scholarly journals The Program Sustainability Assessment Tool: A New Instrument for Public Health Programs

2014 ◽  
Vol 11 ◽  
Author(s):  
Douglas A. Luke ◽  
Annaliese Calhoun ◽  
Christopher B. Robichaux ◽  
Michael B. Elliott ◽  
Sarah Moreland-Russell
Author(s):  
Alix Hall ◽  
Adam Shoesmith ◽  
Rachel C. Shelton ◽  
Cassandra Lane ◽  
Luke Wolfenden ◽  
...  

There is a lack of valid and reliable measures of determinants of sustainability specific to public health interventions in the elementary school setting. This study aimed to adapt and evaluate the Program Sustainability Assessment Tool (PSAT) for use in this setting. An expert reference group adapted the PSAT to ensure face validity. Elementary school teachers participating in a multi-component implementation intervention to increase their scheduling of physical activity completed the adapted PSAT. Structural validity was assessed via confirmatory factor analysis. Convergent validity was assessed using linear mixed regression evaluating the associations between scheduling of physical activity and adapted PSAT scores. Cronbach’s alpha was used to evaluate internal consistency and intracluster correlation coefficients for interrater reliability. Floor and ceiling effects were also evaluated. Following adaptation and psychometric evaluation, the final measure contained 26 items. Domain Cronbach’s alpha ranged from 0.77 to 0.92. Only one domain illustrated acceptable interrater reliability. Evidence for structural validity was mixed and was lacking for convergent validity. There were no floor and ceiling effects. Efforts to adapt and validate the PSAT for the elementary school setting were mixed. Future work to develop and improve measures specific to public health program sustainment that are relevant and psychometrically robust for elementary school settings are needed.


2019 ◽  
Vol 8 (1) ◽  
pp. 127
Author(s):  
Laurent Cleenewerck ◽  
Devender Bhalla ◽  
Kabiru Abubakar Gulma

<p>This research aimed to evaluate the performance of six ongoing public health programs through core performance indicators in Katsina State, Nigeria. The healthcare delivery in Africa is mostly program-based. This requires that such programs need to be evaluated which may in turn help to identify any existing gaps towards the improvement of patients' access and coverage to their given service. We identified all active health facilities where our programs on malaria, Routine Immunization (RI), Family Planning (FP), Tuberculosis and Leprosy (TBL), HIV/AIDS, and Free Medicare (FMC) were being carried out. After that, a representative sample was derived to obtain data regarding five key performance indicators by using a Logistics Indicators Assessment Tool. Of 1,718 facilities, a total of 983 (57.22%) were visited, In other words, by assuming a normal distribution; each facility expectedly covers only 3,371 individuals. All programs provided different and diverse results on each indicator; however, the most obvious challenge was in the stock-out and demand vs. receipt of required medications. These are particularly for malaria, FMC, FP, and HIV. For instance, the stock-out lasted 222 days for malaria and 135 days for FP. Despite this, none of the programs had a lower than gold-standard near-term availability of required products. Program-based healthcare delivery is inadequate and ineffective unless the local system gets simultaneously developed. If required medications are not becoming available, optimal access, coverage, and benefits cannot be expected to be obtained. Clearly, Nigeria experiences a push system of meeting term supplies. Nigeria needs to strengthen its pharmaceutical system.</p>


2022 ◽  
Vol 12 ◽  
Author(s):  
Muhammad Akhtar Abbas Khan ◽  
Saima Hamid ◽  
Tofeeq Ur-Rehman ◽  
Zaheer-Ud-Din Babar

