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PubMed2002

The role of multilateral institutions.

In line with its mission of alleviating poverty through support for environmentally and socially sustainable economic development, The World Bank (along with some other multilateral development banks) is working to help developing countries capture a share of the emerging global market in greenhouse-gas-emissions reductions ('carbon trading'). Under the Kyoto Protocol of the United Nations Framework Convention on Climate Change (UNFCCC), the Joint Implementation instrument and the Clean Development Mechanism now provide an opening for substantial international resource transfers and potential for supporting sustainable development through the transfer of cleaner technologies or sustainable forestry and agro-forestry practices. For example, carbon sequestration represents a non-extractive non-consumptive sustainable use of living natural resources that can be incorporated within a multiple-use 'integrated ecosystem management' approach. The World Bank initiated the Prototype Carbon Fund (PCF) in April 2000, to help spur the development of a global carbon market and to 'learn by doing' how to use carbon-purchase transactions across a range of energy-sector technologies (and some forestry applications) to achieve environmentally credible and cost-effective emissions reductions that benefit developing countries and economies in transition. Building on the success of the PCF ($145 million raised from public and private-sector investors), The World Bank expects to launch two new funds in 2002: the Biocarbon Fund and the Community Development Carbon Fund. These funds will target synergies between carbon markets and objectives such as biodiversity conservation, combating desertification and small-scale community-driven development. Experience from the PCF shows that developing countries can have a comparative advantage in supplying this global market, as emissions reductions can be achieved in developing countries in the range of $3-$5 per ton of CO(2) equivalent, compared with a marginal abatement cost of $10-$15 per ton of CO(2) equivalent in most countries within the Organization for Economic Cooperation and Development. However, realizing this economic potential over the next decade, and targeting the market to the rural poor, will require substantial assistance with project development and government legal and institutional capacity building. Specific needs include raising awareness of the potential of carbon markets at all levels (particularly in energy and land-use sectors), clarifying property rights, particularly in the case of communally held land and resources, ensuring the existence of an attractive investment climate, eliminating policies that create perverse incentives and constraints, and mitigating logistical, political and 'reputational' risks that could deter private-sector investors. It will also be necessary to find ways to reconcile the short-term needs of the rural poor and the typically long-term revenue stream associated with carbon sequestration.

Air Pollution↗
PubMed2006

Global strategy for further reducing the leprosy burden and sustaining leprosy control activities 2006-2010. Operational guidelines.

The Global Strategy for further reducing the leprosy burden and sustaining leprosy control activities (2006 - 2010) has been widely welcomed and endorsed. The overall goal is to provide access to quality leprosy services for all affected communities following the principles of equity and social justice. The purpose of these Operational Guidelines is to help managers of national health services to implement the new Global Strategy in their own countries. This will be done as they develop detailed policies applicable to their own situation, and revise their National Manual for Leprosy Control. Leprosy services are being integrated into the general health services throughout the world; a new emphasis is given here to the need for an effective referral system, as part of an integrated programme. Good communication between all involved in the management of a person with leprosy or leprosy- related complications is essential. These Guidelines should help managers to choose which activities can be carried out at the primary health care level and for which aspects of care patients will have to be referred. This will depend on the nature of the complication and the capacity of the health workers to provide appropriate care at different levels of the health system. The promotion of self-reporting is now crucial to case detection, as case- finding campaigns become less and less cost-effective. It is important to identify and remove barriers that may prevent new cases from coming forward. The procedures for establishing the diagnosis of leprosy remain firmly linked to the cardinal signs of the disease, but the accuracy of diagnosis must be monitored. The Guidelines suggest a greater emphasis on the assessment of disability at diagnosis, so that those at particular risk can be recognized and managed appropriately. The treatment of leprosy with MDT has been a continuing success; neither relapse nor drug-resistance are significant problems and the regimens are well- tolerated. Clear procedures are given for managing irregular treatment with MDT. Leprosy reactions are a serious complication affecting some patients. The Guidelines contains this aspect, with additional references under Further Reading. A key decision for programme managers is to determine how and at which level of the health system leprosy reactions are to be managed in their country. Different countries must develop their own detailed guidelines on this issue. Prevention of disability (POD) is also described in some detail as there is a need for much greater coverage with basic POD activities. This is an important component of 'quality leprosy services' emphasized in the Global Strategy. Items mentioned under Further Reading will be essential for programmes planning to build capacity and increase their service provision in this area. Rehabilitation may include a medical component (such as reconstructive surgery) but its scope is much broader. It is likely that some people affected by leprosy would benefit from socio-economic rehabilitation (for example, vocational training or a small loan). Staff in the health services need to be familiar with what is being done in the locality, and know how and where to refer people who need these services. Recording and reporting are essential to maintain quality in any programme. The indicators selected in the Global Strategy are useful for monitoring and evaluation, and they determine which data must be recorded. The data needed to monitor POD activities have not been collected routinely in the past, so this represents a significant change - national managers must therefore decide for themselves which indicators will be used to ensure quality as these will vary from country to country. Programme management is a broad subject; the topics covered in this Section are those that are central to the running of integrated leprosy control services, including supervision, supply of MDT, partnerships, training and programme evaluation.

