru and Ecuador - introduced, developed and sustained AFHSs. A multiple case study design was chosen, and data from each clinic were collected through document review, observations and informant interviews. National level data were also collected. Data were analysed following thematic analysis. The findings showed that the process of introducing, developing and sustaining AFHSs was long term, and required a creative team effort and collaboration between donors, public institutions and health providers. The motivation and external support was crucial to initiating and sustaining the implementation of AFHSs. Health facilities' transformation into AFHSs was linked to the broader organisation of country health systems, and the evolution of national adolescent health policies. In Peru, the centralised approach to AFHSs introduction facilitated the dissemination of a comprehensive national model to health facilities, but dependency on national directives made it more difficult to systemise them when ideological and organisational changes occurred. In Ecuador, a less centralised approach to introducing AFHSs made for easier integration of the AFHSs model.

Reported Systems Changes and Sustainability Perceptions of Three State Departments of Health Implementing Multi-Faceted Evidence-Based Fall Prevention Efforts

Directory of Open Access Journals (Sweden)

Matthew Lee Smith

2017-06-01

Full Text Available Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”. Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions.

Sustainable Development Goals for Monitoring Action to Improve Global Health.

Science.gov (United States)

Cesario, Sandra K

2016-01-01

Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Green innovation and sustainable industrial systems within sustainability and company improvement perspective

Science.gov (United States)

Edi Nugroho Soebandrija, Khristian

2017-12-01

This paper comprises discussion of Green Innovation and Sustainable Industrial Systems within Sustainability and Company Improvement Perspective of beverage manufacturing company (BMC). The stakeholder theory is the grand theory for the company improvement perspective in this paper. The data processing in this paper is conducted through software which are SEM-PLS with SmartPLS 2.0 and SPSS 19. The specified objective of this paper has focus on sustainability as one of 6 variables, in lieu of those 6 variables as the big picture. The reason behind this focus on sustainability is the fact that there are assorted challenges in sustainability that is ranging from economic, environment and company perspectives. Those challenges in sustainability include the sustainable service supply chain management and its involvement of society. The overall objective is to analyze relationship hypothesis of 6 variables, 4 of them (leadership, organizational learning, innovation, and performance) are based on Malcolm Baldrige’s performance excellence concept to achieve sustainability and competitive advantage through company-competitor and customer questionnaire, and its relation to Total Quality Management (TQM) and Quality Management System (QMS). In conclusion, the spearheaded of company improvement in this paper is in term of consumer satisfaction through 99.997% quality standards. These can be achieved by ambidexterity through exploitation and exploration innovation. Furthermore, in this paper, TQM enables to obtain popularity brand index achievement that is greater than 45.9%. Subsequently, ISO22000 of food security standard encompasses quality standard of ISO9000 and HACCP. Through the ambidexterity of exploitation and exploration (Non Standard Product Inspection) NOSPI machine, the company improvement generates the achievement of 75% automation, 99.997% quality control standard and 80% of waste reduction.

Can Social Protection Improve Sustainable Development Goals for Adolescent Health?

Science.gov (United States)

Cluver, Lucie D; Orkin, F Mark; Meinck, Franziska; Boyes, Mark E; Yakubovich, Alexa R; Sherr, Lorraine

2016-01-01

The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa. We conducted a longitudinal survey of adolescents (10-18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision) and 'care' (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models. Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens. National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.

Can Social Protection Improve Sustainable Development Goals for Adolescent Health?

Directory of Open Access Journals (Sweden)

Lucie D Cluver

Full Text Available The first policy action outlined in the Sustainable Development Goals (SDGs is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa.We conducted a longitudinal survey of adolescents (10-18 years between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision and 'care' (psychosocial support social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models.Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger; SDG 3 (AIDS, tuberculosis, mental health and substance abuse; SDG 4 (educational access; SDG 5 (sexual exploitation, sexual and reproductive health; and SDG 16 (violence perpetration. For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens.National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.

Automated monitoring: a potential solution for achieving sustainable improvement in hand hygiene practices.

