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1.
Artigo em Inglês | MEDLINE | ID: mdl-39457260

RESUMO

Out-of-pocket expenditure (OOPE) directly reflects households' financial burden for healthcare. Despite efforts to enhance accessibility and affordability through government initiatives and insurance schemes, OOPE remains problematic, especially in rural areas with inadequate public healthcare infrastructure. This study examines factors influencing OOPE in Karnataka's Dakshina Kannada, Udupi, and Shimoga districts, investigating socioeconomic characteristics, healthcare infrastructure, and accessibility to inform policies for equitable healthcare access and reduced household financial strain. Using purposive sampling, 61 semi-structured interviews were conducted in rural and urban South Karnataka, recorded in Kannada after obtaining consent, and thematically analyzed. Results revealed mixed perceptions of healthcare quality, cost, and accessibility between government and private hospitals. Government facilities were lauded for improved infrastructure and affordability, while private hospitals were preferred for quality and personalized care despite higher costs. Health insurance significantly impacted OOPE reduction. Participants emphasized the need for increased awareness of government insurance programs and improved quality in public hospitals. The study concludes that private hospitals are favored for superior care despite expenses, while government hospitals are valued for affordability. Expanding insurance coverage and improving public awareness are crucial for enhancing healthcare accessibility and affordability.


Assuntos
Gastos em Saúde , Hospitais Privados , Índia , Humanos , Gastos em Saúde/estatística & dados numéricos , Hospitais Privados/economia , Acessibilidade aos Serviços de Saúde/economia , Feminino , Masculino , Seguro Saúde/economia , Adulto , Pessoa de Meia-Idade , Hospitais Públicos/economia , Qualidade da Assistência à Saúde
2.
Artigo em Inglês | MEDLINE | ID: mdl-39375278

RESUMO

NEED: Cervical cancer is a major global public health issue, particularly affecting low and middle-income countries, distinctly in the South Asian region. This geographical region lacks a well-organized routine cervical screening program. Consequently, this scoping review aimed to investigate the evidence on factors influencing the adoption and implementation of routine cervical cancer screening in South Asia. METHODS: Adopting the "Arksey and O'Malley and Levac et al." methodology, databases such as PubMed, CINAHL, Web of Science, and Scopus were scrutinized in the pursuit of relevant studies. Subsequently, the collected data were synthesized by adopting the Consolidated Framework for Implementation Research (CFIR) model. RESULTS: A total of 837 records were initially identified and screened for eligibility, including 55 studies. The successful adoption and implementation of cervical cancer screening in South Asia encounter numerous obstacles within the health system, including the absence of a comprehensive program protocol for screening, inadequate health infrastructure, and the presence of multiple sociocultural factors, such as social stigma, low levels of education, and concerns related to modesty. CONCLUSION: To optimize adoption and implementation, it is imperative to construct a customized policy framework that incorporates a risk communication strategy tailored to the specific contexts of these nations. Drawing insights from the experiences of South Asian countries in executing cervical cancer screening programs can inform the formulation of policies for similar healthcare initiatives aimed at facilitating the expansion of HPV vaccination efforts.

3.
OMICS ; 28(7): 357-366, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38986085

RESUMO

High-throughput omics technologies have become valuable tools for systems science research and clinical management of sepsis. This article analyzes sepsis research using omics technologies in the European Union (EU) and the United Kingdom from 1990 to May 2023 using bibliometric data from the Web of Science database. Using VOSviewer for network analysis, we examined the distribution patterns, funding characteristics, and collaborations among the states, noting trends of convergence and divergence. The analysis included 2078 articles, revealing an increasing rate of publications on sepsis research using omics approaches. The United Kingdom's research output is notably high, contributing 28.3% of the total research from the EU and United Kingdom combined. Germany, France, the Netherlands, and Italy together account for 56.9% of the publications from the EU member states. The United States is the leading international collaborator, particularly with the United Kingdom, followed by Germany and France. The EU-15 countries have significantly more publication outputs in this domain with growing but limited inclusion of the newer members of the EU. We suggest that the role of EU member states and the United Kingdom in sepsis research using omics technologies can be advanced by facilitating high-value, technology-driven health research, fostering collaboration, convergence, and equity in global health and biomedical research.


