scholarly journals Developing a tool to measure the reciprocal benefits that accrue to health professionals involved in global health

2018 ◽  
Vol 3 (4) ◽  
pp. e000792
Author(s):  
Jannah Margaret Wigle ◽  
Nadia Akseer ◽  
Sarah Carbone ◽  
Raluca Barac ◽  
Melanie Barwick ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Global Health ◽  
Health Professionals ◽  
Local Health ◽  
Health Work ◽  
Middle Income ◽  
Capacity Strengthening ◽  
Individual Level ◽  
Low Middle Income Countries ◽  
Reciprocal Value

Research to date on global health collaborations has typically focused on documenting improvements in the health outcomes of low/middle-income countries. Recent discourse has characterised these collaborations with the notion of ‘reciprocal value’, namely, that the benefits go beyond strengthening local health systems and that both partners have something to learn and gain from the relationship. We explored a method for assessing this reciprocal value by developing a robust framework for measuring changes in individual competencies resulting from participation in global health work. The validated survey and evidence-based framework were developed from a comprehensive review of the literature on global health competencies and reciprocal value. Statistical analysis including factor analysis, evaluation of internal consistency of domains and measurement of floor and ceiling effects were conducted to explore global health competencies among diverse health professionals at a tertiary paediatric health facility in Toronto, Canada. Factor analysis identified eight unique domains of competencies for health professionals and their institutions resulting from participation in global health work. Seven domains related to individual-level competencies and one emphasised institutional capacity strengthening. The resulting Global Health Competency Model and validated survey represent useful approaches to measuring the reciprocal value of global health work among diverse health professionals and settings. Insights gained through application of the model and survey may challenge the dominant belief that capacity strengthening for this work primarily benefits the recipient individuals and institutions in low/middle-income settings.

scholarly journals THE IGNORED PANDEMIC OF PUBLIC HEALTH CORRUPTION: A CALL FOR ACTION AMID AND BEYOND SARS-COV-2/COVID-19

2021 ◽  
Vol 9 (2) ◽  
pp. 108-116
Author(s):  
Jorge A. Sánchez-Duque ◽  
◽  
Zhaohui Su ◽  
Diego Rosselli ◽  
Maria Camila Chica-Ocampo ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Health Care Systems ◽  
Health Resources ◽  
Economic Consequences ◽  
Control Measures ◽  
Local Health ◽  
Middle Income ◽  
Health Initiatives ◽  
Care Systems

Corruption in healthcare is on the rise. When corruption infiltrates global health, causes embezzlement of public health funds, malfunctioning medical equipment, fraudulent or ineffective health services such as expired medicines and fake vaccines that could have life-or-death consequences. A corrupt healthcare system, amid global health crises like the COVID-19 pandemic, when resources are in constraint and trust is in high demand, can lead to devastating, though avoidable, health and economic consequences. It is imperative for policymakers, health experts, patients, caregivers, and global health funders to promptly acknowledge and address corruption in healthcare. The current pandemic generates an emergency and disorder state on health care systems across the globe, especially in low- and middle-income countries, where a weakening of control measures is evident, creating the perfect storm for corruption. This paper builds on existing research to examine processes that support essential stakeholder engagement in anti-corruption efforts. In this context, an extensive review of literature has been conducted by using various databases such as PubMed, Science direct, SCOPUS, Research Gate, and Google Scholar and a total of 45 articles and documents on corruption and COVID-19 were screened and selected by authors independently. To fill the knowledge gaps about the need for actions to be taken during a pandemic like COVID-19, we propose an anti-corruption grassroots movement that focuses on changing the social norms surrounding corruption in healthcare. By pushing forward a practice that normalizes conversations about corruption in everyday health practices and involving more stakeholders in the protection of public health resources, we argue that not only local health systems can become more resilient and resistant to corruption, but also global health initiatives can become more effective and efficient to improve individual and global health.

scholarly journals Perceived Reciprocal Value of Health Professionals’ Participation in Global Health-related Work

2017 ◽  
Vol 83 (1) ◽  
pp. 27
Author(s):  
S.E. Carbone ◽  
J. Wigle ◽  
N. Akseer ◽  
R. Barac ◽  
M. Barwick ◽  
...  
Keyword(s):  
Global Health ◽  
Health Professionals ◽  
Health Related ◽  
Reciprocal Value ◽  
Value Of Health

scholarly journals Joined-Up Thinking in Global Health Education

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Health Education ◽  
Global Health ◽  
Clinical Skill ◽  
Healthcare Providers ◽  
Best Interests ◽  
Healthcare Provision ◽  
Middle Income ◽  
Global Health Education ◽  
Healthcare Needs ◽  
Low Middle Income Countries