Science.gov (United States)

Levchenko, Alexander I; Boscart, Veronique M; Fernie, Geoff R

2014-08-01

Adequate hand hygiene is often considered as the most effective method of reducing the rates of hospital-acquired infections, which are one of the major causes of increased cost, morbidity, and mortality in healthcare. Electronic monitoring technologies provide a promising direction for achieving sustainable hand hygiene improvement by introducing the elements of automated feedback and creating the possibility to automatically collect individual hand hygiene performance data. The results of the multiphase testing of an automated hand hygiene reminding and monitoring system installed in a complex continuing care setting are presented. The study included a baseline Phase 1, with the system performing automated data collection only, a preintervention Phase 2 with hand hygiene status indicator enabled, two intervention Phases 3 and 4 with the system generating hand hygiene reminding signals and periodic performance feedback sessions provided, and a postintervention Phase 5 with only hand hygiene status indicator enabled and no feedback sessions provided. A significant increase in hand hygiene performance observed during the first intervention Phase 3 was sustained over the second intervention Phase 4, with the postintervention phase also indicating higher hand hygiene activity rates compared with the preintervention and baseline phases. The overall trends observed during the multiphase testing, the factors affecting acceptability of the automated hand hygiene monitoring system, and various strategies of technology deployment are discussed.

Understanding Sustainable Diets: A Descriptive Analysis of the Determinants and Processes That Influence Diets and Their Impact on Health, Food Security, and Environmental Sustainability123

Science.gov (United States)

Johnston, Jessica L.; Fanzo, Jessica C.; Cogill, Bruce

2014-01-01

The confluence of population, economic development, and environmental pressures resulting from increased globalization and industrialization reveal an increasingly resource-constrained world in which predictions point to the need to do more with less and in a “better” way. The concept of sustainable diets presents an opportunity to successfully advance commitments to sustainable development and the elimination of poverty, food and nutrition insecurity, and poor health outcomes. This study examines the determinants of sustainable diets, offers a descriptive analysis of these areas, and presents a causal model and framework from which to build. The major determinants of sustainable diets fall into 5 categories: 1) agriculture, 2) health, 3) sociocultural, 4) environmental, and 5) socioeconomic. When factors or processes are changed in 1 determinant category, such changes affect other determinant categories and, in turn, the level of “sustainability” of a diet. The complex web of determinants of sustainable diets makes it challenging for policymakers to understand the benefits and considerations for promoting, processing, and consuming such diets. To advance this work, better measurements and indicators must be developed to assess the impact of the various determinants on the sustainability of a diet and the tradeoffs associated with any recommendations aimed at increasing the sustainability of our food system. PMID:25022991

Managing product returns to achieve supply chain sustainability

DEFF Research Database (Denmark)

Shaharudin, Mohd Rizaimy; Govindan, Kannan; Zailani, Suhaiza

2015-01-01

returns management as part of a comprehensive sustainability effort. The study is exploratory in nature based on five case studies of participating manufacturers in the automotive, and electrical and electronics industry in Malaysia. The interview results reveal that the five participating companies...

59 Poverty Eradication and Sustainability of Healthful Living in Nigeria

African Journals Online (AJOL)

User

2010-10-17

Oct 17, 2010 ... sustainable livelihoods; hunger, and malnutrition; ill health, limited or lack of ... poverty level has changed very little over the past two decades, poverty ... recent estimate of the food and Agriculture Organization of the United ... b) the food and energy price hikes in 2007-2008 increased the global poverty.

[The economic-financial sustainability of the Family Health Strategy in large municipalities].

Science.gov (United States)

Portela, Gustavo Zoio; Ribeiro, José Mendes

2011-03-01

The universalization of basic care and commitment budget of the Ministry of Health with the Family Health Strategy (ESF) through new systematic financing incentives have been highlighted in the Brazilian health policy scenario. One of the great problems observed is the expansion of the strategy for large urban centres. This paper studies the economic-financial sustainability of ESF in Brazilian municipalities of more than 100 thousand inhabitants according to some selected indicators, considering the geographical region to which they belong, their population size and participation in Project for the Expansion and Consolidation Family Health (Proesf). Municipalities belonging to the Southeast region, more developed of the country, have on average better economic-financial performance, but lower average values of coverage of ESF. Municipalities from the North and Northeast, with the lowest average for economic-financial sustainability indicators, were the ones that made more effort to developments in the period. Thus, we observed the dynamics between bigger fiscal capacity and budgetary commitment with the Health Sector for biggest municipalities and in more economically developed regions, and greater vulnerability and dependence of federative transferences for municipalities with less people, in less developed areas.

Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews.

Science.gov (United States)

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

2016-08-01

Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as "sustainable," interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development), all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

[Actively promote nutrition and health surveillance, achieve the national nutrition and health goals].

