scholarly journals Building a Digital Tool for the Adoption of the World Health Organization’s Antenatal Care Recommendations: Methodological Intersection of Evidence, Clinical Logic, and Digital Technology

10.2196/16355 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e16355
Author(s):  
Samira M Haddad ◽  
Renato T Souza ◽  
Jose Guilherme Cecatti ◽  
Maria Barreix ◽  
Tigest Tamrat ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Practice ◽  
Decision Support ◽  
Antenatal Care ◽  
Digital Systems ◽  
World Health ◽  
Evidence Based ◽  
Data Dictionary ◽  
The World

Background One of the key mandates of the World Health Organization (WHO) is to develop guidelines, defined as “a document containing recommendations for clinical practice or public health policy.” Guidelines represent the global standard for information sources shaping clinical practice and public health policies. Despite the rigorous development process and the value of guidelines for setting standards, implementing such standards within local contexts and at the point of care is a well-documented challenge. Digital technologies enable agile information management and may facilitate the adaptation of guidelines to diverse settings of health services delivery. Objective The objective of this paper is to detail the systematic and iterative process involved in transforming the WHO Antenatal Care (ANC) guidelines into a digital decision-support and patient-record application for routine use in primary health care settings, known as the WHO digital ANC module. Methods The WHO convened a team of clinical and digital health experts to develop the WHO digital ANC module as a tool to assist health care professionals in the implementation of WHO evidence-based recommendations for pregnant women. The WHO digital ANC module’s creation included the following steps: defining a minimum viable product (MVP), developing clinical workflows and algorithms, algorithm testing, developing a data dictionary, and the creation of a user interface or application development. The overall process of development took approximately 1 year to reach a stable prototype and to finalize the underlying content requirements of the data dictionary and decision support algorithms. Results The first output is a reference software reflecting the generic WHO ANC guideline content, known as the WHO digital ANC module. Within it, all actionable ANC recommendations have related data fields and algorithms to confirm whether the associated task was performed. WHO recommendations that are not carried out by the health care worker are saved as pending tasks on a woman’s health record, and those that are adequately fulfilled trigger messages with positive reinforcement. The second output consists of the structured documentation of the different components which contributed to the development of the WHO digital ANC module, such as the data dictionary and clinical decision support workflows. Conclusions This is a novel approach to facilitate the adoption and adaptation of recommendations through digital systems at the health service delivery level. It is expected that the WHO digital ANC module will support the implementation of evidence-based practices and provide information for monitoring and surveillance; however, further evidence is needed to understand how the WHO digital ANC module impacts the implementation of WHO recommendations. Further, the module’s implementation will inform the WHO’s ongoing efforts to create a pathway to adaptive and integrated (Smart) Guidelines in Digital Systems to improve health system quality, coverage, and accountability.

scholarly journals Building a Digital Tool for the Adoption of the World Health Organization’s Antenatal Care Recommendations: Methodological Intersection of Evidence, Clinical Logic, and Digital Technology (Preprint)

2019 ◽  
Author(s):  
Samira M Haddad ◽  
Renato T Souza ◽  
Jose Guilherme Cecatti ◽  
Maria Barreix ◽  
Tigist Tamrat ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Practice ◽  
Decision Support ◽  
Antenatal Care ◽  
Digital Systems ◽  
World Health ◽  
Evidence Based ◽  
Data Dictionary ◽  
The World

