A design process to define public challenges addressing SDGs / Un proceso de diseño para definir los desafíos públicos relacionados con los ODS / Um processo de design para definir desafios públicos envolvendo os ODS

Abstract How might we define local innovation challenges that are user-centered but also address strategic goals, such as the Sustainable Development Goals (SDGs)? We propose a design process that introduces a relevant contribution to the practices of the Mission-oriented Innovation Policies (MIPs) field as it goes from Grand Societal Challenges (GSCs) to local innovation challenges, which are more relevant to local needs and capabilities of solution. The main goal of the design process is to go from a GSC, such as "access to health" and one of its missions, like "reducing chronic Non-Communicable Diseases (NCD)," to a more able-to-solve innovation challenge, passing by its mission, and different problems and aspects. Snowball sampling methods allow us to find and mobilize electable subjects and design thinking techniques to process problem mapping, election, and clustering, as well as create challenge statements. It was possible to translate GSC to the local reality while reducing contestation and complexity and producing a problem-grouped map with prioritization and three problem statements (challenges) with open phrasing and solution criteria to foster the users' desired outcomes.

Resumen ¿Cómo podemos definir desafíos locales de innovación local que estén centrados en el usuario pero que también aborden objetivos estratégicos, como los Objetivos de Desarrollo Sostenible (ODS)? Proponemos un proceso de diseño que introduce una contribución relevante a las prácticas en el campo de las políticas de innovación orientadas por misión (en inglés, Mission-oriented Innovation Policies - MIPs), ya que va desde los grandes desafíos sociales (en inglés, Grand Societal Challenges - GSCs), comenzando con los ODS, hasta los desafíos locales de innovación, que son más relevantes para necesidades locales y capacidades de solución. El objetivo principal del proceso de diseño es ir desde un GSC, como "acceso a la salud" y una de sus misiones, como "reducir las Enfermedades Crónicas No Transmisibles (ECNT)", a un desafío de innovación más concreto, pasando por la misión, y por diferentes problemas y aspectos. Los métodos de muestreo de bola de nieve nos permiten encontrar y movilizar sujetos elegibles, y técnicas de design thinking, procesar el mapeo, la elección y la agrupación de problemas; y crear declaraciones de desafío. Fue posible traducir GSC a la realidad local, al mismo tiempo que se reducía la contestación y la complejidad, y se producía un plano agrupado de problemas con priorización, y tres declaraciones de problemas (desafíos) con redacción abierta y criterios de solución para promover los resultados deseados por los usuarios.

Resumo Como podemos definir os desafios locais de inovação que são centrados no usuário, mas também abordam objetivos estratégicos, como os Objetivos de Desenvolvimento Sustentável (ODS)? Propomos um processo de design que apresenta uma contribuição relevante para as práticas no campo das políticas de inovação orientadas para a missão (em inglês, Mission-oriented Innovation Policies - MIPs), uma vez que vai dos grandes desafios societais (em inglês, Grand Societal Challenges - GSCs) aos desafios locais de inovação, que são mais relevantes para as necessidades locais e capacidades de solução. O principal objetivo do processo de desenho é passar de um GSC, como o "acesso à saúde" e uma de suas missões, como "reduzir as Doenças Crônicas Não Transmissíveis (DCNT)", para um desafio de inovação mais capaz de resolver, passando pela sua missão, diferentes problemas e aspectos. Os métodos de amostragem bola de neve nos permitem encontrar e mobilizar assuntos elegíveis e técnicas de design thinking para processar o mapeamento de problemas, eleição e agrupamento; e criar declarações de desafio. Foi possível traduzir o GSC para a realidade local, reduzindo a contestação e a complexidade, e produzindo um mapa agrupado de problemas com priorização e três declarações de problemas (desafios) com formulação aberta e critérios de solução para promover os resultados desejados pelos usuários.

Women's Empowerment: Bringing Women’s Rights and Health into Focus- A Comparative Analysis of State Fact Sheets of National Family Health Survey (NFHS)-4 & 5

Introduction: Women’s empowerment is a crucial factor for economic and social growth. India being committed to making women contribute equally to the growth of the country by 2030 (SDG-5), this study highlighted the major shortcomings in the domain of Women’s health, social and economic growth parameters. Methods: For this study, data related to health and non-health parameters were used from National Family Health Survey factsheets. In reference to “the Global Gender Gap measure by the World Economic Forum”, the indicators have been classified into 4 broad themes, for each of which, indicators were se-lected from NFHS factsheet for analysis, interpretation, and reporting. Results: A2.9% increase in the child sex ratio from 991 to 1022 females per 1000 males over the last two NFHS rounds, indicates a significant societal shift in the country. Out of 21 selected indicators, 4 pa-rameters namely Screening test for cervical and breast cancer, Marriage of women before 18 years of age and Anaemia amongst women have shown a negative change over the past 5 years. Conclusion: The study found that, India has made significant progress around the health, education, economic and social empowerment parameters. But to get an adequate assessment of developments, we need to expand the basket of indicators to holistically analyze change.

Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement

Background: To improve healthcare access and mitigate healthcare costs for its population, Nigeria established a National Health Insurance Scheme (NHIS) in 1999. The NHIS remains Nigeria's leading vehicle for achieving universal health coverage; nonetheless, questions remain regarding its quality and effectiveness. Studies on patient satisfaction have served as a useful strategy to further understand the patient experience and the efficacy of health systems. Aim: To synthesise current knowledge on patient satisfaction with the NHIS. Methods: The authors performed a systematic review of primary literature from 1999 to 2020 reporting on NHIS patient satisfaction in eight databases (including PubMed, Embase, and Africa-wide Information). Results: This search returned 764 unique records of which 21 met criteria for full data extraction. The 21 qualifying studies representing 11 of the 36 Nigerian states, were published from 2011 to 2020, and found moderate overall satisfaction with the NHIS (64%). Further, when disaggregated into specific domains, NHIS enrolees were most satisfied with provider attitudes (77%) and healthcare environments (70%), but less satisfied with laboratories (62%), billings (62%), pharmaceutical services (56%), wait times (55%), and referrals (51%). Importantly, time trends indicate satisfaction with the NHIS is increasing ­ although to differing degrees depending on the domain. Conclusion: The beneficiaries of the NHIS are moderately satisfied with the scheme. They consider it an improvement from being uninsured, but believe that the scheme can be considerably improved. The authors present two main recommendations: (1) shorter wait times may increase patient satisfaction and can be a central focus in improving the overall scheme, and (2) more research is needed across all 36 states to comprehensively understand patient satisfaction towards NHIS in anticipation of potential scheme expansion

Agenda 2030 en Argentina: percepciones de expertos en salud, comparación con expertos de Brasil y primeros impactos de la pandemia COVID-19 / Agenda 2030 in Argentina: perceptions of health experts, comparison with the perceptions of Brazilian experts and the first impacts of the COVID-19 Pandemic

Resumen La Agenda 2030, una estrategia de la Organización de las Naciones Unidas (ONU) para promover un desarrollo humano global y sostenible capaz de satisfacer necesidades sociales básicas, aún se encuentra en sus etapas iniciales en la mayoría de los países de América del Sur. La presente investigación tuvo como objetivo consultar a un grupo de expertos en salud sobre las posibilidades de Argentina de cumplir con la Agenda 2030, en especial las metas del ODS3-Salud y Bienestar-, a su vez que se les consultó sobre los obstáculos, desafíos y recomendaciones de políticas para cumplir con las metas. El cambio de gestión del gobierno en diciembre de 2019, y el surgimiento de la pandemia COVID19 en el presente año, amplió la investigación incorporando el análisis del actual Ministro de Salud de la Nación sobre la Agenda 2030, el estudio realizado y las perspectivas actuales en el periodo de la pandemia. Los resultados fueron analizados en perspectiva comparada con un estudio brasilero, y mostraron que la mayoría de los expertos coincide en el bajo potencial del país para cumplir con las metas de la Agenda 2030. Sin embargo en el análisis del nuevo Ministro de salud surgen "las paradojas de la pandemia" que refieren a la oportunidad de fortalecer el sistema sanitario producto de la pandemia COVID-19.

Abstract The 2030 Agenda - a strategy of the United Nations Organization (UN) to promote global and sustainable human development capable of satisfying basic social needs - is still in the initial stages in most of the countries of South America. The scope of this investigation was to consult a group of health experts on the possibilities of Argentina fulfilling the 2030 Agenda, especially the goals of ODS3 - Health and Wellbeing - when they were consulted on obstacles, challenges, and policy recommendations to meet the goals. The change of management of the government in December 2019, and the outbreak of the Covid-19 pandemic in 2020, broadened the investigation incorporating the analysis of the incumbent Minister of Health of the Nation on the 2030 Agenda, the study carried out and the current perspectives in the pandemic period. The results were analyzed from a comparative standpoint with a Brazilian study, which revealed that most experts agree on the country's potential to meet the goals of the 2030 Agenda. However, in the analysis of the new Minister of Health, there are "the paradoxes of the pandemic" that relate to the opportunity to empower the health system pursuant to the Covid-19 pandemic.

