scholarly journals Intervention studies for improving global health and health care: An important arena for epidemiologists

2009 ◽  
Vol 15 (2) ◽  
Author(s):  
Gunnar Kvåle ◽  
H. Sommerfelt ◽  
K. Fylkesnes
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Intervention Studies ◽  
Care Delivery ◽  
Hiv Infections ◽  
Evidence Base ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Public Health Importance ◽  
Middle Income

Marginalised populations in many low- and middle-income countries experience an increasing burden of disease, in sub-Saharan Africa to a large extent due to faltering health systems and serious HIV epidemics. Also other poverty related diseases (PRDs) are prevalent, especially respiratory and diarrhoeal diseases in children, malnutrition, maternal and perinatal health problems, tuberculosis and malaria. Daily, nearly 30,000 children under the age of 5 die, most from preventable causes, and 8,000 people die from HIV infections. In spite of the availability of powerful preventive and therapeutic tools for combating these PRDs, their implementation, especially in terms of equitable delivery, leaves much to be desired. The research community must address this tragic gap between knowledge and implementation. Epidemiologists have a very important role to play in conducting studies on diseases that account for the largest share of the global disease burden. A shift of focus of epidemiologic research towards intervention studies addressing health problems of major public health importance for disadvantaged population groups is needed. There is a need to generate an evidence-base for interventions that can be implemented on a large scale; this can result in increased funding of health promotion programs as well as enable rational prioritization and integration between different health interventions. This will require close and synergetic teamwork between epidemiologists and other professions across disciplines and sectors. In this way epidemiologists can contribute significantly to improve health and optimise health care delivery for marginalized populations.

scholarly journals Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review

Pharmaceutics ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 809
Author(s):  
Emiliene B. Tata ◽  
Melvin A. Ambele ◽  
Michael S. Pepper
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Ethical Issues ◽  
Care Delivery ◽  
Clinical Care ◽  
Cost Effective ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Successful Implementation ◽  
Sub Saharan

Clinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent of cost-effective high-throughput genotyping techniques coupled with the existence of Clinical Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic “actionable variants” have increased the clinical applicability of PGx testing. The implementation of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health care delivery, considering the high incidence of communicable diseases, the increasing incidence of non-communicable diseases, and the high degree of genetic diversity in these populations. However, the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants, and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers. Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided treatment in SSA.

scholarly journals “Breaking the Silence” to Improve Cancer Survivorship Care for First Nations Peoples

2018 ◽  
Vol 17 (1) ◽  
pp. 160940691877413
Author(s):  
Wendy Gifford ◽  
Roanne Thomas ◽  
Gwen Barton ◽  
Viviane Grandpierre ◽  
Ian D. Graham
Keyword(s):  
Health Care ◽  
First Nations ◽  
Cancer Survivorship ◽  
Health Care Providers ◽  
Large Scale ◽  
Care Delivery ◽  
Survivorship Care ◽  
Care Providers ◽  
Community Based ◽  
Knowledge To Action

There is a significant knowledge-to-action gap in cancer survivorship care for First Nations (FN) communities. To date, many approaches to survivorship have not been culturally responsive or community-based. This study is using an Indigenous knowledge translation (KT) approach to mobilize community-based knowledge about cancer survivorship into health-care programs. Our team includes health-care providers and cancer survivors from an FN community in Canada and an urban hospital that delivers Cancer Care Ontario’s Aboriginal Cancer Program. Together, we will study the knowledge-to-action process to inform future KT research with Indigenous peoples for improving health-care delivery and outcomes. The study will be conducted in settings where research relations and partnerships have been established through our parent study, The National Picture Project. The inclusion of community liaisons and the continued engagement of participants from our parent study will foster inclusiveness and far-reaching messaging. Knowledge about unique cancer survivorship needs co-created with FN people in the parent study will be mobilized to improve cancer follow-up care and to enhance quality of life. Findings will be used to plan a large-scale implementation study across Canada.

scholarly journals Scaling-up health insurance through community- based health insurance schemes in rural sub- Saharan African communities

2013 ◽  
Vol 3 (1) ◽  
pp. 14 ◽  
Author(s):  
Ufuoma John Ejughemre
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Rural Communities ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Seek Health Care ◽  
Community Based Health Insurance ◽  
The Poor ◽  
Sub Saharan

