This study examines the importance of nutrition in the context of Sustainable Development Goal (SDG) 2 (Zero Hunger) and its contribution to advancing other SDGs in the Democratic Republic of Congo (DRC). Using a participatory and semi-quantitative approach, 35 experts from various fields assessed nutrition's impact on SDGs linked to health, education, economic stability, and climate resilience. SDG 2 strongly enhances SDGs such as SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 13 (Climate Action). Good nutrition reduces poverty. Conversely, SDG 2 is strongly influenced by several SDGs, including SDG 1 (No poverty), SDG 8 (decent work and Economic Growth), SDG 14 (Life Below Water), SDG 15 (Life on Land), and SDG 16 (Peace, Justice and Strong Institutions). This study underscores the interconnections of the SDGs and the potential of nutrition to drive progress across other SDGs, fostering sustainable and resilient growth. Future research should expand on these insights by employing longitudinal and quantitative approaches to monitor evolving SDG interactions. There is a necessity for a system-centered, nutrition-first policy approach in the DRC, acknowledging SDG 2 as both a promoter and a beneficiary of a comprehensive sustainable development.

Uganda’s climate is changing with an increase in the frequency and intensity of extreme weather events including droughts, floods, heatwaves, and landslides, with potential impact on health systems. This study documented how these events have impacted health systems and their resilience in three highly vulnerable districts of Bududa, Kasese and Moroto in Uganda, to inform strategies for building climate-resilient health systems in sub-Saharan Africa and similar settings. This study employed a case study approach using qualitative interviews among key informants who were purposively selected. A total of 55 interviews were conducted among stakeholders at the national and district levels as well as non-governmental organizations, including health and non-health officers, health workers, program managers, directors or unit heads. Interviews were audio-recorded and transcribed verbatim. Study transcripts were deductively coded considering the impacts on the health system and adaptation measures in line with the World Health Organization’s Operational framework for climate-resilient and low-carbon health systems. Study quotations were added to supplement the study findings. The study established that landslides, floods, and droughts impacted health systems in the three districts through difficulty coordinating multiple players during response, causing injuries and deaths among health workers, damaging infrastructure, drugs, and information systems. These impacts affected health services delivery. To adapt, the health system employed several strategies including instituting policies, early warning systems, capacity building for health workers, and increasing stock of medicines and supplies at district stores. The other mechanisms were improving water and sanitation at facilities, relocating some facilities, engaging the community on potential diseases and risks, and mobilizing funding to support response. Overall, factors such as a clear policy framework including mechanisms for stakeholder coordination, political will, availability of resources and health workers, high community engagement, and robust surveillance and strong early warning systems were key enablers for the health system adaptation. Extreme weather events impacted all facets of the health system, and districts undertook various mechanisms to deal with them. These lessons should be integrated into strengthening the capacity of health systems to anticipate, respond to, cope with, and recover from extreme weather events.

Background The challenges that the world faces to ensure good life for future generations are vast and complex. The United Nations Sustainable Development Goals (SDGs) aim to meet these challenges. A growing number of higher education institutions have integrated them within their curricula, but there are indications that health professional education has been lagging behind. Therefore, it is important to better understand the views of students in health professional education on the level and depth of their education on sustainable development. Methods This sequential exploratory mixed methods study was based on survey responses from N = 294 nursing ( N = 137) and medical ( N = 157) students of first and last semesters from three Swedish universities. From the full group of survey responders, 21 students participated in 5 focus group discussions (FGDs) and 9 individual interviews. The survey findings were summarized through descriptive statistics and the interviews and FGDs were analyzed by qualitative content analysis. Results The survey findings showed that most students (63%) perceived that they had not learned enough about the SDGs and Agenda 2030 during their education, or for the purposes of their future career. Most of the students (63%) also thought that Agenda 2030 and the SDGs should be a greater part of their education. The qualitative data gave a more in-depth understanding of the quantitative findings, forming two themes: The first theme revealed that the SDGs may be more relevant for health care practice than what the students initially thought, but that the education they had received was in most places superficial, or not tied to the SDGs. The second theme detailed what and how students wished to learn more about. Here, they called for a more in-depth understanding of how to promote equality, equity, inclusion and psychosocial aspects in health care. They also hoped for more knowledge about how to ensure a sustainable working life for themselves. Conclusions Nursing and medical students at three Swedish universities experience that they lack the knowledge necessary to face sustainability challenges they encounter in working life and give some suggestions about how this may be improved in future education.

