Improving Population Health through Clinical–Community Collaboration: A Case Study of a Collaboration between State Government and an Academic Health System

Fracking has helped to usher in an era of energy abundance in the United States. This advanced drilling procedure has helped the nation to attain the status of the largest producer of crude oil and natural gas in the world, but some of its negative externalities, such as human-induced seismicity, can no longer be ignored. The occurrence of earthquakes in communities located at proximity to disposal wells with no prior history of seismicity has shocked residents and have caused damages to properties. It has evoked individuals’ resentment against the practice of injection of fracking’s wastewater under pressure into underground disposal wells. Though the oil and gas companies have denied the existence of a link between such a practice and earthquakes and the local and state governments have delayed their responses to the unforeseen seismic events, the issue has gained in prominence among researchers, affected community residents, and the media. This case study has offered a glimpse into the varied responses of stakeholders to human-induced seismicity in a small city in the state of Texas. It is evident from this case study that although individuals’ complaints and protests from a small community may not be successful in bringing about statewide changes in regulatory policies on disposal of fracking’s wastewater, they can add to the public pressure on the state government to do something to address the problem in a state that supports fracking.

Download Full-text

Democracy and Social Service Delivery in Nigeria: A Case Study of Free Medical Programme of Rivers State Government (2007-2013)

SSRN Electronic Journal ◽

10.2139/ssrn.2602035 ◽

2015 ◽

Author(s):

Chukunonye Abovu Akujuru ◽

Newman Chintuwa Enyioko

Keyword(s):

Service Delivery ◽

State Government ◽

Social Service ◽

Social Service Delivery ◽

Rivers State

Download Full-text

TERRITÓRIO EM DISPUTA NO LITORAL CEARENSE: A RESISTÊNCIA/INOVAÇÃO DO TURISMO COMUNITÁRIO DIANTE DAS AÇÕES E CONTRADIÇÕES DO ESTADO

GEOgraphia ◽

10.22409/geographia2018.2042.a13836 ◽

2018 ◽

Vol 20 (42) ◽

pp. 101

Author(s):

Lenilton Francisco de Assis

Keyword(s):

State Government ◽

Coastal Communities ◽

Northeastern Brazil ◽

Public Investments ◽

Living Space ◽

Tourism Geography ◽

Community Tourism ◽

Worldwide Network ◽

Low Pay

Resumo: O litoral cearense do Nordeste brasileiro já registra várias experiências exitosas de turismo comunitário. Porém, o governo do estado continua preterindo esse potencial e subsidiando a instalação de megaempreendimentos que geram poucos empregos com baixas remunerações. Assim, as comunidades litorâneas que protagonizam o turismo comunitário ficam duplamente penalizadas, pois são deixadas à margem das políticas de turismo e seus territórios viram alvos da cobiça de visitantes atraídos pelo marketing dos investimentos públicos realizados. Tomando como estudo de caso a comunidade de Tatajuba, no município de Camocim, no Ceará, este artigo analisa a luta dos povos do mar pelo território, luta essa que não se traduz apenas na defesa do espaço de vivência, mas também na formação de uma rede de territórios solidários articulados ao mundo, que resiste/inova com a proposta do turismo comunitário. Palavras-chave: Turismo. Território. Turismo comunitário. Geografia do turismo. Tatajuba. DISPUTED TERRITORY ON THE COAST OF CEARÁ: THE STRENGTH AND INNOVATION OF COMMUNITY TOURISM ON THE ACTIONS AND CONTRADICTIONS OF STATEAbstract: The cearense coast of Northeastern Brazil already registers several successful experiences of Community tourism. However, the state government is still neglecting this potential and subsidizing the installation of mega-enterprises that generate few jobs with low pay. Thus, the coastal communities who star the community tourism are doubly penalized because they are abandoned by tourism policies and their territories become targets of greed of visitors attracted by the marketing of public investments. Taking as a case study the community of Tatajuba, in Camocim (municipality, Ceará, Brazil), this article examines the struggle of the peoples of the sea through the territory. This fight not only translates on defense of the living space, but also it represents the formation of a worldwide network of solidary territories that resists and innovates with the proposal of community tourism.Keywords: Tourism. Territory. Community tourism. Tourism geography. Tatajuba. DISPUTA DE TERRITÓRIO EN LA COSTA DE CEARÁ: LA FUERZA/INNOVACIÓN DEL TURISMO COMUNITÁRIO SOBRE LAS ACCIONES Y LAS CONTRADICCIONES DEL ESTADOResumen: El turismo comunitario ya registra varias experiencias exitosas em la costa de Ceará en el noreste de Brasil. Sin embargo, el gobierno del estado continúa pasando por encima de este potencial y subvencionando la instalación de mega-empresas que generan pocos empleos con bajos salarios. Por lo tanto, las comunidades costeras que ofrecen el turismo comunitario son doblemente penalizadas porque quedan excluidas de las políticas de turismo y sus territorios se convierten en objeto de la codicia de los visitantes atraídos por la comercialización de las inversiones públicas. Tomando como caso de estudio la comunidad Tatajuba, en el municipio de Camocim, este artículo examina la lucha de los pueblos del mar por el territorio, lucha que no sólo se traduce en la defensa del espacio de vida, sino también en la formación de una red de territorios articulado con el mundo que resiste e innova con la propuesta del turismo comunitario.Palabras clave: Turismo. Territorio. Turismo comunitario. Geografia del turismo. Tatajuba.