Objectives: Pakistan felt the need for an effective and robust pharmacovigilance (PV) system after one of the deadliest drug-related tragedies causing more than 300 deaths in 2012. The country set up its national PV center in 2015 and joined WHO’s Program for International Drug Monitoring (PIDM) in 2018 as a full member. The current study was aimed to evaluate the PV system’s functionality, identify the gaps, areas of improvement, and a strategy to lead a functional PV system in Pakistan.Methods: The descriptive cross-sectional study was conducted by providing an interviewer-administered questionnaire of the PV system across Pakistan by utilizing the Indicator based Pharmacovigilance assessment tool (IPAT). By a convenience sampling method 36 study participants were selected from the Drug Regulatory Authority of Pakistan (DRAP), drug administration of provincial health departments of 4 provinces and federally affiliated areas, 5 national public health programs, and 23 public and private hospitals. The assessment includes document review, interviews of the key informants by structured open-ended questions, and a review of websites of relevant organizations.Results: Drug Regulatory Authority of Pakistan (DRAP) with a national PV center received a 75% overall performance score on IPAT. To be regarded as “minimally functioning,” a country’s PV and drug safety system must meet all core indicators. DRAP scored 80.76% on the core indicators so cannot be deemed functional at this time. The only province with a regional PV center, Punjab, had scored 72.13% on relevant parameters. Despite receiving funding from the Global Fund, none of the National Public Health Programs (PHPs) have PV centers or associated activities. All hospitals except two private hospitals could not qualify the minimum requirements for functional PV. The absence of a legal framework for mandatory ADR reporting, lack of drug information center, budgetary constraints, no active surveillance activities, the nonexistence of pharmacovigilance risk assessment expert committee, and insufficient coordination among stakeholders were identified as major gaps.Conclusion: The results of the study reveal that Pakistan’s PV system is not fully functional at all levels. A two-phased strategy encompassing the non-financial and financial interventions is proposed to improve the PV systems at the national, provincial, PHPs, and hospitals levels.


2005 ◽  
Vol 10 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Hilde Iversen ◽  
Torbjørn Rundmo ◽  
Hroar Klempe

Abstract. The core aim of the present study is to compare the effects of a safety campaign and a behavior modification program on traffic safety. As is the case in community-based health promotion, the present study's approach of the attitude campaign was based on active participation of the group of recipients. One of the reasons why many attitude campaigns conducted previously have failed may be that they have been society-based public health programs. Both the interventions were carried out simultaneously among students aged 18-19 years in two Norwegian high schools (n = 342). At the first high school the intervention was behavior modification, at the second school a community-based attitude campaign was carried out. Baseline and posttest data on attitudes toward traffic safety and self-reported risk behavior were collected. The results showed that there was a significant total effect of the interventions although the effect depended on the type of intervention. There were significant differences in attitude and behavior only in the sample where the attitude campaign was carried out and no significant changes were found in the group of recipients of behavior modification.


Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 281
Author(s):  
Andrea Haekyung Haselbeck ◽  
Birkneh Tilahun Tadesse ◽  
Juyeon Park ◽  
Malick M. Gibani ◽  
Ligia María Cruz Espinoza ◽  
...  

Typhoid fever remains a significant health problem in sub-Saharan Africa, with incidence rates of >100 cases per 100,000 person-years of observation. Despite the prequalification of safe and effective typhoid conjugate vaccines (TCV), some uncertainties remain around future demand. Real-life effectiveness data, which inform public health programs on the impact of TCVs in reducing typhoid-related mortality and morbidity, from an African setting may help encourage the introduction of TCVs in high-burden settings. Here, we describe a cluster-randomized trial to investigate population-level protection of TYPBAR-TCV®, a Vi-polysaccharide conjugated to a tetanus-toxoid protein carrier (Vi-TT) against blood-culture-confirmed typhoid fever, and the synthesis of health economic evidence to inform policy decisions. A total of 80 geographically distinct clusters are delineated within the Agogo district of the Asante Akim region in Ghana. Clusters are randomized to the intervention arm receiving Vi-TT or a control arm receiving the meningococcal A conjugate vaccine. The primary study endpoint is the total protection of Vi-TT against blood-culture-confirmed typhoid fever. Total, direct, and indirect protection are measured as secondary outcomes. Blood-culture-based enhanced surveillance enables the estimation of incidence rates in the intervention and control clusters. Evaluation of the real-world impact of TCVs and evidence synthesis improve the uptake of prequalified/licensed safe and effective typhoid vaccines in public health programs of high burden settings. This trial is registered at the Pan African Clinical Trial Registry, accessible at Pan African Clinical Trials Registry (ID: PACTR202011804563392).


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