830 resultados para assessment of health-care needs


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Climate change affects the fundamental bases of good human health, which are clean air, safe drinking water, sufficient food, and secure shelter. Climate change is known to impact health through three climate dimensions: extreme heat, natural disasters, and infections and diseases. The temporal and spatial climatic changes that will affect the biology and ecology of vectors and intermediate hosts are likely to increase the risks of disease transmission. The greatest effect of climate change on disease transmission is likely to be observed at the extremes of the range of temperatures at which transmission typically occurs. Caribbean countries are marked by unique geographical and geological features. When combined with their physical, infrastructural development, these features make them relatively more prone to negative impacts from changes in climatic conditions. The increased variability of climate associated with slow-moving tropical depressions has implications for water quality through flooding as well as hurricanes. Caribbean countries often have problems with water and sanitation. These problems are exacerbated whenever there is excess rainfall, or no rainfall. The current report aims to prepare the Caribbean to respond better to the anticipated impact of climate change on the health sector, while fostering a subregional Caribbean approach to reducing carbon emissions by 2050. It provides a major advance on the analytical and contextual issues surrounding the impact of climate change on health in the Caribbean by focusing on the vector-borne and waterborne diseases that are anticipated to be impacted directly by climate change. The ultimate goal is to quantify both the direct and indirect costs associated with each disease, and to present adaptation strategies that can address these health concerns effectively to benefit the populations of the Caribbean.

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This report was prepared at the request of the United Nations Economic Commission for Latin America and the Caribbean (ECLAC) with support from the Caribbean Catastrophe Risk Insurance Facility (CCRIF) to assess strategies for linking the ECLAC Damage and Loss Assessment (DaLA) Methology to the Post Disaster Needs Assessment (PDNA). Each metholodolgy was individually outlined and their use in the Caribbean context was explored in detail to set the framework or lens through which their linking would be viewed. Other methologies that are used within the recovery process were identified and outlined. A gap analysis was conducted on moving from the PDNA with a focus on initial rapid reponse to DaLA. DaLA training materials were reviewed to assess where improvements can be made to seamlessly move from one methology to the next. Additionally, both DaLA and PDNA reports were reviewed to identify specific areas of information which could serve as common data links, and note how this linkage could inform the overall disaster assessments in the region. This is in addition to noting any similarities or variance in the application of both methologies. Challenges to linking both methodologies were identified such as countries lacking well defined recovery frameworks and their ability to fund or finance recovery efforts, in addition to recurrent challenges in the Caribbean region such as inadequacy of baseline data, human resource and training, and identifying teams to conduct the data collection. Recommendations made in terms of the strategies to be employed for the successful linking of both the DaLA and PDNA Methodologies included: creating and maintaining a recovery framework and baseline data; creation of a minimum requirements list for the successful implementation of PDNA and DaLA implementation; and increasing political will in addition to identify a champion to push the subject.