Climate change poses significant risks to the health and well-being of pregnant women and children. These groups are uniquely vulnerable to climate change events due to their changing physiology, behavioural patterns and dependence on family and caregivers. Climate change leads to a range of impacts such as intensification of extreme heat and weather events, spread of infectious diseases as well as ambient air pollution and allergens. This leads to a variety of health risks for pregnant women and children, from pregnancy complications such as preeclampsia and preterm birth to increased risk of infant and child mortality. The impact of climate change is not equally distributed. Vulnerable pregnant women and children, especially those in disadvantaged communities or with comorbidities, are at greatest risk. Climate-related hazards worsen existing disparities, affecting food security, water resources, and vital health infrastructure. Addressing these issues requires a comprehensive approach to mitigate and adapt to climate change impacts, reduce vulnerabilities, and strengthen protective systems for pregnant women and children.

Despite decades of global efforts to reduce under five mortality, 5 million children die before their fifth birthday. Numerous landmark reports have called for integrated approaches to further accelerate reductions, yet interventions are often delivered in silos and, to our knowledge, no global synthesis of the evidence for integrated preventive systems exists. We conducted a scoping review to map the existing literature on systems of well-care visits for children under five years from 2000 to 2023 globally. A systematic search of relevant databases (MEDLINE, the Cochrane Library, Web of Science, and OVID Global Health) was conducted. In total, 8,945 unique documents were identified and after screening titles and abstracts, a total of 1587 articles were assessed for eligibility through full-text review. The information was extracted based on the WHO’s established health system framework, and from these pillars, a conceptual framework was derived on the components and the potential impact on child health care. We found 322 eligible articles (217 primary articles, 105 reviews). Among the primary articles, close to 50

Background Climate change is one of the most complex and important health threats of the 21st century. The knowledge of the impact of climate change on health is expanding rapidly. However, there has been no comprehensive assessment of the impact of climate change on the interlinked pregnancy, perinatal and infant periods. Hence, the objective of this study was to provide an overview of the effects of changing weather and climate hazards on maternal and infant health during pregnancy, the perinatal period and infancy.Methods We conducted a systematic review of peer-reviewed original articles and reviews found in PubMed, Web of Science, Embase, Cochrane, Global Health and WHO regional databases on the subject between January 2000 and May 2025. The included articles were in the English language, detailed exposure to climate change hazards during pregnancy, the perinatal period and up to 1 year of age in the child, with an outcome related to health.Results In total, 596 reviews and original articles were included in the analysis. Our findings demonstrate large differences in the number and types of studies for each climate-related hazard. Direct health effects from rising temperatures and extreme weather events, as well as indirect health effects such as infectious diseases, food insecurity, forced migration and socioeconomic changes due to climate change, have clear negative consequences for pregnant women and infants.Conclusions There is a large evidence base showcasing the harmful impact of climate change on pregnant women and infants through a variety of pathways. Action is urgently needed at all levels to address climate change and there is a need to implement large-scale mitigation and adaptation efforts that protect the health and well-being of pregnant women and infants everywhere.

Cambodia has made progress in reducing the under-five mortality rate and burden of infectious diseases among children over the last decades. However the determinants of child mortality and morbidity in Cambodia is not well understood, and no recent analysis has been conducted to investigate possible determinants. We applied a multivariable logistical regression model and a conditional random forest to explore possible determinants of under-five mortality and under-five child morbidity from infectious diseases using the most recent Demographic Health Survey in 2021-2022. Our findings show that the majority (58%) of under-five deaths occurred during the neonatal period. Contraceptive use of the mother led to lower odds of under-five mortality (0.51 [95% CI 0.32-0.80], p-value 0.003), while being born fourth or later was associated with increased odds (3.25 [95% CI 1.09-9.66], p-value 0.034). Improved household water source and higher household wealth quintile was associated with lower odds of infectious disease while living in the Great Lake or Coastal region led to increased odds respectively. The odds ratios were consistent with the results from the conditional random forest. The study showcases how closely related child mortality and morbidity due to infectious disease are to broader social development in Cambodia and the importance of accelerating progress in many sectors to end preventable child mortality and morbidity.

