scholarly journals Setting the Health Research Priority Agenda for the Ministry of Health (MoH), Kingdom of Saudi Arabia 2020-2025 Project

2021 ◽  
Author(s):  
Athari Alotaibi ◽  
Wafaa Mohamed Abuelmakarem Saleh ◽  
khalid alshaibani ◽  
Abdulaziz Hassan Abdulbaqi ◽  
Maha Alosaimi
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Research ◽  
Collaborative Research ◽  
Full Range ◽  
Essential Medicines ◽  
Research Prioritization ◽  
Research Priority ◽  
Vision 2030 ◽  
The Impact

Abstract BackgroundThe Saudi Vision 2030 project recognized the integral role of health research in transforming, modernizing and governing the healthcare system, as well as improving health. The nature of health research prioritization is context-specific, and there is an obligation to effectively allocate resources to initiatives that will achieve the greatest impact, which is discussed in this paper.MethodsThe best practice for health research prioritization depends on the existing needs and context. The e-Delphi technique was conducted via an online self-administered questionnaire that covered health research topics, topics related to Vision 2030, as well as collaborative research. Criteria used for scoring the selected topics were: appropriateness, relevance, feasibility, urgency, collaboration and impact of research outcome. Research domains were prioritized by ranking the weighted mean aggregate score and all topics of the top five ranked domains, along with the aggregate scores of the answers of those in leadership positions were pooled together, validated, verified, summarized, refined and then classified into themes. ResultsThe participants included those from a full range of health specialties and subspecialties (46.5% physicians, 39% health specialists, 10% pharmacists and 3.6% dentists), and the study achieved balanced regional participation and covered a wide spectrum of qualification and professional levels. In total there were 2252 participants and 98% belonged to MoH. Of those from the MoH, 134 were leaders (85 Headquarters policy makers and 49 regional decision makers), while the rest were made up from individuals from 16 Health Affairs Directorates spanning 75 hospitals and specialized health centers, 24 primary health care centers , 2 healthcare clusters, in addition to five medical cities. Community involvement was represented by 26 organizations. Approximately half of stakeholders contributed to scientific research, while 24% had previous publications, and only 6% had a direct influence in health policymaking. The study deliverables were listed into three agendas:1. Health System Research Priority Themes: Service Delivery, Workforce, Information Systems, Access to Essential Medicines, Financing, Governance & Leadership and Disaster Response. 2. Diseases and Health Problems Themes: Non-Communicable and Communicable Diseases, Trauma, Public Health, Dental Health, Environmental Health, Pilgrims’ Health, Women’s Health, Child & Geriatric Health, Biomedical Technology, Radiology and Physical Technology.3. National and International Collaborative Research Themes: Major research areas impacted by COVID-19, Public Health, ‎ Healthcare Access, Medical Care & Universal Health Coverage, Value-based Healthcare, Health System Financing and Economics, Health Information and Communication Technology, Health System Governance, Health Workforce Development and Health System Preparedness and Response to Emergency.Conclusion Adequate description of the stakeholders and the methodology can strengthen legitimacy, credibility and maximize the impact of the priority setting process. Involvement of policymakers, researchers and funding organizations increases the opportunity of translation into actual research, supports redesigning the research landscape and ensures uptake of results and integration.

scholarly journals What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peter van der Graaf ◽  
Lindsay Blank ◽  
Eleanor Holding ◽  
Elizabeth Goyder
Keyword(s):  
Public Health ◽  
Health Research ◽  
Collaborative Research ◽  
Online Survey ◽  
Public Health Practice ◽  
Rapid Review ◽  
Success Rates ◽  
Evaluation Scheme ◽  
Health Practitioners ◽  
Public Health Practitioners

Abstract Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). Results Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

scholarly journals Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

2017 ◽  
Vol 54 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Elinton Adami CHAIM ◽  
José Carlos PAREJA ◽  
Martinho Antonio GESTIC ◽  
Murillo Pimentel UTRINI ◽  
Everton CAZZO
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Wound Dehiscence ◽  
Pulmonary Complications ◽  
Multidisciplinary Program ◽  
The Impact ◽  
Access To Surgery

ABSTRACT BACKGROUND Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. RESULTS There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. CONCLUSION The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system.

scholarly journals Impact of tobacco tax increases and industry pricing on smoking behaviours and inequalities: a mixed-methods study