The scope of global health is necessarily broad and healthcare professionals need special knowledge and skill to help them work effectively in any multi-cultural, multi-ethnic society. Without some form of training over and above traditional areas of core clinical skill, the healthcare needs of vulnerable populations could be left unmet, whether in low-middle income countries where health infrastructure is poorly developed or in high-income countries where ethnic minorities might struggle accessing the care that they need. Recognising that while healthcare provision is always subject to financial constraint, health is not a commodity to be traded, and nursing and healthcare leaders have a role to play in helping create an environment that is conducive towards enabling patients achieve optimum health. Potential barriers to achieving this include creeping commercialisation, weak systems of governance and lack of recognition for the ethical nature of much healthcare provision. The picture varies greatly between and within countries, between specialism’s and providers and between individuals. Global health education programmes should recognise the moral nature of the enterprise, which creates a need for informed leadership and robust systems of governance. Critical to raising awareness of the interconnected nature of global health is a realisation that 1) Healthcare provision is essentially a form of public service, 2) Systems of governance should be fit for purpose and work to promote patient’s best interests (above those of healthcare providers) and 3) Ethical consideration should be factored into all policy initiatives and programmes for the promotion of global health. Without these elements, policy makers could find it hard finding effective interventions to address global health problems, such as the need to reduce rates of infant mortality. Nursing and global health educators can play their part in helping to create an environment whereby leadership, governance and ethics work together in serving the interests of whole communities.

scholarly journals Designing eLearning courses to meet the digital literacy needs of healthcare workers in lower- and middle-income countries: Experiences from the knowledge for health project

2015 ◽  
pp. 601-615
Keyword(s):  
Knowledge Management ◽  
Health Literacy ◽  
Global Health ◽  
Information And Communication Technologies ◽  
Health Professionals ◽  
Digital Health ◽  
Social Knowledge ◽  
Middle Income ◽  
Implementation Phase ◽  
Middle Income Countries

Traditional conceptualizations of knowledge management fail to incorporate the social aspects in which knowledge management work operates. Social knowledge management places people at the center of all knowledge management, including placing the end user at the center when developing eLearning packages, particularly within the context of digital health literacy. As many health professionals working in lower-resource settings face the digital divide, or experience unequal patterns of access and usage capabilities from computer-based information and communication technologies (ICTs), ensuring that eLearning packages are tailored for their specific needs is critical. Grounded in our conceptualization of social knowledge management, we outline two of our experiences with developing eLearning packages for health professionals working primarily in lower- and middle-income countries. The Global Health eLearning Center provides eLearning courses to health professionals primarily working in the lower- and middle-income country context. The courses have robust and exhaustive mechanisms in place to ensure that issues related to digital health literacy are not barriers to taking the courses and subsequently, applying the course material in practice. In Bangladesh, we developed a digital health package for frontline community fieldworkers that was loaded on netbook computers. To develop this package, community fieldworkers were provided support during the implementation phase to ensure that they were able to use the netbooks correctly with their clients. As new digital technologies proliferate, guaranteeing that global health workers have the prerequisite skills to utilize and apply digital health tools is essential for improving health care.

Global Health Education Faculty Competencies

2018 ◽  
pp. 115-119
Author(s):  
Mirzada Pasic Kurbasic
Keyword(s):  
Medical Education ◽  
Health Education ◽  
Global Health ◽  
Global Perspective ◽  
Local Health ◽  
Middle Income ◽  
Global Health Education ◽  
Fellowship Programs ◽  
Health Education Faculty ◽  
Medical Disciplines

In high-income countries, global health has emerged as a core component of medical education across most medical disciplines. Approximately two-thirds of US pediatric residency programs offer the opportunity to complete short-term global health electives in low- and middle-income countries,1 and about one-fifth of residents pursue such an elective. Internal medicine, emergency medicine, and pediatrics now all offer formal fellowship opportunities in international (ie, global) health. Global health opportunities among Accreditation Council for Graduate Medical Education–accredited pediatric subspecialty fellowship programs are limited but increasing, as noted by its online report.2 Global health has become a branch of science supporting institutionalized education. A rapidly expanding experience indicates that effective global health education should train students to understand global health statuses, to investigate global and local health issues with a global perspective, and to devise interventions to deal with these issues.3

scholarly journals Interventions on Food Security and Water Uses for Improving Nutritional Status of Pregnant Women and Children Younger Than Five Years in Low-Middle Income Countries: A Systematic Review