Assuntos
União Europeia , Sepse , Sepse/genética , Humanos , Reino Unido , Pesquisa Biomédica/tendências , Genômica/métodos , Proteômica/métodos , Metabolômica/métodos
4.
Diabetol Metab Syndr ; 16(1): 182, 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39080764

RESUMO

INTRODUCTION: Effective diabetes management relies mainly on an individual's ability to perform self-care tasks. However, this process is influenced by a complex interplay of factors. This study explores the multifaceted influences on Diabetes Self-Management (DSM), examining both factors influencing and affecting DSM. Understanding these influences is crucial for developing targeted Digital Health Interventions that empower individuals with diabetes to achieve successful self-management. OBJECTIVES: To identify problems faced by Type 2 Diabetes Mellitus (T2DM) individuals in self-managing diabetes and leveraging mHealth technology, with need-based solutions to Empower Self-Management in T2DM. METHODOLOGY: In-depth semi-structured interviews were conducted among ten patients with T2DM visiting the outpatient department of a tertiary care hospital in coastal Karnataka. Additionally, six healthcare professionals (HCPs) working closely with T2DM patients were interviewed to understand their perspectives on using mHealth to manage T2DM effectively. The themes for the solutions described were analyzed using ATLAS-TI software. RESULTS: Our research examined certain factors that might have influenced effective diabetes self-management and investigated patient perspectives on using digital health solutions in diabetes self-management. This study found that technology skills, duration of diabetes, knowledge, and personal beliefs were all significant factors affecting self-management in participants with T2DM. Additionally, socioeconomic factors were also seen to influence effective diabetes self-management. The Google search engine was used by 50% of the participants interviewed to learn about T2DM. Diet management through Google searches was used by a minority (30%) of the patients. None of the participants had previously used any mobile health applications (mHealth apps) to manage T2DM. 20% of the participants expressed limited knowledge about using smartphones or wearables to track health parameters. The study also identified potential non-technological barriers to mHealth adoption. To address these concerns, researchers used an empathy map to develop solutions that promote mHealth use. CONCLUSION: Several challenges and need-based mHealth solutions were identified to empower diabetes self-management education among T2DM patients. Implementing need-based mHealth solutions such as data tracking, personalized feedback, and access to educational resources can lead to better disease control and a higher quality of life for those with T2DM. Further research and development in mHealth interventions, and collaborative efforts among healthcare providers, patients, and technology developers, hold a promising future for the healthcare sector in providing efficient, effective, and accessible care.

5.
Cureus ; 16(6): e62444, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39015849

RESUMO

INTRODUCTION: Cardiovascular diseases are a major public health issue and the leading cause of mortality globally. The global economic burden of out-of-pocket expenditure (OOPE) for cardiovascular surgeries and procedures is substantial, with average costs being significantly higher than other treatments. This imposes a heavy economic burden. Government insurance schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aim to enhance affordability and access to cardiac care. METHODOLOGY: This retrospective study analyzed OOPE incurred for top cardiac surgeries under AB-PMJAY, private insurance, and uninsured patients at a tertiary care teaching hospital in Karnataka. Data of 1021 patients undergoing common cardiac procedures from January to July 2023 were analyzed using descriptive statistics (mean, median) and the Shapiro-Wilk test for normality. The study aims to evaluate financial risk protection offered by AB-PMJAY compared to private plans and inform effective policy-making in reducing the OOPE burden for surgeries in India. RESULTS: The study analyzed OOPE across 1021 patients undergoing any of four surgeries at a tertiary care teaching hospital in Karnataka. AB-PMJAY patients incurred zero OOPE across all surgeries. Uninsured patients faced the highest median OOPE, ranging from ₹1,15,292 (1390.57 USD) to ₹1,72,490 (2080.45 USD) depending on surgery type. Despite the presence of private insurance, the median out-of-pocket expenditure ranged from ₹1,689 (20.38 USD) to ₹68,788 (829.67 USD). Significant variations in OOPE were observed within different payment groups. Private insurance in comparison with AB-PMJAY had limitations like co-payments, deductibles, and limited coverage resulting in higher OOPE for patients. DISCUSSION: The results illustrate the efficacy of AB-PMJAY in reducing the financial burden and improving the affordability of cardiac procedures compared to private insurance. This emphasizes the significance of programmmes funded by the government in reducing the OOPE burden and ensuring equitable healthcare access. The comprehensive and particular estimates of OOPE for different surgical procedures, categorized by payment methods provide valuable information to guide the development of policies that aim to reduce OOPE and progress toward universal health coverage in India.