Science.gov (United States)

Ding, Gangqiang; Zhao, Wenhua; Chen, Junshi

2016-03-01

The results of Chinese Nutrition and Health Surveillance (2010-2012) showed that the anemia prevalence in China reduced significantly compared with 2002, and people's nutrition and health status have improved. Unbalanced diet still exist, such as low intake of vegetables and fruits, and high intake of salt. The serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia were high among urban adults, and more attention should be paid for high serum total cholesterol level among older adults. These results are significant to the development of nutrition and health intervention strategy, carry out nutrition intervention and the achievement of national nutrition and health goals.

Promoting health equity: WHO health inequality monitoring at global and national levels

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

2015-01-01

Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

Promoting health equity: WHO health inequality monitoring at global and national levels.

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

2015-01-01

Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Promoting health equity: WHO health inequality monitoring at global and national levels

Directory of Open Access Journals (Sweden)

Ahmad Reza Hosseinpoor

2015-09-01

Full Text Available Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Cross-country analysis of strategies for achieving progress towards global goals for women's and children's health.

Science.gov (United States)

Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M; Kuruvilla, Shyama

2016-05-01

To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls' education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals.

Sustained availability of trimethoprim in drinking water to achieve higher plasma sulphonamide-trimethoprim antibacterial activity in broilers.

Science.gov (United States)

Sumano, H; Hernandez, L; Gutierrez, L; Bernad-Bernad, M J

2005-02-01

(1) In order to make trimethoprim (TMP) available to broilers throughout the day, a sustained release formulation (SRF) of the drug in the form of granules was added to the water tank that supplies drinking water. (2) Broilers were initially dosed with sulphachloropiridazine-TMP (SCP-TMP 5:1) and then further medicated throughout the day, achieving in the end a dose of 30 mg/kg each of SCP and TMP (group A). Group B received a preparation with the same dose of SCP and TMP (1:1) as group A, but administered as a single dose without the SRF of TMP. Group C received the customary SCP-TMP 5:1 preparation (30 and 6 mg/kg, respectively). Water tanks were completely consumed in 3 to 4 h. (3) Broilers were bled at different times and concentration of antibacterial activity in serum determined by correlating the composite antibacterial activity of SCP and TMP with actual concentrations of these drugs by means of a microbiological agar diffusion assay. (4) Time vs serum concentrations of activity were higher in group B; the increments in the maximum serum concentration for group B over groups A and C being 39 and 67%, respectively. (5) However, the sustained concentration of activity over time, measured as the area under the cu)rve, was highest in group A. Group B had higher values for area under the curve than group C. (6) An additional dose of TMP to achieve 30 mg/kg of both SCP and TMP improves the serum concentration of this combination over the customary 5:1 proportion. The best values for sustaining antibacterial activity were obtained using a 1:1 ratio as in group A. The use of a SRF as in group A may translate into better clinical results.

The medium-term sustainability of organisational innovations in the national health service

Directory of Open Access Journals (Sweden)

Finn Rachael

2011-03-01

Full Text Available Abstract Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion

The medium-term sustainability of organisational innovations in the national health service

Science.gov (United States)

2011-01-01

Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion Through comparison and

Measuring the health-related Sustainable Development Goals in 188 countries

DEFF Research Database (Denmark)

Truelsen, Thomas Clement; Christensen, Hanne Krarup

2016-01-01

BACKGROUND: In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases......, Injuries, and Risk Factors Study 2015 (GBD 2015). METHODS: We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990...... and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed...

Energy interventions that facilitate sustainable development and impact health: an overview of systematic reviews.

Science.gov (United States)

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

2016-04-01

Objective To inform policy by providing an overview of systematic reviews on interventions that facilitate sustainable energy use and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 13 databases and nine websites based on a pre-defined protocol, including clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese during the 17 years from January 1997 - January 2014 was included. To classify as "sustainable," interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Five systematic reviews and one economic evaluation met the inclusion criteria. The most promising interventions that impacted health were electricity for lighting and other uses (developing countries); improved stoves for cooking and health and/or cleaner fuels for cooking (developing countries); and household energy efficiency measures (developed countries). These interventions also had potential environmental and economic impacts. Their cost-effectiveness is not known, nor is their impact on health inequalities. Conclusions What is needed now is careful implementation of interventions where the impacts are likely to be positive but their implementation needs to be rigorously evaluated, including possible adverse impacts. Care needs to be taken not to exacerbate health inequalities and to consider context, human behavior and cultural factors so that the potential health benefits are realized in real-life implementation. Possible impact on health inequalities needs to be considered and measured in future primary studies and systematic reviews.