Context: The knotty and monumental problem of health inequality and the high burden of diseases in sub-Saharan Africa bothers on the poor state of health of many of its citizens particularly in rural communities. These issues are further exacerbated by the harrowing conditions of health care delivery and the poor financing of health services in many of these communities. Against these backdrops, health policy makers in the region are not just concerned with improving peoples’ health but with protecting them against the financial costs of illness. What is important is the need to support more robust strategies for healthcare financing in these communities in sub-Saharan Africa. Objective: This review assesses the evidence of the extent to which community-based health insurance (CBHI) is a more viable option for health care financing amongst other health insurance schemes in rural communities in sub-Saharan Africa. Patterns of health insurance in sub-Saharan Africa: Theoretically, the basis for health insurance is that it allows for risk pooling and therefore ensures that resources follow sick individuals to seek health care when needed. As it were, there are different models such as social, private and CBHI schemes which could come to bear in different settings in the region. However, not all insurance schemes will come to bear in rural settings in the region. Community based health insurance: CBHI is now recognized as a community-initiative that is community friendly and has a wide reach in the informal sector especially if well designed. Experience from Rwanda, parts of Nigeria and other settings in the region indicate high acceptability but the challenge is that these schemes are still very new in the region. Recommendations and conclusion: Governments and international development partners in the region should collect- ively develop CBHI as it will help in strengthening health systems and efforts geared towards achieving the millennium development goals. This is because it is inextricably linked to the health care needs of the poor. 

scholarly journals COVID-19 and the Mental Health of People From Refugee Backgrounds

2020 ◽  
Vol 50 (4) ◽  
pp. 415-417 ◽  
Author(s):  
Susan Rees ◽  
Jane Fisher
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Delivery ◽  
General Health ◽  
Mental Health Problems ◽  
Care Delivery ◽  
Health Problems ◽  
Vulnerable Population ◽  
High Income ◽  
Health Practitioners

Approximately 1 in 10 of the current 26 million people who are refugees reside in high-income countries. They have commonly experienced trauma related to violence, insecurity, persecution and shortage of food and medicine. Our research suggests that COVID-19 and its health and social sequalae may be triggering past traumatic reactions, exacerbating mental health problems and undermining functioning. The purpose of this article is to promptly communicate these anecdotal findings to general health practitioners to ensure informed and sensitive health care delivery to this vulnerable population.

scholarly journals Special Section: Assessing Information Technologies for Health: Evaluation and Implementation: A Call for Action

2006 ◽  
Vol 15 (01) ◽  
pp. 11-15
Author(s):  
J. L. Talmon
Keyword(s):  
Health Care ◽  
Information Technologies ◽  
Large Scale ◽  
Special Section ◽  
Evaluation Studies ◽  
Evidence Base ◽  
Decision Makers ◽  
Unintended Effects ◽  
Evaluation Practice ◽  
Recommendations For Action

SummaryTo raise awareness for actions that are urgently needed to accompany the large scale implementations of ICT in Health Care that are currently taking place in many countries around the world.An analysis of a few studies that have recently been described in the literature guided by recent suggestions for research and development of evaluation of health ICT.Six specific recommendations for action are specified:Development of good implementation practice,Development of an experience base of implementation of ICT in health care,Setting up a surveillance system for unintended effects,Build an evidence base of best evaluation practice,Developing guidelines for proper reporting of evaluation studies,Education of clinicians and decision makers.

scholarly journals HEALTH EDUCATION AND COMMUNITY MOBILIZATION IN NIGERIA - ISSUES AND PROSPECTS

2020 ◽  
Author(s):  
Ekpomebe Elozino ◽  
Leonard E. Ananomo ◽  
Andrew Abanum Onome Vivian
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Care Delivery ◽  
Care Delivery ◽  
National Development ◽  
International Health ◽  
Community Mobilization ◽  
Sub Saharan Africa ◽  
International Health Organizations ◽  
Sub Saharan

The significance of health to national development and poverty eradication over the centuries, in that improving health status and increasing life expectancy adds to long term economic growth. This article examined the condition of health education and community mobilization in Nigeria's health care delivery. Health literacy is imperative to power and sustains government efforts in fostering health for all. Many developing countries, particularly those in Sub-Saharan Africa, in the 1970s witnessed remarkable and improper inequalities in the provision and delivery of health services. This contributed to and explained the exploration of diverse approaches to enhance health care delivery by international health organizations.

