scholarly journals Institutionalising an evidence-informed approach to guideline development: progress and challenges at the World Health Organization

2018 ◽  
Vol 3 (5) ◽  
pp. e000716 ◽  
Author(s):  
Unni Gopinathan ◽  
Steven J Hoffman
Keyword(s):  
Public Health ◽  
World Health Organization ◽  
Guideline Development ◽  
Health Interventions ◽  
World Health ◽  
Public Health Interventions ◽  
Independent Evaluation ◽  
Development Processes ◽  
Health Organization

This study explored experiences, perceptions and views among World Health Organization (WHO) staff about the changes, progress and challenges brought by the guideline development reforms initiated in 2007. Thirty-five semistructured interviews were conducted with senior WHO staff. Sixteen of the interviewees had in-depth experience with WHO’s formal guideline development process. Thematic analysis was conducted to identify key themes in the qualitative data, and these were interpreted in the context of the existing literature on WHO’s guideline development processes. First, the reforms were seen to have transformed and improved the quality of WHO’s guidelines. Second, independent evaluation and feedback by the Guidelines Review Committee (GRC) was described to have strengthened the legitimacy of WHO’s recommendations. Third, WHO guideline development processes are not yet designed to systematically make use of all types of research evidence needed to inform decisions about health systems and public health interventions. For example, several interviewees expressed dissatisfaction with the insufficient attention paid to qualitative evidence and evidence from programme experience, and how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process evaluates the quality of evidence from non-randomised study designs, while others believed that GRADE was just not properly understood or applied. Fourth, some staff advocated for a more centralised quality assurance process covering all outputs from WHO’s departments and scientific advisory committees, especially to eliminate strategic efforts aimed at bypassing the GRC’s requirements. Overall, the ‘culture change’ senior WHO staff called for over 10 years ago appears to have gradually spread throughout the organisation. However, at least two major challenges remain: (1) ensuring that all issued advice benefits from independent evaluation, monitoring and feedback for quality and (2) designing guideline development processes to better acquire, assess, adapt and apply the full range of evidence that can inform recommendations on health systems and public health interventions.

scholarly journals An Inconsistent Canadian Provincial and Territorial Response During the Early COVID-19 Pandemic

2021 ◽  
Vol 9 ◽  
Author(s):  
Amelie Cyr ◽  
Prosanta Mondal ◽  
Gregory Hansen
Keyword(s):  
Public Health ◽  
Early Response ◽  
Health Interventions ◽  
World Health ◽  
Public Health Interventions ◽  
Community Based ◽  
Governmental Agencies ◽  
Health Organization ◽  
Time Of Intervention ◽  
National Approach

Objectives: According to the World Health Organization (WHO), an early and consistent international and national response is needed to control a pandemic's spread. In this analysis, we evaluate the coordination of Canada's early response to the coronavirus (COVID-19) pandemic in terms of public health interventions and policies implemented in each province and territory.Methods: Retrospective data was obtained from publicly accessible websites maintained by federal, provincial and territorial governmental agencies. Consistent with WHO's spreading of the disease pandemic action, individual and community-based public health interventions and policies were the focus. Time of intervention or policy, and COVID-19 cases per million at time of intervention was recorded for each province and territory.Results: Most public health interventions and policies demonstrated wide time ranges of implementation across individual provinces and territories. At time of implementation, there were also wide variations in the number of positive COVID-19 cases in these jurisdictions. Cases per million per implemented day were also not similar across interventions or policy, suggesting that other factors may have been preferentially considered.Conclusions: Whether an earlier and more structured national approach would have lessened the pandemic's burden is uncertain, calls for greater federal coordination and leadership should to examined.

scholarly journals Mandating the Use of Proximity Tracking Apps During Coronavirus Disease 2019: Ethical Justifications