The Knowledge Base for Achieving the Sustainable Development Goal Targets on Water Supply, Sanitation and Hygiene.

Science.gov (United States)

Hutton, Guy; Chase, Claire

2016-05-27

Safe drinking water, sanitation, and hygiene (WASH) are fundamental to an improved standard of living. Globally, 91% of households used improved drinking water sources in 2015, while for improved sanitation it is 68%. Wealth disparities are stark, with rural populations, slum dwellers and marginalized groups lagging significantly behind. Service coverage is significantly lower when considering the new water and sanitation targets under the sustainable development goals (SDGs) which aspire to a higher standard of 'safely managed' water and sanitation. Lack of access to WASH can have an economic impact as much as 7% of Gross Domestic Product, not including the social and environmental consequences. Research points to significant health and socio-economic consequences of poor nutritional status, child growth and school performance caused by inadequate WASH. Groundwater over-extraction and pollution of surface water bodies have serious impacts on water resource availability and biodiversity, while climate change exacerbates the health risks of water insecurity. A significant literature documents the beneficial impacts of WASH interventions, and a growing number of impact evaluation studies assess how interventions are optimally financed, implemented and sustained. Many innovations in behavior change and service delivery offer potential for scaling up services to meet the SDGs.

New risk indicator approach for Operators, Workers, Bystanders and Residents for a sustainable use of plant protection products

NARCIS (Netherlands)

Sacchettini, G.; Calliera, M.; Marchis, A.; Glass, R.; Ellis, C.B.; Machera, K.; Gerritsen-Ebben, R.; Spanoghe, P.; Capri, E.

2015-01-01

In 2009, the European Union adopted the Directive on Sustainable Use of pesticides (SUD, Directive 2009/128/EC) establishing a framework for achieving a sustainable use of Plant Protection Products (PPPs) through reducing the risks and impacts of PPP use on human health and the environment,

Healthcare quality in Ghana : Improving healthcare quality and health worker motivation to promote sustainable health insurance

NARCIS (Netherlands)

Alhassan, R.K.

2017-01-01

This thesis is about promoting a sustainable National Health Insurance Scheme (NHIS) in Ghana through improved client-centred quality care and effective community engagement in quality care assessment. The thesis comprises of two main parts. Part one reports on findings from baseline surveys

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

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Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

Science.gov (United States)

Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

2014-12-01

This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation. © 2014 The New York Academy of Sciences.

Code of Sustainable Practice in Occupational and Environmental Health and Safety for Corporations.

Science.gov (United States)

Castleman, Barry; Allen, Barbara; Barca, Stefania; Bohme, Susanna Rankin; Henry, Emmanuel; Kaur, Amarjit; Massard-Guilbaud, Genvieve; Melling, Joseph; Menendez-Navarro, Alfredo; Renfrew, Daniel; Santiago, Myrna; Sellers, Christopher; Tweedale, Geoffrey; Zalik, Anna; Zavestoski, Stephen

2008-01-01

At a conference held at Stony Brook University in December 2007, "Dangerous Trade: Histories of Industrial Hazard across a Globalizing World," participants endorsed a Code of Sustainable Practice in Occupational and Environmental Health and Safety for Corporations. The Code outlines practices that would ensure corporations enact the highest health and environmentally protective measures in all the locations in which they operate. Corporations should observe international guidelines on occupational exposure to air contaminants, plant safety, air and water pollutant releases, hazardous waste disposal practices, remediation of polluted sites, public disclosure of toxic releases, product hazard labeling, sale of products for specific uses, storage and transport of toxic intermediates and products, corporate safety and health auditing, and corporate environmental auditing. Protective measures in all locations should be consonant with the most protective measures applied anywhere in the world, and should apply to the corporations' subsidiaries, contractors, suppliers, distributors, and licensees of technology. Key words: corporations, sustainability, environmental protection, occupational health, code of practice.

Sustainability and power in health promotion: community-based participatory research in a reproductive health policy case study in New Mexico.

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Mendes, Rosilda; Plaza, Veronica; Wallerstein, Nina

2016-03-01

Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's 'power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders.We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power

Public Health Achievements and Challenges: Symposium of the University of Mostar Faculty of Health Studies.

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Ravlija, Jelena; Vasilj, Ivan; Babic, Dragan; Marijanovic, Inga

2017-05-01

Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way.

Multi-Sector Sustainability Browser (MSSB) User Manual: A ...