Communicable Disease Control↗
PubMed2005

Health information systems: the foundations of public health.

Public health decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. The products of historical, social and economic forces, they are complex, fragmented and unresponsive to needs. International donors in health are largely responsible for the problem, having prioritized urgent needs for data over longer-term country capacity-building. The result is painfully apparent in the inability of most countries to generate the data needed to monitor progress towards the Millennium Development Goals. Solutions to the problem must be comprehensive; money alone is likely to be insufficient unless accompanied by sustained support to country systems development coupled with greater donor accountability and allocation of responsibilities. The Health Metrics Network, a global collaboration in the making, is intended to help bring such solutions to the countries most in need.

Decision Making↗
PubMed2005

Highlights/best practices of San Francisco's Asian American Network for Cancer Awareness, Research, and Training (AANCART).

The Asian American Network for Cancer Awareness, Research, and Training in San Francisco (AANCART-SF) consists of two distinct entities, working in cooperation to advance cancer awareness, research, and training among Asian Americans: a university-based group with expertise in the Vietnamese community and a community-based health plan with expertise in the Chinese community. In addition to the goals shared with other AANCART sites, AANCART-SF is a unique effort in capacity building in that it aims to expand and export community-academic research expertise from one Asian population, the Vietnamese, to other Asian populations. It also aims to build the research capability of those serving the Chinese community through a health plan.

Asian↗
PubMed2006

Latin American Cancer Research Coalition. Community primary care/academic partnership model for cancer control.

The Latin American Cancer Research Coalition (LACRC) was funded by NCI as a Special Populations Network to 1) provide training to clinic staff in cancer control and foster development of Latino faculty training, 2) conduct a needs assessment with the community clinics, 3) enhance the ability of the clinics to promote healthy lifestyles, 4) collaborate on research projects to improve use of early detection, and 5) explore partnerships to increase access to culturally competent cancer care. The LACRC developed a model for cancer control focused on community-based clinics as the focal point for in-reach and community outreach targeted to Latinos to reduce cancer disparities. This framework was designed to link the community to local hospitals and academic centers, build capacity, and promote diffusion of innovations directly into delivery systems. Eight research projects submitted by junior investigator/clinic teams have been funded by NCI. These research projects range from recruiting for clinical trials to prevention to survivorship. The LACRC has trained 6 cancer control coordinators from partner sites and educated 59 undergraduate minority student interns in aspects of cancer control research. Central to LACRC's success to date has been the creation and maintenance of an infrastructure of trusting relationships, especially those developed between clinician/investigators and individuals within the greater Latino community. Community clinics can be effective agents for cancer control among Latinos. Latinos are likely to participate in research conducted by culturally representative teams of researchers using culturally appropriate recruiting strategies. Cancer 2006. (c) 2006 American Cancer Society.

Central America↗
PubMed2006

Redes En Acción. Increasing Hispanic participation in cancer research, training, and awareness.