BACKGROUND One of the key mandates of the World Health Organization (WHO) is to develop guidelines, defined as “a document containing recommendations for clinical practice or public health policy.” Guidelines represent the global standard for information sources shaping clinical practice and public health policies. Despite the rigorous development process and the value of guidelines for setting standards, implementing such standards within local contexts and at the point of care is a well-documented challenge. Digital technologies enable agile information management and may facilitate the adaptation of guidelines to diverse settings of health services delivery. OBJECTIVE The objective of this paper is to detail the systematic and iterative process involved in transforming the WHO Antenatal Care (ANC) guidelines into a digital decision-support and patient-record application for routine use in primary health care settings, known as the WHO digital ANC module. METHODS The WHO convened a team of clinical and digital health experts to develop the WHO digital ANC module as a tool to assist health care professionals in the implementation of WHO evidence-based recommendations for pregnant women. The WHO digital ANC module’s creation included the following steps: defining a minimum viable product (MVP), developing clinical workflows and algorithms, algorithm testing, developing a data dictionary, and the creation of a user interface or application development. The overall process of development took approximately 1 year to reach a stable prototype and to finalize the underlying content requirements of the data dictionary and decision support algorithms. RESULTS The first output is a reference software reflecting the generic WHO ANC guideline content, known as the WHO digital ANC module. Within it, all actionable ANC recommendations have related data fields and algorithms to confirm whether the associated task was performed. WHO recommendations that are not carried out by the health care worker are saved as pending tasks on a woman’s health record, and those that are adequately fulfilled trigger messages with positive reinforcement. The second output consists of the structured documentation of the different components which contributed to the development of the WHO digital ANC module, such as the data dictionary and clinical decision support workflows. CONCLUSIONS This is a novel approach to facilitate the adoption and adaptation of recommendations through digital systems at the health service delivery level. It is expected that the WHO digital ANC module will support the implementation of evidence-based practices and provide information for monitoring and surveillance; however, further evidence is needed to understand how the WHO digital ANC module impacts the implementation of WHO recommendations. Further, the module’s implementation will inform the WHO’s ongoing efforts to create a pathway to adaptive and integrated (Smart) Guidelines in Digital Systems to improve health system quality, coverage, and accountability.

scholarly journals The Contribution of Public Health Investments to the Economic Growth of Cameroon

2017 ◽  
Vol 4 (1) ◽  
pp. 12-21 ◽  
Author(s):  
Ismaila Amadu ◽  
Ngoe Fritz Eseokwea ◽  
Marcel Ngambi
Keyword(s):  
Public Health ◽  
Economic Growth ◽  
Health Care ◽  
Health Care Services ◽  
Health Spending ◽  
World Health ◽  
Quality Health Care ◽  
Health Investments ◽  
The World ◽  
The Government

The goal of this paper is to determine the contribution of public health investments to the economic growth of Cameroon. The study used the human capital model of Lucas (1988) within the framework of endogenous growth theories. The Vector Error Correction Model (VECM) was employed in the estimations procedure using the World Development Indicators (WDI, 2013) data from the World Bank over the period spanning from 1988 to 2013.The findings show that government health expenditures contribute to economic growth only in the long run. From our results, we recommend that: first, the government should increase health spending to 10 or 15 percent of its GDP as initially suggested by the African Union and the World Health Organization respectively; second, government should enhance the provision of health care services by the private sector by putting in place incitation measures; third, competitive awards should be granted to those health units that render quality health care services.Int. J. Soc. Sc. Manage. Vol. 4, Issue-1: 12-21

scholarly journals Pakistan’s Response to COVID-19: Overcoming National and International Hypes to Fight the Pandemic (Preprint)

2021 ◽  
Author(s):  
Hashaam Akhtar ◽  
Maham Afridi ◽  
Samar Akhtar ◽  
Hamaad Ahmad ◽  
Sabahat Ali ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
World Health Organization ◽  
Public Health Emergency ◽  
World Health ◽  
High Population ◽  
Economic Systems ◽  
The World ◽  
Health Organization

UNSTRUCTURED The COVID-19 outbreak started as pneumonia in December 2019 in Wuhan, China. The subsequent pandemic was declared as the sixth public health emergency of international concern on January 30, 2020, by the World Health Organization. Pakistan could be a potential hotspot for COVID-19 owing to its high population of 204.65 million and its struggling health care and economic systems. Pakistan was able to tackle the challenge with relatively mild repercussions. The present analysis has been conducted to highlight the situation of the disease in Pakistan in 2020 and the measures taken by various stakeholders coupled with support from the community to abate the risk of catastrophic spread of the virus.

scholarly journals 3.E. Workshop: The Role of Digital Public Health in the European Climate Pact and Green deal

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Digital Health ◽  
Digital Systems ◽  
World Health ◽  
Director General ◽  
European Climate ◽  
The World ◽  
Climate Crisis ◽  
The Impact