Background The Sustainable Development Goals (SDGs) adopted in 2015 compromises 17 universal and indivisible goals for sustainable development, however the interactions between the SDGs in Somalia is not known which is vital for understanding potential synergies and trad-offs between the SDGs. Hence, this study aims to identify and classify the linkages between the SDGs with a focus on health and well-being (SDG 3) in Somalia. Methods Following the SDG Synergies approach, 35 leading experts from the public and private sectors as well as academia and civil society gathered for a 2-day workshop in Mogadishu and scored the interactions between the individual SDGs on a seven point-scale from − 3 to + 3. From this, a cross-impact matrix was created, and network models were used to showcase the direct and indirect interactions between the SDGs with a focus on SDG 3 (good health and well-being). Results Many promoting and a few restricting interactions between the different SDGs were found. Overall, SDG 16 (peace, justice, and strong institutions) influenced the other SDGs the most. When second-order interactions were considered, progress on SDG 16 (peace, justice, and strong institutions) showed the largest positive impact on SDG 3 (good health and well-being). SDG 3 (good health and well-being) was heavily influenced by progress on other SDGs in Somalia and making progress on SDG 3 (good health and well-being) positively influenced progress on all other SDGs. Conclusion The findings revealed that in Somalia, the interactions between the SDGs are mostly synergistic and that SDG 16 (peace, justice, and strong institutions) has a strong influence on progress on other SDGs as well as progress on SDG 3 (good health and well-being). This study highlights the need for a multisectoral strategy to accelerate progress on the SDGs in Somalia in general, and particularly SDG 3 (good health and well-being).

Introduction While Uganda has made significant strides towards the 2030 Agenda, several development challenges persist, including a high disease burden, poverty and the effects of climate change. Multisectoral collaboration is critical in achieving Uganda’s Sustainable Development Goals (SDGs); however, most sectors in the country still operate in isolation. Understanding the linkages between the goals in Uganda is critical for accelerating progress on health and the SDGs. This study aimed at taking initial steps in investigating the linkages between health and other SDGs in Uganda.Methods A 2-day workshop with 29 multisectoral stakeholders was conducted to explore the nature of linkages between the SDGs nationally in Uganda. Results were analysed using the SDG synergies approach and presented using a cross-impact matrix to show the nature and strength of linkages between the goals.Results Overall, there were more positive linkages between the SDGs than negative ones. Progress on SDG 10 (reduced inequalities) was considered to have the most positive influence on the 2030 Agenda. SDG 3 (good health and well-being) was the goal that was perceived to be most positively affected if progress was made on other goals. The economic goals, SDG 8 (decent work and economic growth) and SDG 9 (industry, innovation and infrastructure) were the goals that promoted other goals the least. Negative linkages were perceived between SDG 13 (climate action) and the economic goals (SDG 8; SDG 9).Conclusion The findings reveal that promoting linkages were perceived to be the majority, but some restricting linkages between the SDGs also exist. The promoting linkages suggest a need for integrated approaches in attaining SDG 3 and other SDGs in Uganda. Further addressing inequalities in their different forms, policy reforms, local community engagements and continuous monitoring are critical for sustainable development in Uganda.

Background In 2015, the United Nations adopted the 2030 Agenda for Sustainable Development, including the 17 Sustainable Development Goals (SDGs). Higher education institutions have a role in raising awareness and building skills among future professionals for implementing the SDGs. This review describes how the SDGs have been integrated into higher education globally. Objectives Determine how have the SDGs been integrated into higher education globally. Describe the differences in the integration of the SDGs in higher education across high-income countries (HICs) and low- and middle-income countries (LMICs). Methods Following a scoping review methodology, we searched Medline, Web of Science, Global Health, and Educational Resources Information Center, as well as websites of key institutions including universities, identifying peer-reviewed articles and grey literature published between September 2015 and December 2021. Results We identified 20 articles and 38 grey literature sources. Since 2018, the number of publications about the topic has been increasing. The SDGs were most frequently included in bachelor-level education and disciplines such as engineering and technology; humanities and social sciences; business, administration, and economics. Methods of integrating the SDGs into higher education included workshops, courses, lectures, and other means. Workshops and courses were the most frequent. The methods of integration varied in high-income countries compared to low- and middle-income countries. High-income countries seemed to follow a more academic approach to the SDGs while low- and middle-income countries integrate the SDGs with the aim to solve real-world problems. Conclusion This study provides examples of progress in integrating the SDGs into higher education. Such progress has been skewed to high-income countries, bachelor-level initiatives, and certain disciplines. To advance the integration of the SDGs, lessons learned from universities globally should be shared broadly, equitable partnerships formed, and students engaged, while simultaneously increasing funding for these processes.

