scholarly journals Health system considerations related to voluntary and forced displacement in the Eastern Mediterranean Region: a critical analysis of the available literature

2021 ◽  
Author(s):  
Eman Sharara ◽  
Chaza Akik ◽  
Michela Martini ◽  
Jocelyn DeJong
Keyword(s):  
Health System ◽  
Health Care Access ◽  
Large Scale ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Building Blocks ◽  
System Response ◽  
New Governance ◽  
Forced Displacement ◽  
And Migration

Background: The WHO Region for the Eastern Mediterranean has had a history of complex migration patterns, with high levels of migration to, from and within the Region, overlaid by massive recent forced displacement. Relatively little is known about the health system response to this large-scale mobility. Aims: To review the literature on the Region critically, identify gaps and suggest areas needing research and policy attention. Method: A search of the published literature using MEDLINE and POPLINE was conducted on health and migration focusing on the WHO health system building blocks with no date or language limitations. Results: Out of 4679 retrieved articles published between 1964 and January 2019, 140 met our inclusion criteria; 45 additional articles were included in a December 2020 update. Most publications focused on refugees and on the delivery of services. Conclusions: Few studies explored the responsiveness of health system to refugees and migrants compared with those for host communities, or assessed the quality of services or refugees’/migrants’ perceptions of available health services. Few suggested new approaches to financing health care access for these populations or new governance arrangements.

scholarly journals Identifying pathways for large-scale implementation of a school-based mental health programme in the Eastern Mediterranean Region: a theory-driven approach

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii112-ii123 ◽  
Author(s):  
Olakunle Alonge ◽  
Anna Chiumento ◽  
Hesham M Hamoda ◽  
Eman Gaber ◽  
Zill-e- Huma ◽  
...  
Keyword(s):  
Mental Health ◽  
Mediterranean Region ◽  
Large Scale ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Theory Of Change ◽  
Programme Implementation ◽  
School Based ◽  
Mental Health Programme ◽  
Health Programme

Abstract Globally there is a substantial burden of mental health problems among children and adolescents. Task-shifting/task-sharing mental health services to non-specialists, e.g. teachers in school settings, provide a unique opportunity for the implementation of mental health interventions at scale in low- and middle-income countries (LMICs). There is scant information to guide the large-scale implementation of school-based mental health programme in LMICs. This article describes pathways for large-scale implementation of a School Mental Health Program (SMHP) in the Eastern Mediterranean Region (EMR). A collaborative learning group (CLG) comprising stakeholders involved in implementing the SMHP including policymakers, programme managers and researchers from EMR countries was established. Participants in the CLG applied the theory of change (ToC) methodology to identify sets of preconditions, assumptions and hypothesized pathways for improving the mental health outcomes of school-aged children in public schools through implementation of the SMHP. The proposed pathways were then validated through multiple regional and national ToC workshops held between January 2017 and September 2019, as the SMHP was being rolled out in three EMR countries: Egypt, Pakistan and Iran. Preconditions, strategies and programmatic/contextual adaptations that apply across these three countries were drawn from qualitative narrative summaries of programme implementation processes and facilitated discussions during biannual CLG meetings. The ToC for large-scale implementation of the SMHP in the EMR suggests that identifying national champions, formulating dedicated cross-sectoral (including the health and education sector) implementation teams, sustained policy advocacy and stakeholders engagement across multiple levels, and effective co-ordination among education and health systems especially at the local level are among the critical factors for large-scale programme implementation. The pathways described in this paper are useful for facilitating effective implementation of the SMHP at scale and provide a theory-based framework for evaluating the SMHP and similar programmes in the EMR and other LMICs.

scholarly journals Enabling virtual collaboration in Digital Cultural Heritage in the SEEM region

2018 ◽  
Vol 19 (2) ◽  
pp. 161-174
Author(s):  
Panayiotis Charalambous ◽  
George Artopoulos
Keyword(s):  
Cultural Heritage ◽  
Data Storage ◽  
Large Scale ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Regional Level ◽  
Digital Tools ◽  
Virtual Collaboration ◽  
Horizon 2020 ◽  
Digital Cultural Heritage