Abstract   Europe is facing two major structural changes: the climate crisis, having a significant impact on public health, and digitalization of the economy, that could play a role in mitigating climate change and its impacts on public health. The COVID-19 pandemic has affected our lives in many ways including how we see public health, the climate change and has created the conditions for the almost exponential growth for telemedicine and digitalization in healthcare. Underlining that the world is facing an increasing innovation and integration of digital tools to address public health and environmental problems, as the UN Secretary-General and the Director-General of the World Health Organization both declared that we are currently fighting a climate “pandemic” in the same way as we are fighting COVID-19. Digital solutions have been implemented to address COVID-19 and impacted by reducing CO2 emissions and improving quality of life. Digital systems, including Artificial Intelligence, robots and drones, are now changing the paradigm of public health and environment management. Due to the complex nature of the information ecosystem our societies and communities live in, a digital public health approach can be managed to reduce harm to individual, community and population health, support social cohesion and trust in emergency response and interventions to deal with climate change. Digital health could, within 10 years establish a new paradigm in public and environmental health. Public health professionals need urgently to tackle digital health to bridge the gap with others areas of healthcare. During the COVID-19 crisis, national public health authorities have been challenged in the way they communicate with the public, engage with communities in collecting data to improve response, providing the scientific evidence, the day-to-day facts and figures. Likewise, The European Climate Pact provides a space for collectively develop and implement climate solutions. The Climate Pact is an open, inclusive and evolving initiative for climate action through an online platform and citizen dialogues and exchanges, it will foster the link between the digital and green transition. This workshop aims to share the experiences of digital public health interventions with significant impact on climate change mitigation during the pandemic. It will be organised as a round table, starting by setting the scene with an introduction to key digital health concepts and challenges. Each speaker will give a short pitch on how they have experienced the challenge of using digital systems in public health and how they approached its management during the crisis. This will be followed by a panel discussion. Participants will have ample time to ask questions to the panellists. The workshop will end with a summary of a selection of tools participants can use in their own environmental management activities and key take home messages from the panellist will be provided as a conclusion. Key messages Digital Public Health has been establishing evidence on interventions with significant effects on reducing the impact of climate crisis. A Partnership is needed across the health system and society to manage this crisis. European Green Deal and Climate Pact could be used as a roadmap in digital public health.

scholarly journals Public health fault lines in the fight against COVID-19: Lessons from Africa

2021 ◽  
Vol 11 (2) ◽  
pp. 260-262
Author(s):  
Saikou Omar Sillah ◽  
Xu Yihua
Keyword(s):  
Public Health ◽  
Health Care ◽  
World Health Organization ◽  
Health Care System ◽  
Virus Disease ◽  
Public Health Emergency ◽  
World Health ◽  
Rapid Spread ◽  
The World ◽  
Health Organization

On 31st December 2019, the World Health Organization (WHO) was notified of a cluster of cases of pneumonia of unknown cause detected in the Wuhan, Hubei Province of China which eventually was named to be the Corona virus disease. In response to the rapid spread of the virus, WHO declared it a public health emergency of international concern (PHEIC) on 30th January, 2020. As per the quest to recharge the COVID-19 response power, there is seemingly little or no tangible plans to help permanently reorient Africa’s health care system. In the wake of widespread vaccine nationalism, donor countries continue to secure large quantities of vaccines from developers and manufacturers, causing global disparity in access to COVID-19 vaccines.

Healthcare in Brazil

2020 ◽  
pp. 63-68
Author(s):  
Elena Frolova
Keyword(s):  
Public Health ◽  
Health Care ◽  
Medical Care ◽  
National Health System ◽  
World Health ◽  
Economic Losses ◽  
Average Life Expectancy ◽  
Healthcare Needs ◽  
The World ◽  
The Right

