The role of policy in improving diets : experiences from the Pacific obesity prevention in communities food policy project

There is global interest in using multisectoral policy approaches to improve diets, and reduce obesity and non-communicable disease. However, there has been ad hoc implementation, which in some sectors such as the economic sector has been very limited, because of the lack of quality evidence on potential costs and impacts, and the inherent challenges associated with cross-sectoral policy development and implementation. The Pacific Obesity Prevention in Communities food policy project aimed to inform relevant policy development and implementation in Pacific Island countries. The project developed an innovative participatory approach to identifying and assessing potential policy options in terms of their effectiveness and feasibility. It also used policy analysis methodology to assess three policy initiatives to reduce fatty meat availability and four soft drink taxes in the region, in order to identify strategies for supporting effective policy implementation.

Noncommunicable disease prevention and control in Mongolia: a policy analysis

BACKGROUND: Noncommunicable diseases (NCDs) are the major global cause of morbidity and mortality. In Mongolia, a number of health policies have been developed targeting the prevention and control of noncommunicable diseases. This paper aimed to evaluate the extent to which NCD-related policies introduced in Mongolia align with the World Health Organization (WHO) 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. METHODS: We conducted a review of policy documents introduced by the Government of Mongolia from 2000 to 2013. A literature review, internet-based search, and expert consultation identified the policy documents. Information was extracted from the documents using a matrix, mapping each document against the six objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs and five dimensions: data source, aim and objectives of document, coverage of conditions, coverage of risk factors and implementation plan. 45 NCD-related policies were identified. RESULTS: Prevention and control of the common NCDs and their major risk factors as described by WHO were widely addressed, and policies aligned well with the objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. Many documents included explicit implementation or monitoring frameworks. It appears that each objective of the WHO 2008-2013 NCD Action Plan was well addressed. Specific areas less well and/or not addressed were chronic respiratory disease, physical activity guidelines and dietary standards. CONCLUSIONS: The Mongolian Government response to the emerging burden of NCDs is a population-based public health approach that includes a national multisectoral framework and integration of NCD prevention and control policies into national health policies. Our findings suggest gaps in addressing chronic respiratory disease, physical activity guidelines, specific food policy actions restricting sales advertising of food products, and a lack of funding specifically supporting NCD research. The neglect of these areas may hamper addressing the NCD burden, and needs immediate action. Future research should explore the effectiveness of national NCD policies and the extent to which the policies are implemented in practice.

Hibridismos regulatórios: uma análise do processo de agencificação no saneamento básico brasileiro

O presente trabalho tem por objetivo entender como os fatores contextuais têm influenciado o processo de transferência do modelo de agência reguladora independente (ARI) no setor de saneamento básico brasileiro. Devido à divergência existente entre estes fatores contextuais, verificou-se que estão surgindo, pelo país, modelos distintos de ARIs. Sendo assim, a contribuição empírica desta dissertação está em, além de apresentar os fatores envolvidos na transferência do modelo, identificar os tipos de ARIs resultantes das divergências contextuais no saneamento básico. Estes modelos são: (i) ARI Estadual multissetorial, (ii) ARI estadual exclusiva de saneamento básico, (iii) ARI Municipal, (iv) ARI Regional ou Consorciada e (v) Buro/regulocracia. Entretanto, para chegar a estes resultados, foi necessário construir um modelo teórico que superasse as restrições existentes na literatura de policy transfer. Para tanto, esta teoria foi utilizada em conjunto com o path dependence, uma vez que, após as primeiras pesquisas no setor, verificou-se uma forte influência das variáveis históricas sobre o saneamento. Nesta interseção consiste a contribuição teórica deste trabalho, uma vez que, com a integração de elementos do path dependence na literatura de policy transfer foi possível romper com uma das principais limitações desta teoria: a unidirecionalidade da transferência.

Expectations and industrial output in Uruguay: Sectoral interdependence and common trends

This paper examines the interdependence between expectations and growth by analysing Uruguayan manufacturing industry, divided for the purpose into four industry groupings differentiated by trade participation and production specialization. The study shows that there is a long-run relationship between industrialists' expectations and output growth in each grouping. In the most trade-oriented groupings the relationship is one of predetermination, showing how useful expectations are as a guide to sectoral growth. Expectations in the four industrial groupings are shown to follow a common long-run trend, identified with the one guiding the export grouping. Impulse-response simulations derived from a multisectoral vector autoregression (VAR) model confirm the important role of the industries most exposed to international competition in spreading shorter-term shocks.

Monetary and Exchange Rate Policy in Multisectorial Economies

We develop a two-sector economy where each sector is classified as classical/Keynesian (contract/noncontract) in the labor market and traded/nontraded in the product market. We consider the effects of changes in monetary and exchange rate policy on sectoral and aggregate prices and outputs for different sectoral characterizations. Duca (1987) shows that nominal wage rigidity facilitates the effectiveness of monetary policy even in the classical sector. We demonstrate that trade price rigidity provides a similar path for the effectiveness of monetary policy, in this case, even when both sectors are classical.