O Brasil cumprirá o ODS 3. 1 da Agenda 2030? Uma análise sobre a mortalidade materna, de 1996 a 2018 / Will Brazil comply with the SDG 3. 1 of the 2030 Agenda? An analysis of maternal mortality, from 1996 to 2018

Resumo O objetivo deste artigo é analisar as possibilidades de cumprimento da Meta 3.1 dos Objetivos de Desenvolvimento Sustentável pelo Brasil, a partir do diagnóstico sobre a situação da mortalidade materna nas Regiões de Saúde (CIR), em 2018, e as principais características desta mortalidade, entre 1996 e 2018, no país. Estudo com duas etapas articuladas: análise bibliográfica sobre a mortalidade materna no Brasil; e pesquisa no Sistema de Informação sobre Mortalidade (SIM). Em 2018, das 450 CIR, 159 apresentaram razão de mortalidade materna (RMM) superior a 70 por 100 mil nascidos vivos (NV). Entre 1996 e 2018, no Brasil, houve redução entre mulheres de 30 a 49 anos. Entretanto, a faixa de 10 a 29 anos permaneceu inalterada ao longo da série. A disseminação dos Comitês de Mortalidade Materna, o Programa de Humanização do Pré-Natal e Nascimento (PHPN), a Política Nacional de Atenção Integral à Saúde da Mulher (PNAISM) e a Rede Cegonha influenciaram melhorias na gravidez tardia, mas, não impactaram a prevenção dos óbitos entre mães jovens. O cumprimento do ODS 3.1 requer: a priorização das CIR com RMM superior a 70,0/100 mil NV; a qualificação dos serviços de pré-natal, com foco na atenção entre mulheres de 10 e 29 anos e nas complicações hipertensivas; a e legalização do aborto.

Abstract This article aims to analyze if it is possible for Brazil to meet the Sustainable Development Goals (SDG) 3.1, based on a diagnosis of the situation of maternal mortality in the Health Regions (HRs) of Brazil, in 2018, and the main characteristics of this mortality between 1996 and 2018 in the country. The study consists of two articulated phases: (i) bibliographical analysis of maternal mortality in Brazil; (ii) study in the Mortality Information System (SIM, in Portuguese). In 2018, from the 450 HRs, 159 showed a maternal mortality rate (MMR) of above 70 per 100,000 live births (LBs). Between 1996 and 2018, in Brazil, there was a reduction among women 30 to 49 years of age. However, in the age group of 10 to 29 years, there was no change during the time studied. The dissemination of the Maternal Mortality Committees, the PHPN, the PNAISM, and the "Stork Network" have all contributed to improvements in late pregnancies; however, they were inefficient at preventing deaths among young mothers. Compliance with SDG 3.1 requires: prioritization of CIR with MMR greater than 70.0/100,000 LB; qualification of prenatal services, focusing on care among women aged 10 to 29 years and hypertensive complications; and legalization of abortion.

Promoção da saúde e qualidade de vida: uma perspectiva histórica ao longo dos últimos 40 anos (1980-2020) / Health promotion and quality of life: a historical perspective of the last two 40 years (1980-2020)

Resumo Este artigo atualiza o texto anterior do autor principal publicado em 2000, revisitando as evidências científicas que reafirmam a contribuição da saúde para a qualidade de vida de indivíduos e populações. Mais do que o acesso a serviços de saúde de qualidade, é necessário enfrentar os determinantes da saúde em toda a sua amplitude, o que requer políticas públicas saudáveis, uma efetiva articulação intersetorial do poder público e a mobilização da população. Os autores revisitam a emergência e o desenvolvimento da promoção da saúde, centrando sua análise nas estratégias mais promissoras para o incremento da qualidade de vida propostas pelo setor saúde, sobretudo em formações sociais com alta desigualdade sociosanitária, como é o caso do Brasil, reforçada pela recente pandemia de COVID-19. É no movimento dos municípios saudáveis e em ações intersetoriais, na saúde em todas as políticas e no enfrentamentos dos determinantes sociais da saúde que tais estratégias se concretizam, através de seus próprios fundamentos e práticas, que estão estreitamente relacionados com as inovações na gestão pública para o desenvolvimento local integrado e sustentável, "vis a vis" a nova Agenda 2030 e seus Objetivos do Desenvolvimento Sustentável (ODS).