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This report analyses the agriculture, health and tourism sectors in Saint Lucia to assess the potential economic impacts of climate change on the sectors. The fundamental aim of this report is to assist with the development of strategies to deal with the potential impact of climate change in Saint Lucia. It also has the potential to provide essential input for identifying and preparing policies and strategies to help advance the Caribbean subregion closer to solving problems associated with climate change and attaining individual and regional sustainable development goals. Some of the key anticipated impacts of climate change for the Caribbean include elevated air and sea-surface temperatures, sea-level rise, possible changes in extreme events and a reduction in freshwater resources. The economic impact of climate change on the three sectors was estimated for the A2 and B2 IPCC scenarios until 2050. An evaluation of various adaptation strategies for each sector was also undertaken using standard evaluation techniques. The key subsectors in agriculture are expected to have mixed impacts under the A2 and B2 scenarios. Banana, fisheries and root crop outputs are expected to fall with climate change, but tree crop and vegetable production are expected to rise. In aggregate, in every decade up to 2050, these sub-sectors combined are expected to experience a gain under climate change with the highest gains under A2. By 2050, the cumulative gain under A2 is calculated as approximately US$389.35 million and approximately US$310.58 million under B2, which represents 17.93% and 14.30% of the 2008 GDP respectively. This result was unexpected and may well be attributed to the unavailability of annual data that would have informed a more robust assessment. Additionally, costs to the agriculture sector due to tropical cyclones were estimated to be $6.9 million and $6.2 million under the A2 and B2 scenarios, respectively. There are a number of possible adaptation strategies that can be employed by the agriculture sector. The most attractive adaptation options, based on the benefit-cost ratio are: (1) Designing and implementation of holistic water management plans (2) Establishment of systems of food storage and (3) Establishment of early warning systems. Government policy should focus on the development of these adaption options where they are not currently being pursued and strengthen those that have already been initiated, such as the mainstreaming of climate change issues in agricultural policy. The analysis of the health sector placed focus on gastroenteritis, schistosomiasis, ciguatera poisoning, meningococal meningitis, cardiovascular diseases, respiratory diseases and malnutrition. The results obtained for the A2 and B2 scenarios demonstrate the potential for climate change to add a substantial burden to the health system in the future, a factor that will further compound the country’s vulnerability to other anticipated impacts of climate change. Specifically, it was determined that the overall Value of Statistical Lives impacts were higher under the A2 scenario than the B2 scenario. A number of adaptation cost assumptions were employed to determine the damage cost estimates using benefit-cost analysis. The benefit-cost analysis suggests that expenditure on monitoring and information provision would be a highly efficient step in managing climate change and subsequent increases in disease incidence. Various locations in the world have developed forecasting systems for dengue fever and other vector-borne diseases that could be mirrored and implemented. Combining such macro-level policies with inexpensive micro-level behavioural changes may have the potential for pre-empting the re-establishment of dengue fever and other vector-borne epidemic cycles in Saint Lucia. Although temperature has the probability of generating significant excess mortality for cardiovascular and respiratory diseases, the power of temperature to increase mortality largely depends on the education of the population about the harmful effects of increasing temperatures and on the existing incidence of these two diseases. For these diseases it is also suggested that a mix of macro-level efforts and micro-level behavioural changes can be employed to relieve at least part of the threat that climate change poses to human health. The same principle applies for water and food-borne diseases, with the improvement of sanitation infrastructure complementing the strengthening of individual hygiene habits. The results regarding the tourism sector imply that the tourism climatic index was likely to experience a significant downward shift in Saint Lucia under the A2 as well as the B2 scenario, indicative of deterioration in the suitability of the island for tourism. It is estimated that this shift in tourism features could cost Saint Lucia about 5 times the 2009 GDP over a 40-year horizon. In addition to changes in climatic suitability for tourism, climate change is also likely to have important supply-side effects on species, ecosystems and landscapes. Two broad areas are: (1) coral reefs, due to their intimate link to tourism, and, (2) land loss, as most hotels tend to lie along the coastline. The damage related to coral reefs was estimated at US$3.4 billion (3.6 times GDP in 2009) under the A2 scenario and US$1.7 billion (1.6 times GDP in 2009) under the B2 scenario. The damage due to land loss arising from sea level rise was estimated at US$3.5 billion (3.7 times GDP) under the A2 scenario and US$3.2 billion (3.4 times GDP) under the B2 scenario. Given the potential for significant damage to the industry a large number of potential adaptation measures were considered. Out of these a short-list of 9 potential options were selected by applying 10 evaluation criteria. Using benefit-cost analyses 3 options with positive ratios were put forward: (1) increased recommended design speeds for new tourism-related structures; (2) enhanced reef monitoring systems to provide early warning alerts of bleaching events, and, (3) deployment of artificial reefs or other fish-aggregating devices. While these options had positive benefit-cost ratios, other options were also recommended based on their non-tangible benefits. These include the employment of an irrigation network that allows for the recycling of waste water, development of national evacuation and rescue plans, providing retraining for displaced tourism workers and the revision of policies related to financing national tourism offices to accommodate the new climate realities.