Hispanics are affected by many health care disparities. The National Cancer Institute (NCI), through its Special Populations Branch, is supporting networking and capacity-building activities designed to increase Hispanic participation and leadership in cancer research. Redes En Acción established a national network of cancer research centers, community-based organizations, and federal partners to facilitate opportunities for junior Hispanic scientists to participate in training and research projects on cancer control. Since 2000, Redes En Acción has established a network of more than 1800 Hispanic leaders involved in cancer research and education. The project has sustained 131 training positions and submitted 29 pilot projects to NCI for review, with 16 awards for a total of $800,000, plus an additional $8.8 million in competing grant funding based on pilot study results to date. Independent research has leveraged an additional $32 million in non-Redes funding, and together the national and regional network sites have participated in more than 1400 community and professional awareness events. In addition, the program conducted extensive national survey research that provided the basis for the Redes En Acción Latino Cancer Report, a national agenda on Hispanic cancer issues. Redes En Acción has increased participation in cancer control research, training, and awareness among Hispanic scientists and within Hispanic communities. Cancer 2006. (c) 2006 American Cancer Society.

Biomedical Research↗
PubMed2006

Special Populations Networks--how this innovative community-based initiative affected minority and underserved research programs.

The Special Populations Networks (SPN) Program was created to address both community needs for cancer information and NCI's desire to obtain community-based answers to research questions and promote training opportunities for racial/ethnic minority and underserved researchers in populations with an unequal burden of cancer. The SPN program included 3 components: 1) infrastructure and capacity building combined with cancer awareness, 2) community-based research, and 3) community-centered training. The 18 SPN grantees conducted more than 1000 cancer awareness activities. More than 2000 community lay health workers were trained. Communities formalized more than 300 partnerships with Memoranda of Understanding (MOU). More than 255 pilot research project applications were submitted by junior researchers and over 135 were funded. Approximately 90% of the applications were submitted by minority junior researchers; of which more than 100 were funded. More than 290 scientific publications thus far have resulted from the work of the SPNs. In the first 3 years of the program, the SPNs also secured an additional $20 million in outside funding. The SPN program effected a paradigm shift for minority research programs by combining community-based cancer awareness, research, and training into a single program. By engaging research leaders of minority and underserved populations to aid their own, train their own, and develop research to help their own, the SPN program activated the power of their commitment to their own. That commitment was reflected in the trust and participation offered by their communities. Cancer 2006. (c) 2006 American Cancer Society.

Community Networks↗
PubMed2002

A proposal for cervical screening information systems in developing countries.

The effective and efficient delivery of cervical screening programs requires information for planning, management, delivery and evaluation. Specially designed systems are generally required to meet these needs. In many developing countries, lack of information systems constitutes an important barrier to development of comprehensive screening programs and the effective control of cervical cancer. Our report outlines a framework for creating such systems in developing countries and describes a conceptual model for a cervical screening information system. The proposed system is modular, recognizing that there will be considerable between-region heterogeneity in current status and priorities. The proposed system is centered on modules that would allow for the assembly and computerization of data on Pap tests, since these represent the main screening modality at the present time. Additional modules would process data and create and maintain a screening database (e.g., standardize, edit, link and update modules) and allow for the integration of other types of data, such as cervical histopathology results. An open systems development model is proposed, since it is most compatible with the goals of local stakeholder involvement and capacity-building.

Databases as Topic↗
PubMed1995

Using empowerment theory in collaborative partnerships for community health and development.

Models of community empowerment help us understand the process of gaining influence over conditions that matter to people who share neighborhoods, workplaces, experiences, or concerns. Such frameworks can help improve collaborative partnerships for community health and development. First, we outline an interactive model of community empowerment that describes reciprocal influences between personal or group factors and environmental factors in an empowerment process. Second, we describe an iterative framework for the process of empowerment in community partnerships that includes collaborative planning, community action, community change, capacity building, and outcomes, and adaptation, renewal, and institutionalization. Third, we outline activities that are used by community leadership and support organizations to facilitate the process of community empowerment. Fourth, we present case stories of collaborative partnerships for prevention of substance abuse among adolescents to illustrate selected enabling activities. We conclude with a discussion of the challenges and opportunities of facilitating empowerment with collaborative partnerships for community health and development.

Adolescent↗
PubMed2001

The elaboration of the 'Stockholm convention' on persistent organic pollutants (POPs): a negotiation process fraught with obstacles and opportunities.