Objectives Multisectoral collaboration highlighted as key in delivering on the Sustainable Development Goals (SDGs), but still little is known on how to move from rhetoric to action. Cambodia has made remarkable progress on child health over the last decades with multisectoral collaborations being a key success factor. However, it is not known how country stakeholders perceive child health in the context of the SDGs or multisectoral collaborations for child health in Cambodia.Design, settings and participants Through purposive sampling, we conducted semistructured interviews with 29 key child health stakeholders from a range of government and non-governmental organisations in Cambodia. Guided by framework analysis, themes, subthemes and categories were derived.Results We found that the adoption of the SDGs led to increased possibility for action and higher ambitions for child health in Cambodia, while simultaneously establishing child health as a multisectoral issue among key child stakeholders. There seems to be a discrepancy between the desired step-by-step theory of conducting multisectoral collaboration and the real-world complexities including funding and power dynamics that heavily influence the process of collaboration. Identified success factors for multisectoral collaborations included having clear responsibilities, leadership from all and trust among stakeholders while the major obstacle found was lack of sustainable funding.Conclusion The findings from this in-depth multistakeholder study can inform policy-makers and practitioners in other countries on the theoretical and practical process as well as influencing aspects that shape multisectoral collaborations in general and for child health specifically. This is vital if multisectoral collaborations are to be successfully leveraged to accelerate the work towards achieving better child health in the era of the SDGs.

A systematic and contextualized assessment of the interactions between the Sustainable Development Goals and health in the Democratic Republic of Congo is currently lacking. This study aimed to characterize and classify the linkages between the Sustainable Development Goals in the DRC with a focus on health and well-being. In this semi-qualitative participatory study, 35 experts assessed 240 interactions between 16 of the 17 SDGs during a two-day workshop in Kinshasa, Democratic Republic of the Congo, using a scale from +3 (strongly promoting) to −3 (strongly restricting). SDG 16 (Peace, justice, and strong institutions) had the strongest promoting influence on other goals and was identified as a key priority for the DRC to attain the SDGs. Progress on SDG 3 (good health and well-being) was perceived as promoting progress on most SDGs, and through second-order interactions, a positive feedback loop was identified. Furthermore, progress on the other SDGs was deemed to promote progress on SDG 3, with SDG 16 having the greatest positive potential when second-order interactions were taken into account. Our results show the importance of recognizing synergies and trade-offs concerning the interactions between health and other SDGs and that it is imperative to set up structures bringing together different sectors to accelerate work towards achieving the 2030 Agenda.

Sustainable health , a multisectoral area for study, research, and practice towards improving health and well-being for all while staying within planetary boundaries, is a prerequisite to reaching the 2030 agenda and the work and journey towards a world in which everyone, everywhere can live a healthy and fulfilled life.

Children are bearing and will continue to bear a high burden from climate change, through direct and indirect pathways. Climate change adaptation interventions are essential to limit the current and projected impacts of climate change on child health. However, the perspective of children and their health with regards to adaptation in research and policy is limited. Ensuring that adaptation interventions are context specific, consider interrelated barriers to implementation and leverage existing structures including multisectoral collaboration is vital. Further, a life-course perspective on child health and well-being could serve as a template for tailoring adaptation interventions to the specific vulnerabilities and needs of specific development periods of the child. A meaningful engagement of children and young persons in the design and implementation of adaptation interventions is essential to increase effectiveness and uptake. With climate change effecting millions of children worldwide, it is high time to put child health at the center of adaptation.

The international response to the COVID-19 pandemic provided opportunities for countries to use digital technologies for vaccine deployment and associated activities, but misaligned digital investments could weaken or fragment national systems. In this review of 311 funding applications from 120 country governments to four donor agencies (UNICEF; Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the World Bank) up to May 1, 2022, we found that 272 (87%) of the applications included at least one digital aspect and that substantial funding has been dedicated towards digital aspects from donors. The majority of digital aspects concerned immunisation information systems, vaccine acceptance and uptake, and COVID-19 surveillance. As the global community sets its sights on a COVID-19-free world, continued coordinated investments in digital health and health information systems for pandemic preparedness and response will be key to strengthening the resilience of health systems.

Background: The Sustainable Development Goals (SDGs) are integrated, indivisible and interdependent and interact and affect each other directly and indirectly. However, the 2030 Agenda does not attempt to identify or characterise these interactions.Evidence: The SDG Synergies approach was developed to enable the investigation of the strength and nature of interactions between SDGs based on the perception of a multistakeholder group. Two examples are given to concretely demonstrate how this approach overcomes present challenges and can be applied to situate health within the 2030 Agenda.Policy Options and Recommendations: There are clear benefits to situate desired health policy outcomes within the 2030 Agenda, and the SDG Synergies approach can be used as lever for including health aspects in traditional non-health sectors. Although focusing on specific health policies cannot be substituted with multisectoral policies alone, utilizing tools and methods such as the SDG Synergies approach can help policy makers put health at the centre of the SDGs.Conclusion: SDG Synergies is an impactful approach for policy makers to gain a systemic understanding of how broader sustainable development shape the health and well-being of people and vice versa.