6.
Phys Rev E ; 109(6-1): 064612, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39021036

RESUMO

We derive the macroscopic dynamic equations for ferromagnetic smectic-A liquid crystals for which the spontaneous magnetization is parallel to the layer normal of the layering. As additional macroscopic variables when compared to simple fluids, we have the layer displacement u, familiar from smectic liquid crystals, and the magnetization density M. We find a number of reversible and dissipative cross-coupling terms to the additional macroscopic variables and discuss possible experiments to detect them. Among other effects, we point out that the velocity of first sound becomes anisotropic due to the influence of the modulus of the magnetization, while the magnitude of the velocity of second sound is modified. As for the static behavior, we find cross-coupling terms between the magnitude of the magnetization, on the one hand, and layer compression as well as osmotic pressure, on the other hand. In addition, we point out that as a dissipative effect, temperature gradients can induce gradients in the magnetization parallel to the layer normal, mediated by layer compressions.

7.
Zdr Varst ; 63(3): 113-122, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38881632

RESUMO

Objective: Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans. Methods: A cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12-15 years. A structured self-administered and anonymous questionnaire inquired about the children's attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children's ability to maintain health. Results: Overall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0-1.3), middle/low maternal education (OR=1.2, 95%CI=1.1-1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2-1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1-1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4-2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1-1.4). Conclusions: Almost 1/3rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.

8.
Nicotine Tob Res ; 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38820229

RESUMO

INTRODUCTION: Tobacco usage is an epidemic as statistics point towards smoking as the second leading cause of death. Populations experiencing humanitarian emergencies may experience a higher propensity for tobacco, alcohol, and other substance abuse disorders. This review aimed to map tobacco prevention and control interventions in humanitarian settings. METHODS: The search for this scoping review was conducted in six databases and supplemented with a gray literature search. Articles were screened at title-abstract and full-text by two pairs of authors, and data was abstracted by three individuals independently. An adapted diffusion of governance framework is used to discuss the findings. RESULTS: A total of 26 articles were included from the searches conducted in the databases and grey literature. The interventions targeted all age groups. The documents retrieved from the grey literature search were classified as population-based interventions, as they were not restricted to a particular group of individuals. Interventions were delivered at various locations, using different methods and engaging multiple stakeholders. Interventions assessed were grouped into packaging, labeling, and other policy interventions (pricing and taxes). CONCLUSION: There are few tobacco prevention and control interventions in the humanitarian context. The diffusion of governance perspective in implementing these interventions in humanitarian settings provides a cue for inter-sectoral cooperation among different stakeholders and disciplines beyond the health sector. Our review recommends exploring complementarity between the demand and supply side interventions for tobacco control. IMPLICATIONS: The scoping review has highlighted various tobacco prevention and control efforts in humanitarian settings. The interventions were delivered using various modes, and yet the burden of smoking is higher among the humanitarian population. Further research may use impact evaluation techniques to assess the impact of these interventions to facilitate the re-design of the implementation approach and policy priorities.

9.
Glob Public Health ; 19(1): 2348646, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38718287

RESUMO

The implementation of Human Papillomavirus (HPV) vaccination is crucial for eliminating cervical cancer in India. The infodemic, characterised by misleading information, could hinder the successful implementation of the initiative. Misinformation related to the HPV vaccine, such as rumours, has been reported and circulated, contributing to an alarming pattern of vaccine hesitancy observed on social media. This study aimed to identify the public sentiment towards HPV vaccination based on the 'Behavioral and Social Drivers (BeSD)' framework through geospatial, content and sentiment analysis. A total of 1,487 tweets were extracted. After preprocessing, 1010 tweets were identified for sentiment and content analysis. The sentiments expressed towards the HPV vaccine are mixed, with a generally positive outlook on the vaccines. Within the population, there is a pervasive proliferation of misinformation, primarily focusing on vaccine safety and efficacy, contentious subjects, ethical considerations, and a prevalent sense of uncertainty in selecting the appropriate vaccine. These observations are crucial for developing targeted strategies to address public concerns and enhance vaccination rates. The insights gained from these results will guide policymakers, healthcare practitioners, and public health organisations to implement evidence-based interventions, thereby countering vaccine hesitancy and improving public health outcomes.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Mídias Sociais , Neoplasias do Colo do Útero , Feminino , Humanos , Papillomavirus Humano , Índia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde , Opinião Pública , Neoplasias do Colo do Útero/prevenção & controle , Hesitação Vacinal
10.
F1000Res ; 13: 184, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38779318