It has been observed that many researchers in the humanities do not use digital tools to their full extent for their research. Some of the most pressing needs of researchers in Digital Cultural Heritage (DCH) are data storage and handling and large scale computing. Linking these researchers to experienced groups will significantly improve productivity and research innovation in DCH. This work presents our efforts in enabling virtual collaboration for research in the South East and Eastern Mediterranean region and more specifically the deployment of the Clowder CMS system and the development of extraction services to handle, manage and automatically process DCH data. We give technical descriptions of the system and provide some results and discussions of our efforts to enable virtual collaboration between regional level DCH researchers in the context of the Horizon 2020 funded VI-SEEM project.

scholarly journals Classifications of Winter Euro-Atlantic Circulation Patterns: An Intercomparison of Five Atmospheric Reanalyses

2017 ◽  
Vol 30 (19) ◽  
pp. 7847-7861 ◽  
Author(s):  
Jan Stryhal ◽  
Radan Huth
Keyword(s):  
Twentieth Century ◽  
Mediterranean Region ◽  
Large Scale ◽  
Climate Models ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Synoptic Climatology ◽  
Cmip5 Models ◽  
Circulation Patterns ◽  
Twentieth Century Reanalysis

Abstract Atmospheric reanalyses have been widely used to study large-scale atmospheric circulation and its links to local weather and to validate climate models. Only little effort has so far been made to compare reanalyses over the Euro-Atlantic domain, with the exception of a few studies analyzing North Atlantic cyclones. In particular, studies utilizing automated classifications of circulation patterns—one of the most popular methods in synoptic climatology—have paid little or no attention to the issue of reanalysis evaluation. Here, five reanalyses [ERA-40; NCEP-1; JRA-55; Twentieth Century Reanalysis, version 2 (20CRv2); and ECMWF twentieth-century reanalysis (ERA-20C)] are compared as to the frequency of occurrence of circulation types (CTs) over eight European domains in winters 1961–2000. Eight different classifications are used in parallel with the intention to eliminate possible artifacts of individual classification methods. This also helps document how substantial effect a choice of method can have if one quantifies differences between reanalyses. In general, ERA-40, NCEP-1, and JRA-55 exhibit a fairly small portion of days (under 8%) classified to different CTs if pairs of reanalyses are compared, with two exceptions: over Iceland, NCEP-1 shows disproportionately high frequencies of CTs with cyclones shifted south- and eastward; over the eastern Mediterranean region, ERA-40 and NCEP-1 disagree on classification of about 22% of days. The 20CRv2 is significantly different from other reanalyses over all domains and has a clearly suppressed frequency of zonal CTs. Finally, validation of 32 CMIP5 models over the eastern Mediterranean region reveals that using different reanalyses can considerably alter errors in the CT frequency of models and their rank.

scholarly journals The complexity of scaling up an mHealth intervention: the case of SMS for Life in Tanzania from a health systems integration perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carmen Sant Fruchtman ◽  
Selemani Mbuyita ◽  
Mary Mwanyika-Sando ◽  
Marcel Braun ◽  
Don de Savigny ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Large Scale ◽  
Digital Health ◽  
Health Sector ◽  
Building Blocks ◽  
Scaling Up ◽  
Stock Management ◽  
Study Approach