Background:With the implementation of the Sustainable Development Goals, a systematic assessment of how the goals influence child health and vice versa has been lacking. We aimed to contribute to such an assessment by investigating the interactions between child health and the Sustainable Development Goals in Cambodia. Methods:Based on the SDG Synergies approach, 272 interactions between 16 Cambodian Sustainable Development Goals and child health were evaluated by an interdisciplinary Cambodian stakeholder group. From this a cross-impact matrix was derived and network analysis applied to determine first and second-order effects of the interactions with a focus on child health. Results:We show that with the exception of Cambodian Sustainable Development Goal 15 (life on land) the interactions are perceived to be synergistic between the child health and the Cambodian Sustainable Development Goals, and progress on Cambodian Sustainable Development Goal 16 (peace, justice and strong institutions) could have the largest potential to contribute to the achievement of the Cambodian Sustainable Development Goals, both when it comes to first and second-order interactions. Conclusions:In this stakeholder assessment, our findings provide novel insights on how complex relationships play out at the country level and highlight important synergies and trade-offs, vital for accelerating the work toward the betterment of child health and achieving the Sustainable Development Goals.

Introduction: Intrapartum-related events account for nearly 700,000 neonatal deaths globally yearly. Endotracheal intubation is a cornerstone in preventing many of these deaths, but it is a difficult skill to acquire. Previous studies have described intubation performances in high-income coun-tries, but data from low-and middle-income countries are lacking. We aimed to assess the performance of delivery room intubation in a lower middle -income country.Methods: This prospective observational study was conducted at the Phu San Hanoi Hospital, Vietnam, from September 2020 to January 2021. Video cameras were positioned above the resuscitation tables and data were extracted using adopted software (NeoTapAS). All neonates requiring positive pressure ventilation were included. Our main variables of interest were time to first intubation attempt, first intubation attempt duration, and successful first intubation attempt.Results: 18,107 neonates were born during the five months. Of these, 75 (0.4%) received positive pressure ventilation, and 36 (0.2%) required endotracheal intubation of whom 24 were captured on video. The median time to the first intubation attempt was 252 seconds (range 91-771 sec-onds), the median first attempt duration was 49 seconds (range 10-105 seconds), and the first attempt success rate was 75%.Conclusion: Incidences of positive pressure ventilation and endotracheal intubation were low in comparison to global estimates. Three out of four intubations were successful at the first attempt and the procedural duration was often longer than recommended. Future studies should focus on how to achieve and maintain intubation skills and could include considering alternative devices for airway management at birth.

Background The quality of neonatal resuscitation after delivery needs to be improved to reach the Sustainable Development Goals 3.2 (reducing neonatal deaths to <12/1,000 live newborns) by the year 2030. Studies have emphasized the importance of correctly performing the basic steps of resuscitation including stimulation, heart rate assessment, ventilation, and thermal control. Recordings with video cameras have previously been shown to be one way to identify performance practices during neonatal resuscitation. Methods A description of a low-cost delivery room set up for video recording of neonatal resuscitation. The technical setup includes rechargeable high-definition cameras with two-way audio, NeoBeat heart rate monitors, and the NeoTapAS data collection tools for iPad with direct data export of data for statistical analysis. The setup was field tested at Mulago National Referral Hospital, Kampala, Uganda, and Phu San Hanoi Hospital, Hanoi, Vietnam. Results The setup provided highly detailed resuscitation video footage including data on procedures and team performance, heart rate monitoring, and clinical assessment of the neonate. The data were analyzed with the free-of-charge NeoTapAS for iPad, which allowed fast and accurate registration of all resuscitative events. All events were automatically registered and exported to R statistical software for further analysis. Conclusions Video analysis of neonatal resuscitation is an emerging quality assurance tool with the potential to improve neonatal resuscitation outcomes. Our methodology and technical setup are well adapted for low- and lower-middle-income countries settings where improving neonatal resuscitation outcomes is crucial. This delivery room video recording setup also included two-way audio communication that potentially could be implemented in day-to-day practice or used with remote teleconsultants.