RESUMO

Background: Health security as a domain has gained tremendous importance in the recent past. Emerging and re-emerging diseases globally, coupled with the derailment of the determinants of health mainly the socio-political environment, has made health security a cross-cutting entity in diverse fields including International Relations (IR). With the ongoing global polycrisis, the health-related issues which were previously sidelined as a concept of less strategic importance in the IR field, are now contributing to the shift of the world order. This has instilled an increased participation of IR scholars in the discussions and debates on health security concerns. The field of IR contains numerous theoretical lenses through which scholars analyze such situations, policies, and systems of the world. Methods: In this paper, we use a scoping review method to inspect how IR theories have been applied in analyzing health security concerns. Results: We observed that various diverging IR theories have been used to deliberate on states' actions in tackling the recent pandemic and have also been prescriptive about the changing notions of multilateralism and international governing organizations. Realism, liberalism, and securitization were among the most frequently applied IR theories in the context of health security discussions. Conclusions: This work provides an impetus to enhance the interaction among interdisciplinary teams leading to evolving solutions that can address issues of global importance in the contemporary world.


Assuntos
Diplomacia , Humanos , Saúde Global , Internacionalidade , Cooperação Internacional
11.
PLoS One ; 19(4): e0292192, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38635845

RESUMO

The COVID-19 pandemic has highlighted the importance of local evidence ecosystems in which academia and practice in the Public Health Service (PHS) are interconnected. However, appropriate organizational structures and well-trained staff are lacking and evidence use in local public health decision-making has to be integrated into training programs in Germany. To address this issue, we developed a framework incorporating a toolbox to conceptualize training programs designed to qualify public health professionals for working at the interface between academia and practice. We conducted a scoping review of training programs, key-informant interviews with public health experts, and a multi-professional stakeholder workshop and triangulated their output. The resulting toolbox consists of four core elements, encompassing 15 parameters: (1) content-related aspects, (2) context-related aspects, (3) aspects relevant for determining the training format, and (4) aspects relevant for consolidation and further development. Guiding questions with examples supports the application of the toolbox. Additionally, we introduced a how-to-use guidance to streamline the creation of new training programs, fostering knowledge transfer at the academia-practice interface, equipping public health researchers and practitioners with relevant skills for needs-based PHS research. By promoting collaborative training development across institutions, our approach encourages cross-institutional cooperation, enhances evidence utilization, and enables efficient resource allocation. This collaborative effort in developing training programs within local evidence ecosystems not only strengthens the scientific and practical impact but also lays a foundation for implementing complex public health measures effectively at the local level.


Assuntos
Ecossistema , Pandemias , Humanos , Saúde Pública , Pessoal de Saúde , Cuidados Paliativos
13.
Eur Phys J E Soft Matter ; 47(2): 10, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38305841

RESUMO

We present the macroscopic dynamics of ferroelectric smectic A, smectic [Formula: see text], liquid crystals reported recently experimentally by three groups. In this fluid and orthogonal smectic phase, the macroscopic polarization, [Formula: see text], is parallel to the layer normal thus giving rise to [Formula: see text] overall symmetry for this phase in the spatially homogeneous limit. A combination of linear irreversible thermodynamics and symmetry arguments is used to derive the resulting dynamic equations applicable at sufficiently low frequencies and sufficiently long wavelengths. Compared to non-polar smectic A phases, we find a static cross-coupling between compression of the layering and bending of the layers, which does not lead to elastic forces, but to elastic stresses. In addition, it turns out that a reversible cross-coupling between flow and the magnitude of the polarization modifies the velocities of both, first and second sound. At the same time, the relaxation of the polarization gives rise to dissipative effects for second sound at the same order of the wavevector as for the sound velocity. We also analyze reversible cross-coupling terms between elongational flow and electric fields as well as temperature and concentration gradients, which lend themselves to experimental detection. Apparently this type of terms has never been considered before for smectic phases. The question how the linear [Formula: see text] coupling in the energy alters the macroscopic response behavior when compared to usual non-polar smectic A phases is also addressed.