Abstract This article updates the previous text of the main author published in 2000, revisiting the scientific evidence that reaffirms the contribution of health to the quality of life of individuals and populations. More than the access to health services of any quality, it is necessary to face determinants of health in its entirety, which requires healthy public policies, an effective intersectoral articulation of public power and mobilization of the population. The authors revisit the emergence and development of health promotion, focusing on the analysis of the most promising health strategies for the increase in quality of life, especially in societies with high social and health inequalities, as in the case of Brazil, reinforced by the recent pandemic of COVID-19. Such strategies were concretized on healthy municipalities and intersectoral actions, in health and in all policies which confront social determinants, through their own foundations and practices that are closely related to innovations in public management for integrated and sustainable local development, in view of the 2030 Agenda and its Sustainable Development Objectives (SDG).

Antibiofilm and anti-inflammatory potential of lignans with collegial effect: Secoisolariciresinol diglucoside and sesamin as antimicrobial sources

Linum usitatissimum (L.), the Flaxseed (FS) and Sesamum indicum (L.), the sesame seeds (SS) are rich sourcesof lignans, secoisolariciresinol diglucoside (SDG), and Sesamin (Sm), respectively. Synergistic effects of theSDG and Sm lignan samples were investigated in the present study, a first of its kind. The high performanceliquid chromatography fingerprint identified the presence of SDG and sesamin in FS and SS. Antimicrobialactivity of SDG+Sm combination by disc diffusion in opposition to Bacillus subtilis, Escherichia coli,Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus significantly arrests growthof the bacteria in comparison to independent use of SDG and Sm. Bacterial biofilm inhibition capacity ofSDG+Sm imaged by confocal laser scanning microscopy revealed the loss of microcolonies. SDG+Sm couldinhibit the 15-LOX and COX-2 enzyme at relatively lower concentrations. Furthermore, SDG+Sm quenchedfree radicals produced by Fenton’s reagent studied by DNA-protection assay indicating its robust antioxidantproperty in protecting the DNA. These results put together encourage the use of a combination of FS and SSseed lignans SDG+Sm in a wide range of applications as natural preservatives with pharmacological effects,such as anti-inflammatory agent and aid, in their promotion as nutraceuticals.

Risk factors and perinatal outcome associated with low birth weight in a prospective cohort: is there a shift towards sustainable developmental goal 3

Background: Low birth weight is a socio, economic, cultural and community based health issue which reflects responsibility and commitment of local and national administrative authorities. It continues to be a cause of short and long term adverse perinatal outcome with a bearing on adult non communicable health risks.Methods: This is a prospective observational and analytic study to know the prevalence, risk factors and perinatal outcome of LBW, from July 2017 to December 2018 in department of Obstetrics and Gynecology, MIMS Medical College, Andhra Pradesh, India. Maternal risk factors and outcomes associated with LBW were defined through risk ratios.Results: 721 infants including 116 LBW and 605 NBW born during study period were included in the study. Prevalence of LBW was 16%. Preterm birth accounted for 35%, FGR for 13.8% and SGA for 51.2% of them. Maternal factors like age <20 years and >35years, social status II to IV, below higher secondary education, house maker, primi gravida, grand multi para, BMI <18.5kg/M2 or >24.9kg/M2, Hb<11 gm% were having higher RR for LBW. LBW infants showed frequent association with oligo or polyhydramnious and hemorrhagic or turbid amniotic fluid. They had higher risks for non reassuring fetal heart rate changes, for induced delivery or an elective caesarean section. More often they needed NICU care for longer duration and showed a higher risk for malformations and neonatal mortality. Overall perinatal mortality was 5.54 per 1000 live birth.Conclusions: LBW is a risk factor for neonatal morbidity and mortality; which can be minimised by institutional delivery. High prevalence PTB (35%) warrants obstetricians to be more vigilant about indentifying the risk factors and adequate management planning. Constitutionally small baby at birth probably needs redefining normal birth weight for different ethnicity.

Mortalidade por acidentes de transporte de trânsito em adolescentes e jovens, Brasil, 1996-2015: cumpriremos o ODS 3. 6? / Mortality by road traffic accidents in adolescents and young people, Brazil, 1996-2015: will we achieve SDG 3. 6?