Science.gov (United States)

EPA’s Sustainable and Healthy Communities (SHC) Research Program is developing methodologies, resources, and tools to assist community members and local decision makers in implementing policy choices that facilitate sustainable approaches in managing their resources affecting the built environment, natural environment, and human health. In order to assist communities and decision makers in implementing sustainable practices, EPA is developing computer-based systems including models, databases, web tools, and web browsers to help communities decide upon approaches that support their desired outcomes. Communities need access to resources that will allow them to achieve their sustainability objectives through intelligent decisions in four key sustainability areas: • Land Use • Buildings and Infrastructure • Transportation • Materials Management (i.e., Municipal Solid Waste [MSW] processing and disposal) The Multi-Sector Sustainability Browser (MSSB) is designed to support sustainable decision-making for communities, local and regional planners, and policy and decision makers. Document is an EPA Technical Report, which is the user manual for the Multi-Sector Sustainability Browser (MSSB) tool. The purpose of the document is to provide basic guidance on use of the tool for users

Strengthening monitoring and evaluation (M&E) and building sustainable health information systems in resource limited countries: lessons learned from an M&E task-shifting initiative in Botswana.

Science.gov (United States)

Mpofu, Mulamuli; Semo, Bazghina-Werq; Grignon, Jessica; Lebelonyane, Refeletswe; Ludick, Steven; Matshediso, Ellah; Sento, Baraedi; Ledikwe, Jenny H

2014-10-03

The demand for quality data and the interest in health information systems has increased due to the need for country-level progress reporting towards attainment of the United Nations Millennium Development Goals and global health initiatives. To improve monitoring and evaluation (M&E) of health programs in Botswana, 51 recent university graduates with no experience in M&E were recruited and provided with on-the-job training and mentoring to develop a new cadre of health worker: the district M&E officer. Three years after establishment of the cadre, an assessment was conducted to document achievements and lessons learnt. This qualitative assessment included in-depth interviews at the national level (n = 12) with officers from government institutions, donor agencies, and technical organizations; and six focus group discussions separately with district M&E officers, district managers, and program officers coordinating different district health programs. Reported achievements of the cadre included improved health worker capacity to monitor and evaluate programs within the districts; improved data quality, management, and reporting; increased use of health data for disease surveillance, operational research, and planning purposes; and increased availability of time for nurses and other health workers to concentrate on core clinical duties. Lessons learnt from the assessment included: the importance of clarifying roles for newly established cadres, aligning resources and equipment to expectations, importance of stakeholder collaboration in implementation of sustainable programs, and ensuring retention of new cadres. The development of a dedicated M&E cadre at the district level contributed positively to health information systems in Botswana by helping build M&E capacity and improving data quality, management, and data use. This assessment has shown that such cadres can be developed sustainably if the initiative is country-led, focusing on recruitment and capacity

Nuclear technology for sustainable development and FNCA activities

International Nuclear Information System (INIS)

Machi, Sueo

2004-01-01

Nuclear techniques have been contributing to sustainable development and human welfare through their applications in agriculture, health care, food supply, industry, water resources and environmental conservation. Nuclear techniques are more advantageous and/or complementary with other techniques to achieve goals. For many applications nuclear technique is more environmentally friendly because it does not need chemical agents to induce necessary reactions. This paper also illustrates successful applications of nuclear techniques and activities of the regional nuclear cooperation in Asia, FNCA (Forum for Nuclear Cooperation in Asia) to achieve common goals with limited resources. (author)

An Analysis of Determinants of Under-5 Mortality across Countries: Defining Priorities to Achieve Targets in Sustainable Developmental Goals.

Science.gov (United States)

Acheampong, Michael; Ejiofor, Chukwudi; Salinas-Miranda, Abraham

2017-06-01

Objectives The end of the era of millennium development goals (MDGs) ushered in the sustainable development goals (SDGs) with a new target for the reduction of under-five mortality rates (U5MR). Although U5MR decreased globally, the reduction was insufficient to meet MDGs targets because significant socioeconomic inequities remain unaddressed across and within countries. Thus, further progress in achieving the new SDGs target will be hindered if there is no adequate prioritization of important socioeconomic, healthcare, and environmental factors. The objective of this study was to assess factors that account most for the differences in U5MR between countries around the globe. Methods We conducted an ordinary least squares (OLS) regression-based prioritization analysis of socioeconomic, healthcare, and environmental variables from 109 countries to understand which factors explain the differences in U5MR best. Results All indicators examined individually affected differences in U5MR between countries. However, the results of multivariate OLS regression showed that the most important factors that accounted for the differences were, in order: fertility rate, total health expenditure per capita, access to improved water and sanitation, and female employment rate. Conclusions To achieve the new global target for U5MR, policymakers must focus on certain priority areas, such as interventions that address access to affordable maternal healthcare services, educational programs for mothers, especially those who are adolescents, and safe drinking water and sanitation.