2020 ◽  
Vol 8 (6) ◽  
pp. 1-140
Author(s):  
Timea R Partos ◽  
Rosemary Hiscock ◽  
Anna B Gilmore ◽  
J Robert Branston ◽  
Sara Hitchman ◽  
...  
Keyword(s):  
Public Health ◽  
Health Research ◽  
Tobacco Industry ◽  
Control Policy ◽  
Public Health Research ◽  
Pricing Strategies ◽  
The Uk ◽  
Tax Changes ◽  
The Impact ◽  
Evaluation Project

Background Increasing tobacco prices through taxation is very effective for reducing smoking prevalence and inequalities. For optimum effect, understanding how the tobacco industry and smokers respond is essential. Tobacco taxation changes occurred in the UK over the study period, including annual increases, a shift in structure from ad valorem to specific taxation and relatively higher increases on roll-your-own tobacco than on factory-made cigarettes. Objectives Understanding tobacco industry pricing strategies in response to tax changes and the impact of tax on smokers’ behaviour, including tax evasion and avoidance, as well as the effect on smoking inequalities. Synthesising findings to inform how taxation can be improved as a public health intervention. Design Qualitative analysis and evidence synthesis (commercial and Nielsen data) and longitudinal and aggregate cross-sectional analyses (International Tobacco Control Policy Evaluation Project data). Setting The UK, from 2002 to 2016. Data sources and participants Data were from the tobacco industry commercial literature and retail tobacco sales data (Nielsen, New York, NY, USA). Participants were a longitudinal cohort (with replenishment) of smokers and ex-smokers from 10 surveys of the International Tobacco Control Policy Evaluation Project (around 1500 participants per survey). Main outcome measures (1) Tobacco industry pricing strategies, (2) sales volumes and prices by segments over time and (3) smokers’ behaviours, including products purchased, sources, brands, consumption, quit attempts, success and sociodemographic differences. Review methods Tobacco industry commercial literature was searched for mentions of tobacco products and price segments, with 517 articles extracted. Results The tobacco industry increased prices on top of tax increases (overshifting), particularly on premium products, and, recently, the tobacco industry overshifted more on cheap roll-your-own tobacco than on factory-made cigarettes. Increasingly, price rises were from industry revenue generation rather than tax. The tobacco industry raised prices gradually to soften impact; this was less possible with larger tax increases. Budget measures to reduce cheap product availability failed due to new cheap factory-made products, price marking and small packs. In 2014, smokers could buy factory-made (roll-your-own tobacco) cigarettes at real prices similar to 2002. Exclusive roll-your-own tobacco and mixed factory-made cigarettes and roll-your-own tobacco use increased, whereas exclusive factory-made cigarette use decreased, alongside increased cheap product use, rather than quitting. Quitting behaviours were associated with higher taxes. Smokers consumed fewer factory-made cigarettes and reduced roll-your-own tobacco weight over time. Apparent illicit purchasing did not increase. Disadvantaged and dependent smokers struggled with tobacco affordability and were more likely to smoke cheaper products, but disadvantage did not affect quit success. Limitations Different for each data set; triangulation increased confidence. Conclusions The tobacco industry overshifted taxes and increased revenues, even when tax increases were high. Therefore, tobacco taxes can be further increased to reduce price differentials and recoup public health costs. Government strategies on illicit tobacco appear effective. Large, sudden tax increases would reduce the industry’s ability to manipulate prices, decrease affordability and increase quitting behaviours. More disadvantaged, and dependent, smokers need more help with quitting. Future work Assessing the impact of tax changes made since 2014; changing how tax changes are introduced (e.g. sudden intermittent or smaller continuous); and tax changes on tobacco initiation. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 6. See the NIHR Journals Library website for further project information.

scholarly journals Impact of the Umoyo mother-infant pair model on HIV-positive mothers’ social support, perceived stigma and 12-month retention of their HIV-exposed infants in PMTCT Care: Evidence from a cluster randomised control trial in Zambia

2019 ◽  
Author(s):  
Sydney Chauwa Phiri ◽  
Sandra Mudhune ◽  
Margaret L Prust ◽  
Prudence Haimbe ◽  
Hilda Shakwelele ◽  
...  
Keyword(s):  
Public Health ◽  
Social Support ◽  
Health System ◽  
T Test ◽  
Perceived Stigma ◽  
Hiv Exposed Infants ◽  
Pair Model ◽  
Hiv Exposed ◽  
The Impact ◽  
Infant Pair