The conclusion in December 2000 of the negotiations for the 'Stockholm Convention' can clearly be labeled as a success. The Convention text was negotiated in merely five sessions of the Intergovernmental Negotiating Committee (INC) and accomplished after its fifth session despite the fact that numerous controversial issues, such as the inclusion of new substances under the ambit of the Convention, the acknowledgement of the precautionary principle or--clearly most controversial--the financing mechanisms, remained to be resolved. This paper attempts to provide a somewhat impressionistic account of the negotiations leading to the conclusion of the 'Stockholm Convention' as experienced by the members of the Swiss delegation participating in the negotiations of the INC. Besides a brief overview on the 'history' of the negotiations, it will focus on some issues of special interest--and controversy--to the negotiators, and finally attempt to provide an outlook on the future of the work performed by the INC and the implementation of the Convention. Issues of special interest are environmental policy issues, capacity building and financing, trade-related issues, precautionary principles, and technical and scientific issues.

Commerce↗
PubMed2005

Context enrichment of health risk surveillance data for use and application: conceptual considerations from an Australian perspective.

Increasing the relevance of health surveillance data for use and application remains a critical issue among users and stakeholders. However methods for displaying and communicating health risk data could do more to enrich these data for use and application. There is too much focus on developers, users and stakeholders and not enough focus on pathway models of disease and health. A greater focus on pathway models would help detail a wider explanation of the health problems across sectors and encourage better acceptance of responsibility for their occurrence within other sectors. Contextual enrichment of health data would encourage a shared theory among these players that would permit greater use and application. Better use of data and its translation into information and increased policy traction are likely to be achieved through processes that effectively: (1) establish a shared theoretical base for risk behaviour surveillance; (2) deliver data about the health and developmental status of individuals living in contexts over time; (3) maintain a systems approach to monitoring and surveillance that builds capacity for development, ownership, access to and dissemination of the data outside of the health system and (4) achieve sustainable partnerships that produce more intersectoral engagement.

Adult↗
PubMed2003

Environmental and habitat management: the case of Ethiopia and Ghana.

This article examines the environment and habitat management experiences of Ethiopia and Ghana in the postindependence period (1960-2000). Based on extensive archival research, semistructured focused interviews of environment and habitat officers of the World Bank, the United Nations System and the International Union for the Conservation of Nature (IUCN) and personal professional field experiences, the paper argues that the uncritical adoption of externally generated discourses, narratives, policy guidelines, and strategies of environmental and habitat management has structured thought and action in both countries. The experience of both countries in defining and responding to environmental and human settlement management is explored from a political ecology perspective. The analysis indicates that both countries have essentially adopted a technocratic, state-centered, and unsustainable management strategy framework based on population control, poverty reduction, sustainable development, and capacity-building. It also suggests that international organizations such as the World Bank, INCN, and the United Nations system have been important sources of thought and action in both countries. Conversely, regional international organizations such as the Economic Commission for Africa, the Organization of African Unity and the African Development Bank have largely served as conduits for the diffusion of global discourses, narratives, policies and strategies. The need for adopting management policies and strategies that are based on principles of multiple engagement, decentralization, incentives, public education, and participation is underscored.

Conservation of Natural Resources↗
PubMed2003

The tribal environment: solid waste in Indian country.

The issue of solid waste management in Indian country is multidimensional in scope because it affects more than just regulatory concerns. There are more than 550 federally recognized Alaska Native and American Indian Tribes in the United States. Tribes are sovereign nations that have a special relationship to the federal government and a unique legal status. The environmental problems faced by tribes are many, and it is only fair that tribes, as sovereigns, specify the levels of protection on their lands. The one-size-fits-all regulatory approach to environmental problems and solid waste management in particular does not work and often leads to conflict between tribes and the federal and state governments. Inherent tensions also exist between tribes and various levels of government concerning jurisdiction of lands and managing solid waste. These intergovernmental relationships are often complex and present unique challenges to all. More research needs to be done on targeting resources to meet the capacity-building needs of tribes, as well as the overall environmental management needs of Indian country under the federal trust obligation. Successful intergovernmental relationships can be fostered through partnership arrangements between tribes and federal, state, and local governments. In the area of solid waste such partnerships have worked. It requires that all levels of government deal with tribes with careful consideration of their cultural, historic, and socioeconomic aspects, which are often intertwined.