Integrated Systems Health Management for Sustainable Habitats (Using Sustainability Base as a Testbed)

Science.gov (United States)

Martin, Rodney A.

2017-01-01

Habitation systems provide a safe place for astronauts to live and work in space and on planetary surfaces. They enable crews to live and work safely in deep space, and include integrated life support systems, radiation protection, fire safety, and systems to reduce logistics and the need for resupply missions. Innovative health management technologies are needed in order to increase the safety and mission-effectiveness for future space habitats on other planets, asteroids, or lunar surfaces. For example, off-nominal or failure conditions occurring in safety-critical life support systems may need to be addressed quickly by the habitat crew without extensive technical support from Earth due to communication delays. If the crew in the habitat must manage, plan and operate much of the mission themselves, operations support must be migrated from Earth to the habitat. Enabling monitoring, tracking, and management capabilities on-board the habitat and related EVA platforms for a small crew to use will require significant automation and decision support software.Traditional caution and warning systems are typically triggered by out-of-bounds sensor values, but can be enhanced by including machine learning and data mining techniques. These methods aim to reveal latent, unknown conditions while still retaining and improving the ability to provide highly accurate alerts for known issues. A few of these techniques will briefly described, along with performance targets for known faults and failures. Specific system health management capabilities required for habitat system elements (environmental control and life support systems, etc.) may include relevant subsystems such as water recycling systems, photovoltaic systems, electrical power systems, and environmental monitoring systems. Sustainability Base, the agency's flagship LEED-platinum certified green building acts as a living laboratory for testing advanced information and sustainable technologies that provides an

Global Mental Health: sharing and synthesizing knowledge for sustainable development.

Science.gov (United States)

O'Donnell, K; O'Donnell, M Lewis

2016-01-01

Global mental health (GMH) is a growing domain with an increasing capacity to positively impact the world community's efforts for sustainable development and wellbeing. Sharing and synthesizing GMH and multi-sectoral knowledge, the focus of this paper, is an important way to support these global efforts. This paper consolidates some of the most recent and relevant 'context resources' [global multi-sector (GMS) materials, emphasizing world reports on major issues] and 'core resources' (GMH materials, including newsletters, texts, conferences, training, etc.). In addition to offering a guided index of materials, it presents an orientation framework (global integration) to help make important information as accessible and useful as possible. Mental health colleagues are encouraged to stay current in GMH and global issues, to engage in the emerging agendas for sustainable development and wellbeing, and to intentionally connect and contribute across sectors. Colleagues in all sectors are encouraged to do likewise, and to take advantage of the wealth of shared and synthesized knowledge in the GMH domain, such as the materials featured in this paper.

Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews

Directory of Open Access Journals (Sweden)

Michelle M. Haby

Full Text Available ABSTRACT Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as “sustainable,” interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development, all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

Crossing scales and disciplines to achieve forest sustainability

Science.gov (United States)

Michael J. Papaik; Brian Sturtevant; Christian Messier

2008-01-01

Forest land managers are faced with unprecedented global pressures to produce resources for human consumption (e.g., Liu and Diamond 2005), while still maintaining essential ecosystem services benefiting society at multiple spatial scales (Costanza et al. 1997). These global pressures alone present daunting challenges to sustainable forest management (SFM) worldwide (...

Do children make you happier? Sustained child-wish and mental health in women 11-17 years after fertility treatment.