Abstract Background Public health systems in resource-constrained settings have a critical role to play in the elimination of HIV transmission but are often financially constrained. This study is an evaluation of a mother-infant-pair model called “Umoyo”, which was designed to be low cost and scalable in a public health system. Facilities with the Umoyo model dedicate a clinic day to provide services to only HIV-exposed-infants (HEIs) and their mothers. Such models are in operation with reported success in Zambia but have not been rigorously tested. This work establishes whether the Umoyo model would improve 12-month retention of HEIs. Methods A cluster randomized trial including 28 facilities was conducted across two provinces of Zambia to investigate the impact on 12-month retention of HEIs in care. These facilities were offering prevention of mother to child transmission (PMTCT) services and supported by the same implementing partner. Randomization was achieved by use of the covariate constrained optimization technique. Secondary outcomes included the impact of Umoyo clinics on social support and perceived HIV stigma among mothers. For each of the outcomes, a difference-in-difference analysis was conducted at the facility level using the unweighted t-test. Results From 13 control (12-month retention at endline: 45%) and 11 intervention facilities (12-month retention at endline: 33%), it was found that Umoyo clinics had no impact on 12-month retention of HEIs in the t-test (-11%; 99% CI: -40.1%, 17.2%). Regarding social support and stigma, the un-weighted t-test showed no impact though sensitivity tests showed that Umoyo had an impact on increasing social support (0.31; 99% CI: 0.08, 0.54) and reducing perceived stigma from health care workers (-0.27: 99% CI: -0.46, -0.08). Conclusion The Umoyo approach of having a dedicated clinic day for HEIs and their mothers did not improve retention of HEIs though there are indications that it can increase social support among mothers and reduce stigma. Without further support to the underlying health system, based on the evidence generated through this evaluation, the Umoyo clinic day approach on its own is not considered an effective intervention to increase retention of HIV-exposed infants.

scholarly journals When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. Movsisyan ◽  
E. Rehfuess ◽  
S. L. Norris
Keyword(s):  
Public Health ◽  
Health System ◽  
Guideline Development ◽  
Decision Criteria ◽  
Evidence Mapping ◽  
Different Types ◽  
Explicit Consideration ◽  
Procedural Guidance ◽  
Main Message ◽  
The Impact

Abstract Background Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. Main message A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps. Conclusions Through explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria.

scholarly journals Ethnicity and COVID-19: an urgent public health research priority

The Lancet ◽  
2020 ◽  
Vol 395 (10234) ◽  
pp. 1421-1422 ◽  
Author(s):  
Manish Pareek ◽  
Mansoor N Bangash ◽  
Nilesh Pareek ◽  
Daniel Pan ◽  
Shirley Sze ◽  
...  
Keyword(s):  
Public Health ◽  
Health Research ◽  
Public Health Research ◽  
Research Priority

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

scholarly journals Breast Feeding in Pandemic Situation. How Does Sri Lanka Face the Challenge?

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 214-214
Author(s):  
Neerodha Dharmasoma
Keyword(s):  
Public Health ◽  
Sri Lanka ◽  
Health System ◽  
Breast Feeding ◽  
Public Health System ◽  
Feeding Practices ◽  
Health Staff ◽  
Emergency Situations ◽  
Public Health Staff ◽  
The Impact

Abstract Objectives Sri Lanka has been awarded the first-ever ‘Green’ breastfeeding (BF) nation status by the World Breastfeeding Trends Initiative (WBTi) in January 2020 (1) with the support of public health system. But, deviating attention of health services towards emergency pandemic situation has resulted in strained health systems and interruptions in humanitarian response leading to eroding access to essential and often life-saving nutrition services. Therefore, optimal breast feeding practices are at risk due to infected mothers’ isolation practices, exhausted public health system and misbeliefs among the community (2). This finds out how Sri Lanka plans to maintain high standards of breast feeding in pandemic situation. Methods We searched for the publications on breast feeding, Sri Lanka in pandemic situation from January 2020 to date. Results As a low and middle income country with an unbeatable public health system, Sri Lanka has already issued an interim guideline for public health staff in continuation maternal and child care services (3). It ensures domiciliary visits by public health midwives (PHMs), although the clinic based teaching sessions on breast feeding have been cancelled. Community awareness has been created that no evidence of transmission of SARS COV-2 via breast milk is available and how the benefits of breast feeding outweigh the risk of infection (4). It is recommended that breast feeding shouldn't be interrupted at all and hand hygienic practices before touching the baby are ideal. Infected mothers can wear a protective mask and rooming in, and kangaroo mother care should be practiced. Sri Lanka already had guidelines on ensuring adequate and appropriate infant feeding guidelines in emergency situations (5). Conclusions Despite the challenges faced by community and public health staff, Sri Lanka make efforts to maintain the achieved breast feeding standards. Further studies are needed to assess the impact of the pandemic on breast feeding practices in near future. Funding Sources None

scholarly journals Approaches to Health Research Priority Setting in the Philippines across the Years

