1
|
Mohammadi-Nasrabadi F, Ghodsi D, Haghighian-Roudsari A, Esfarjani F, Khoshfetrat MR, Houshialsadat Z, Mohammadi-Nasrabadi M, Fadavi G, Majdzadeh R. Economic Sanctions Affecting Household Food and Nutrition Security and Policies to Cope With Them: A Systematic Review. Int J Health Policy Manag 2023; 12:7362. [PMID: 38618825 PMCID: PMC10590471 DOI: 10.34172/ijhpm.2023.7362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/16/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND This review was conducted to identify the impact of economic sanctions on household food and nutrition security and policies to cope with them in countries exposed to sanctions. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020 were used to identify, select, appraise, and synthesize studies. Electronic databases in addition to Persian ones have been systematically searched for all related documents published until March 2022. Exclusion criteria were: lack of data related to food insecurity in countries subject to sanction and very low quality of the article. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal checklists. The results were presented as qualitative and quantitative syntheses. RESULTS Of 1428 identified studies, 36 publications remained in the review, which belong to Iran (n=8), Cuba (n=8), Russia (n=7), Iraq (n=7), and Haiti (n=6), respectively. Declining gross domestic product (GDP), devaluation of the national currency, and the quality of food, increase in inflation, unemployment, and consumer prices, infant and under 5 years mortality, energy, and protein deficiency, and the poverty rate were reported as sanction consequences. The most important strategies to improve food security were the humanitarian assistance provided by the international community (Haiti), equity and priority for vulnerable groups mainly by expanding the healthcare system (Cuba), adopting a food ration system in the oil-for-food program, and fixing the price of food baskets (Iraq), import substitution and self-sufficiency (Russia), support domestic production, direct and indirect support and compensation packages for vulnerable households (the approach of resistance economy in Iran). CONCLUSION Due to the heterogeneity of studies, meta-analysis was not possible. Since inadequate physical and economic food access caused by sanctions affects especially disadvantaged and vulnerable groups, planning to improve food security and providing support packages for these groups seems necessary.
Collapse
Affiliation(s)
- Fatemeh Mohammadi-Nasrabadi
- Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Haghighian-Roudsari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Esfarjani
- Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Khoshfetrat
- Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Houshialsadat
- School of Public Health, Physiotherapy and Sports Sciences, University College Dublin, Dublin, Ireland
| | - Maryam Mohammadi-Nasrabadi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Fadavi
- Food, Halal and Agricultural Products Research Group, Research Center of Food Technology and Agricultural Products, Standard Research Institute, Karaj, Iran
| | - Reza Majdzadeh
- Interdisciplinary Research and Practice Division, School of Health and Social Care, University of Essex, Colchester, UK
| |
Collapse
|
2
|
Sharma A, Mishra SR, Kaplan WA. Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade. Global Health 2017; 13:61. [PMID: 28830500 PMCID: PMC5568715 DOI: 10.1186/s12992-017-0282-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/28/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Nepal was struck by devastating earthquakes in April-May 2015, followed by the India-Nepal border blockade later that year. METHODS We used the United Nations Commodity Trade Statistics (UN Comtrade) database to analyse exports of various health commodities from India to Nepal from January 2011-September 2016. We used time-series regressions of trading volume vs. unit price to ask how well Nepal's trading history with India prior to the earthquake and blockade was able to predict unit prices of health commodities imported into Nepal during and after the earthquake and the blockade. Regression residuals were used to quantify the extent to which the blockade impacted the price of healthcare commodities crossing into Nepal. RESULTS During the blockade period (September 2015-early February 2016), the volume of all retail medicines traded across the India-Nepal border was reduced by 46.5% compared to same months in 2014-2015. For medical dressings, large volumes were exported from India to Nepal during and shortly after the earthquakes (May-June 2015), but decreased soon thereafter. During the earthquake, the difference between observed and predicted values of unit price (residuals) for all commodities show no statistical outliers. However, during the border blockade, Nepal paid USD 22.3 million more for retail medicines than one would have predicted based on its prior trading history with India, enough to provide healthcare to nearly half of Kathmandu's citizens for 1 year. CONCLUSION The India-Nepal blockade was a geopolitical natural experiment demonstrating how a land-locked country is vulnerable to the vagaries of its primary trading partner. Although short-lived, the blockade had an immediate impact on traded medicine volumes and prices, and provided a large opportunity cost with implications for public health.