Science.gov (United States)

Gameiro, Sofia; van den Belt-Dusebout, Alexandra W; Bleiker, Eveline; Braat, Didi; van Leeuwen, Flora E; Verhaak, Christianne M

2014-10-10

Are fertility treatment-related factors, parenthood status and sustained child-wish associated with women's long-term mental health? Sustaining a child-wish is more strongly associated with women's long-term mental health than fertility treatment-related factors and parenthood status. About one-third of the couples starting fertility treatment do not achieve parenthood and have to adjust to an unfulfilled child-wish. In women, remaining childless after treatment is associated with less favourable mental health. It is unclear if this is only related to their childlessness or if adjustment after unsuccessful treatment is affected by other variables. These include diagnostic and treatment-related factors (cause of fertility problems, age at first consultation, type and number of treatments) and the psychological ability to come to terms with the unfulfilled child-wish. Differentiating the relative contribution of these factors to women's long-term mental health will provide useful knowledge to support patients adjusting to negative treatment outcomes. A cross-sectional study with a nationally representative sample of 7148 women who started fertility treatment at any of the 12 IVF hospitals in the Netherlands from 1995 through 2000. Of 16 482 women who were invited to participate, 7148 (43.4%) provided psychological data. The average age of women was 47 years and the average age at first fertility consultation was 30 years. Fifty-one per cent of women did IUI and 85% did IVF/ICSI. Ninety per cent of women were married/cohabiting, 20.9% remained childless and 5.9% had a child-wish. Women completed a questionnaire assessing diagnostic and treatment factors (retrospective data), parenthood status, sustained child-wish and mental health. A multiple regression analysis controlling for background variables showed that, first, male factor (P mental health. Secondly, starting fertility treatment at an older age was associated with better mental health (P mental health for

Paid parental leave and family wellbeing in the sustainable development era

OpenAIRE

Heymann, Jody; Sprague, Aleta R.; Nandi, Arijit; Earle, Alison; Batra, Priya; Schickedanz, Adam; Chung, Paul J.; Raub, Amy

2017-01-01

Background The Sustainable development goals (SDGs) have the potential to have a significant impact on maternal and child health through their commitments both to directly addressing health services and to improving factors that form the foundation of social determinants of health. To achieve change at scale, national laws and policies have a critical role to play in implementing the SDGs’ commitments. One particular policy that could advance a range of SDGs and importantly improve maternal a...

Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

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Maziar Moradi-Lakeh

2015-10-01

Full Text Available In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP, was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016. It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME affiliated hospitals, reduce out-of-pocket (OOP payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes should be addressed through proper revision(s while nontechnical concerns (which are derived from conflicting interests must be responded through clarification and providing transparent information. The

Roadmap to sustainable textiles and clothing regulatory aspects and sustainability standards of textiles and the clothing supply chain

CERN Document Server

2015-01-01

This book covers the elements involved in achieving sustainability in textiles and clothing sector. The chapters covered in three volumes of this series title cover all the distinctive areas earmarked for achieving sustainable development in textiles and clothing industry. This third volume highlights the areas pertaining to the regulatory aspects and sustainability standards applicable to textiles and clothing supply chain. There are various standards earmarked for measuring the environmental impacts and sustainability of textile products. There are also plenty of certification schemes available along with the index systems applicable to textile sector. Brands and manufactures are also venturing into new developments to achieve sustainable development in textile sector. This third volume addresses all these important aspects.

Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study.

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Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra

2010-07-01

The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

Are Physicians Obliged to Lead Environmental Sustainability Efforts in Health Care Organizations?

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Macpherson, Cheryl C; Hill, Jonathan

2017-12-01

Climate change threatens health, health care, and the industries and resources upon which these depend. The growing prevalence and severity of its health consequences and economic costs are alarming health professionals and organizations as their professional obligations, grounded in the core value of health, include protecting against these harms. One means of fulfilling these obligations is to lead or support sustainability initiatives that are built upon current, reliable, accurate, and unbiased evidence and collaboratively tailored to meet specific needs and respond to specific contexts. We consider why and how health professionals and organizations should lead or support such initiatives. © 2017 American Medical Association. All Rights Reserved.

Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

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Nuti, Sabina

2017-01-01

Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

Ecological Footprints and Lifestyle Archetypes: Exploring Dimensions of Consumption and the Transformation Needed to Achieve Urban Sustainability

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Jennie Moore

2015-04-01

Full Text Available The global urban transition increasingly positions cities as important influencers in determining sustainability outcomes. Urban sustainability literature tends to focus on the built environment as a solution space for reducing energy and materials demand; however, equally important is the consumption characteristics of the people who occupy the city. While size of dwelling and motor vehicle ownership are partially influenced by urban form, they are also influenced by cultural and socio-economic characteristics. Dietary choices and purchases of consumable goods are almost entirely driven by the latter. Using international field data that document urban ways of living, I develop lifestyle archetypes coupled with ecological footprint analysis to develop consumption benchmarks in the domains of: food, buildings, consumables, transportation, and water that correspond to various levels of demand on nature’s services. I also explore the dimensions of transformation that would be needed in each of these domains for the per capita consumption patterns of urban dwellers to achieve ecological sustainability. The dimensions of transformation needed commensurate with ecological carrying capacity include: a 73% reduction in household energy use, a 96% reduction in motor vehicle ownership, a 78% reduction in per capita vehicle kilometres travelled, and a 79% reduction in air kilometres travelled.