14.
J Epidemiol Glob Health ; 14(1): 4-12, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38224386

RESUMO

Malaria is a major public health problem in developing countries. The burden of malaria in fragile and conflict-affected states (FCAS) is increasing year by year. Moreover, the population living in FCAS is often the most vulnerable and at high risk of malaria due to factors, such as deteriorating healthcare system, mass relocations, and reduced resilience to shocks. Therefore, this scoping review aims to map the interventions that are conducted at the FCAS on malaria prevention among the general population. In addition, this review can help policy-makers and international health bodies, providing a comprehensive overview that can lead to more targeted, effective, and context-specific interventions. Databases, such as PubMed, EBSCO-CINAHL, Web of Science, ProQuest, and Cochrane Central Register of Controlled Trials, were searched using specified search terms. A total of 3601 studies were retrieved from the search. After screening, 62 studies were included in the synthesis that met the eligibility criteria. Narrative analysis of the findings was done. The results revealed that in fragile countries, interventions for children below 5 years of age included IPTi, TDA, and ACT. In conflicted countries, interventions for children below 5 years of age included TDA, LLINs, SMC, drug trials, and vaccination. Similar interventions were reported for other age groups and populations. Despite ongoing conflicts, malaria interventions have been maintained in these countries, but a persistent high burden of malaria remains. To achieve the goals of malaria elimination, the results of the review highlight the need for continued research and evaluation of malaria control interventions to assess their effectiveness and impact. Strengthening health systems, building partnerships, utilizing digital health technologies, and conducting context-specific research are recommended to improve healthcare access and reduce the burden of malaria in FCAS.


Assuntos
Cooperação Internacional , Malária , Humanos , Malária/prevenção & controle , Países em Desenvolvimento , Conflitos Armados
15.
Syst Rev ; 13(1): 14, 2024 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-38178265

RESUMO

INTRODUCTION: The HPV vaccine is characterized by its significant effectiveness in preventing the occurrence of cervical cancer. However, the South Asian countries face multiple challenges in implementing the human papillomavirus vaccine (HPV) at scale. Implementation of human papillomavirus vaccination for eliminating cervical cancer necessitates investigating the factors that impact the health system of these nations. Hence, this review will map the evidence on factors influencing the scaling up of human papillomavirus vaccination in South Asia. METHODS: The proposed scoping review will follow the steps given by Arksey and O'Malley and Levac et al. The search approach will follow McGowan et al. (14) evidence-based manual for Peer Analysis of Electronic Search Strategies (PRESS 2015) for systematic searches. Using a comprehensive search, the literature from 2006 onward will be identified from PubMed, CINAHL, EMBASE, Web of Science, and Scopus. The search strategy will include terms relating to the HPV vaccine and implementation. A predefined criterion for the inclusion and exclusion of studies will be adopted by three review authors independently to determine the eligible studies. The results will be narratively synthesized and examined in addition to being quantitatively presented to provide an outline. The review will be presented per the "Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR)" guidelines. CONCLUSIONS/DISCUSSION: The evaluation is anticipated to map the barriers and enablers influencing the rollout of the human papillomavirus vaccine. Lessons learned from the South Asian countries, where the vaccine has been implemented, may contribute to aiding the implementation of the vaccine in countries with similar health systems in an effective manner. SYSTEMATIC REVIEW REGISTRATION: The protocol was prospectively registered on the "open science framework". The registration DOI is https://doi.org/10.17605/OSF.IO/T5SW9 .


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Ásia Meridional , Infecções por Papillomavirus/prevenção & controle , Projetos de Pesquisa , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto/métodos , Neoplasias do Colo do Útero/prevenção & controle , Vacinação
16.
Chaos ; 33(8)2023 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38060792

RESUMO

We investigate the properties of time-dependent dissipative solitons for a cubic complex Ginzburg-Landau equation stabilized by nonlinear gradient terms. The separation of initially nearby trajectories in the asymptotic limit is predominantly used to distinguish qualitatively between time-periodic behavior and chaotic localized states. These results are further corroborated by Fourier transforms and time series. Quasiperiodic behavior is obtained as well, but typically over a fairly narrow range of parameter values. For illustration, two examples of nonlinear gradient terms are examined: the Raman term and combinations of the Raman term with dispersion of the nonlinear gain. For small quintic perturbations, it turns out that the chaotic localized states are showing a transition to periodic states, stationary states, or collapse already for a small magnitude of the quintic perturbations. This result indicates that the basin of attraction for chaotic localized states is rather shallow.

