scholarly journals Primary-level palliative care national capacity: Pallium Canada

2021 ◽  
pp. bmjspcare-2021-003036
Author(s):  
Jose Pereira ◽  
Srini Chary ◽  
Jonathan Faulkner ◽  
Bonnie Tompkins ◽  
Jeffrey B Moat
Keyword(s):  
Palliative Care ◽  
Core Competencies ◽  
Geographical Area ◽  
National Level ◽  
Scale Up ◽  
Education Programme ◽  
Lessons Learned ◽  
Non Profit ◽  
Primary Level ◽  
Large Geographical Area

The need to improve access to palliative care across many settings of care for patients with cancer and non-cancer illnesses is recognised. This requires primary-level palliative care capacity, but many healthcare professionals lack core competencies in this area. Pallium Canada, a non-profit organisation, has been building primary-level palliative care at a national level since 2000, largely through its Learning Essential Approaches to Palliative Care (LEAP) education programme and its compassionate communities efforts. From 2015 to 2019, 1603 LEAP course sessions were delivered across Canada, reaching 28 123 learners from different professions, including nurses, physicians, social workers and pharmacists. This paper describes the factors that have accelerated and impeded spread and scale-up of these programmes. The need for partnerships with local, provincial and federal governments and organisations is highlighted. A social enterprise model, that involves diversifying sources of revenue to augment government funding, enhances long-term sustainability. Barriers have included Canada’s geopolitical realities, including large geographical area and thirteen different healthcare systems. Some of the lessons learned and strategies that have evolved are potentially transferrable to other jurisdictions.

scholarly journals How Do Floods and Drought Impact Economic Growth and Human Development at the Sub-National Level in India?

Climate ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 123
Author(s):  
Upali Amarasinghe ◽  
Giriraj Amarnath ◽  
Niranga Alahacoon ◽  
Surajit Ghosh
Keyword(s):  
Economic Growth ◽  
Human Development ◽  
Geographical Area ◽  
National Level ◽  
Large Area ◽  
Indian States ◽  
Mitigation And Adaptation ◽  
Large Geographical Area ◽  
Substantial Investment ◽  
The Impact

This paper tries to shift the focus of research on the impact of natural disasters on economic growth from global and national levels to sub-national levels. Inadequate sub-national level information is a significant lacuna for planning spatially targeted climate change adaptation investments. A fixed-effect panel regression analyses of 19 states from 2001 to 2015 assess the impacts of exposure to floods and droughts on the growth of gross state domestic product (GSDP) and human development index (HDI) in India. The flood and drought exposure are estimated using satellite data. The 19 states comprise 95% of the population and contribute 93% to the national GDP. The results show that floods indeed expose a large area, but droughts have the most significant impacts at the sub-national level. The most affected GSDPs are in the non-agriculture sectors, positively by the floods and negatively by droughts. No significant influence on human development may be due to substantial investment on mitigation of flood and drought impacts and their influence on better income, health, and education conditions. Because some Indian states still have a large geographical area, profiling disasters impacts at even smaller sub-national units such as districts can lead to effective targeted mitigation and adaptation activities, reduce shocks, and accelerate income growth and human development.

Successful strategies and lessons learned from development of large-scale partnerships of national non-gowernmental organisations

2005 ◽  
Vol 12 (3-4) ◽  
pp. 131-137 ◽  
Author(s):  
William Potts-Datema ◽  
Becky J. Smith ◽  
Howard Taras ◽  
Theresa C. Lewallen ◽  
James F. Bogden ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
School Health ◽  
National Level ◽  
Health And Safety ◽  
The United States ◽  
Lessons Learned ◽  
Children And Youth ◽  
Non Profit ◽  
Outcomes For Children