Abstract Background SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. Its goal was to increase visibility to antimalarial stock-outs through the use of SMS technology. The objective of this case study was to show the multiple innovations that SMS for Life brought to the Tanzanian public health sector and to discuss the challenges of scaling up that led to its discontinuation from a health systems perspective. Methods A qualitative case-study approach was used. This included a literature review, a document review of 61 project documents, a timeline of key events and the collection and analysis of 28 interviews with key stakeholders involved in or affected by the SMS for Life programme. Data collection was informed by the health system building blocks. We then carried out a thematic analysis using the WHO mHealth Assessment and Planning for Scale (MAPS) Toolkit as a framework. This served to identify the key reasons for the discontinuation of the programme. Results SMS for Life was reliable at scale and raised awareness of stock-outs with real-time monitoring. However, it was discontinued in 2015 after 4 years of a national rollout. The main reasons identified for the discontinuation were the programme’s failure to adapt to the continuous changes in Tanzania’s health system, the focus on stock-outs rather than ensuring appropriate stock management, and that it was perceived as costly by policy-makers. Despite its discontinuation, SMS for Life, together with co-existing technologies, triggered the development of the capacity to accommodate and integrate future technologies in the health system. Conclusion This study shows the importance of engaging appropriate stakeholders from the outset, understanding and designing system-responsive interventions appropriately when scaling up and ensuring value to a broad range of health system actors. These shortcomings are common among digital health solutions and need to be better addressed in future implementations.

scholarly journals Recent advances in research and control of malaria, leishmaniasis, trypanosomiasis and schistosomiasis

2003 ◽  
Vol 9 (4) ◽  
pp. 518-533 ◽  
Author(s):  
S. L. Croft ◽  
L. Vivas ◽  
S. Brooker
Keyword(s):  
Large Scale ◽  
Environmental Control ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Fold Increase ◽  
Sub Saharan Africa ◽  
World Health ◽  
Roll Back Malaria ◽  
Regular Treatment ◽  
Recent Advances

In the Eastern Mediterranean Region of the World Health Organization [WHO], malaria, schistosomiasis, leishmaniasis and trypanosomiasis are the parasitic diseases of major importance. Our review focuses on recent advances in the control and treatment of these diseases with particular reference to diagnosis, chemotherapy, vaccines, vector and environmental control. The Roll Back Malaria Programme, for example, emphasizes the use of insecticide treated bednets in Africa and targets a 30-fold increase in treated bednet use by 2007. Increasing risk factors for leishmaniasis include urbanization, extended agricultural projects and civil unrest and the increase in patients with Leishmania infantum and HIV co-infection in the Region may signal a new threat. In the past 20 years, human African trypanosomiasis has resurged in sub-Saharan Africa; within the Region it has become more common in the southern Sudan where anthroponotic and zoonotic sub-species infections overlap. Schistosomiasis in the Region is caused by either Schistosoma haematobium or S. mansoni and large-scale control efforts include providing regular treatment to at-risk groups and supporting drug delivery through schools.

Eastern Mediterranean Drying: Projected Changes in Dynamics and Thermodynamics and Their Relation to Large-Scale Processes

2021 ◽  
Author(s):  
Eilat Elbaum ◽  
Chaim I. Garfinkel ◽  
Ori Adam ◽  
Efrat Morin
Keyword(s):  
Surface Temperature ◽  
Large Scale ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Coupled Model ◽  
Past Century ◽  
Stratospheric Polar Vortex ◽  
Dynamic Component ◽  
Near Surface ◽  
Projected Changes

<p>Observations from the past century and projections for the end of this century show a decrease in precipitation over the eastern Mediterranean Sea and surrounding land areas. Changes in precipitation are controlled by both thermodynamic and dynamic processes, but the relative contributions of these processes, in particular on regional scales, is not well understood. Models included in the fifth and sixth phases of the Coupled Model Intercomparison Project (CMIP5 and CMIP6) exhibit a wide spread in the magnitude of expected drying in the eastern Mediterranean region, as well as in other meteorological variables. By decomposing projected changes in the moisture budget in 48 models into mean dynamic and mean thermodynamic components, we explore the contribution of each of these components to the model spread in regional drying. In the eastern Mediterranean, the dynamic component explains 64% and the thermodynamic component explains 9% of the variance in net precipitation change. We further examine the relation of the regional components to changes in five large-scale mechanisms: tropical vertical stratification, global near-surface temperature, latitude of the eddy-driven jet, stratospheric polar vortex, and arctic amplification. Of these, we find that a decrease in the dynamical contribution in the eastern Mediterranean, causing regional drying, is most strongly related to a northward shift of the eddy-driven jet and a rise in global near-surface temperature.</p>