17.
Glob Public Health ; 18(1): 2288269, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38063361

RESUMO

Cervical cancer is a significant public health concern globally, with low and middle-income countries bearing the highest burden, specifically the South Asian region. Therefore, the current scoping review aimed to highlight the factors influencing the implementation of human papillomavirus (HPV) vaccination in South Asia. Adopting the 'Arksey and O'Malley and Levac et al.' methodology, multiple electronic databases were searched to identify relevant records. The results were narratively synthesised and discussed, adopting the Consolidated Framework for Implementation Research (CFIR) model. We identified 527 records, which were assessed for eligibility based on title, abstract, and full text by three reviewers, followed by data extraction of 29 studies included for analysis in the review. Implementing HPV vaccination programs in South Asia faces various challenges, such as economic, health system, financial, health literacy, and sociocultural factors that hinder their successful implementation. To successfully implement the vaccine, a tailored risk communication strategy is necessary for these countries. Knowledge gained from the experience of South Asian nations in implementing the HPV vaccine can assist in policymaking in similar healthcare for advancing the implementation of HPV vaccination.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Infecções por Papillomavirus/prevenção & controle , Atenção à Saúde , Vacinação/métodos , Ásia Meridional , Neoplasias do Colo do Útero/prevenção & controle
19.
F1000Res ; 12: 820, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37928171

RESUMO

Background: Health diplomacy is one of the emerging avenues for academics where foreign policy dynamics and global health meet. Its relevance has augmented especially after the COVID-19 pandemic that brought the world to a halt. International organization and national entities that are responsible for health governance as well as its socio-economic determinants have been increasingly involved in the negotiations for a collective action towards a better health infrastructure and preparedness. However, the approach to health diplomacy seems to vary with whether health is looked through diplomacy lens or vice versa. Thus, inculcating adequate and appropriate competencies of both fields to conduct negotiations for health while keeping national interests and international commitments intact is imperative. Methods: This study investigates 50 programmes/courses that have been currently offered around the globe to understand the competencies that have been identified as essential for a health diplomat. We examined four aspects: i) geographical distribution of programme/course (ii) the type of global health diplomacy programme being offered and their duration (iii) mode of teaching and (iv) cross-cutting themes that the programme offers. Results: We found that the courses/programmes have been mostly provided by the countries of the Global North who play a key part in international negotiations. Although there were diverse types of certifications identified, they can be classified into two groups - core health diplomacy and inclusive health diplomacy programmes. The health diplomacy training is preferred to be provided in-person due to the nature of the work. Conclusions: While competencies for health governance and international relation have been dominant among the current programmes, other cross-cutting themes such as economics, politics, law, public policy, crisis management, environment and public health have been considered essential. The article concludes with a proposal of a framework to streamline the sectors and the competencies that is required in health diplomats.


Assuntos
Diplomacia , Humanos , Fortalecimento Institucional , Pandemias , Política , Saúde Pública
20.
JMIR Res Protoc ; 12: e38521, 2023 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-37747764

RESUMO

BACKGROUND: Hepatitis C is a disease with a strong social component, as its main transmission route is via blood, making it associated with lifestyle. Therefore, it is suitable to be worked on from the perspective of public health policy, which still has a lot of room to explore and improve, contrary to diagnoses and treatments, which are already very refined and effective. OBJECTIVE: An interactive gamified policy tool, designated as Let's End HepC (LEHC), was created to understand the impact of policies related to hepatitis C on the disease's epidemiology on a yearly basis until 2030. METHODS: To this end, an innovative epidemiological model was developed, integrating Markov chains to model the natural history of the disease and adaptive conjoint analysis to reflect the degree of application of each of the 24 public health policies included in the model. This double imputation model makes it possible to assess a set of indicators such as liver transplant, incidence, and deaths year by year until 2030 in different risk groups. Populations at a higher risk were integrated into the model to understand the specific epidemiological dynamics within the total population of each country and within segments that comprise people who have received blood products, prisoners, people who inject drugs, people infected through vertical transmission, and the remaining population. RESULTS: The model has already been applied to a group of countries, and studies in 5 of these countries have already been concluded, showing results very close to those obtained through other forms of evaluation. CONCLUSIONS: The LEHC model allows the simulation of different degrees of implementation of each policy and thus the verification of its epidemiological impact on each studied population. The gamification feature allows assessing the adequate fulfillment of the World Health Organization goals for the elimination of hepatitis C by 2030. LEHC supports health decision makers and people who practice patient advocacy in making decisions based on science, and because LEHC is democratically shared, it ends up contributing to the increase of citizenship in health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/38521.

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