National governments worldwide work to improve education and health outcomes for children and youth and influence their behaviours. Also heavily engaged are national non-governmental organisations (NGOs) in the voluntary and non-profit sector. While individual agencies and non-profit organisations are often concerned with specific issues of interest related to their charge, constituency or membership, they often develop allegiances with like-minded groups to accomplish broader goals. Two such collaborations in the United States are the focus of this discussion, the National Co-ordinating Committee on School Health and Safety (NCCSHS) and the Friends of School Health (hereafter, "the Friends"). This article reviews these two significant partnerships of public health and education NGOs and outlines successful strategies and lessons learned from the development of these large-scale partnerships. NCCSHS is a collaboration of 64 NGOs and six U.S. government departments representing both the fields of public health and education. Nearly all major NGOs working in fields related to school health are represented, and the six primary governmental agencies all have at least some responsibility for students' health and safety. The group is the primary intersection of NGOs and the Federal government related to school health at the national level. The Friends of School Health ("the Friends") is the primary school health advocacy coalition at the national level in the United States. Sixty-one education and public health NGOs participate. The coalition serves as a communication mechanism and venue for collaborative action on issues before the U.S. Congress and state legislatures that relate to school health. Since the coalition advocates to legislators and other decision makers, no government agencies participate. The paper describes the strategies relating to the initial development of the collaboratives and their ongoing operation. A common theme in development of both of these examples of large-scale partnerships is trust. Like any partnership, the ability to work and grow is dependent on the level of trust among the partners. Both the National Coordinating Committee on School Health and Safety and the Friends of School Health work together successfully within and across their collaborations, to improve health and educational outcomes for children and youth. While both experience challenges, and neither would indicate that its work is near completion, they provide important insight into how these collaboratives can initially develop and subsequently operate productively while providing important contributions to the promotion of healthy schools, and ultimately, healthy nations.

scholarly journals A quality improvement approach to the reduction of HIV-related stigma and discrimination in healthcare settings

2019 ◽  
Vol 4 (3) ◽  
pp. e001587 ◽  
Author(s):  
Daniel J Ikeda ◽  
Laura Nyblade ◽  
Kriengkrai Srithanaviboonchai ◽  
Bruce D Agins
Keyword(s):  
Quality Improvement ◽  
Southeast Asia ◽  
National Level ◽  
Scale Up ◽  
Lessons Learned ◽  
Routine Practice ◽  
People Living With Hiv ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Related Stigma

HIV-related stigma and discrimination (S&D) in healthcare settings represents a potent barrier to achieving global aims to end the HIV epidemic, particularly in Southeast Asia (Cambodia, Lao People’s Democratic Republic, Thailand and Vietnam). Evidence-based approaches for measuring and reducing S&D in healthcare settings exist, but their incorporation into routine practice remains limited, in part due to a lack of attention to how unique organisational practices—beyond the knowledge and attitudes of individuals—may abet and reinforce S&D. Application of a quality improvement (QI) approach in which facilities leverage routine measurement of S&D among healthcare workers and people living with HIV, team-based learning, root cause analysis, and tests of change offers a novel means through which to address S&D in local contexts and develop interventions to address individual-level and organisation-level drivers of S&D. To support the adoption of a QI approach to S&D reduction, the Southeast Asia Stigma Reduction QI Learning Network was launched with Ministries of Health from Cambodia, Lao PDR, Thailand and Vietnam, to co-develop strategies for implementing QI activities in participating facilities. Since the inception of Network activities in 2017, Ministry-led QI activities to address S&D have been implemented in 83 facilities and 29 provinces across participating countries. Moreover, 27 strategies and interventions have been tested to date and are being evaluated for scale up by participating facilities, spanning multiple drivers and organisational domains. Lessons learned through Network activities offer national-level and facility-level HIV programmes best practices for implementing a QI approach to S&D reduction.

scholarly journals The Third Sector: The “Other” Actors of Rural Development, Andalusia 2000–2015

