scholarly journals Global health systems partnerships: a mixed methods analysis of Mozambique’s HPV vaccine delivery network actors

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Caroline Soi ◽  
Jessica Shearer ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Global Health ◽  
Health Systems ◽  
Hpv Vaccine ◽  
Vaccine Delivery ◽  
Delivery Network

scholarly journals Global Health Classroom: Mixed Methods Evaluation of an Interinstitutional Model for Reciprocal Global Health Learning Among Samoan and New Zealand Medical Students

2020 ◽  
Author(s):  
Roshit Bothara ◽  
Malama Tafuna'i ◽  
Tim Wilkinson ◽  
Jen Desrosiers ◽  
Susan Jack ◽  
...  
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Medical Students ◽  
Global Health ◽  
Learning Outcomes ◽  
Health Systems ◽  
Virtual Classroom ◽  
Determinants Of Health ◽  
Mutual Benefit ◽  
Global Health Education

Abstract Background Global health education partnerships should be collaborative and reciprocal to ensure mutual benefit. Utilisation of digital technologies can overcome geographic boundaries and facilitate collaborative global health learning. Global Health Classroom (GHCR) is a collaborative global health learning model involving medical students from different countries learning about each other’s health systems, cultures, and determinants of health via videoconference. Principles of reciprocity and inter-institutional partnership informed the development of GHCR. This study explores learning outcomes and experiences in GHCR between students from New Zealand and Samoa. Methods The study used a mixed methods approach employing post-GHCR questionnaires and semi-structured face-to-face interviews to explore self-reported learning and experiences among medical students in GHCR. The GHCR collaboration studied was between the medical schools at the University of Otago, New Zealand and the National University of Samoa, Samoa.ResultsQuestionnaire response rate was 85% (74/87). Nineteen interviews were conducted among New Zealand and Samoan students. Students reported acquiring the intended learning outcomes relating to patient care, health systems, culture, and determinants of health with regards to their partner country. There was evidence of attitudinal changes including cultural curiosity and humility. Some reported a vision for progress regarding their own health system. Students reported that interacting with their international peers in the virtual classroom made learning about global health real and tangible. Mutual benefit to students from both countries indicated reciprocity.Conclusions The study demonstrates GHCR to be a promising model for collaborative and reciprocal global health learning using a student-led format and employing digital technology to create a virtual classroom. The self-reported learning outcomes align favourably with those recommended in the literature. In view of our positive findings, we present GHCR as an adaptable model for equitable, collaborative global health learning between students in internationally partnered institutions.

scholarly journals Global health classroom: mixed methods evaluation of an interinstitutional model for reciprocal global health learning among Samoan and New Zealand medical students

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Roshit K. Bothara ◽  
Malama Tafuna’i ◽  
Tim J. Wilkinson ◽  
Jen Desrosiers ◽  
Susan Jack ◽  
...  
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Medical Students ◽  
Global Health ◽  
Learning Outcomes ◽  
Health Systems ◽  
Virtual Classroom ◽  
Determinants Of Health ◽  
Cultural Humility ◽  
Questionnaire Response

Abstract Background Global health education partnerships should be collaborative and reciprocal to ensure mutual benefit. Utilisation of digital technologies can overcome geographic boundaries and facilitate collaborative global health learning. Global Health Classroom (GHCR) is a collaborative global health learning model involving medical students from different countries learning about each other’s health systems, cultures, and determinants of health via videoconference. Principles of reciprocity and interinstitutional partnership informed the development of the GHCR. This study explores learning outcomes and experiences in the GHCR between students from New Zealand and Samoa. Methods This study used a mixed methods approach employing post-GHCR questionnaires and semi-structured face-to-face interviews to explore self-reported learning and experiences among medical students in the GHCR. The GHCR collaboration studied was between the medical schools at the University of Otago, New Zealand and the National University of Samoa, Samoa. Results Questionnaire response rate was 85% (74/87). Nineteen interviews were conducted among New Zealand and Samoan students. Students reported acquiring the intended learning outcomes relating to patient care, health systems, culture, and determinants of health with regards to their partner country. Interview data was indicative of attitudinal changes in relation to cultural humility and curiosity. Some reported a vision for progress regarding their own health system. Students in the GHCR reported that learning with their international peers in the virtual classroom made learning about global health more real and tangible. The benefits to students from both countries indicated reciprocity. Conclusions This study demonstrates GHCR to be a promising model for collaborative and reciprocal global health learning using a student-led format and employing digital technology to create a virtual classroom. The self-reported learning outcomes align favourably with those recommended in the literature. In view of our positive findings, we present GHCR as an adaptable model for equitable, collaborative global health learning between students in internationally partnered institutions.

