scholarly journals Institutional strengthening for evidence-based health policies in the DR Congo (RIPSEC): Impact

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Mwembo-Tambwe ◽  
F Chenge ◽  
B Criel
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health System ◽  
Health Knowledge ◽  
Scientific Evidence ◽  
Health Science ◽  
Health Coverage ◽  
District Health ◽  
The Public ◽  
Systems Research

Abstract Issue In the DRC, the need to strengthen the health system for a more equitable charge of the health of the population in a perspective of universal health coverage proves to be relevant. Develop a culture that promotes decision-making based on scientific evidence, essential to improve the overall performance of the health system from this perspective Description of the Problem The RIPSEC program aims to (i) develop the capacity to manage health knowledge in the DRC through the creation of a Health Knowledge Center in the DRC, (CCSC- Asbl); to strengthen the scientific capacity of the Public Health Schools and the National Institute of Biomedical Research in health systems research and education and to strengthen the training capacity of the Public Health Schools by Development of Learning and Research Health Districts (LRHD). We assess the level of achievement of the results of this program. Results The majority of objectives have been reached.The CCSC-Asbl, created is an autonomous institution with legal personality. It produces scientific evidence and support for decision-making. The Ministry of Health has been strengthened and diversified. Institutional capacities and visibility have been strengthened through continuing education and the publication of scientific articles. But, no doctorals theses has been completed yet. Establishment of a consultation framework for health science training institutes: online training, short-term joint training on health system research. The third component concerns the development of LHRD; Transformation processes in the district went through a strengthening of the capacity of the district health teams and via a process of action-research. Lessons The RIPSEC program is increasingly becoming part of the Congolese health system as a strong partner. Key messages This experience can be used elsewhere in different contexts This program could be continued to perpetuate these fragile achievements. It corresponds to the felt needs and the priority of the health education system in the DRC or elsewhere.

scholarly journals Analysis of the Socio-environmental Management of Covid 19 in Perú

2021 ◽  
Vol 259 ◽  
pp. 03003
Author(s):  
Sandra Cueto ◽  
Jorge Ferrer ◽  
Alvaro Guevara ◽  
Yensy Segovia
Keyword(s):  
Public Health ◽  
Environmental Management ◽  
Decision Making ◽  
Mortality Rate ◽  
Health System ◽  
Initial Phase ◽  
Public Health System ◽  
The Public ◽  
Cultural Heterogeneity ◽  
Scientific Support

The objective of this article is to analyze the management of Covid-19 from a socio-environmental perspective, with a scientific, holistic and adaptive approach. On March 16 of 2020, the Peruvian government began to implement measures to slow the spread of the virus and allow time to strengthen the public health system and after 9 months the results have placed the country among the first places in the mortality rate world level. The basic lines of action of the Peruvian government have been focused on: reducing crowds, stocking up with hospital supplies and detecting infected. However, we identified that the actions corresponding to such basic lines lacked scientific support, were academically biased and inappropriate to the context. Our analysis has been accompanied by proposals that should have been applied in the initial phase of the proliferation of the virus, each of these proposals are designed based on scientific interdisciplinarity and adapted to the geographical and cultural heterogeneity of Peru. It is concluded that decision making must be in accordance with the different realities of the country and that since it is a diverse country, these decisions must be approached seeking the benefit of the entire population.

scholarly journals Evaluation of the Feasibility and Sustainability of the Joint Human and Animal Vaccination and Its Integration to the Public Health System in the Danamadji Health District, Chad

2021 ◽  
Author(s):  
Mahamat Fayiz Abakar ◽  
Djimet Seli ◽  
Filippo Lechthaler ◽  
Lisa Crump ◽  
Arielle Mancus ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Impact Analysis ◽  
Budget Impact ◽  
Public Health System ◽  
Financial Sustainability ◽  
District Health ◽  
The Public ◽  
Mobile Pastoralists ◽  
Animal Vaccination