Alaska↗
PubMed2005

Trends in global protected area governance, 1992-2002.

Governance refers to the interactions among structures, processes, and traditions that determine direction, how power is exercised, and how the views of citizens or stakeholders are incorporated into decision-making. Governance is now recognized as a critical aspect of effective conservation and is a prominent part of the Convention on Biological Diversity's work program on protected areas. This study reports on a global survey to assess changes in governance of protected area systems between 1992 and 2002 based on responses from 41 countries. Results indicate that substantial changes have taken place with overall trends towards increased participation of more stakeholders, greater use of formal accountability mechanisms, and a wider range of participatory techniques. Many of these changes are supported by legislative and policy requirements and 75% of respondents reported changes in legislation over the past decade. Protected areas are becoming more influenced by global forces. A majority of respondents reported increased involvement of the private sector. Funding is coming from a broader range of sources, with a smaller proportion of income coming from government sources in 2002. Absolute funding amounts have increased, but almost two-thirds report that budgets fall short of requirements. Almost 90% of respondents felt that protected area governance had improved over the last decade; 67% felt that this had also led to improved management effectiveness. Respondents felt that secure funding, capacity building, and increased community involvement were the main governance needs for the future.

Conservation of Natural Resources↗
PubMed2001

Turning scientific approaches into practical conservation actions: the case of Comunidad Indigena de Nuevo San Juan Parangaricutiro, Mexico.

Optimum natural resource management and biodiversity conservation are desirable goals. These, however, often exclude each other, since maximum economic benefits have promoted drastic reductions in biodiversity throughout the world. This dilemma confronts local stakeholders, who usually go for maximizing economic inputs, whereas other social (e.g., academic) sectors are favor conservation practices. In this paper we describe the way two scientific approaches--landscape and participatory research--were used to develop sound and durable land use scenarios. These two approaches included expert knowledge of both social and environmental conditions in indigenous communities. Our major emphasis was given to detect spatially explicit land use scenarios and capacity building in order to construct a decision support system operated by stakeholders of the Comunidad Indigena de Nuevo San Juan Parangaricutiro in Mexico. The system for decision-making was fed with data from inventories of both abiotic and biotic biodiversity components. All research, implementation, and monitoring activities were conducted in close collaboration with members of the indigenous community. As a major result we obtained a number of forest alternative uses that favor emerging markets and make this indigenous community less dependent on a single market. Furthermore, skilled members of the community are now running the automated system for decision-making. In conclusion, our results were better expressed as products with direct benefits in local livelihoods rather than pure academic outputs.

Conservation of Natural Resources↗
PubMed2006

[The European Vision Institute. Opening up new frontiers?].

The European Vision Institute EEIG (EVI) creates a new legal entity based on Community law to facilitate and encourage cross-border co-operation in vision research. Its major objectives are to conduct and support research, training, health information dissemination and other programmes with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight and the special health problems and requirements of the blind and visually disabled. EVI aims to foster centres in the EU in capacity building for innovative projects, to increase the flexibility, attractiveness and competitiveness of research careers, especially for young researchers. In addition, EVI will serve to co-ordinate activities with patient organisations and to build a pan-European platform for clinical trials.

Academies and Institutes↗
PubMed2006

The making of an interdisciplinary partnership: the case of the Chicago Food System Collaborative.

Interdisciplinary partnerships foster innovation to address pressing social problems. This paper describes an interdisciplinary partnership called the Chicago Food System Collaborative (CFSC) composed of a team of partners from four academic institutions and three community-based organizations representing a total of eight disciplines that included: community development and community organizing, community psychology, geography, nursing, nutrition, public health, sociology, and urban planning and policy. Partners came together to address the issue of access to healthy foods and nutrition in a working class African American neighborhood. We analyze and discuss the core principles that guided the partnership and its impact across three dimensions: understanding through interdisciplinary action research, building capacity, and facilitating innovations in practices and policies. Despite the challenges of interdisciplinary partnerships, the potential benefits and impact of such efforts reflect their value as a comprehensive approach to addressing complex social problems.

Black or African American↗