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      Tracing the emergence of drowning prevention on the global health and development agenda: a policy analysis

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      , MBA a , b , * , , Prof, PhD b , c , , Prof, PhD b , c , , MD d , , PhD b , e
      The Lancet. Global Health
      Elsevier Ltd

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          Summary

          Drowning has been a neglected health issue, largely absent from the global health and development discourse, until the UN General Assembly adopted its first resolution on global drowning prevention in 2021. This policy analysis examines the role of issue characteristics, actor power, ideas, and political contexts in the emergence of drowning prevention, and it also identifies opportunities for future actions. We identified three factors crucial to enhancing prioritisation: (1) methodological advancements in population-representative data and evidence for effective interventions; (2) reframing drowning prevention in health and sustainable development terms with an elevated focus on high burdens in low-income and middle-income contexts; and (3) political advocacy by a small coalition. Ensuring that the UN resolution on global drowning prevention is a catalyst for action requires positioning of drowning prevention within global health and sustainable development agendas; strengthening of capacity for multisectoral action; expansion of research measuring burden and identifying solutions in diverse contexts; and incorporation of inclusive global governance, commitments, and mechanisms that hold stakeholders to account.

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          Generation of political priority for global health initiatives: a framework and case study of maternal mortality.

          Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship.
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            Understanding Process Tracing

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              Injury patterns in rural and urban Uganda.

              To describe and contrast injury patterns in rural and urban Uganda. One rural and one urban community in Uganda. Community health workers interviewed adult respondents in households selected by multistage sampling, using a standardized questionnaire. In the rural setting, 1,673 households, with 7,427 persons, were surveyed. Injuries had an annual mortality rate of 92/100,000 persons, and disabilities a prevalence proportion of 0.7%. In the urban setting 2,322 households, with 10,982 people, were surveyed. Injuries had an annual mortality rate of 217/100,000, and injury disabilities a prevalence proportion of 2.8%. The total incidence of fatal, disabling, and recovered injuries was 116/1,000/year. Leading causes of death were drowning in the rural setting, and road traffic in the city. Injuries are a substantial burden in Uganda, with much higher rates than those in most Western countries. The urban population is at a higher risk than the rural population, and the patterns of injury differ. Interventions to control injuries should be a priority in Uganda.
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                Author and article information

                Contributors
                Journal
                Lancet Glob Health
                Lancet Glob Health
                The Lancet. Global Health
                Elsevier Ltd
                2214-109X
                21 April 2022
                July 2022
                21 April 2022
                : 10
                : 7
                : e1058-e1066
                Affiliations
                [a ]Royal Life Saving Society—Australia, Sydney, NSW, Australia
                [b ]Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
                [c ]The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
                [d ]Department of the Social Determinants of Health, Division of UHC/Healthier Populations, World Health Organization, Geneva, Switzerland
                [e ]The George Institute for Global Health, New Delhi, India
                Author notes
                [* ]Correspondence to: Mr Justin-Paul Scarr, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney 2042, NSW, Australia jscarr@ 123456georgeinstitute.org.au
                Article
                S2214-109X(22)00074-2
                10.1016/S2214-109X(22)00074-2
                9197772
                35461520
                2585f192-a347-42dc-92e9-211c75d066b9
                © 2022 World Health Organization

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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                Health Policy

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