scholarly journals Mass Disasters and Burnout in Nephrology Personnel

2021 ◽  
pp. CJN.08400520
Author(s):  
Mehmet Sukru Sever ◽  
Alberto Ortiz ◽  
Umberto Maggiore ◽  
Enrique Bac-García ◽  
Raymond Vanholder
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Ad Hoc ◽  
Care Delivery ◽  
Health Problems ◽  
Care Providers ◽  
Coping With Stress ◽  
Work Related ◽  
Health Care Infrastructure ◽  
Mass Disasters

Mass disasters result in extensive health problems and make health care delivery problematic, as has been the case during the COVID-19 pandemic. Although COVID-19 was initially considered a pulmonary problem, it soon became clear that various other organs were involved. Thus, many care providers, including kidney health personnel, were overwhelmed or developed burnout. This review aims to describe the spectrum of burnout in mass disasters and suggests solutions specifically for nephrology personnel by extending previous experience to the COVID-19 pandemic. Burnout (a psychologic response to work-related stress) is already a frequent part of routine nephrology practice and, not surprisingly, is even more common during mass disasters due to increased workload and specific conditions, in addition to individual factors. Avoiding burnout is essential to prevent psychologic and somatic health problems in personnel as well as malpractice, understaffing, and inadequate health care delivery, all of which increase the health care burden of disasters. Burnout may be prevented by predisaster organizational measures, which include developing an overarching plan and optimizing health care infrastructure, and ad hoc disaster-specific measures that encompass both organizational and individual measures. Organizational measures include increasing safety, decreasing workload and fear of malpractice, optimizing medical staffing and material supplies, motivating personnel, providing mental health support, and enabling flexibility in working circumstances. Individual measures include training on coping with stress and problematic conditions, minimizing the stigma of emotional distress, and maintaining physical health. If these measures fall short, asking for external help is mandatory to avoid an inefficient disaster health care response. Minimizing burnout by applying these measures will improve health care provision, thus saving as many lives as possible.

scholarly journals Hearing from men in Eswatini: Shifts in HIV risk and service uptake—Findings from DREAMS implementation science research

2021 ◽  
Author(s):  
Keyword(s):  
Implementation Science ◽  
Adolescent Girls ◽  
Young Women ◽  
Hiv Risk ◽  
Large Scale ◽  
Hiv Infections ◽  
Science Research ◽  
Sub Saharan Africa ◽  
Engaging Men ◽  
Sub Saharan

HIV prevention efforts across sub-Saharan Africa are increasingly focused on engaging men, for their own health and that of their partners and families. We examined whether and how HIV risk and protective factors are changing among men in Eswatini (formerly Swaziland)—a country with a substantial HIV burden. The study is part of the Population Council’s implementation science research portfolio on the DREAMS Partnership1, a large-scale initiative to reduce new HIV infections among adolescent girls and young women (AGYW) and their partners.

scholarly journals Sensor Data Integration: A New Cross-Industry Collaboration to Articulate Value, Define Needs, and Advance a Framework for Best Practices

10.2196/34493 ◽  
2021 ◽  
Vol 23 (11) ◽  
pp. e34493
Author(s):  
Ieuan Clay ◽  
Christian Angelopoulos ◽  
Anne Lord Bailey ◽  
Aaron Blocker ◽  
Simona Carini ◽  
...  
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Data Integration ◽  
Health Outcomes ◽  
Large Scale ◽  
Care Delivery ◽  
Sensor Data ◽  
Digital Medicine ◽  
Industry Collaboration ◽  
Stakeholder Needs

Data integration, the processes by which data are aggregated, combined, and made available for use, has been key to the development and growth of many technological solutions. In health care, we are experiencing a revolution in the use of sensors to collect data on patient behaviors and experiences. Yet, the potential of this data to transform health outcomes is being held back. Deficits in standards, lexicons, data rights, permissioning, and security have been well documented, less so the cultural adoption of sensor data integration as a priority for large-scale deployment and impact on patient lives. The use and reuse of trustworthy data to make better and faster decisions across drug development and care delivery will require an understanding of all stakeholder needs and best practices to ensure these needs are met. The Digital Medicine Society is launching a new multistakeholder Sensor Data Integration Tour of Duty to address these challenges and more, providing a clear direction on how sensor data can fulfill its potential to enhance patient lives.

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