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This report analyses the agriculture, health and tourism sectors in Jamaica to assess the potential economic impacts of climate change on the sectors. The fundamental aim of this report is to assist with the development of strategies to deal with the potential impact of climate change on Jamaica. It also has the potential to provide essential input for identifying and preparing policies and strategies to help move the Region closer to solving problems associated with climate change and attaining individual and regional sustainable development goals. Some of the key anticipated manifestations of climate change for the Caribbean include elevated air and sea-surface temperatures, sea-level rise, possible changes in extreme events and a reduction in freshwater resources. The economic impact of climate change on the three sectors was estimated for the A2 and B2 IPCC scenarios until 2050. An evaluation of various adaptation strategies was also undertaken for each sector using standard evaluation techniques. The outcomes from investigating the agriculture sector indicate that for the sugar-cane subsector the harvests under both the A2 and B2 scenarios decrease at first and then increase as the mid-century mark is approached. With respect to the yam subsector the results indicate that the yield of yam will increase from 17.4 to 23.1 tonnes per hectare (33%) under the A2 scenario, and 18.4 to 23.9 (30%) tonnes per hectare under the B2 scenario over the period 2011 to 2050. Similar to the forecasts for yam, the results for escallion suggest that yields will continue to increase to mid-century. Adaptation in the sugar cane sub-sector could involve replanting and irrigation that appear to generate net benefits at the three selected discount rates for the A2 scenario, but only at a discount rate of 1% for the B2 scenario. For yam and escallion, investment in irrigation will earn significant net benefits for both the A2 and B2 scenarios at the three selected rates of discount. It is recommended that if adaptation strategies are part of a package of strategies for improving efficiency and hence enhancing competitiveness, then the yields of each crop can be raised sufficiently to warrant investment in adaptation to climate change. The analysis of the health sector demonstrates the potential for climate change to add a substantial burden to the future health systems in Jamaica, something that that will only compound the country’s vulnerability to other anticipated impacts of climate change. The results clearly show that the incidence of dengue fever will increase if climate change continues unabated, with more cases projected for the A2 scenario than the B2. The models predicted a decrease in the incidence of gastroenteritis and leptospirosis with climate change, indicating that Jamaica will benefit from climate change with a reduction in the number of cases of gastroenteritis and leptospirosis. Due to the long time horizon anticipated for climate change, Jamaica should start implementing adaptation strategies focused on the health sector by promoting an enabling environment, strengthening communities, strengthening the monitoring, surveillance and response systems and integrating adaptation into development plans and actions. Small-island developing states like Jamaica must be proactive in implementing adaptation strategies, which will reduce the risk of climate change. On the global stage the country must continue to agitate for the implementation of the mitigation strategies for developed countries as outlined in the Kyoto protocol. The results regarding the tourism sector suggest that the sector is likely to incur losses due to climate change, the most significant of which is under the A2 scenario. Climatic features, such as temperature and precipitation, will affect the demand for tourism in Jamaica. By 2050 the industry is expected to lose US$ 132.2 million and 106.1 million under the A2 and B2 scenarios, respectively. In addition to changes in the climatic suitability for tourism, climate change is also likely to have important supply-side effects from extreme events and acidification of the ocean. The expected loss from extreme events is projected to be approximately US$ 5.48 billion (A2) and US$ 4.71 billion (B2). Even more devastating is the effect of ocean acidification on the tourism sector. The analysis shows that US$ 7.95 billion (A2) and US$ 7.04 billion is expected to be lost by mid-century. The benefit-cost analysis indicates that most of the adaptation strategies are expected to produce negative net benefits, and it is highly likely that the cost burden would have to be carried by the state. The options that generated positive ratios were: redesigning and retrofitting all relevant tourism facilities, restoring corals and educating the public and developing rescue and evacuation plans. Given the relative importance of tourism to the macroeconomy one possible option is to seek assistance from multilateral funding agencies. It is recommended that the government first undertake a detailed analysis of the vulnerability of each sector and, in particular tourism, to climate change. Further, more realistic socio-economic scenarios should be developed so as to inform future benefit-cost analysis.

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This report analyses the agriculture, coastal and human settlements and health sectors in Guyana to assess the potential economic impacts of climate change. The fundamental aim of this report is to assist with the development of strategies to deal with the potential impact of climate change on Guyana. It also has the potential to provide essential input for identifying and preparing policies and strategies to help bring the Caribbean sub-region closer to solving problems associated with climate change and attaining national and regional sustainable development goals. Some of the key anticipated manifestations of climate change for the Caribbean include elevated air and sea-surface temperatures, sea-level rise, possible changes in extreme events and a reduction in freshwater resources. The economic impact of climate change on the three sectors was estimated for the A2 and B2 IPCC scenarios until 2050 (agriculture and health sectors) and 2100 (coastal and human settlements sector). An exploration of various adaptation strategies was also undertaken for each sector using standard evaluation techniques. The study of the impact of climate change on the agriculture sector focused on three leading sub-sectors namely: sugar-cane, rice-paddy and fisheries. In estimating costs, the sugar sub-sector is projected to experience losses under A2 between US$ 144 million (at 4% discount rate) and US$300 million (1% rate); comparative statistics for rice are US$795 million and US$1577 million, respectively; while for fisheries, the results show that losses range from US$15 million (4% rate) and US$34 million (1% rate). In general, under the B2 scenarios, there are gains for sugar up to 2030 under all three discount rates while for rice the performance is somewhat better with gains realized under all three discount rates up to 2040. For fisheries, gains are forecasted under all three rates up to 2050, following marginal losses to 2020. In terms of the benefit-cost analysis conducted on selected adaptation measures under the A2 scenario, there were net benefits for all three commodities under all three discount rates. For the sugar-cane sub-sector these are: drainage and irrigation upgrade, purchase of new machinery for planting and harvesting, developing and replanting climate tolerant sugar-cane. The rice-paddy sub-sector will benefit from adaptive strategies, which include maintenance of drainage and irrigation systems, research and development, as well as education and training. Adaptation in the fisheries sub-sector must include measures such as, mangrove development and restoration and public education. The analysis of the coastal and human settlements sector has shown that based upon exposed assets and population, SLR can be classified as having the potential to create catastrophic conditions in Guyana. The main contributing factor is the concentration of socioeconomic infrastructure along the coastline in vulnerable areas.