2020 ◽  
Vol 7 ◽  
Author(s):  
Riya Dave ◽  
Rashmi Gupta
Keyword(s):  
Public Health ◽  
Large Degree ◽  
Health Interventions ◽  
World Health ◽  
Contact Tracing ◽  
Public Health Interventions ◽  
Societal Factors ◽  
Digital World ◽  
Health Organization ◽  
Mandatory Policy

The rise of the coronavirus disease 2019 (COVID-19) in a digital world has expectedly called upon technologies, such as wearables and mobile devices, to work in conjunction with public health interventions to tackle the pandemic. One significant example of this integration is the deployment of proximity tracking apps on smartphones to enhance traditional contact tracing methods. Many countries have adopted proximity tracking apps; however, there is a large degree of global differentiation in the voluntariness of the apps. Further, the concept of a mandatory policy—forcing individuals to use the apps—has been met with ethical concerns (e.g., privacy and liberty). While ethical considerations surrounding deployment have been put forth, such as by the World Health Organization, ethical justifications for a mandatory policy are lacking. Here, we use the Faden–Shebaya framework, which was formed to justify public health interventions, to determine if the compulsory use of proximity tracking apps is ethically appropriate. We show that while theoretically justified, due to the current state of proximity tracking applications and societal factors, it is difficult to defend a mandatory policy in practice.

The role of the World Bank and WHO Model Disability Survey in public health

2017 ◽  
Vol 25 (4) ◽  
pp. 262-264
Author(s):  
Carla Sabariego
Keyword(s):  
Public Health ◽  
World Bank ◽  
Population Level ◽  
Health Interventions ◽  
World Health ◽  
Public Health Interventions ◽  
The World Bank ◽  
The World ◽  
Health Organization

Abstract: The Model Disability Survey (MDS) is the tool recommended by the world health organization (WHO) to collect data on disability at the population level. It consciously promotes a narrative of inclusion, as disability is understood as a continuum, ranging from low to high levels. Public health currently faces the challenge of responding to demographic and health shifts leading to an increase in disability in the population. The MDS provides the information needed to meet these challenges and develop targeted public health interventions.

scholarly journals Ethics check-up of public health immunization programs in Canada

2021 ◽  
Vol 47 (04) ◽  
pp. 237-241
Author(s):  
Noni E MacDonald ◽  
Shawn Harmon ◽  
Janice E Graham
Keyword(s):  
Public Health ◽  
Health Interventions ◽  
World Health ◽  
Immunization Programs ◽  
Vaccine Research ◽  
Public Health Interventions ◽  
Immunization Program ◽  
Ethics Review ◽  
Health Organization ◽  
Effective Public Health

The World Health Organization (WHO) recognizes immunization as one of the most successful and effective public health interventions for saving lives. In developing a roadmap for prioritizing use of the coronavirus disease 2019 (COVID-19) vaccines in the context of limited supply, WHO highlighted the importance of a values (ethical principles) framework. Immunization does need to be subject to independent ethical scrutiny of vaccine research data, manufacturing practices, the legal and ethical assurance of informed consent, and also social justice issues with respect to program equity, including right to access. An ethics review of Australia’s immunization program was reported in 2012. This CANVax (Canadian Vaccination Evidence Resource and Exchange Centre) Brief offers an ethics review of immunization in Canada using the criteria utilized for Australia.

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

scholarly journals Psychometric validation of the Chinese version of the PaArticular Scales among elderly residents in long-term care facilities with joint contractures

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-chang Chen ◽  
Keh-chung Lin ◽  
Chen-Jung Chen ◽  
Shu-Hui Yeh ◽  
Ay-Woan Pan ◽  
...  
Keyword(s):  
World Health Organization ◽  
Long Term Care ◽  
Chinese Version ◽  
World Health ◽  
Term Care ◽  
Joint Contractures ◽  
The World ◽  
Health Organization

