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Objective Eradication of poverty is Target 1 of the first of eight Millennium Development Goals, which were adopted by world leaders at the United Nations General Assembly in the year 2000. This study aims to explore the influence of political and social context in the achievement of poverty eradication. Methods A retrospective ecological study was carried out to explore associations between progress towards the achievement of Target 1 in 2002 and political and social context variables. The study contained cross-sectional estimates in 1990, 1995, 2000 and 2002. The analysis and observation unit was the countries (n = 88). A descriptive analysis was made, as well as simple and multiple analyses with logistic regression. Findings Of the 88 countries studied, 71 (80.7%) are not on track to achieving the target of eradicating poverty. The factor most associated with non-attainment of this goal was reduced government consumption per capita (odds ratio, OR: 13.8; 95% confidence interval, CI: 2.92DS65.26). In the multiple regression analysis, the most significant factors are: reduced government consumption per capita (OR: 9.8; 95% CI: 1.82DS52.75), losses in the balance between imports and exports (OR: 5.3; 95% CI: 1.32DS21.54) and more inequality in family income (OR: 4.7; 95% CI: 1.12DS20.01). Conclusion Progress towards achievement of Target 1 seems to be hindered, fundamentally, by the significant reduction in government consumption in certain countries and the absence of redistribution policies. To understand the political determinants of poverty, more attention must be paid to the national and international political milieu, which seem to have a relevant impact on this problem and hence on population health. Copyright © 2008 World Health Organization [ABSTRACT FROM AUTHOR]

Issues related to maternal mortality have generated a lot of empirical and theoretical information. However, despite the amount of work published on the topic, maternal mortality continues to occur at high rates and solutions to the problem are still not clear. Scientific research on maternal mortality is focused mainly on clinical factors. However, this approach may not be the most useful if we are to understand the problem of maternal mortality as a whole and appreciate the importance of economical, political and social macrostructural factors. In this paper, we report the number of scientific studies published between 2000 and 2004 about the main causes of maternal death, as identified by WHO, and compare the proportion of papers on each cause with the corresponding burden of each cause. Secondly, we systematically review the characteristics and quality of the papers on the macrostructural determinants of maternal mortality. In view of their burden, obstructed labour, unsafe abortion and haemorrhage are proportionally underrepresented in the scientific literature. In our review, most studies analysed were cross-sectional, and were carried out by developed countries without the participation of researchers in the developing countries where maternal mortality was studied. The main macrostructural factors mentioned were socioeconomic variables. Overall, there is a lack of published information about the cultural and political determinants of maternal mortality. We believe that a high-quality scientific approach must be taken in studies of maternal mortality in order to obtain robust comparative data and that study design should be improved to allow causality between macrostructural determinants and maternal mortality to be shown. Copyright © 2006 World Health Organization [ABSTRACT FROM AUTHOR]

Objective: To describe the adaptation and scaling-up of an intervention to improve the visual health of children in the Apurimac region, Peru., Methods: In a pilot screening programme in 2009-2010, 26 schoolteachers were trained to detect and refer visual acuity problems in schoolchildren in one district in Apurimac. To scale-up the intervention, lessons learnt from the pilot were used to design strategies for: (i) strengthening multisector partnerships; (ii) promoting the engagement and participation of teachers and (iii) increasing children's attendance at referral eye clinics. Implementation began in February 2015 in two out of eight provinces of Apurimac, including hard-to-reach communities. We made an observational study of the processes and outcomes of adapting and scaling-up the intervention. Qualitative and quantitative analyses were made of data collected from March 2015 to January 2016 from programme documents, routine reports and structured evaluation questionnaires completed by teachers., Findings: Partnerships were expanded after sharing the results of the pilot phase. Training was completed by 355 teachers and directors in both provinces, belonging to 315 schools distributed in 24 districts. Teachers' appraisal of the training achieved high positive scores. Outreach eye clinics and subsidies for glasses were provided for poorer families. Data from six districts showed that attendance at the eye clinic increased from 66% (45/68 children referred) in the pilot phase to 92% (237/259) in the implementation phase., Conclusion: Adaptation to the local context allowed the scaling-up of an intervention to improve visual health in children and enhanced the equity of the programme.