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      Family medicine: Global health in practice

      , 1

      Family Medicine and Community Health

      Compuscript

      Family medicine, primary care, global health

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          Abstract

          For nearly 40 years, family medicine has been providing guiding principles in major global health programs. This article has two aims: (1) to review past major global health campaigns with a specific focus on the roles of family medicine to illustrate its relevance in global health, and (2) to address practical approaches to attain health, which nurture sustainability of local health resources and resilience of the community. Regardless of the differences in the goals of past global health campaigns, three key approaches have emerged as essential interventions in the field based on family medicine principles, the so-called six Cs. The key approaches are (1) to protect families, (2) to train health care providers, and (3) to empower people. Family medicine continues to be a powerful tool to improve people’s health in our own communities and in global health practice.

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          Most cited references 13

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          Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970-2010: a systematic analysis of progress towards Millennium Development Goal 4.

          Previous assessments have highlighted that less than a quarter of countries are on track to achieve Millennium Development Goal 4 (MDG 4), which calls for a two-thirds reduction in mortality in children younger than 5 years between 1990 and 2015. In view of policy initiatives and investments made since 2000, it is important to see if there is acceleration towards the MDG 4 target. We assessed levels and trends in child mortality for 187 countries from 1970 to 2010. We compiled a database of 16 174 measurements of mortality in children younger than 5 years for 187 countries from 1970 to 2009, by use of data from all available sources, including vital registration systems, summary birth histories in censuses and surveys, and complete birth histories. We used Gaussian process regression to generate estimates of the probability of death between birth and age 5 years. This is the first study that uses Gaussian process regression to estimate child mortality, and this technique has better out-of-sample predictive validity than do previous methods and captures uncertainty caused by sampling and non-sampling error across data types. Neonatal, postneonatal, and childhood mortality was estimated from mortality in children younger than 5 years by use of the 1760 measurements from vital registration systems and complete birth histories that contained specific information about neonatal and postneonatal mortality. Worldwide mortality in children younger than 5 years has dropped from 11.9 million deaths in 1990 to 7.7 million deaths in 2010, consisting of 3.1 million neonatal deaths, 2.3 million postneonatal deaths, and 2.3 million childhood deaths (deaths in children aged 1-4 years). 33.0% of deaths in children younger than 5 years occur in south Asia and 49.6% occur in sub-Saharan Africa, with less than 1% of deaths occurring in high-income countries. Across 21 regions of the world, rates of neonatal, postneonatal, and childhood mortality are declining. The global decline from 1990 to 2010 is 2.1% per year for neonatal mortality, 2.3% for postneonatal mortality, and 2.2% for childhood mortality. In 13 regions of the world, including all regions in sub-Saharan Africa, there is evidence of accelerating declines from 2000 to 2010 compared with 1990 to 2000. Within sub-Saharan Africa, rates of decline have increased by more than 1% in Angola, Botswana, Cameroon, Congo, Democratic Republic of the Congo, Kenya, Lesotho, Liberia, Rwanda, Senegal, Sierra Leone, Swaziland, and The Gambia. Robust measurement of mortality in children younger than 5 years shows that accelerating declines are occurring in several low-income countries. These positive developments deserve attention and might need enhanced policy attention and resources. Bill & Melinda Gates Foundation. Copyright 2010 Elsevier Ltd. All rights reserved.
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            Social determinants of health inequalities

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              Noncommunicable Diseases

                (2013)
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                Author and article information

                Journal
                FMCH
                Family Medicine and Community Health
                FMCH
                Compuscript (Ireland )
                2009-8774
                2305-6983
                September 2015
                October 2015
                : 3
                : 3
                : 37-40
                Affiliations
                1Family Medicine and Community Health, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106-5036, USA
                Author notes
                CORRESPONDING AUTHOR: Masahiro J. Morikawa, Family Medicine and Community Health, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106-5036, USA, E-mail: mjmkobe@ 123456gmail.com
                Article
                fmch20150126
                10.15212/FMCH.2015.0126
                Copyright © 2015 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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                Self URI (journal page): http://fmch-journal.org/
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