Sustainable flood risk management – What is sustainable?

DEFF Research Database (Denmark)

Sørup, Hjalte Jomo Danielsen; Brudler, Sarah; Lerer, Sara Maria

2016-01-01

Sustainable flood risk management has to be achieved since flood protection is a fundamental societal service that we must deliver. Based on the discourse within the fields of risk management and sustainable urban water management, we discuss the necessity of assessing the sustainability of flood...... risk management, and propose an evaluation framework for doing so. We argue that it is necessary to include quantitative sustainability measures in flood risk management in order to exclude unsustainable solutions. Furthermore, we use the concept of absolute sustainability to discuss the prospects...... of maintaining current service levels without compromising future generation’s entitlement of services. Discussions on the sustainability of different overall flood risk schemes must take place. Fundamental changes in the approaches will require fundamental changes in the mind-sets of practitioners as well...

Challenges to achieving sustainable community health development within a donor aid business model.

Science.gov (United States)

Ashwell, Helen; Barclay, Lesley

2010-06-01

This paper explores the paradox of donor aid being delivered through a business model through a case study in Papua New Guinea. A retrospective review of project implementation and an outcome evaluation provided an opportunity to examine the long-term results and sustainability of a large project. Analysis was informed by data collected from 175 interviews (national, provincial, district and village), 93 community discussions and observations across 10 provinces. Problems with the business model of delivering aid were evident from implementation data and in an evaluation conducted two years after project completion (2006). Compounding the business model effect were challenges of over-ambitious project goals with limited flexibility to adapt to changing circumstances, a donor payment system requiring short-term productivity and excessive reporting requirements. An overly ambitious project design, donor dominance within the business model and limited local counterpart capacity created problems in the community initiatives component of the project. Contractual pressures can negatively influence long-term outcomes that require development of local leadership and capacity. Future planning for donor project designs needs to be flexible, smaller in scope and have a longer timeframe of seven to 10 years. Donor-funded projects need to be sufficiently flexible to apply proven principles of community development, build local ownership and allow adequate time to build counterpart knowledge and skills.

Creating Flexible and Sustainable Work Models for Academic Obstetrician-Gynecologists Engaged in Global Health Work.

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Molina, Rose; Boatin, Adeline; Farid, Huma; Luckett, Rebecca; Neo, Dayna; Ricciotti, Hope; Scott, Jennifer

2017-10-01

To describe various work models for obstetrics and gynecology global health faculty affiliated with academic medical centers and to identify barriers and opportunities for pursuing global health work. A mixed-methods study was conducted in 2016 among obstetrics and gynecology faculty and leaders from seven academic medical institutions in Boston, Massachusetts. Global health faculty members were invited to complete an online survey about their work models and to participate in semistructured interviews about barriers and facilitators of these models. Department chairs and residency directors were asked to participate in interviews. The survey response rate among faculty was 65.6% (21/32), of which 76.2% (16/21) completed an interview. Five department leaders (45.5% [5/11]) participated in an interview. Faculty described a range of work models with varied time and compensation, but only one third reported contracted time for global health work. The most common barriers to global health work were financial constraints, time limitations, lack of mentorship, need for specialized training, and maintenance of clinical skills. Career satisfaction, creating value for the obstetrics and gynecology department, and work model flexibility were the most important facilitators of sustainable global health careers. The study identified challenges and opportunities to creating flexible and sustainable work models for academic obstetrics and gynecology clinicians engaged in global health work. Additional research and innovation are needed to identify work models that allow for sustainable careers in global women's health. There are opportunities to create professional standards and models for academic global health work in the obstetrics and gynecology specialty.

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

Science.gov (United States)

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-01-01

The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Electronic search was done for literature published between 2003-2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients' trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors.

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

Directory of Open Access Journals (Sweden)

Robert Kaba Alhassan

Full Text Available The introduction of the national health insurance scheme (NHIS in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana.Electronic search was done for literature published between 2003-2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context.Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients' trust in the scheme and consequently decreases (reenrolment rates. These sustainability challenges were reviewed and discussed in this paper.The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors.

Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

Science.gov (United States)