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dinsdag 17 april 2018

The Lancet: [Viewpoint] Monitoring country progress and achievements by making global predictions: is the tail waggin...

[Viewpoint] Monitoring country progress and achievements by making global predictions: is the tail wagging the dog?
The world has seen explosive growth in the use of estimates for key health indicators. UN agencies, such as WHO and UNICEF, and academic institutions, notably the Global Burden of Disease (GBD) work of the Institute of Health Metrics and Evaluation (IHME), have stepped up the frequency and scope of global health estimates. Funding agencies, led by the Bill and Melinda Gates Foundation, are making major investments in global health estimation. Several prominent, high-impact academic journals prioritise publication of global health estimates, which are usually received with great interest in the international health and development community and media.
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[Comment] The Lancet Commission on malaria eradication
20 years ago, infectious diseases dominated the global health agenda. Policy makers, researchers, implementers, and donors united in the fight against infectious diseases, creating the Millennium Development Goals, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the Vaccine Alliance, the US President's Emergency Plan For AIDS Relief (PEPFAR), the Roll Back Malaria Partnership, the Multilateral Initiative on Malaria (MIM),1 and more. Tremendous progress was made. Malaria benefited spectacularly and there has been a 47% reduction in global deaths from the disease since 2000.
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[Series] Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health
A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from low-income, middle-income, and high-income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread.
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[Series] Intervention strategies to improve nutrition and health behaviours before conception
The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are likely to be scalable and have positive effects on a range of health outcomes: supplementation and fortification; cash transfers and incentives; and behaviour change interventions.
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[Series] Origins of lifetime health around the time of conception: causes and consequences
Parental environmental factors, including diet, body composition, metabolism, and stress, affect the health and chronic disease risk of people throughout their lives, as captured in the Developmental Origins of Health and Disease concept. Research across the epidemiological, clinical, and basic science fields has identified the period around conception as being crucial for the processes mediating parental influences on the health of the next generation. During this time, from the maturation of gametes through to early embryonic development, parental lifestyle can adversely influence long-term risks of offspring cardiovascular, metabolic, immune, and neurological morbidities, often termed developmental programming.
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