2021 ◽  
Vol 18 (9) ◽  
pp. 4799
Author(s):  
Cristina Urgell-Lahuerta ◽  
Elena Carrillo-Álvarez ◽  
Blanca Salinas-Roca
Keyword(s):  
Systematic Review ◽  
Food Security ◽  
Global Health ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Health Impact ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Global Health Issue

Malnutrition is a global health issue concerning children and pregnant women in low- and middle-income countries (LMICs). The aim of this review was to assess the health-impact outcomes of interventions addressing food security, water quality and hygiene in order to address the improvement of the nutritional status in children below five years and pregnant women in LMICs. Using PRISMA procedures, a systematic review was conducted by searching in biomedical databases clinical trials and interventions for children and pregnant women. Full articles were screened (nf = 252) and critically appraised. The review included 27 randomized and non-randomized trials and interventions. Based on the analysis, three agents concerning nutritional status were identified. First, exclusive breastfeeding and complementary feeding were fundamental elements in preventing malnutrition. Second, provision of sanitation facilities and the promotion of hygienic practices were also essential to prevent infections spread and the consequent deterioration of nutritional status. Finally, seasonality was also seen to be a relevant factor to consider while planning and implementing interventions in the populations under study. In spite of the efforts conducted over last decades, the improvement in food insecurity rates has remained insufficient. Therefore, the development of global health programs is fundamental to guide future actions.

scholarly journals The global diet and activity research (GDAR) network: a global public health partnership to address upstream NCD risk factors in urban low and middle-income contexts

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Tolu Oni ◽  
◽  
Felix Assah ◽  
Agnes Erzse ◽  
Louise Foley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Global Health ◽  
Health Research ◽  
Research Network ◽  
Global Health Research ◽  
Middle Income ◽  
Capacity Strengthening ◽  
Health Partnership ◽  
Upstream Determinants ◽  
Low And Middle Income

Abstract Background Non-communicable diseases (NCDs) are the leading cause of death globally. While upstream approaches to tackle NCD risk factors of poor quality diets and physical inactivity have been trialled in high income countries (HICs), there is little evidence from low and middle-income countries (LMICs) that bear a disproportionate NCD burden. Sub-Saharan Africa and the Caribbean are therefore the focus regions for a novel global health partnership to address upstream determinants of NCDs. Partnership The Global Diet and Activity research Network (GDAR Network) was formed in July 2017 with funding from the UK National Institute for Health Research (NIHR) Global Health Research Units and Groups Programme. We describe the GDAR Network as a case example and a potential model for research generation and capacity strengthening for others committed to addressing the upstream determinants of NCDs in LMICs. We highlight the dual equity targets of research generation and capacity strengthening in the description of the four work packages. The work packages focus on learning from the past through identifying evidence and policy gaps and priorities, understanding the present through adolescent lived experiences of healthy eating and physical activity, and co-designing future interventions with non-academic stakeholders. Conclusion We present five lessons learned to date from the GDAR Network activities that can benefit other global health research partnerships. We close with a summary of the GDAR Network contribution to cultivating sustainable capacity strengthening and cutting-edge policy-relevant research as a beacon to exemplify the need for such collaborative groups.

scholarly journals Extent, nature and consequences of performing outside scope of training in global health

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Ashti Doobay-Persaud ◽  
Jessica Evert ◽  
Matthew DeCamp ◽  
Charlesnika T. Evans ◽  
Kathryn H. Jacobsen ◽  
...  
Keyword(s):  
Global Health ◽  
Health Professionals ◽  
Online Survey ◽  
Moral Distress ◽  
Human Resources For Health ◽  
Final Analysis ◽  
Ethical Challenges ◽  
Short Term ◽  
Middle Income ◽  
Emergency Situations