Collapse
Affiliation(s)
- Abhishek Sharma
- Precision Health Economics, Boston, MA USA
- Center for Global Health and Development, Department of Global Health, Boston University School of Public Health, Boston, MA USA
| | | | - Warren A. Kaplan
- Center for Global Health and Development, Department of Global Health, Boston University School of Public Health, Boston, MA USA
| |
Collapse
|
3
|
|
4
|
Ollé Goig JE. [Haiti, before and after]. Med Clin (Barc) 2011; 136:549-52. [PMID: 21354579 DOI: 10.1016/j.medcli.2010.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 11/04/2010] [Accepted: 11/09/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Jaime E Ollé Goig
- Asociación Catalana para el Control de la Tuberculosis en el Tercer Mundo (ACTMON), Barcelona, España.
| |
Collapse
|
5
|
|
6
|
Khan FA, Smith BM, Schwartzman K. Earthquake in Haiti: is the Latin American and Caribbean region's highest tuberculosis rate destined to become higher? Expert Rev Respir Med 2010; 4:417-9. [PMID: 20658900 DOI: 10.1586/ers.10.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
7
|
Reid BC, Psoter WJ, Gebrian B, Wang MQ. The effect of an international embargo on malnutrition and childhood mortality in rural Haiti. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2007; 37:501-13. [PMID: 17844931 DOI: 10.2190/mr65-2605-1285-0406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The study objective was to determine the effect of an international embargo against Haiti, from October 1991 through October 1994, on early childhood protein-energy malnutrition and all-cause mortality in a geographic area where humanitarian aid was continuously available to the children in the study. The authors used longitudinal anthropometric records on 1593 children, 24 months old or younger, living in the rural Grand Anse Department of Haiti from 1989 through 1996. Kaplan-Meier graphs for all-cause mortality accounting for malnutrition status and stratified by calendar period were applied to the database and assessed using logrank tests. Adjusted relative risks were assessed by Cox regression. The results show that despite the continuous availability of preventive services (1989-1996), higher all-cause mortality was more strongly associated with a calendar period coinciding with the international embargo than with periods before and after the embargo. The incidence of childhood mortality and of severe malnutrition were also higher during the period of the embargo than in the periods before and after the embargo. The findings suggest that future international sanctions, even those with humanitarian/medical exceptions, could result in substantial infant death.
Collapse
Affiliation(s)
- Britt C Reid
- Epidemiology and Genetics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7324, USA.
| | | | | | | |
Collapse
|
8
|
Mukherjee JS, Eustache FE. Community health workers as a cornerstone for integrating HIV and primary healthcare. AIDS Care 2007; 19 Suppl 1:S73-82. [PMID: 17364390 DOI: 10.1080/09540120601114485] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Haiti is the poorest and most heavily HIV-burdened country in the Western hemisphere, with even less health infrastructure than many countries of sub-Saharan Africa. Since the early 1980s the HIV epidemic has affected the poorest communities in Haiti, who lack access to even basic healthcare. Large-scale HIV treatment requires that basic healthcare services be built and scaled up simultaneously with HIV-prevention and -care programmes. Such improvement in access to general healthcare will require substantial investments in health infrastructure, service delivery and human development. This study describes the contribution of the non-governmental organization, Zanmi Lasante (ZL) to the HIV prevention and treatment scale-up and to the ongoing efforts to improve primary healthcare (PHC) services in the public health system in Haiti. The model depends on community health workers (CHWs) who supervise antiretroviral therapy (ART) and provide community outreach, including active case finding and outreach to marginalized populations. Zanmi Lasante has recruited, trained and financed a large cadre of CHWs to provide such linkages between communities and health centres in rural Haiti. The study analysed key components of their work--their self-perception, their role in enhancing community uptake of services and their role in targeting vulnerable groups. We found that most patients at risk were properly identified at a community level. The CHWs are facilitating the uptake of PHC services, including by the most vulnerable households. The general training of CHWs has created a positive self-definition in these cadres of their medical, patient support and health service roles; although with some variability across different groups. The results of this study will be used to emphasize, standardized and strengthen the biosocial training of CHWs.
