Susanna Lehtimaki - Academia.edu (original) (raw)

Papers by Susanna Lehtimaki

The Lancet Global Health, Dec 31, 2023

PLOS global public health, May 1, 2024

BMJ Global Health

Negotiations are underway at the WHO for a legally binding instrument for pandemic prevention, pr... more Negotiations are underway at the WHO for a legally binding instrument for pandemic prevention, preparedness and response. As seen in the International Health Regulations, however, countries signing up to an agreement is no guarantee of its effective implementation. We, therefore, investigated the potential design features of an accountability framework for the proposed pandemic agreement that could promote countries’ compliance with it. We reviewed the governance of a number of international institutions and conducted over 40 interviews with stakeholders and experts to investigate how the pandemic agreement could be governed.We found that enforcement mechanisms are a key feature for promoting the compliance of countries with the obligations they sign up for under international agreements but that they are inconsistently applied. It is difficult to design enforcement mechanisms that successfully avoid inflicting unintended harm and, so, we found that enforcement mechanisms generally ...

The Lancet Global Health, Aug 1, 2020

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Health Policy and Planning, Oct 25, 2019

Community health worker (CHW) programmes have been used for decades to improve access to health s... more Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low-and middle-income countries. With more than half of the world's population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low-and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

The Lancet Global Health, Sep 1, 2022

Background: An estimated 1 in 5 adolescents experience a mental health disorder each year; yet be... more Background: An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low-and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues. Objective: This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low-and middle-income countries). Methods: We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews. Results: In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings. Conclusions: Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low-and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.

Frontiers in digital health, Dec 14, 2020

JMIR mental health, Apr 29, 2021

To address the challenges in pandemic preparedness and response (PPR), the World Health Assembly ... more To address the challenges in pandemic preparedness and response (PPR), the World Health Assembly (WHA), at a special session in November 2021, established an Intergovernmental Negotiating Body (the INB) and tasked it with drafting a new legal instrument for PPR. During its second meeting in July 2022, the INB decided to develop the accord under Article 19 of the WHO Constitution, which grants the WHO the authority to negotiate a legally-binding Convention or Agreement and requires ratification by countries according to their local laws to enter into force. The aim is to complete negotiations and adopt a new pandemic instrument at the WHA in May 2024. The new legally binding agreement aims to address many of the failures exposed by the COVID-19 pandemic. However, the adoption of such an agreement is not the end of the process but the beginning. The negotiations on the instrument must establish a mechanism to monitor countries' compliance with the accord, particularly on the legally-binding elements. In this paper, we recommend creating such a mechanism as part of the accord: an independent committee of experts that monitors state parties' compliance with the pandemic accord and the timeliness, completeness, and robustness of states’ reports on their obligations. Its primary purpose would be to verify state self-reports by triangulating them with a range of publicly available information, making direct inquiries, and accepting confidential submissions. It would report its findings to a body consisting of or that is directly accountable to heads of state, with a particular focus on elevating instances of non-compliance or inadequate reporting. Its reports would also be available to the public. The proposed design builds on the analysis of strengths and weaknesses of existing monitoring approaches to 11 international treaties and mechanisms within and outside of health, a review of the literature, and interviews and input from more than 40 experts from around the world.

Bulletin of The World Health Organization, Jul 8, 2020

BMJ Global Health, Aug 1, 2017

Maternal and child health services and an integrated, life-cycle approach to the prevention of no... more Maternal and child health services and an integrated, life-cycle approach to the prevention of non-communicable diseases.