Download Full-text

Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

Globalization and Health ◽

10.1186/s12992-021-00702-7 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Amare Worku Tadesse ◽

Kassu Ketema Gurmu ◽

Selamawit Tesfaye Kebede ◽

Mahlet Kifle Habtemariam

Keyword(s):

Health Promotion ◽

Global Health ◽

Health System ◽

Universal Health Coverage ◽

World Health ◽

Health Coverage ◽

Health Security ◽

Universal Health ◽

Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

Download Full-text

Description of a Multi-faceted COVID-19 Pandemic Physician Workforce Plan at a Multi-site Academic Health System

Journal of General Internal Medicine ◽

10.1007/s11606-020-06543-1 ◽

2021 ◽

Author(s):

Sachin R. Pendharkar ◽

Evan Minty ◽

Caley B. Shukalek ◽

Brendan Kerr ◽

Paul MacMullan ◽

...

Keyword(s):

Health System ◽

Acute Care ◽

Care Physician ◽

System Capacity ◽

Medical Emergency ◽

Physician Workforce ◽

Future Health ◽

Academic Health ◽

Response Planning ◽

Implementation Period

Abstract Background The evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems. Intervention The Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. The MEOC Pandemic Plan comprised seven components, each with unique structure and processes. Methods In this manuscript, we describe MEOC’s Pandemic Plan that was designed and implemented from March to May 2020 and re-escalated in October 2020. We report on the plan’s structure and process, early implementation outcomes, and unforeseen challenges. Data sources included MEOC documents, health system, public health, and physician engagement implementation data. Key Results From March 5 to October 26, 2020, 427 patients were admitted to COVID-19 units in Calgary hospitals. In the initial implementation period (March–May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. Of these, 234 physicians signed up for hospital shifts, and 227 physicians received in-person personal protective equipment simulation training. Ninety-three physicians were deployed on COVID-19 units at four large acute care hospitals. The resurgence of cases in September 2020 has prompted re-escalation including re-activation of COVID-19 units. Conclusions MEOC leveraged an academic health system partnership to rapidly design, implement, and refine a comprehensive, scalable COVID-19 acute care physician workforce plan whose components are readily applicable across jurisdictions or healthcare crises. This description may guide other institutions responding to COVID-19 and future health emergencies.

Download Full-text

Who could be One Health Activist at the community level?: A case for India

Human Resources for Health ◽

10.1186/s12960-021-00558-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Sandul Yasobant ◽

Walter Bruchhausen ◽

Deepak Saxena ◽

Farjana Zakir Memon ◽

Timo Falkenberg

Keyword(s):

Health System ◽

Work Experience ◽

Financial Incentives ◽

One Health ◽

Health Workers ◽

Structured Interview ◽

Communicable Diseases ◽

Community Level ◽

System Level

Abstract Background Community health workers (CHWs) are the mainstay of the public health system, serving for decades in low-resource countries. Their multi-dimensional work in various health care services, including the prevention of communicable diseases and health promotion of non-communicable diseases, makes CHWs, the frontline workers in their respective communities in India. As India is heading towards the development of One Health (OH), this study attempted to provide an insight into potential OH activists (OHA) at the community level. Thus, this case study in one of India’s western cities, Ahmedabad, targeted identifying OHA by exploring the feasibility and the motivation of CHWs in a local setting. Methods This case study explores two major CHWs, i.e., female (Accredited Social Health Activists/ASHA) health workers (FHWs) and male (multipurpose) health workers (MHWs), on their experience and motivation for becoming an OHA. The data were collected between September 2018 and August 2019 through a mixed design, i.e., quantitative data (cross-sectional structured questionnaire) followed by qualitative data (focus group discussion with a semi-structured interview guide). Results The motivation of the CHWs for liaisoning as OHA was found to be low; however, the FHWs have a higher mean motivation score [40 (36–43)] as compared to MHWs [37 (35–40)] out of a maximum score of 92. Although most CHWs have received zoonoses training or contributed to zoonoses prevention campaigns, their awareness level was found to be different among male and female health workers. Comparing the female and male health workers to act as OHA, higher motivational score, multidisciplinary collaborative work experience, and way for incentive generation documented among the female health workers. Conclusion ASHAs were willing to accept the additional new liaison role of OHAs if measures like financial incentives and improved recognition are provided. Although this study documented various systemic factors at the individual, community, and health system level, which might, directly and indirectly, impact the acceptance level to act as OHA, they need to be accounted for in the policy regime.

Download Full-text