Brazil is the largest country in South America both in terms of population and area, while the country ranks fifth in the world in terms of territory. About 200 million people live in the country, the average life expectancy as of 2019 was 75.7 years, Portuguese is official language. Healthcare in Brazil at the present stage occupies a rightful place in the ranking of world health care systems. Not much is allocated for healthcare needs according to the European standards — about 8.5 % of GDP. However 1 % from any banking transaction in the country goes for medicine. At the same time the state pays close attention to health issues, fully providing financing for such costly areas as the treatment of HIV-associated pathology and hepatitis C, hemodialysis, and insulin therapy. But it was not always this way. Until 1988, before the right of all citizens to receive guaranteed medical care was enshrined in the Brazilian Constitution, healthcare in the country was available only to wealthy segments of the population, while the poor could only rely on the provision of medical services as part of charity. National Health System was established in the country in 1990 due to the adoption of the Constitution, which proclaimed the right to health as one of the fundamental human rights. Today, this system is one of the largest public health systems in the world, which covers provision of health care for about 200 million people. The country moved from the category of «recipient» of medical care at the world level to the category of «donor» not so long ago, and is very successful in this. This is one of the few states where public health interests of the nation are put above economic ones. This fact was confirmed during the tobacco control company. Brazil, being a major exporter of tobacco products, took an active part in this company, despite the fact that it suffered major economic losses [1].

scholarly journals Variations in processes for guideline adaptation: a qualitative study of World Health Organization staff experiences in implementing guidelines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhicheng Wang ◽  
Quinn Grundy ◽  
Lisa Parker ◽  
Lisa Bero
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Qualitative Study ◽  
Local Development ◽  
World Health ◽  
Recent Experience ◽  
Who Guidelines ◽  
Guideline Adaptation ◽  
The World ◽  
Adaptation Processes

Abstract Background The World Health Organisation (WHO) publishes a large number of clinical practice and public health guidelines to promote evidence-based practice across the world. Due to the variety of health system capacities and contextual issues in different regions and countries, adapting the recommendations in the guidelines to the local situation is vital for the success of their implementation. We aim to understand the range of experiences with guideline adaptation from the perspectives of those working in WHO regional and country offices. Our findings will inform development of guidance on how to improve adaptability of WHO guidelines. Methods A grounded theory-informed, qualitative study was carried out between March 2018 and December 2018. Seventeen semi-structured interviews were conducted with participants who included WHO guideline developers and staff in the headquarters, regional and country offices recruited from a sample of published WHO guidelines. Participants were eligible for recruitment if they had recent experience in clinical practice or public health guideline implementation. Deidentified transcripts of these interview were analysed through three cycles of coding. Results We categorised the adaptation processes described by the participants into two dominant models along a spectrum of guideline adaptation processes. First, the Copy or Customise Model is a pragmatic approach of either copying or customising WHO guidelines to suit local needs. This is done by local health authorities and/or clinicians directly through consultations with WHO staff. Selections and adjustments of guideline recommendations are made according to what the implementers deemed important, feasible and applicable through the consensus discussions. Second, the Capacity Building Model focuses on WHO building local capacity in evidence synthesis methods and adaptation frameworks to support local development of a national guideline informed by international guidelines. Conclusions In comparing and contrasting these two models of guideline adaptation, we outline the different kinds of support from WHO that may be necessary to improve the effectiveness and efficiency of the respective models. We also suggest clarifications in the descriptions of the process of guideline adaptation in WHO and academic literature, to help guideline adaptors and implementers decide on the appropriate course of action according to their specific circumstances. Ethics This project was conducted with ethics approval from The University of Sydney (Project number: 2017/723) and WHO (Protocol ID: 00001).

Policy Development in Disaster Preparedness and Management: Lessons Learned from the January 2001 Earthquake in Gujarat, India

2003 ◽  
Vol 18 (4) ◽  
pp. 372-384 ◽  
Author(s):  
Rannveig Bremer
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Disaster Preparedness ◽  
Policy Development ◽  
Disaster Relief ◽  
World Health ◽  
Disaster Victims ◽  
Primary Health ◽  
The World

