Research on health priorities: a regional agenda and its implementation in Jordan and Pakistan

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

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Global Health Priority-Setting

10.1093/oso/9780190912765.001.0001 ◽

2019 ◽

Cited By ~ 1

Keyword(s):

Global Health ◽

Priority Setting ◽

Health Resources ◽

Decision Makers ◽

Health Priorities ◽

Health Coverage ◽

Household Finances ◽

Health Gains ◽

Global Priority ◽

Financing Gap

Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development assistance for health has plateaued and domestic funding on health in most countries is growing at rates too low to close the financing gap. National and international decision-makers face tough choices about how scarce health care resources should be spent. Should additional funds be spent on primary prevention of stroke, treating childhood cancer, or expanding treatment for HIV/AIDS? Should health coverage decisions take into account the effects of illness on productivity, household finances, and children’s educational attainment, or should they just focus on health outcomes? Does age matter for priority-setting or should it be ignored? Are health gains far in the future less important than gains in the present? Should higher priority be given to people who are sicker or poorer? This book provides a framework for how to think about evidence-based priority-setting in health. Over 18 chapters, ethicists, philosophers, economists, policymakers, and clinicians from around the world assess the state of current practice in national and global priority-setting, describe new tools and methodologies to address establishing global health priorities, and tackle the most important ethical questions that decision-makers must consider in allocating health resources.

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Stakeholders’ Perspectives on the Unmet Needs and Health Priorities of the Urban Poor in South-East Nigeria

International Quarterly of Community Health Education ◽

10.1177/0272684x211033441 ◽

2021 ◽

pp. 0272684X2110334

Author(s):

Ifeyinwa Arize ◽

Daniel Ogbuabor ◽

Chinyere Mbachu ◽

Enyi Etiaba ◽

Benjamin Uzochukwu ◽

...

Keyword(s):

Urban Areas ◽

Urban Poor ◽

Health Workers ◽

Cost Of Care ◽

Health Needs ◽

Health Priorities ◽

Primary Health Care System ◽

Dual Practice ◽

Double Burden ◽

Primary Health

Relatively little is known about readiness of urban health systems to address health needs of the poor. This study explored stakeholders’ perception of health needs and strategies for improving health of the urban poor using qualitative analysis. Focus group discussions (n = 5) were held with 26 stakeholders drawn from two Nigerian states during a workshop. Urban areas are characterised by double burden of diseases. Poor housing, lack of basic amenities, poverty, and poor access to information are determinants of health of the urban poor. Shortage of health workers, stock-out of medicines, high cost of care, lack of clinical practice guidelines, and dual practice constrain access to primary health services. An overarching strategy, that prioritises community-driven urban planning, health-in-all policies, structured linkages between informal and formal providers, financial protection schemes, and strengthening of primary health care system, is required to address health needs of the urban poor.

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Predictors of Discontinuation of Modern Spacing Contraceptives in India

Asia Pacific Journal of Public Health ◽

10.1177/1010539520983149 ◽

2020 ◽

pp. 101053952098314

Author(s):

Shahina Begum ◽

Himanshu Chaurasia ◽

Kusum V. Moray ◽

Beena Joshi

Keyword(s):

Contraceptive Use ◽

Oral Contraceptive Pill ◽

Family Health ◽

Reproductive Age ◽

Health Priorities ◽

Unintended Pregnancies ◽

Reproductive Age Women ◽

One Year ◽

Women In India

Data from National Family Health Survey (2015-2016) was analyzed to examine the contraceptive acceptance, discontinuation rates, and associated factors among reproductive age women in India over one year. Findings revealed that 11.7% accepted modern methods of which 68% were for spacing. Only 5% switched to other methods. Discontinuation rate was high among condom (56.8%) and oral contraceptive pill users (34.5%), among women aged less than 25 years, with parity less than 2, belonging to rural area, and having no education. Health concerns/side effects, husband’s disapproval, or method failure were most common reasons cited for discontinuation. The data show high discontinuation rates among some subgroups of women and for certain methods. Hence, women need to be provided options to switch methods to meet changing contraceptive needs and health priorities. Continuum of care with follow-up and counselling can facilitate sustained contraceptive use to avert unintended pregnancies.

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Refocusing School Health Programs to Address Public Health Priorities

Journal of School Health ◽

10.1111/j.1746-1561.1997.tb03474.x ◽

1997 ◽

Vol 67 (8) ◽

pp. 357-358

Keyword(s):

Public Health ◽

School Health ◽

Health Programs ◽

Health Priorities ◽

School Health Programs

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Digitally-enabled approach to improving primary care in a rural and remote low-resource setting

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.043 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Ansell

Keyword(s):

Primary Care ◽

Public Sector ◽

Low Income ◽

Digital Health ◽

Health Priorities ◽

Rural And Remote ◽

Low Resource Settings ◽

Digital Platform ◽

Low Resource ◽

Out Of Pocket Payments

Abstract Introduction An innovative digitally-supported multi-sectoral solution for supporting end-to-end primary care for rural and remote low-income populations in Western Visayas, Philippines was examined to determine its efficacy in supporting health access. This solution brings together multisectoral stakeholders using a digital platform to coordinate the provision of a virtual primary care system. The solution also supports ordering and delivery of low-cost insurance and medicines, with the aim of reducing out-of-pocket payments and complementing public-sector services. Methods Processes and outputs for a novel data-driven digital health solution were documented and analyzed through a mixed methods approach. Researchers conducted interviews with a range of stakeholders, including program beneficiaries and partners. Quantitative data focusing on the project outputs were also examined. Results Through an integrated digital platform to coordinate inputs from the public sector (Department of Health); private sector (pharmaceutical, insurance, and telecom firms); and community (in the form of a peer-worker network), this model offers an example of an innovative approach to primary health delivery in low-resource settings. These inputs are leveraged and informed by a 'big-data' precision approach, based on detailed epidemiological profiles of community residents. This dataset allows for the evidence-based identification of village-specific health priorities and development of corresponding interventions. This approach has contributed to increased access to medicines; affordability of medicines and health services; and community resilience among the target populations. However, barriers involving a local shortage of health human resources and cumbersome eHealth regulations affect program impact. Conclusions This research provides evidence for the scale-up of a multisectoral digital approach to support the implementation of UHC targets in Philippines. Key messages Implementing digital health solutions in low-resource settings is possible. Changes are needed in Philippines health regulations for digital health to properly support UHC implementation.

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Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041503 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041503

Author(s):

Peizhen Zhao ◽

Weiming Tang ◽

Huanhuan Cheng ◽

Shujie Huang ◽

Heping Zheng ◽

...

Keyword(s):

Condom Use ◽

Hiv Testing ◽

Transmitted Disease ◽

Cross Sectional Study ◽

Health Priorities ◽

Consistent Condom ◽

Sectional Study ◽

Cross Sectional ◽

Syphilis Testing ◽

Testing Uptake

ObjectivesUnderscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider’s ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China.DesignA cross-sectional study was performed between July 2016 and December 2016.SettingSeven STD clinics in Guangdong Province, China.ParticipantsHeterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing.Outcome measuresThe syphilis and HIV testing uptake determined by patient receipt of results.ResultsA total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake.ConclusionsThe low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.

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