Promoción de salud para la generación de entornos saludables en un barrio vulnerable: el caso de Las Remudas, Gran Canaria

Las desigualdades sociales en salud se reflejan también en la segregación espacial de barrios que concentran desventajas estructurales generando entornos poco saludables. Este estudio describe las acciones y estrategias desarrolladas, dentro de un proceso de intervención socio-comunitaria en salud, para mejorar el entorno de un barrio desfavorecido y la percepción vecinal de las transformaciones vividas. Metodología: Se construye un estudio de caso a partir de entrevistas semiestructuradas a informantes clave. Resultado: los informantes reconocen la transformación del entorno en aspectos urbanísticos, ambientales y sociales y la importancia de su participación en ello. La apertura de nuevos comercios o la disminución de la criminalidad son indicadores objetivos de esta mejora. Conclusión: Las intervenciones de promoción de salud para mejorar el entorno deben considerar su multidimensionalidad y, por tanto, su abordaje multisectorial a través de metodologías participativas que involucren a los diversos actores sociales.

Evaluation report of the training course on disaster assessment methodology

The Economic Commission for Latin America and the Caribbean (ECLAC) has been a pioneer in the field of disaster assessment and in the development and dissemination of the Disaster Assessment Methodology. The organization’s history in assessing disasters started in 1972 with the earthquake that struck Managua, Nicaragua. Since then, ECLAC has led more than 90 assessments of the social, environmental and economic effects and impacts of disasters in 28 countries in the region. The Sustainable Development and Disaster Unit provides expert assistance in disaster assessment and disaster risk reduction to Caribbean states and to all countries across Latin America. Considering that assessing the effects and impacts of disasters is critical to the Latin American and Caribbean countries, the Unit has started a new cycle of training courses. The training is designed for policymakers and professionals involved directly with disaster risk management and risk reduction. Additionally, and since the methodology is comprehensive in approach, it is also designed for sector specialists, providing a multisectoral overview of the situation after a disaster, as well as an economic estimate of the damages, losses and additional costs. In an attempt to strengthen disaster risk reduction through its financial instruments, the National Bank for Economic and Social Development (BNDES for its acronym in Portuguese) of Brazil requested that ECLAC undertake a four-day training programme on the Disaster Assessment Methodology.

Economic reform, allocative effiency and terms of trade

It has widely been agreed that the distorted price system is one of the causes of inefficient ecooomic decisions in centrally planned economies. The paper investigates the possible effect of a price reform on the allocation of resources in a situation where micro-efficiency remains unchanged. Foreign trade and endogenously induced terms-of-trade changes are focal points ín the multisectoral applied general equilibrium analysis. Special attention is paid to some methodological problems connected to the representation of foreign trade in such models. The adoption of Armington's assumption leads to an export demand function and this in turn gives rise to the question of optimal export structure, different from the equilibrium one-an aspect so far neglected in the related literature. The results show, that the applied model allows for a more flexible handling of the overspecialization problem, than the linear programming models. It also becomes evident that the use of export demand functions brings unwanted terms-of-trade changes into the model, to be avoided by a suitable reformulation of the model. The analysis also suggests, that a price reform alone does not significantly increase global economic efficiency. Thus the effect of an economic reform on micro-efficiency appears to be a more crucial factor. The author raises in conclusion some rather general questions related to the foreign trade practice of small open economies.

Adaptability of nonlinear equilibrum models to central planning

Linear multisectoral models have for long been applied in the Hungarian national economic planning. Price-quantity correspondences and interaction, however, cannot easily be taken into account in the traditional linear framework. Computable general equilibrium modelers in the West have developed techniques which use extensively price-quantity interdependences. However, since they are usually presented with the controversial strict neoclassical interpretation, the possibility of their adaptation to socialist planning models has been concaled. This paper reflects on some results of a research investigating the possible adaptation of eqailibrium modeling techniques to central planning models.

The issue of macroeconomic closure revisited and extended

Léon Walras (1874) already had realized that his neo-classical general equilibrium model could not accommodate autonomous investment. Sen analysed the same issue in a simple, one-sector macroeconomic model of a closed economy. He showed that fixing investment in the model, built strictly on neo-classical assumptions, would make the system overdetermined, thus, one should loosen some neo-classical condition of competitive equilibrium. He analysed three not neo-classical “closure options”, which could make the model well determined in the case of fixed investment. Others later extended his list and it showed that the closure dilemma arises in the more complex computable general equilibrium (CGE) models as well, as does the choice of adjustment mechanism assumed to bring about equilibrium at the macro level. By means of numerical models, it was also illustrated that the adopted closure rule can significantly affect the results of policy simulations based on a CGE model. Despite these warnings, the issue of macro closure is often neglected in policy simulations. It is, therefore, worth revisiting the issue and demonstrating by further examples its importance, as well as pointing out that the closure problem in the CGE models extends well beyond the problem of how to incorporate autonomous investment into a CGE model. Several closure rules are discussed in this paper and their diverse outcomes are illustrated by numerical models calibrated on statistical data. First, the analyses is done in a one-sector model, similar to Sen’s, but extended into a model of an open economy. Next, the same analyses are repeated using a fully-fledged multisectoral CGE model, calibrated on the same statistical data. Comparing the results obtained by the two models it is shown that although, using the same closure option, they generate quite similar results in terms of the direction and – to a somewhat lesser extent – of the magnitude of change in the main macro variables, the predictions of the multi-sectoral CGE model are clearly more realistic and balanced.