2019 ◽  
Vol 53 (3) ◽  
Author(s):  
Alain Jason A. Generale ◽  
Reneepearl Kim P. Sales ◽  
Teddy S. Dizon ◽  
Alan B. Feranil
Keyword(s):  
Priority Setting ◽  
Health Research ◽  
Research Agenda ◽  
Policy Formulation ◽  
The Philippines ◽  
Lessons Learned ◽  
Gradual Change ◽  
Research Priority ◽  
The Impact ◽  
Health Research Priority Setting

Background. As one of the research councils under the Department of Science and Technology (DOST), health research priority setting has been the mandate of the Philippine Council for Health Research and Development (PCHRD) since its establishment in 1982. The development of the National Unified Health Research Agenda (NUHRA) convenes the major stakeholders for health in the country to establish the priorities for health research. The NUHRA aims to address the most urgent health issues in the country for the generation of solutions to the health concerns of the country. Objectives and Method. Through document review, this paper describes the approaches and lessons learned in research priority setting since the establishment of the Philippine National Health Research System. Results. The Philippines has employed a bottoms-up, top-down, and a combination of both approaches to develop its health research agenda. Conclusion. The health research agenda-setting must consider evolving funding sources, its link to production of researches with high probability of knowledge translation to health technology innovation, and policy formulation. Measuring the impact of the NUHRA to the health systems and health situation of the country is a difficult assessment, but the gradual change in healthcare technology utilization and evidence-informed policies towards health equity can be a subjective measurement of the NUHRA’s success.

scholarly journals OPEN VS LAPAROSCOPIC HERNIA REPAIR IN THE BRAZILIAN PUBLIC HEALTH SYSTEM. AN 11-YEAR NATIONWIDE POPULATION-BASED STUDY

2020 ◽  
Vol 57 (4) ◽  
pp. 484-490
Author(s):  
Eduardo Morais EVERLING ◽  
Daniela Santos BANDEIRA ◽  
Felipe Melloto GALLOTTI ◽  
Priscila BOSSARDI ◽  
Antoninho José TONATTO-FILHO ◽  
...  
Keyword(s):  
Public Health ◽  
Minimally Invasive ◽  
Hernia Repair ◽  
Health System ◽  
Public Health System ◽  
Laparoscopic Hernia Repair ◽  
Dominant Group ◽  
The Public ◽  
Early Return ◽  
The Impact

ABSTRACT BACKGROUND: Abdominal wall hernia is one of the most common surgical pathologies. The advent of minimally invasive surgery raised questions about the best technique to be applied, considering the possibility of reducing postoperative pain, a lower rate of complications, and early return to usual activities. OBJECTIVE: To evaluate the frequency of open and laparoscopic hernioplasties in Brazil from 2008 to 2018, analyzing the rates of urgent and elective surgeries, mortality, costs, and the impact of laparoscopic surgical training on the public health system. METHODS: Nationwide data from 2008 to 2018 were obtained from the public health registry database (DATASUS) for a descriptive analysis of the selected data and parameters. RESULTS: 2,671,347 hernioplasties were performed in the period, an average of 242,850 surgeries per year (99.4% open, 0.6% laparoscopic). The economically active population (aged 20-59) constituted the dominant group (54.5%). There was a significant reduction (P<0.01) in open surgeries, without a compensatory increase in laparoscopic procedures. 22.3% of surgeries were urgent, with a significant increase in mortality when compared to elective surgeries (P<0.01). The distribution of laparoscopic surgery varied widely, directly associated with the number of digestive surgeons. CONCLUSION: This study presents nationwide data on hernia repair surgeries in Brazil for the first time. Minimally invasive techniques represent a minor portion of hernioplasties. Urgent surgeries represent a high percentage when compared to other countries, with increased mortality. The data reinforce the need for improvement in the offer of services, specialized training, and equalization in the distribution of procedures in all regions.

Sign in / Sign up

Export Citation Format

Share Document