AbstractIntroduction:During the last decades, several humanitarian emergencies have occurred, with an increasing number of humanitarian organizations taking part in providing assistance. However, need assessments, medical intelligence, and coordination of the aid often are sparse, resulting in the provision of ineffective and expensive assistance. When an earthquake with the strength of 7.7 on the Richter scale struck the state of Gujarat, India, during the early morning on 26 January 2001, nearly 20,000 persons were killed, nearly 170,000 were injured, and 600,000 were rendered homeless. This study identifies how assigned indicators to measure the level of health care may improve disaster preparedness and management, thus, reducing human suffering.Methods:During a two-week mission in the disaster area, the disaster relief provided to the disaster-affected population of Gujarat was evaluated. Vulnerability due to climate, geography, culture, religion, gender, politics, and economy, as each affected the outcome, was studied. By assigning indicators to the eight ELEMENTS of the Primary Health Care System as advocated by the World Health Organization (WHO), the level of public health and healthcare services were estimated, an evaluation of the impact of the disaster was conducted, and possible methods for improving disaster management are suggested. Representatives of the major relief organizations involved were interviewed on their relief policies. Strategies to improve disaster relief, such as policy development in the different aspects of public health/primary health care, were sought.Results:Evaluation of the pre-event status of the affected society revealed a complex situation in a vulnerable society with substantial deficiencies in the existing health system that added to the severity of the disaster. Most of the civilian hospitals had collapsed, and army field hospitals provided medical care to most of the patients under primitive conditions using tents. When the foreign field hospitals arrived 5 to 7 days after the earthquake, most of the casualties requiring surgical intervention already had been operated on. Relief provided to the disaster victims had reduced quality for the following reasons: (1) proper public health indicators had not yet been developed; (2) efficient coordination was lacking; (3) insufficient, overestimated, or partly irrelevant relief was provided; (4) relief was delayed because of bureaucracy; and (5) policies on the delivery of disaster relief had not been developed.Conclusion:To optimize the effectiveness of limited resources, disaster preparedness and the provision of feasible and necessary aid is of utmost importance. An appropriate, rapid, crisis intervention could be achieved by continual surveillance of the world's situation by a Relief Coordination Center. A panel of experts could evaluate and coordinate the international disaster responses and make use of stored emergency material and emergency teams. A successful disaster response will depend on accurate and relevant medical intelligence and socio-geographical mapping in advance of, during, and after the event(s) causing the disaster. More effective and feasible equipment coordinated with the relief provided by the rest of the world is necessary. If policies and agreements are developed as part of disaster preparedness, on international, bilateral, and national levels, disaster relief may be more relevant, less chaotic, and easier to estimate, thus, bringing improved relief to the disaster victims.

scholarly journals Responses to the Pandemic COVID-19 in Primary Health Care in Oman: Muscat Experience

2021 ◽  
Vol 36 (1) ◽  
pp. e216-e216
Author(s):  
Thamra Al Ghafri ◽  
Fatma Al Ajmi ◽  
Lamya Al Balushi ◽  
Padma Mohan Kurup ◽  
Aysha Al Ghamari ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Technology Use ◽  
Scale Up ◽  
Building Blocks ◽  
World Health ◽  
Public Health Response ◽  
Primary Health ◽  
The World

Objectives: As coronavirus disease (COVID-19) was pervading different parts of the world, little has been published regarding responses undertaken within primary health care (PHC) facilities in Arabian Gulf countries. This paper describes such responses from January to mid-April 2020 in PHC, including public health measures in Muscat, Oman. Methods: This is a descriptive study showing the trends of the confirmed positive cases of COVID-19 and the undertaken responses to the evolving epidemiological scenario. These responses were described utilizing the World Health Organizations’ building blocks for health care systems: Leadership and governance, Health workforce, Service delivery, Medical products and technologies, and health information management. Results: In mid-April 2020, cases of COVID-19 increased to 685 (particularly among non-nationals). As the cases were surging, the PHC responded by executing all guidelines and policies from the national medical and public health response committees and integrating innovative approaches. These included adapting comprehensive and multi-sectoral strategies, partnering with private establishments, and strengthening technology use (in tracking, testing, managing the cases, and data management). Conclusions: Facilities in the Muscat governorate, with the support from national teams, seemed to continuously scale-up their preparedness and responses to meet the epidemiological expectations in the management of COVID-19.

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