Collapse
|
9
|
Butler CD, Corvalan CF, Koren HS. Human Health, Well-Being, and Global Ecological Scenarios. Ecosystems 2005; 8:153-162. [PMID: 32214890 PMCID: PMC7088287 DOI: 10.1007/s10021-004-0076-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2003] [Accepted: 03/17/2004] [Indexed: 10/29/2022]
Abstract
This article categorizes four kinds of adverse effects to human health caused by ecosystem change: direct, mediated, modulated, and systems failure. The effects are categorized on their scale, complexity, and lag-time. Some but not all of these can be classified as resulting from reduced ecosystem services. The articles also explores the impacts that different socioeconomic-ecologic scenarios are likely to have on human health and how changes to human health may, in turn, influence the unfolding of four different plausible future scenarios. We provide examples to show that our categorization is a useful taxonomy for understanding the complex relationships between ecosystems and human well-being and for predicting how future ecosystem changes may affect human health.
Collapse
Affiliation(s)
- Colin D. Butler
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 0200 Australia
| | | | - Hillel S. Koren
- Carolina Environmental Program, University of North Carolinaat Chapel Hill, Chapel Hill, North Carolina 2759-1105 USA
| |
Collapse
|
10
|
Abstract
The issue of overpopulation has fallen out of favor among most contemporary demographers, economists, and epidemiologists. Discussing population control has become taboo. This taboo could be hazardous to public health
Collapse
Affiliation(s)
- Colin D Butler
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
| |
Collapse
|
11
|
|
12
|
Abstract
Health trends over much of the past century have been generally, and notably, positive throughout the world. In several regions, however, life expectancy has declined over the past 1-2 decades. This trend suggests that the expectation that emerged in the 1960s and 1970s of worldwide gains and convergence in population health status is not guaranteed by a general deterministic process. National populations can now be clearly grouped into those that have achieved rapid gains in life expectancy; those whose gains are slower or are perhaps plateauing; and those in which the trends have reversed. Over the past two centuries, outside times of war and famine, such reversals have been rare. Exploration of these varied population health trends elucidates better the close relation between population health and the processes of economic, social, and technological change. Such analysis has shown that the health status of human populations should be a guiding criterion in the debate on sustainable development.
Collapse
Affiliation(s)
- Anthony J McMichael
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia 0200.
| | | | | | | |
Collapse
|
13
|
Smith Fawzi MC, Lambert W, Singler JM, Koenig SP, Léandre F, Nevil P, Bertrand D, Claude MS, Bertrand J, Salazar JJ, Louissaint M, Joanis L, Farmer PE. Prevalence and risk factors of STDs in rural Haiti: implications for policy and programming in resource-poor settings. Int J STD AIDS 2004; 14:848-53. [PMID: 14678595 PMCID: PMC6276366 DOI: 10.1258/095646203322556200] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The goals of the current study are to: (1) estimate the prevalence of sexually transmitted diseases (STDs) among women accessing services at a women's health clinic in rural Haiti; and (2) identify risk factors for STDs in this setting. The design is a case control study, comparing risk factors for women who demonstrated positive laboratory results for chlamydia and/or gonorrhoea to women who tested negative for both of these pathogens. The strongest risk factors for chlamydia and/or gonorrhoea were largely economic variables, with work as a domestic servant increasing the risk by four-fold. Working as a market vendor reduced a woman's risk of having an STD by approximately 45%. Given that economic factors are strongly associated with STD risk in this context, one potential mechanism for reducing the risk of STDs, including HIV, would involve increasing economic opportunities for women in rural Haiti.
Collapse
Affiliation(s)
- M C Smith Fawzi
- Program in Infectious Disease and Social Change, Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Bourguignon E. Faith, Healing and "Ecstasy Deprivation": Secular Society in a New Age of Anxiety. ANTHROPOLOGY OF CONSCIOUSNESS 2003. [DOI: 10.1525/ac.2003.14.1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
15
|
Gastineau Campos N, Farmer P. Partners: discernment and humanitarian efforts in settings of violence. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2003; 31:506-515. [PMID: 14968653 DOI: 10.1111/j.1748-720x.2003.tb00118.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
One hundred years ago, most wars occurred between nations; today, large-scale violent conflict consists almost exclusively of civil wars in which civilians constitute 30 percent of casualties.’ According to a recent World Bank study of conflict, the poorest one-sixth of the worlds population suffers four-fifths of the consequences of civil wars. While poverty is the greatest risk factor determining a nation’s likelihood of entering into conflict, it is also one of instability’s most predictable consequencet—thus, war is a vicious cycle, and poor nations may remain at risk for intense violence for years or even decades.
Collapse
|