Abstract Background Joint contractures, which affect activity, participation, and quality of life, are common complications of neurological conditions among elderly residents in long-term care facilities. This study examined the reliability and validity of the Chinese version of the PaArticular Scales in a population with joint contractures. Methods A cross-sectional study design was used. The sample included elderly residents older than 64 years with joint contractures in an important joint who had lived at one of 12 long-term care facilities in Taiwan for more than 6 months (N = 243). The Chinese version of the PaArticular Scales for joint contractures was generated from the English version through five stages: translation, review, back-translation, review by a panel of specialists, and a pretest. Test-retest reliability, internal consistency reliability, construct validity, and criterion validity were evaluated, and the results were compared with those for the World Health Organization Quality of Life scale and the World Health Organization Disability Assessment Schedule. Results The Chinese version of the PaArticular Scales had excellent reliability, with a Cronbach α coefficient of 0.975 (mean score, 28.98; standard deviation, 17.34). An exploratory factor analysis showed three factors and one factor with an eigenvalue > 1 that explained 75.176 and 62.83 % of the total variance in the Activity subscale and Participation subscale, respectively. The subscale-to-total scale correlation analysis showed Pearson correlation coefficients of 0.881 for the Activity subscale and 0.843 for the Participation subscale. Pearson’s product-moment correlation revealed that the correlation coefficient (r) between the Chinese version of the PaArticular Scales and the World Health Organization Disability Assessment Schedule was 0.770, whereas that for the World Health Organization Quality of Life scale was − 0.553; these values were interpreted as large coefficients. Conclusions The underlying theoretical model of the Chinese version of the PaArticular Scales functions well in Taiwan and has acceptable levels of reliability and validity. However, the Chinese version must be further tested for applicability and generalizability in future studies, preferably with a larger sample and in different clinical domains.

scholarly journals Implicações do uso do Aparelho de Amplificação Sonora Individual na qualidade de vida de idosos

CoDAS ◽  
2017 ◽  
Vol 29 (5) ◽  
Author(s):  
Camila Zorzetto Carniel ◽  
Juliana Cristina Ferreira de Sousa ◽  
Carla Dias da Silva ◽  
Carla Aparecida de Urzedo Fortunato-Queiroz ◽  
Miguel Ângelo Hyppolito ◽  
...  
Keyword(s):  
Quality Of Life ◽  
World Health Organization ◽  
The Elderly ◽  
World Health ◽  
World Health Organization Quality ◽  
Hearing Handicap ◽  
Organization Quality ◽  
Health Organization ◽  
Post Hoc

RESUMO Objetivo Avaliar, por meio de questionários padronizados, a qualidade de vida de idosos com deficiência auditiva diagnosticada que utilizam ou não a prótese auditiva (AASI) e de idosos sem queixa auditiva. Método Trata-se de um estudo transversal, com amostra não probabilística, distribuída em três grupos divididos da seguinte forma: 30 idosos com perda auditiva diagnosticada e com indicação para uso do aparelho de amplificação sonora individual (AASI), mas que ainda não faziam uso da prótese; 30 idosos com deficiência auditiva que usavam o AASI; e 30 idosos sem queixa auditiva. Os participantes completaram um questionário que investigava dados sociodemográficos e familiares, o Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) e o World Health Organization Quality of Life - versão breve (WHOQOL-Breve). Além das análises descritivas dos dados, foram realizados testes para comparação dos três grupos, aplicando-se a análise de variância (ANOVA) e o teste post hoc de Bonferroni. Resultados Os três grupos se diferenciaram significativamente em todos os domínios de qualidade de vida. O grupo de idosos com perda auditiva diagnosticada e com indicação para uso do AASI apresentou menores escores que o grupo de idosos com deficiência auditiva que usavam o AASI e que o grupo de referência. O grupo com AASI apresentou os melhores resultados de qualidade de vida. Conclusão A perda auditiva afeta a qualidade de vida do idoso. O uso efetivo da prótese auditiva é benéfico a esta população, melhorando suas condições de vida e saúde.

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