scholarly journals Global health systems partnerships: A mixed methods analysis of HPV vaccine delivery network actors in Mozambique

2020 ◽  
Author(s):  
Caroline Soi ◽  
Jessica Shearer ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Social Network ◽  
Mixed Methods ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Global Health ◽  
Hpv Vaccine ◽  
Evaluation Framework ◽  
Country Ownership ◽  
Outcome Scores ◽  
Partnership Network

Abstract Background Global health partnerships have expanded exponentially in the last two decades with Gavi, the Vaccine Alliance considered the model’s pioneer and leader because of its vaccination programs’ implementation mechanism. Gavi, relies on diverse domestic and international partners to carry out its programs in low- and middle-income countries under a Partnership Engagement Framework (PEF). We harnessed an established partnership evaluation framework, to conduct an in-depth examination of Mozambique’s Gavi driven partnership network which delivered the human papillomavirus (HPV) vaccine during the demonstration phase.Methods We utilized mixed methods to assess five partnership dimensions. Qualitative tools gauged contextual factors, prerequisites, partner performance and practices while a social network analysis (SNA) survey measured the partnership structure and perceived added value in terms of effectiveness, efficiency and country ownership. The 40 key informants who were interviewed included frontline ministry of health workers, ministry of education staff and supporting partner organization members, of whom 34 participated in the social network analysis survey.Results SNA measures for partnership structure revealed a partnership network characterized by high overall connectivity. Reachability 100% and average distance 2.5 scores were high, features that are favorable for rapid and widespread diffusion of information that is needed for engaging and handling multiple implementation scales. High SNA effectiveness and efficiency measures for structural holes (85%) and low redundancy (30%) coupled with high mean perceived effectiveness (97.6%) and efficiency (79.5%) outcome scores were observed. Additionally, the tie strength average score of 4.1 on a scale of 5 denoted high professional trust. These are all markers of a partnership where disparate institutions and organizations worked in a collaborative environment in which each entity’s comparative advantage was leveraged. Lower perceived outcome scores for country ownership (24%) were found with the challenges of working with out-of-country partners being prominently cited by study participants as reasons.Conclusions While there is room for improvement on the country ownership aspects of the partnership, the expanded, diverse and inclusive collaboration of institutions and organizations that implemented the Mozambique HPV vaccine demonstration project was effective and efficient and we recommend that the country adapt a similar model during the national scale up.

scholarly journals Global health systems partnerships: A mixed methods analysis of HPV vaccine delivery network actors in Mozambique

2020 ◽  
Author(s):  
Caroline Soi ◽  
Jessica Shearer ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Social Network ◽  
Mixed Methods ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Global Health ◽  
Hpv Vaccine ◽  
Evaluation Framework ◽  
Country Ownership ◽  
Outcome Scores ◽  
Partnership Network

Abstract Global health partnerships have expanded exponentially in the last two decades with Gavi, the Vaccine Alliance considered the model’s pioneer and leader because of its vaccination programs’ implementation mechanism. Gavi, relies on diverse domestic and international partners to carry out its programs in low- and middle-income countries under a Partnership Engagement Framework (PEF). We harnessed an established partnership evaluation framework, to conduct an in-depth examination of Mozambique’s Gavi driven partnership network which delivered the human papillomavirus (HPV) vaccine during the demonstration phase. Methods We utilized mixed methods to assess five partnership dimensions. Qualitative tools gauged contextual factors, prerequisites, partner performance and practices while a social network analysis (SNA) survey measured the partnership structure and perceived added value in terms of effectiveness, efficiency and country ownership. The 40 key informants who were interviewed included frontline ministry of health workers, ministry of education staff and supporting partner organization members, of whom 34 participated in the social network analysis survey. Results SNA measures for partnership structure revealed a partnership network characterized by high overall connectivity. Reachability 100% and average distance 2.5 scores were high, features that are favorable for rapid and widespread diffusion of information that is needed for engaging and handling multiple implementation scales. High SNA effectiveness and efficiency measures for structural holes (85%) and low redundancy (30%) coupled with high mean perceived effectiveness (97.6%) and efficiency (79.5%) outcome scores were observed. Additionally, the tie strength average score of 4.1 on a scale of 5 denoted high professional trust. These are all markers of a partnership where disparate institutions and organizations worked in a collaborative environment in which each entity’s comparative advantage was leveraged. Lower perceived outcome scores for country ownership (24%) were found with the challenges of working with out-of-country partners being prominently cited by study participants as reasons. Conclusions While there is room for improvement on the country ownership aspects of the partnership, the expanded, diverse and inclusive collaboration of institutions and organizations that implemented the Mozambique HPV vaccine demonstration project was effective and efficient and we recommend that the country adapt a similar model during the national scale up.