2021 ◽  
Vol 13 (24) ◽  
pp. 13976
Author(s):  
Eugenio Cejudo-García ◽  
Francisco Navarro-Valverde ◽  
José Antonio Cañete-Pérez ◽  
Noelia Ruiz-Moya
Keyword(s):  
Rural Development ◽  
Rural Areas ◽  
Geographical Area ◽  
Third Sector ◽  
Non Profit ◽  
The Third ◽  
General Terms ◽  
Large Geographical Area ◽  
Non Profit Organizations ◽  
The Third Sector

Civil society plays an essential role in the development of our rural areas. In spite of this, little research has been conducted on the role of non-profit organizations, often referred to in general terms as the third sector, within the framework of the LEADER program for rural development, especially in such a large geographical area as Andalusia, the study area of this research. The diversity of the groups that make up the “Others” group of rural development stakeholders is one of its most important characteristics. Over the course of the study period (2000–2015), these organizations have played a very significant role in Andalusia in both quantitative and qualitative terms. In order to find out more about the diversity of third sector organizations and to quantify and evaluate their importance, we carried out a detailed analysis of all the LEADER projects commenced in Andalusia between 2000 and 2015. The quantitative and quantitative results obtained highlight the diversity of these projects and how widely their presence varied from one type of rural area to the next. Our research reopens the debate about the growing role played by non-profit organizations in developed societies at a global level and within LEADER in particular.

scholarly journals Private Forests in Nepal: Status and Policy Analysis

2017 ◽  
Vol 15 (1) ◽  
pp. 120-130 ◽  
Author(s):  
Swoyambhu M. Amatya ◽  
Prakash Lamsal
Keyword(s):  
Present Status ◽  
National Level ◽  
Timber Harvesting ◽  
Lessons Learned ◽  
Private Land ◽  
Private Forest ◽  
Community Forest ◽  
Private Forest Owners ◽  
Forest Owners ◽  
Private Forests

 This paper reviews and analyses the present status of private forests and tenure administration in light of existing legal, policy, and regulatory frameworks in Nepal. Additionally, the present status of private forests, as well as the scenarios of timber harvesting, transportation, marketing, and their administration are thoroughly revised. Provisions regarding forests and trees on private land and their basis are examined and implications are articulated for potential policy improvements for enhanced tenure security. It is shown that robust national-level policies and legal frameworks exist, and that there is an increasing trend of timber flows to markets from private forests over the past five years. However, there is still skepticism, mistrust and fear amongst private forest owners, saw millers, and forest administration that prevents the full use of the bundle of rights that legal and policy provisions have promised. An unusually slow pace of private forest registration, lengthy and multi stage processes for obtaining harvesting and transportation permits, and official bans on important commercial species, among others, are found to be the factors that most hinder the private forest owners’ and tree growers’ interests, and their rights and obligations with respect to the management and use of their private forest resources. It is concluded that a simplified permitting process along with programmatic support would promote and help to grow private forestry and that Nepal’s experience and lessons learned from community forest implementation would be a great asset to move towards this end. Connecting community forest user groups for organised and cooperative action, and mobilising their institutional strength and accumulated funds for pro-farmer technical and regulatory support would allow farmers to intensify tree plantations and forest management. Further steps are required to convince policymakers and secure necessary budgetary support to this end..

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

scholarly journals Scaling Up Delivery of Biofortified Staple Food Crops Globally: Paths to Nourishing Millions

2021 ◽  
pp. 037957212098250
Author(s):  
Jennifer K. Foley ◽  
Kristina D. Michaux ◽  
Bho Mudyahoto ◽  
Laira Kyazike ◽  
Binu Cherian ◽  
...  
Keyword(s):  
Pearl Millet ◽  
Large Scale ◽  
Scale Up ◽  
Lessons Learned ◽  
Raw Material ◽  
Micronutrient Deficiencies ◽  
Seed Systems ◽  
Public And Private ◽  
Context Specific ◽  
Public And Private Sector