Abstract Background Globalization has made it possible for global health professionals and trainees to participate in short-term training and professional experiences in a variety of clinical- and non-clinical activities across borders. Consequently, greater numbers of healthcare professionals and trainees from high-income countries (HICs) are working or volunteering abroad and participating in short-term experiences in low- and middle-income countries (LMICs). How effective these activities are in advancing global health and in addressing the crisis of human resources for health remains controversial. What is known, however, is that during these short-term experiences in global health (STEGH), health professionals and those in training often face substantive ethical challenges. A common dilemma described is that of acting outside of one’s scope of training. However, the frequency, nature, circumstances, and consequences of performing outside scope of training (POST) have not been well-explored or quantified. Methods The authors conducted an online survey of HIC health professionals and trainees working or volunteering in LMICs about their experiences with POST, within the last 5 years. Results A total of 223 survey responses were included in the final analysis. Half (49%) of respondents reported having been asked to perform outside their scope of training; of these, 61% reported POST. Trainees were nearly twice as likely as licensed professionals to report POST. Common reasons cited for POST were a mismatch of skills with host expectations, suboptimal supervision at host sites, inadequate preparation to decline POST, a perceived lack of alternative options and emergency situations. Many of the respondents who reported POST expressed moral distress that persisted over time. Conclusions Given that POST is ethically problematic and legally impermissible, the high rates of being asked, and deciding to do so, were notable. Based on these findings, the authors suggest that additional efforts are needed to reduce the incidence of POST during STEGH, including pre-departure training to navigate dilemmas concerning POST, clear communication regarding expectations, and greater attention to the moral distress experienced by those contending with POST.

scholarly journals Barriers to decolonising educational partnerships in global health

2021 ◽  
Vol 6 (11) ◽  
pp. e006964
Author(s):  
John Kulesa ◽  
Nana Afua Brantuo
Keyword(s):  
Global Health ◽  
Implementation Process ◽  
Educational Interventions ◽  
Educational Partnerships ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Partnerships ◽  
Low Middle Income Countries ◽  
Global Health Equity ◽  
The Ideal

Global health partnerships between high-income countries and low/middle-income countries can mirror colonial relationships. The growing call to advance global health equity therefore involves decolonising global health partnerships and outreach. Through decolonisation, local and international global health partners recognise non-western forms of knowledge and authority, acknowledge discrimination and disrupt colonial structures and legacies that influence access to healthcare.Despite these well-described aims, the ideal implementation process for decolonising global health remains ill-defined. This ambiguity exists, in part, because partners face barriers to adopting a decolonised perspective. Such barriers include overemphasis on intercountry relationships, implicit hierarchies perpetuated by educational interventions and ethical dilemmas in global health work.In this article, we explore the historical entanglement of education, health and colonialism. We then use this history as context to identify barriers that arise when decolonising contemporary educational global health partnerships. Finally, we offer global health partners strategies to address these challenges.

scholarly journals Addressing Fairness, Bias, and Appropriate Use of Artificial Intelligence and Machine Learning in Global Health

2021 ◽  
Vol 3 ◽  
Author(s):  
Richard Ribón Fletcher ◽  
Audace Nakeshimana ◽  
Olusubomi Olubeko
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Health Care ◽  
Global Health ◽  
Minority Groups ◽  
Target Population ◽  
Local Context ◽  
Local Health ◽  
Middle Income ◽  
The Impact

In Low- and Middle- Income Countries (LMICs), machine learning (ML) and artificial intelligence (AI) offer attractive solutions to address the shortage of health care resources and improve the capacity of the local health care infrastructure. However, AI and ML should also be used cautiously, due to potential issues of fairness and algorithmic bias that may arise if not applied properly. Furthermore, populations in LMICs can be particularly vulnerable to bias and fairness in AI algorithms, due to a lack of technical capacity, existing social bias against minority groups, and a lack of legal protections. In order to address the need for better guidance within the context of global health, we describe three basic criteria (Appropriateness, Fairness, and Bias) that can be used to help evaluate the use of machine learning and AI systems: 1) APPROPRIATENESS is the process of deciding how the algorithm should be used in the local context, and properly matching the machine learning model to the target population; 2) BIAS is a systematic tendency in a model to favor one demographic group vs another, which can be mitigated but can lead to unfairness; and 3) FAIRNESS involves examining the impact on various demographic groups and choosing one of several mathematical definitions of group fairness that will adequately satisfy the desired set of legal, cultural, and ethical requirements. Finally, we illustrate how these principles can be applied using a case study of machine learning applied to the diagnosis and screening of pulmonary disease in Pune, India. We hope that these methods and principles can help guide researchers and organizations working in global health who are considering the use of machine learning and artificial intelligence.

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