scholarly journals A Review of Drought in the Middle East and Southwest Asia

2016 ◽  
Vol 29 (23) ◽  
pp. 8547-8574 ◽  
Author(s):  
Mathew Barlow ◽  
Benjamin Zaitchik ◽  
Shlomit Paz ◽  
Emily Black ◽  
Jason Evans ◽  
...  
Keyword(s):  
Middle East ◽  
Large Scale ◽  
Crop Yields ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Storm Track ◽  
Data Uncertainty ◽  
Southwest Asia ◽  
Drought Forecasting ◽  
Wide Range

Abstract The Middle East and southwest Asia are a region that is water stressed, societally vulnerable, and prone to severe droughts. Large-scale climate variability, particularly La Niña, appears to play an important role in regionwide droughts, including the two most severe of the last 50 years—1999–2001 and 2007/08—with implications for drought forecasting. Important dynamical factors include orography, thermodynamic influence on vertical motion, storm-track changes, and moisture transport. Vegetation in the region is strongly impacted by drought and may provide an important feedback mechanism. In future projections, drying of the eastern Mediterranean region is a robust feature, as are temperature increases throughout the region, which will affect evaporation and the timing and intensity of snowmelt. Vegetation feedbacks may become more important in a warming climate. There are a wide range of outstanding issues for understanding, monitoring, and predicting drought in the region, including dynamics of the regional storm track, the relative importance of the range of dynamical mechanisms related to drought, the regional coherence of drought, the relationship between synoptic-scale mechanisms and drought, the predictability of vegetation and crop yields, the stability of remote influences, data uncertainty, and the role of temperature. Development of a regional framework for cooperative work and dissemination of information and existing forecasts would speed understanding and make better use of available information.

scholarly journals Prevalence of nephropathy among type two diabetes patients in Eastern Mediterranean Region: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Shahryar Zeighami ◽  
Sonia Shaabani ◽  
Mohammad Moheb ◽  
Maryam Pakfetrat ◽  
Seyede Pegah Azarchehry ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Large Scale ◽  
Eastern Mediterranean ◽  
Meta Analysis ◽  
Eastern Mediterranean Region ◽  
Global Epidemic ◽  
High Prevalence ◽  
Meta Regression Analysis ◽  
Stage Renal Disease ◽  
Type Two Diabetes

Abstract Objectives: The global epidemic of Diabetes Mellitus exerts a substantial burden on health services. This high prevalence of diabetes leads to an increase in diabetic complications, especially diabetic nephropathy, a leading cause of end stage renal disease and renal replacement therapies. Due to its’ the high prevalence reported by Individual studies in EMR, we conducted a meta-analysis of relevant studies to estimate diabetic retinopathy in EMR.Method: We searched for the relevant keywords in title and abstract of Medline/PubMed, Scopus, Embase, Web of knowledge, and Gray literature from Jan 1st, 2000 to December 13, 2019. The two-step screening was carried out by two independent researchers and relevant data were extracted. Estimation of summary proportions, subgroup analysis, meta-regressions, and publication bias assessment were performed. Results: Out of 3,225 identified citations, 38 articles were entered into meta-analysis, involving 112,235 patients. The prevalence of nephropathy in type two diabetes was 26.34% (95% confidence interval (CI)= 21.04, 32%); and it was 30.42% (95% CI= 23.38, 37.94%) in males and 22.1% (95% CI= 16.05, 28.79%) in females. The meta-regression analysis showed that HDI, publication year, mean duration of diabetes, mean age, and diagnostic test were not significant moderators (p = .332, .725, .280, .220, and .468, respectively).Conclusions: Diabetic nephropathy high prevalence in EMR implicates the importance of diabetes screening, periodic examinations, diabetes care, and risk factor controls. Large-scale longitudinal studies should be conducted in EMR.

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