Author Archives: Lancet Global Health

[Correspondence] Early antenatal care visit as indicator for health equity monitoring

Early antenatal care visits can be used as an indicator for health equity monitoring in the context of the Sustainable Development Goals (SDGs). National-level surveys, health information system data, and perinatal studies demonstrate substantial differences between countries grouped by income in the proportion of women initiating the first antenatal care visit in the first trimester of pregnancy. In the analysis by Ann-Beth Moller and colleagues (October, 2017),1 early antenatal care coverage showed an inverse association with country-level income, ranging from more than 80% in high-income countries to 52% in lower-middle-income and 24% in low-income countries in 2013.

Posted in Journal Watch | Comments closed

[Correspondence] Epidemiological data for hepatitis D in Africa – Authors’ reply

Jose Debes and Shemal Shah highlight the paucity of data from east Africa, one of our major findings. The authors draw attention to a study from Tanzania, where samples that initially tested positive for antibodies against hepatitis D virus by a commercial assay did not test positive on retesting with a second assay.1 The performance of the second assay relative to the first was unknown. Given that the first assay was used widely in the studies included in our analysis without confirmation by a second assay, we elected not to take retesting into account for the study from Tanzania and to maintain consistency with data available from the other studies.

Posted in Journal Watch | Comments closed

[Articles] Prevalence of chronic obstructive pulmonary disease in the global population with…

Our findings suggest a high prevalence of COPD in the global population with HIV, and an association with HIV. As such, COPD deserves more attention from HIV health-care providers, researchers, policy makers, and stakeholders for improved detection, overall proper management, and efficient control of COPD in people with HIV. Efforts to address this burden should focus on promoting the decrease of tobacco consumption and adherence to highly active antiretroviral therapy to reduce viral load.

Posted in Journal Watch | Comments closed

[Comment] Collision of communicable and non-communicable disease epidemics—the case of HIV…

In this issue of The Lancet Global Health, Jean Joel Bigna and colleagues report the results of their systematic review and meta-analysis of studies of chronic obstructive pulmonary disease (COPD) in people with HIV.1 COPD is one of the most common non-communicable diseases that, as a group, are the leading causes of morbidity and mortality worldwide.2 HIV is one of the principal infectious causes for morbidity and mortality globally.3 Although typically thought of as a problem of high-income countries, most of the burden of non-communicable diseases is seen in low-income and middle-income countries (LMICs), where they drive and perpetuate poverty.

Posted in Journal Watch | Comments closed

[Correspondence] Epidemiological data for hepatitis D in Africa

Alexander Stockdale and colleagues (October, 2017)1 describe the epidemiology of hepatitis D virus in Africa, and conclude that the infection is more common in west Africa than in other regions, particularly east Africa. This epidemiological statement is generally known among practising hepatologists and has important implications when screening for hepatitis D virus. However, a few points should be highlighted from the study.

Posted in Journal Watch | Comments closed

[Correspondence] Measuring women’s empowerment: a need for context and caution – Authors’…

Women’s empowerment is a complex concept, with no consensus on its definition or on the domains that compose the construct.1 Thus, it is expected that any attempt to measure empowerment will have limitations and will not satisfy all parties interested in the topic. However, we know that an attribute that is not measurable or measured tends to be overlooked. The Sustainable Development Goals (SDGs) raised the need for a measure of women’s empowerment so that it can be monitored and compared between contexts and stakeholders made accountable.

Posted in Journal Watch | Comments closed

[Correspondence] Measuring women’s empowerment: a need for context and caution

Sustainable Development Goal 5 (SDG5) urges governments to monitor progress towards gender equality and empowering women and girls. Improved measurement is needed to meet this mandate, which requires that women’s empowerment be well defined, adequately measured by use of representative and focused samples, and statistically comparable across countries, years, and social groups. Accordingly, it is unclear whether the survey-based women’s empowerment (SWPER) index, reported in The Lancet Global Health by Fernanda Ewerling and colleagues (September, 2017),1 improves measurement of SDG5.

Posted in Journal Watch | Comments closed

[Comment] Revisiting strategies to eliminate mother-to-child transmission of syphilis

Mother-to-child transmission of syphilis, so-called congenital syphilis, can result in adverse pregnancy outcomes such as fetal loss, stillbirth, neonatal death, preterm birth, low birthweight, and congenital anomalies.1 Roughly 1 million pregnant women are estimated to be infected with syphilis worldwide, with the highest prevalence in east and southern Africa.2 Antenatal screening and treatment with a single dose of benzathine benzylpenicillin successfully cures both maternal and congenital syphilis and prevents adverse pregnancy outcomes due to syphilis.

Posted in Journal Watch | Comments closed

[Articles] Progress on catastrophic health spending in 133 countries: a retrospective…

The proportion of the population that is supposed to be covered by health insurance schemes or by national or subnational health services is a poor indicator of financial protection. Increasing the share of GDP spent on health is not sufficient to reduce catastrophic payment incidence; rather, what is required is increasing the share of total health expenditure that is prepaid, particularly through taxes and mandatory contributions.

Posted in Journal Watch | Comments closed

[Articles] Monitoring universal health coverage within the Sustainable Development Goals:…

Service coverage within universal health coverage can be measured with an index of tracer indicators. Our universal health coverage service coverage index is simple to compute by use of available country data and can be refined to incorporate relevant indicators as they become available through SDG monitoring.

Posted in Journal Watch | Comments closed

[Comment] Investigating the sexual transmission of Zika virus

The sexual transmissibility of Zika virus, a pathogen that is transmitted primarily by aedes mosquitos, has important implications,1 particularly for women because infection during pregnancy causes adverse pregnancy and fetal outcomes, including microcephaly.2 WHO has included transmission through sexual intercourse and bodily fluids as a priority in its Zika Virus Research Agenda, which was a crucial component of the public health response to the 2015–16 Zika virus outbreak in South America. However, in the absence of methodologically rigorous population-based studies, the epidemiology of sexually transmitted Zika virus remains poorly understood.

Posted in Journal Watch | Comments closed

[Comment] Informality and health: universal health coverage in the era of SDGs

Universal health coverage (UHC), the idea that “all individuals and communities receive quality health-care services that they need, and are protected from health threats without suffering financial hardship”, is a key agenda item for WHO and other global health stakeholders.1 This concept is reflected in Sustainable Development Goal (SDG) 3, which calls for ensuring healthy lives and promoting wellbeing for all at all ages, and the specific target on UHC (SDG 3.8). The agreement on these goals and targets has led to a proliferation of initiatives that aim to track progress in their attainment by 2030.

Posted in Journal Watch | Comments closed

[Articles] Progress on impoverishing health spending in 122 countries: a retrospective…

Out-of-pocket spending on health can add to the poverty head count and the depth of poverty by diverting household spending from non-health budget items. The scale of such impoverishment varies between countries and depends on the poverty line but might in some low-income countries account for as much as four percentage points of the poverty head count. Increasing the share of total health expenditure that is prepaid, especially through taxes and mandatory contributions, can help reduce impoverishment.

Posted in Journal Watch | Comments closed

[Comment] Towards a meaningful measure of universal health coverage for the next billion

Effectively monitoring universal health coverage (UHC) has become increasingly important, especially given the centrality of UHC in the Sustainable Development Goal (SDG) era and its ascent in policy dialogues. Further, a pillar of WHO’s Global Programme of Work for 2019–231 is the provision of universal health coverage (UHC) to 1 billion more people. Yet without greater consensus on what set of health services should comprise an ideal measure of UHC, we lack a roadmap for achieving and monitoring these aims.

Posted in Journal Watch | Comments closed