Resumo O objetivo deste artigo é analisar principais características da mortalidade por ATT no Brasil, 1996-2015, com foco na faixa de 10-29 anos. Estudo com 2 etapas articuladas: (i) revisão bibliográfica sobre o tema violência no trânsito no Brasil; (ii) estudo da mortalidade por ATT no SIM. A primeira situa o estado da arte da produção científica sobre o tema e produz o referencial teórico para a análise da segunda. No período, morreram por ATT cerca de 39.000 pessoas/ano, das quais cerca de 13.200 adolescentes e jovens. Para atingir o ODS 3.6, o país deve reduzir a mortalidade para algo em torno de 19.500/ano e, entre adolescentes e jovens, para 6.500/ano. Com a instituição do CTB houve queda na taxa de mortalidade por ATT entre 1997 e 2000. A taxa aumentou na década posterior. O foco nos adolescentes e jovens ajuda a compreender: no período pós CTB e Lei Seca, motociclistas do sexo masculino, pretos e pardos tornaram-se as principais vítimas. A literatura levantada propicia a análise dos dados e demonstra que a redução passa por uma discussão articulada que envolve políticas de saúde do trabalhador, gênero, emprego, mobilidade urbana e propaganda. Em termos de ODS isto significa que atingir o ODS 3.6 é um processo que envolve a interação com políticas que visem outros ODS.

Abstract This paper aims to analyze the main characteristics of Road Traffic Accidents (RTA) mortality in Brazil for the period 1996-2015, focusing on the 10-29 years' age group. This is a two-step study consisting of (i) a bibliographic review on the topic of traffic violence in Brazil, and (ii) a study on RTA mortality in the Mortality Information System (SIM). The former situates the state of the art of scientific production on the theme and produces the theoretical reference for the analysis of the latter. During the period, about 39,000 people died by RTA, of which about 13,200 adolescents and young people died. The country should curb mortality to somewhere around 19,500/year and, among adolescents and young people, to 6,500/year to achieve SDG 3.6. With the establishment of the Brazilian Traffic Code (CTB), RTA mortality rate fell between 1997 and 2000. The rate increased in the subsequent decade. The focus on adolescents and young people help us understand that, in the post-CTB and Prohibition, male black and brown motorcyclists became the main victims. The literature provides data analysis and shows that reduction is currently submitted to an articulated discussion that involves worker's health, gender, employment, urban mobility and advertising policies. Concerning SDG, this means that achieving SDG 3.6 is a process that involves interacting with policies targeting other SDGs.

Utilization of maternal and neonatal care services in rural Lucknow: a community bases cross sectional study.

Introduction: In India, report says that we failed to achieve the Millennium Development Goals. The maternal mortality rate and infant mortality rate in developing regions are approximately 15 times higher than developed countries. Hence safe delivery and essential newborn care, besides neonatal care in domestic setting and timely referral for cases unmanageable are important areas to be addressed. This study was aimed to assess the current pattern of utilization of maternal and neonatal care services in rural areas of Lucknow. Material and Method: This community based cross sectional study was conducted in between August 2014 to July 2015. Study site was rural area of Lucknow. The study unit was a recently delivered woman, defined as a woman who gave live birth in last one year. A multi stage random sampling technique was used. We uses SPSS version 17 for our statistical analysis. Results: We interviewed 368 RDWs and found that 10.6 % of RDWs did not visit even once to health care facility and almost 62% of registered RDWs were registered early. About 70% RDWs completed at least three ANC visits, 67.7% received complete course of tetanus toxoid and 79.1% received at least one hundred of iron and folic acid (IFA) tablets. Approximately 90% deliveries were conducted by qualified physicians in government institution. There was a clear reduction in facilitating services by health care workers before and after delivery. We found that age less than 30 years, higher socioeconomic strata, educational level higher than matriculation of RDWs were likely to complete their ANC cares and these associations were statistically significant. Conclusion: We are still far away from health for all. To achieve SDG, a multi prong approach is need of hour.

Impact of SDG on blood glucose and blood lipid concentrates of middle and old aged female patients / 国际中医中药杂志

Objective To investigate the influence of SDG on blood glucose and blood lipid concentrates of middle and old aged patients. Methods The impacts of SDG on blood glucose and blood lipid concentrates in body of patients with hyperglycemia were conducted through an 8-week random and double-blind experiments with controlled group only given placebo. The influence degree of SDG on blood glucose and blood lipid concentrates of the selected patients was analyzed. Results The results showed that serum glucose of the groups received 400mg/d of dietary SDG for 8 weeks or 600 mg/d for 4 weeks decreased significantly compared with the controlled group (P<0.05). Conclusion Giving either 400 mg/d of dietary SDG for 8 weeks or 600 mg/d for 4 weeks to patients could significantly decrease the serum glucose concentrates of them.