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This research paper assesses the likely economic impact of climate change on the health sector in Trinidad and Tobago. The analysis, however, was limited to the economic impact of only a few climate-related diseases1 for which data were available. The approach utilized in this paper makes for easy extrapolation once the data on the other climate-related illnesses become available so that a full impact assessment can be carried out.

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Climate change is considered to be the most pervasive and truly global of all issues affecting humanity. It poses a serious threat to the environment, as well as to economies and societies. Whilst it is clear that the impacts of climate change are varied, scientists have agreed that its effects will not be evenly distributed and that developing countries and small island developing States (SIDS) will be the first and hardest hit. Small island developing States, many of whom have fewer resources to adapt socially, technologically and financially to climate change, are considered to be the most vulnerable to the potential impacts of climate change. An economic analysis of climate change can provide essential input for identifying and preparing policies and strategies to help move the Caribbean closer to solving the problems associated with climate change, and to attaining individual and regional sustainable development goals. Climate change is expected to affect the health of populations. In fact, the World Health Organization (WHO), in Protecting Health from Climate Change (2008), states that the continuation of current patterns of fossil fuel use, development and population growth will lead to ongoing climate change, with serious effects on the environment and, consequently, on human lives and health. Assessing the economics of potential health impacts of climate variability and change requires an understanding of both the vulnerability of a population and its capacity to respond to new conditions. The Intergovernmental Panel on Climate Change (IPCC) defines vulnerability as the degree to which individuals and systems are susceptible to, or unable to cope with, the adverse effects of climate change, including climate variability and extremes (WHO and others, 2003). The United Nations Economic Commission for Latin America and the Caribbean (ECLAC), in collaboration with the Caribbean Community Centre for Climate Change (CCCCC), is pursuing a regional project to ―Review the Economics of Climate Change in the Caribbean‖ (RECCC). The purpose of the project is to assess the likely economic impacts of climate change on key sectors of Caribbean economies, through applying robust simulation modelling analyses under various socio-economic scenarios and carbon emission trajectories for the next 40 years. The findings are expected to stimulate local and national governments, regional institutions, the private sector and civil society to craft and implement policies, cost-effective options and efficient choices to mitigate and adapt to climate change.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Objectives: evaluating the level of information about the examination of uterine cervical cancer and its association with sociodemographic variables in women of a health care unit in the city of Bauru, São Paulo, Brazil. Methods: we conducted a cross-sectional descriptive study with 370 women aged 25 to 59, through structured interviews in their own homes; we used descriptive statistics and the χ2 test. Results: 40.5% of the women had not undergone the Papanicolaou test at the recommended frequency; 58.2% incorrectly defined the test, and 69.5% did not know about the risk factors for the development of cervical cancer; the knowledge about the test showed statistically significant association with schooling and family income of the studied population. Conclusions: women present deficiencies on the proper practice of the Papanicolaou test, on knowledge about the test, risk factors and prevention methods. Therefore, it is necessary to develop primary health actions for the most vulnerable population.

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Ecological processes in tropical forests are being affected at unprecedented rates by human activities. Yet, the continuity of ecological functions like seed dispersal is crucial for forest regeneration. It thus becomes increasingly urgent to be able to rapidly assess the health status of these processes in order to take appropriate management measures. We tested a method to rapidly evaluate seed removal rates on two animal-dispersed tree species, Virola kwatae and V.michelii (Myristicaceae), at three sites in French Guiana with increasing levels of anthropogenic disturbance. We counted fallen fruits, fruit valves, and seeds of each focal fruiting tree in a single 1m2 quadrat, and calculated two indices: the proportion of seeds removed and the proportion of fruits opened by mammals. They both provide an indirect and rapid assessment of frugivore activity. Our results showed a significant decrease in the proportion of removed seeds (16%) and fruits opened (19%) at the most impacted site in comparison with the other two sites (79% for seeds, 60% and 35% for fruits). This testifies to an increased impoverishment of the primate and toucan communities at the disturbed sites. This standardized protocol provides fast information about the health status of the community of seed dispersers and predators and of their seed removal services. It is time- and cost-effective and is not species-specific, allowing comparisons among sites or over time. We suggest using it with the pantropical Myristicaceae and any other capsule-producing family to rapidly assess the health status of seed removal processes across the tropics.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)