Abstract BackgroundOne Health approaches such as the Joint human and animal vaccination programmes (JHAVP) are shown to be feasible and to increase health care access to hard-to-reach communities such as mobile pastoralists. However, the financial sustainability and the integration into the public health systems at the district level of such programmes are still challenging. The main objective of the present study was to give insight to the feasibility and financial sustainability of JHAVP integrated as part of the public health system in Chad.MethodsWe conducted a mixed methods study using semi-structured key informant interviews, focus group discussions and budget impact analysis. Strengths, weaknesses, opportunities, and threats were analysed regarding the feasibility and sustainability of the implementation of JHAVP in Danamadji health district in Chad. Feasibility was further analysed using three dimensions: acceptability, implementation, and adaptation. Financial sustainability of JHAVP was analysed through budget impact analysis of implementation of the programme at district level.ResultsThe acceptability of this approach was regularly assessed by immunization campaign teams through evaluation meetings which included pastoralists. The presence of authorities in the meetings and workshops of the programme had an incentive effect since they represent a mark of consideration these populations generally declared to be lacking. The coordination between the public health and veterinary services at central and decentralized level seemed to be a key element in the success of the implementation of the programme. Regarding financial sustainability, the total incremental budget impact was 27% slightly decreasing to 26% after five years, which accounts for up to one third of the total budget of the district health office. Also, given that most of the costs for each round are recurrent costs, efficiency gains from scale effects over time are limited.ConclusionBased on these findings, we conclude that for JHAVP to be routinely delivered at the district health level, a considerable increase in financial resources would be required. The district could benefit from joint immunization to maintain contact with mobile pastoralists to promote the use of available immunization services at district level.

scholarly journals MANAGEMENT OF INSTITUTIONAL AND PREVENTIVE ACTIVITIES IN THE PUBLIC HEALTH SYSTEM OF UKRAINE

2021 ◽  
Vol 74 (5) ◽  
pp. 1237-1240
Author(s):  
Iryna M. Khomenko ◽  
Oleksandra P. Ivakhno ◽  
Yaroslav V. Pershehuba ◽  
Ivan P. Kozyarin ◽  
Svitlana P. Koshova
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Knowledge ◽  
Public Health System ◽  
Health Management ◽  
System Component ◽  
Preventive Program ◽  
The Public ◽  
System Establishment ◽  
Specialty Certification

The aim: Scientific justification of the public health management methods and instruments for improvement of its effectiveness. Materials and methods: The authors conducted a complex research of the public health of Ukraine personnel resources development during the system establishment and building. Conclusions: The paper justifies the competence-based model of a specialist (the postgraduate educational level) as well as the university educational standards of the first (bachelor) and second (master) levels of specialty 229 “Public health”, knowledge branch 22 “Healthcare”. The authors have established insufficient level of the youth motivation for obtaining the specialty certification and described disadvantages of both advocacy program within the public health system and its leadership within the preventive system component. The authors emphasize the necessity of an integrated preventive program maintaining and strengthening the population health, using the advocacy component and available information resources of the public health.

scholarly journals Progress of health care in rural India: a critical review of National Rural Health Mission

2017 ◽  
Vol 5 (1) ◽  
pp. 4 ◽  
Author(s):  
S. Gopalakrishnan ◽  
A. Immanuel
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Rural Health ◽  
Public Health System ◽  
National Rural Health Mission ◽  
Rural India ◽  
Health Coverage ◽  
The Public ◽  
Public Health Infrastructure

National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.

scholarly journals Staying afloat: community perspectives on health system resilience in the management of pregnancy and childbirth care during floods in Cambodia

2020 ◽  
Vol 5 (4) ◽  
pp. e002272 ◽  
Author(s):  
Dell D Saulnier ◽  
Hom Hean ◽  
Dawin Thol ◽  
Por Ir ◽  
Claudia Hanson ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health System ◽  
Health Systems ◽  
Public Health System ◽  
Health Needs ◽  
Structured Interviews ◽  
The Public ◽  
Pregnancy And Childbirth ◽  
Childbirth Care