A Mixed Methods Evaluation of a Multi-Country, Cross-Sectoral Knowledge Transfer Partnership to Improve Health Systems Across Africa

2018 ◽  
Vol 10 (1) ◽  
pp. 136-148
Author(s):  
Erika Linnander ◽  
◽  
Katherine LaMonaca ◽  
Marie A. Brault ◽  
Medha Vyavahare ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Knowledge Transfer ◽  
Health Systems ◽  
Mixed Methods Evaluation ◽  
Improve Health

scholarly journals Artificial intelligence for good health: a scoping review of the ethics literature

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kathleen Murphy ◽  
Erica Di Ruggiero ◽  
Ross Upshur ◽  
Donald J. Willison ◽  
Neha Malhotra ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Global Health ◽  
Population Health ◽  
Health Systems ◽  
Scoping Review ◽  
Industrial Revolution ◽  
Ethical Issues ◽  
Grey Literature ◽  
Ethical Implications

Abstract Background Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

scholarly journals Reimagining global health systems for the 21st century: lessons from the COVID-19 pandemic

2021 ◽  
Vol 6 (4) ◽  
pp. e004882
Author(s):  
Yibeltal Assefa ◽  
Charles F Gilks ◽  
Remco van de Pas ◽  
Simon Reid ◽  
Dereje Gedle Gete ◽  
...  
Keyword(s):  
Global Health ◽  
Health Systems ◽  
21St Century

scholarly journals Effects of transition on HIV and non-HIV services and health systems in Kenya: a mixed methods evaluation of donor transition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniela C. Rodríguez ◽  
Diwakar Mohan ◽  
Caroline Mackenzie ◽  
Jess Wilhelm ◽  
Ezinne Eze-Ajoku ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Service Delivery ◽  
Health Systems ◽  
Local Level ◽  
Health Facilities ◽  
Government Support ◽  
Hiv Care ◽  
Local Context ◽  
Mixed Methods Evaluation ◽  
The Us

Abstract Background In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly achieving the UNAIDS 90–90-90 targets. In Kenya, PEPFAR designated over 400 health facilities in Northeastern Kenya to be transitioned to government support (known as central support (CS)). Methods We conducted a mixed methods evaluation exploring the effect of GP on health systems, and HIV and non-HIV service delivery in CS facilities. Quantitative data from a facility survey and health service delivery data were gathered and combined with data from two rounds of interviews and focus group discussions (FGDs) conducted at national and sub-national level to document the design and implementation of GP. The survey included 230 health facilities across 10 counties, and 59 interviews and 22 FGDs were conducted with government officials, health facility providers, patients, and civil society. Results We found that PEPFAR moved quickly from announcing the GP to implementation. Despite extensive conversations between the US government and the Government of Kenya, there was little consultation with sub-national actors even though the country had recently undergone a major devolution process. Survey and qualitative data identified a number of effects from GP, including discontinuation of certain services, declines in quality and access to HIV care, loss of training and financial incentives for health workers, and disruption of laboratory testing. Despite these reports, service coverage had not been greatly affected; however, clinician strikes in the post-transition period were potential confounders. Conclusions This study found similar effects to earlier research on transition and provides additional insights about internal country transitions, particularly in decentralized contexts. Aside from a need for longer planning periods and better communication and coordination, we raise concerns about transitions driven by epidemiological criteria without adaptation to the local context and their implication for priority-setting and HIV investments at the local level.

scholarly journals A framework for identifying and learning from countries that demonstrated exemplary performance in improving health outcomes and systems

2020 ◽  
Vol 5 (12) ◽  
pp. e002938
Author(s):  
Austin Carter ◽  
Nadia Akseer ◽  
Kevin Ho ◽  
Oliver Rothschild ◽  
Niranjan Bose ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Global Health ◽  
Health Outcomes ◽  
Mixed Methods Research ◽  
Multidisciplinary Teams ◽  
Ongoing Research ◽  
Qualitative And Quantitative ◽  
Success Stories ◽  
Quantitative Analyses ◽  
Comprehensive Framework

This paper introduces a framework for conducting and disseminating mixed methods research on positive outlier countries that successfully improved their health outcomes and systems. We provide guidance on identifying exemplar countries, assembling multidisciplinary teams, collecting and synthesising pre-existing evidence, undertaking qualitative and quantitative analyses, and preparing dissemination products for various target audiences. Through a range of ongoing research studies, we illustrate application of each step of the framework while highlighting key considerations and lessons learnt. We hope uptake of this comprehensive framework by diverse stakeholders will increase the availability and utilisation of rigorous and comparable insights from global health success stories.

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