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Globally, dietary factors are responsible for about one in five deaths. In many low- and middle-income countries different forms of malnutrition (including obesity and undernutrition) can co-exist within the same population. This double burden of malnutrition is placing a disproportional strain on health systems, slowing progress towards universal health coverage (UHC). Poor nutrition also impedes the growth of local economies, ultimately affecting the global economy. In this article, we argue that comprehensive primary health care should be used as a platform to address the double burden of malnutrition. We use a conceptual framework based on human rights and the Astana Declaration on primary health care to examine existing recommendations and propose guidance on how policy-makers and providers of community-oriented primary health care can strengthen the role of nutrition within the UHC agenda. Specifically, we propose four thematic areas for action: (i) bridging narratives and strengthening links between the primary health care and the nutrition agenda with nutrition as a human rights issue; (ii) encouraging primary health-care providers to support local multisectoral action on nutrition; (iii) empowering communities and patients to address unhealthy diets; and (iv) ensuring the delivery of high-quality promotive, preventive, curative and rehabilitative nutrition interventions. For each theme we summarize the available strategies, policies and interventions that can be used by primary health-care providers and policy-makers to strengthen nutrition in primary health care and thus the UHC agenda. Environ un deces sur cinq dans le monde est du a des facteurs alimentaires. Dans de nombreux pays a faible et moyen revenu, differentes formes de malnutrition (y compris l'obesite et la denutrition) peuvent coexister au sein d'une merme population. Ce double fardeau de malnutrition exerce une pression demesuree sur les systemes de sante, ralentlssant la progression vers une couverture maladle unlverselle (CMU). Une mauvalse alimentation entra ve egalement la crolssance des economies locales, ce qui enfin de compteaffectel'economie mondiale. Dans cet article, nous estimons qu'll est imperatlf d'utillser une approche globale des soins de sante primaires commeplateforme pours'attaquer au double fardeau de la malnutrition. Nous avons employe un cadre conceptuel fonde sur les droits humainset la Declaration d'Astana sur les soins de sante primaires. D'une part pour examiner les recommandations existantes, et d'autre part pour fournir un eclairage sur la maniere dont les legislateurs et les prestataires de soins de sante primaires, implantes au niveau communautaire, peuvent renforcer le role de la nutrition dans le programme de CMU. Nous proposons plusexactementquatre champs d'action: (i) aligner les discours et consolider les liens entre les soins de sante primaires et le programme de nutrition, en integrant ce dernier dans la thematique des droits humains; (ii) encourager les prestataires de soins de sante primaires a soutenlr les Initiatives locales multisectorielles portant sur la nutrition; (iii) donner aux patients et aux collectivites le pouvoir de lutter contre l'alimentation desequilibree; et enfin, (iv) assurer la mise en ceuvre d'interventions de qualite pour la promotion, la prevention, le traitement et la rehabilitation en matiere de nutrition. Pour chaque champ d'action, nous resumons les strategies, politiques et interventions a la disposition des legislateurs et prestataires de soins de sante primaires pour renforcer le role de la nutrition dans les soins de sante primaires et, par consequent, le programme de CMU. Los factores alimentarios son responsables de aproximadamente una de cada cinco muertes en todo el mundo. Diferentes tipos de malnutricion (incluidas la obesidad y la desnutricion) pueden coexistir en la misma poblacion de muchos paises de ingresos bajos y medios. Esta doble carga de la malnutricion esta ejerciendo una presion desproporcionada sobre los sistemas sanitarios, lo que ralentiza los progresos hacia la cobertura sanitaria universal (CSU). Ademas, la mala nutricion dificulta el crecimiento de las economias locales, lo que en ultima instancia afecta a la economia global. En este articulo, se argumenta que la atencion primaria de salud integral se deberia utilizar como plataforma para abordar la doble carga de la malnutricion. Se utiliza un marco conceptual basado en los derechos humanos y en la Declaracion de Astana sobre la atencion primaria de salud para analizar las recomendaciones existentes y proponer directrices sobre como los responsables de formular las politicas y los proveedores de atencion primaria de salud orientada a la comunidad pueden fortalecer la funcion de la nutricion dentro del programa de la CSU. En concreto, se proponen cuatro areas tematicas de accion: (i) narrativas de vinculacion y fortalecimiento de los vinculos entre la atencion primaria de salud y el programa de nutricion en donde la nutricion sea una cuestion de derechos humanos; (ii) alentar a los proveedores de atencion primaria de salud a que apoyen la medida multisectorial local sobre la nutricion; (iii) potenciar a las comunidades y a los pacientes para tratar las dietas poco saludables; y (iv) garantizar la realizacion de intervenciones de nutricion de alta calidad de tipo promocional, preventivo, curativo y de rehabilitacion. Para cada tema se resumen las estrategias, politicas e intervenciones disponibles que los proveedores de atencion primaria de salud y los responsables de formular las politicas pueden utilizar para fortalecer la nutricion en la atencion primaria de salud y, por consiguiente, el programa de la CSU. [phrase omitted], Introduction About one in five deaths globally are attributable to poor diets, making dietary factors responsible for 11 million deaths annually, more than any other risk factors covered by the [...]

The Member States of the World Health Organization (WHO) are committed to achieve quality, equity and dignity for women, newborns and children as reflected in the four World Health Assembly [...]

The authors discuss the Global Health Strategy presented by the European Commission in November 2022. Topics include purpose of the strategy, core issues for the debate on the seminar arranged by the Karolinska Institutet (KI) to contribute to the operalization of the strategy, and the challenge to operationalize the European Union (EU) Global Health Strategy to create integrated and coordinated Systems for One Health across sectors and actors.

Objective: To determine the prevalence of active convulsive epilepsy (ACE) and describe the clinical characteristics and associated factors among a rural Ugandan population., Methods: The entire population in Iganga/Mayuge Health Demographic Surveillance Site (IM-HDSS) was screened using two questions about seizures during a door-to-door census exercise. Those who screened positive were assessed by a clinician to confirm diagnosis of epilepsy. A case control study with the patients diagnosed with ACE as the cases and age/sex-matched controls in a ratio of 1:1 was conducted., Results: A total of 64,172 (92.8%) IM-HDSS residents, with a median age of 15.0 years (interquartile range [IQR]: 8.0-29.0), were screened for epilepsy. There were 152 confirmed ACE cases, with a prevalence of 10.3/1,000 (95% confidence interval [CI]: 9.5-11.1) adjusted for nonresponse and screening sensitivity. Prevalence declined with age, with the highest prevalence in the 0-5 years age group. In an analysis of n = 241 that included cases not identified in the survey, nearly 70% were unaware of their diagnosis. Seizures were mostly of focal onset in 193 (80%), with poor electroencephalogram (EEG) agreement with seizure semiology. Antiepileptic drug use was rare, noted in 21.2% (95% CI: 16.5-25.8), and 119 (49.3%) reported using traditional medicines. History of an abnormal antenatal period (adjusted odds ratio [aOR] 10.28; 95%CI 1.26-83.45; p = 0.029) and difficulties in feeding, crying, breathing in the perinatal period (aOR 10.07; 95%CI 1.24-81.97; p = 0.031) were associated with ACE in children. In adults a family history of epilepsy (aOR 4.38 95%CI 1.77-10.81; p = 0.001) was the only factor associated with ACE., Significance: There is a considerable burden of epilepsy, low awareness, and a large treatment gap in this population of rural sub-Saharan Africa. The identification of adverse perinatal events as a risk factor for developing epilepsy in children suggests that epilepsy burden may be decreased by improving obstetric and postnatal care.