IntroductionResilient health systems have the capacity to continue providing health services to meet the community’s diverse health needs following floods. This capacity is related to how the community manages its own health needs and the community and health system’s joined capacities for resilience. Yet little is known about how community participation influences health systems resilience. The purpose of this study was to understand how community management of pregnancy and childbirth care during floods is contributing to the system’s capacity to absorb, adapt or transform as viewed through a framework on health systems resilience.MethodsEight focus group discussions and 17 semi-structured interviews were conducted with community members and leaders who experienced pregnancy or childbirth during recent flooding in rural Cambodia. The data were analysed by thematic analysis and discussed in relation to the resilience framework.ResultsThe theme ‘Responsible for the status quo’ reflected the community’s responsibility to find ways to manage pregnancy and childbirth care, when neither the expectations of the health system nor the available benefits changed during floods. The theme was informed by notions on: i) developmental changes, the unpredictable nature of floods and limited support for managing care, ii) how information promoted by the public health system led to a limited decision-making space for pregnancy and childbirth care, iii) a desire for security during floods that outweighed mistrust in the public health system and iv) the limits to the coping strategies that the community prepared in case of flooding.ConclusionsThe community mainly employed absorptive strategies to manage their care during floods, relieving the burden on the health system, yet restricted support and decision-making may risk their capacity. Further involvement in decision-making for care could help improve the health system’s resilience by creating room for the community to adapt and transform when experiencing floods.

scholarly journals NGOs, austerity, and universal health coverage in Mozambique

2019 ◽  
Vol 15 (S1) ◽  
Author(s):  
James Pfeiffer ◽  
Rachel R. Chapman
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Universal Health Coverage ◽  
Public Health System ◽  
Health Coverage ◽  
Donor Funding ◽  
The Public ◽  
Public Sector Health ◽  
Universal Health

AbstractIn many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country’s structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow “off-budget” to NGO “implementing partners,” with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.

scholarly journals Towards universal health coverage: reforming the neglected district health system in Africa

2019 ◽  
Vol 4 (Suppl 9) ◽  
pp. e001498 ◽  
Author(s):  
Prosper Tumusiime ◽  
Aku Kwamie ◽  
Oladele B Akogun ◽  
Tarcisse Elongo ◽  
Juliet Nabyonga-Orem
Keyword(s):  
Decision Making ◽  
Health System ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
African Countries ◽  
District Health ◽  
District Health System ◽  
The Hierarchical Structure ◽  
Sub Saharan ◽  
Universal Health

In most African countries, the district sphere of governance is a colonial creation for harnessing resources from the communities that are located far away from the centre with the assistance of minimally skilled personnel who are subordinate to the central authority with respect to decision-making and initiative. Unfortunately, postcolonial reforms of district governance have retained the hierarchical structure of the local government. Anchored to such a district arrangement, the (district) health system (DHS) is too weak and impoverished to function in spite of enormous knowledge and natural resources for a seamless implementation of universal health coverage (UHC). Sadly, the quick-fix projects of the 1990s with the laudable intention to reduce the burden of disease within a specified time-point dealt the fatal blow on the DHS administration by diminishing it to a stop-post and a warehouse for commodities (such as bednets and vaccines) destined for the communities. We reviewed the situation of the district in sub-Saharan African countries and identified five attributes that are critical for developing a UHC-friendly DHS. In this analytical paper, we discuss decision-making authority, coordination, resource control, development initiative and management skills as critical factors. We highlight the required strategic shifts and recommend a dialogue for charting an African regional course for a reformed DHS for UHC. Further examination of these factors and perhaps other ancillary criteria will be useful for developing a checklist for assessing the suitability of a DHS for the UHC that Africa deserves.

New and emerging environmental hazards and situations

2016 ◽  
Author(s):  
Alec Dobney ◽  
Greg Hodgson
Keyword(s):  
Public Health ◽  
Scientific Evidence ◽  
Health Science ◽  
Health Practitioner ◽  
Health Issues ◽  
The Public ◽  
Environmental Public Health ◽  
Public Health Professionals ◽  
Technological Advances ◽  
Health Related

Environmental public health scientists and health protection practitioners are constantly challenged to respond to new or poorly understood hazards. Practitioners might also be required to address well-characterized hazards that have either increased in magnitude or re-emerged in different situations. Developing technological advances and new and emerging industrial processes (such as fracking, nanotechnology, shale gas, waste fires) can raise difficult questions for the public health practitioner, especially where research and health-related evidence is lacking. In these cases, public health science has a key role in undertaking and communicating risks and in providing the most accurate available scientific evidence and public health advice. The field of environmental public health is crowded with complex problems demanding our attention. It is impossible to devote sufficient clinical, research, and advocacy energies to all of these problems at once. Clinicians, public health professionals, and environmental public health scientists have to choose which health issues take priority.

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