Background: Micronutrient deficiencies affect over one quarter of the world’s population. Biofortification is an evidence-based nutrition strategy that addresses some of the most common and preventable global micronutrient gaps and can help improve the health of millions of people. Since 2013, HarvestPlus and a consortium of collaborators have made impressive progress in the enrichment of staple crops with essential micronutrients through conventional plant breeding. Objective: To review and highlight lessons learned from multiple large-scale delivery strategies used by HarvestPlus to scale up biofortification across different country and crop contexts. Results: India has strong public and private sector pearl millet breeding programs and a robust commercial seed sector. To scale-up pearl millet, HarvestPlus established partnerships with public and private seed companies, which facilitated the rapid commercialization of products and engagement of farmers in delivery activities. In Nigeria, HarvestPlus stimulated the initial acceptance and popularization of vitamin A cassava using a host of creative approaches, including “crowding in” delivery partners, innovative promotional programs, and development of intermediate raw material for industry and novel food products. In Uganda, orange sweet potato (OSP) is a traditional subsistence crop. Due to this, and the lack of formal seed systems and markets, HarvestPlus established a network of partnerships with community-based nongovernmental organizations and vine multipliers to popularize and scale-up delivery of OSP. Conclusions: Impact of biofortification ultimately depends on the development of sustainable markets for biofortified seeds and products. Results illustrate the need for context-specific, innovative solutions to promote widespread adoption.

scholarly journals Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Arias-Casais ◽  
Eduardo Garralda ◽  
Miguel Antonio Sánchez-Cárdenas ◽  
John Y. Rhee ◽  
Carlos Centeno
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Long Term Care ◽  
Task Force ◽  
National Level ◽  
Structured Interviews ◽  
Term Care ◽  
Care Facilities ◽  
Rating Process

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

scholarly journals The epidemiology of Moebius syndrome in Italy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Arturo Carta ◽  
Stefania Favilla ◽  
Giacomo Calzetti ◽  
Maria Cristina Casalini ◽  
Pier Francesco Ferrari ◽  
...  
Keyword(s):  
Demographic Data ◽  
Geographical Area ◽  
National Level ◽  
Age At Diagnosis ◽  
University Hospital ◽  
Italian Population ◽  
Moebius Syndrome ◽  
Cross Sectional ◽  
Geographical Regions ◽  
Chi Square Analysis

Abstract Background The epidemiology of Moebius syndrome (MBS) is difficult to assess. In the present study, we investigated the epidemiology of MBS in a well-defined population within a precise geographical area. Materials and methods Our university hospital is the only national referral center for the diagnosis and treatment of MBS. Participants in this cross-sectional study were patients affected by MBS who had been periodically followed by our medical staff since 1998. Most of the patients were referred to our hospital by the Italian Association of Moebius Syndrome (AISMO). Demographic data necessary for study purposes were made available in the AISMO database, updated to April 2018. Subjects were assigned to geographical macroareas that are conventionally used in surveys and epidemiological investigations by the Italian National Institute of Statistics. The rates and prevalence of MBS cases were calculated on the basis of the last available survey of the Italian population. Each study parameter was then calculated with reference to the whole country and macroarea partition. The sex rate and the corresponding prevalence were calculated with respect to the weighted whole population and to the respective sex population. Chi-square analysis was adopted to investigate possible differences among geographical regions and/or sexes. A p value < 0.05 was considered statistically significant. Results One hundred and sixty-four out of 212 MBS patients fulfilled our inclusion criteria. All cases occurred in Caucasian patients and were sporadic. The median age at diagnosis was 3.6 years, ranging from 0 to 55 years; this range was significantly reduced to 0–5 years (median age at diagnosis: 2.2 years) in patients included after 2007. The calculated prevalence at birth was 0.06 cases per 10,000 live births, with an overall prevalence of 0.27/100,000, without any sex or geographical predominance. Conclusions The prevalence of MBS observed herein, rounded for possible underestimation, was 0.3/100,000 people, without any regional difference in the distribution of cases. Our data confirm the rarity of the disease on a national level.

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