Gestão e desenvolvimento regional na ride/DF: corsap-DF/GO como modalidade de associativismo territorial

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Geografia, Programa de Pós-Graduação em Geografia, 2015.

Relatório de Estágio de Intervenção Comunitária

O presente Relatório reflete o percurso desenvolvido durante o estágio, realizado na Escola Secundária Mouzinho da Silveira, visando o desenvolvimento de competências de Enfermeira Especialista em Enfermagem Comunitária e tendo por base o Diagnóstico de Situação da Saúde dos adolescentes das turmas de 7º e 8º ano, no ano letivo de 2012/2013 e a implementação de um Projeto de Intervenção. O projeto desenvolvido insere-se no âmbito da Promoção da Saúde e Prevenção de comportamentos de risco na adolescência. Os adolescentes são considerados pela OMS, como um grupo que vivencia grandes mudanças a nível físico, psicológico, familiar e social sendo suscetíveis ao desenvolvimento de comportamentos de risco que se poderão perpetuar no futuro. É com base neste raciocínio, que se torna essencial uma intervenção multissectorial, planeada entre os profissionais dos vários contextos em que os adolescentes se inserem, especialmente no contexto escolar onde estes passam muito do seu tempo. O estágio, centrou-se nos hábitos de vida dos adolescentes, ou seja, conhecer os comportamentos de risco que os adolescentes praticam diariamente e através desses dados, programar um projeto de intervenção com vista à promoção de hábitos de vida saudáveis. Para isso, foram desenvolvidas várias atividades, nomeadamente reuniões com os docentes dado que, estes são elementos chave neste processo pela convivência e partilha de experiencias diárias com os adolescentes, e sessões de educação para a saúde. Na realização da intervenção foi utilizada a Metodologia do Planeamento em Saúde e as sessões de educação para a saúde sustentaram-se na Teoria da Aprendizagem Social de Bandura. Foram abrangidos 232 adolescentes, num total de 269, (no momento da aplicação do questionário) na Intervenção de Promoção de Hábitos de Vida Saudáveis dos adolescentes. Nesta intervenção obtivemos mais de 95.5% dos questionários respondidos com posicionamento na escala de satisfação na categoria de Satisfeito ou mais. Este relatório retrata o papel do Enfermeiro Especialista em Saúde Comunitária, que através das suas competências específicas, adequa as práticas, aplica um Planeamento em -Saúde eficaz, mobiliza os recursos comunitários e as equipas, na busca da excelência nos cuidados de Enfermagem prestados e de ganhos de Saúde da comunidade.

Noncommunicable disease prevention and control in Mongolia: a policy analysis

Background: Noncommunicable diseases (NCDs) are the major global cause of morbidity and mortality. In Mongolia, a number of health policies have been developed targeting the prevention and control of noncommunicable diseases. This paper aimed to evaluate the extent to which NCD-related policies introduced in Mongolia align with the World Health Organization (WHO) 2008– 2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs.

Methods: We conducted a review of policy documents introduced by the Government of Mongolia from 2000 to 2013. A literature review, internet-based search, and expert consultation identified the policy documents. Information was extracted from the documents using a matrix, mapping each document against the six objectives of the WHO 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs and five dimensions: data source, aim and objectives of document, coverage of conditions, coverage of risk factors and implementation plan. 45 NCD-related policies were identified.

Results: Prevention and control of the common NCDs and their major risk factors as described by WHO were widely addressed, and policies aligned well with the objectives of the WHO 2008– 2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. Many documents included explicit implementation or monitoring frameworks. It appears that each objective of the WHO 2008– 2013 NCD Action Plan was well addressed. Specific areas less well and/or not addressed were chronic respiratory disease, physical activity guidelines and dietary standards.

Conclusions: The Mongolian Government response to the emerging burden of NCDs is a population-based public health approach that includes a national multisectoral framework and integration of NCD prevention and control policies into national health policies. Our findings suggest gaps in addressing chronic respiratory disease,physical activity guidelines, specific food policy actions restricting sales advertising of food products, and a lack of funding specifically supporting NCD research. The neglect of these areas may hamper addressing the NCD burden, and needs immediate action. Future research should explore the effectiveness of national NCD policies and the extent to which the policies are implemented in practice.